Assessment of patient safety culture: what tools for medical students?

BACKGROUND: The assessment of patient safety culture refers mainly to surveys exploring the perceptions of health professionals in hospitals. These surveys have less relevance when considering the assessment of the patient safety culture of medical students, especially at university or medical school. They are indeed not fully integrated in care units and constitute a heterogeneous population. This work aimed to find appropriate assessment tools of the patient safety culture of medical students. METHODS: Systematic review of the literature. Surveys related to a care unit were excluded. A typology of the patient safety culture of medical students was built from the included surveys. RESULTS: Eighteen surveys were included. In our typology of patient safety culture of medical students (15 dimensions), the number of dimensions explored by survey (n) ranged from 1 to 12, with 6 "specialized" tools (n ≤ 4) and 12 "global" tools (N ≥ 5). These surveys have explored: knowledge about patient safety, acknowledgment of the inevitability of human error, the lack of skills as the main source of errors, the errors reporting systems, disclosure of medical errors to others health professionals or patients, teamwork and patient involvement to improve safety in care. CONCLUSIONS: We recommend using Wetzel's survey for making an overall assessment of the patient safety culture of medical students at university. In a specific purpose-e.g. to assess an educational program on medical error disclosure-the authors recommend to determine which dimensions of patient safety will be taught, to select the best assessment tool. Learning on patient safety should however be considered beyond the university. International translations of tools are required to create databases allowing comparative studies.

The development and implementation of pharmaceutical care across borders.

The community pharmacist is an essential professional for a high standard healthcare delivery system. However, many indicators, at the EU level or national level, suggest that the tasks entrusted to him, since the beginning of the 20th century, must ensure a safe and efficient treatment to patient. In several member states, the legislation has recently been changed and community pharmacists in Europe have redefined their role in the healthcare delivery system in order to focus more on patients' care. In France, the new reform concerning hospitals and the report on community pharmacy, written by social inspectors for the government, in some aspects, contains propositions similar to those adopted in Canada.

[Stopping the use of unused drugs for humanitarian purposes: Stakes and perspectives]. / Arrêt de la valorisation humanitaire des médicaments non utilisés : enjeux et perspectives.

Since the 1970s, drugs unused by French households have been collected for humanitarian aid. In 1993, the Cyclamed system was created by pharmacists in order to manage and collect unused drugs. However, experience has shown that in developing countries unused drugs caused more problems than they solved, including: poorly adapted to the needs of the population, poor quality of the collected medicines, interferences with local pharmaceutical policies, misappropriation... As recommended by the World Health Organisation, most of the humanitarian organizations stopped unused drug donations. In France this practice has been forbidden since the 1st of January 2009. Associations that still desire to send unused drugs to developing countries must develop other approaches, such as essential generic medicines or emergency health kits.