Interprofessional collaboration mediates the relationship between perceived organizational learning and safety climate in hospitals: A cross-sectional study.

BACKGROUND: Organizational learning (OL) and interprofessional collaboration (IPC) are said to enhance medical safety in hospitals, but the relationship between these variables has not been quantitatively tested. OBJECTIVE: This study examines the mediating effects of IPC on the relationship between OL and safety climate (improvement, compliance, and patient/family involvement). METHODS: An anonymous self-reporting questionnaire was administered to 1,495 healthcare workers from November 2021 to January 2022. The questions regarded the hospital's safety climate, OL, and IPC. A mediation analysis using structural equation modeling was conducted to examine the mediating role of IPC on the relationship between OL and the three safety climates. The indirect effect was estimated using 2,000 bootstrap samples. RESULTS: Responses from 643 healthcare workers were analyzed. The direct effects of OL were 𝛽 = .74, 75 (p < .001) on improvement and involvement and 𝛽 = 0.1 (p > .05) on compliance. The indirect effects of IPC on improvement and involvement were 𝛽 = .14 (95%CI: .00 ∼ .06) and 𝛽 = .37 (95%CI: .04 ∼ .09), respectively. CONCLUSION: This study determined the mechanisms that enhance a hospital's safety climate, demonstrating that IPC mediates the relationship between OL and improvement and patient/family involvement. However, OL and IPC are not related to compliance.

Impact of Collaborative Leadership, Workplace Social Capital, and Interprofessional Collaboration Practice on Patient Safety Climate.

PURPOSE: Patient safety climate is an important factor in promoting patient safety for healthcare organizations. This study investigated the relationship between collaborative leadership and patient safety climate, the mediation effect of workplace social capital, or interprofessional collaboration practice. METHODS: A web-based cross-sectional questionnaire survey was administered between May 2021 and May 2022, to employees of three acute care hospitals in Japan. The relationship between variables was verified by structural equation modeling. RESULTS: A total of 1,276 staff members participated in the study. Collaborative leadership affected the workplace social capital (ß = .734) and interprofessional collaboration (ß = .561), which were positively associated with patient safety climate (ß = .403 and .405, respectively), verifying the mediating relationship of workplace social capital and interprofessional collaboration between collaborative leadership and patient safety climate. CONCLUSIONS: Collaborative leadership enhances the reciprocity and interprofessional practices of the healthcare team. The interaction among interprofessional team members fosters a patient safety climate. The results of this survey suggest that the development of collaborative leadership, which encourages interprofessional collaboration and fosters workplace social capital, is inherently crucial for cultivating a patient safety climate.

Interprofessional Team Collaboration as a Mediator Between Workplace Social Capital and Patient Safety Climate: A Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: Patient-safety climate is one of the most important organizational factors contributing to health care quality. We hypothesized that a patient safety climate is fostered by the willingness to collaborate and trust among members as well as by daily collaborative practices. This study aimed to clarify the effect of workplace social capital on patient safety climate. We also sought to investigate the mediating effect of interprofessional team collaboration on the relationship between workplace social capital and patient safety climate. METHODS: This cross-sectional survey was conducted from November 2021 to January 2022 using anonymous web-based questionnaires. The survey was distributed to 1495 employees working in a hospital in Tokyo, Japan. The questionnaire included the patient safety climate scale, workplace social capital scale, Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II-J), and demographic items. Structural equation modeling was performed to verify the associations among the 3 variables. In addition, a significance test for indirect effects was conducted using the bootstrap method to confirm the mediating effect of AITCS-II-J. RESULTS: A total of 725 employees participated in this survey, and 632 data items were analyzed. Nurses were the highest number of respondents (68.2%), followed by physicians (13.3%). Workplace social capital and patient safety were directly and significantly associated (ß = .309, P < .01). Furthermore, the partially indirect effect of the AITCS-II-J on the association between workplace social capital and patient safety climate was also significant (ß = .430, P < .01). CONCLUSIONS: Workplace social capital was significantly and directly related to patient safety climate and was also significantly related to patient safety climate partially mediated by interprofessional team collaboration. Our findings suggest the importance of workplace social capital and routine multidisciplinary collaboration for a patient safety climate to manage health care quality.

Molecular Epidemiological Analysis of the Spreading Conditions of Trichophyton in Long-Term Care Facilities in Japan.

Tinea pedis and tinea unguium are common infectious diseases, and many elderly people are reported to contract these infections. In this study, to investigate whether strains of the same origin are spreading inside a long-term care facility, we analyzed Trichophyton rubrum and Trichophyton mentagrophytes, isolated from the residents and staff at the facilities located in the Kanto area, using a genomic analytical method targeting tandem repeat regions in the nontranscribed spacer (NTS) region of ribosomal DNA. Five NTS types were confirmed in T. rubrum. T. rubrum of various types (types 1 to 5) was detected at each facility, but there was no isolate specific to one facility only. Eight NTS types of T. mentagrophytes were detected, and T. mentagrophytes that carried an NTS type that was confirmed at one facility only (types C4II, F4II, and D4II) was isolated. These T. mentagrophytes sequence types were isolated from several subjects residing at the same facility. This study proved that a T. mentagrophytes strain of the same type had spread in long-term care facilities. We believe in the importance of cleaning at a long-term care facility as a countermeasure to the spread of Trichophyton species.

Discovery of Terbinafine Low Susceptibility Trichophyton rubrum strain in Japan.

This is the first confirmed report of terbinafine low susceptibility Trichophyton rubrum, BGUTR13, in Japan collected from the whole sole of the elderly over 65s with cotton swab sampling method at the special nursing care-home in 2016. We revealed BGUTR13 showed low susceptibility (MIC, >128 µg/mL) against terbinafine. But, BGUTR13 exhibited normal susceptibility to itraconazole, did not showed cross-resistance. Also, the squalene epoxidase gene of terbinafine low susceptibility strain BGUTR13 which is the target of terbinafine contained newly confirmed one mismatch. We suggested the possibility that the resistance mechanism of terbinafine low susceptibility strains is due to the loss of sensitivity of squalene epoxidase inhibitors and does not affect antifungal drugs with other different mechanisms of action.

Epidemiological Study on Trichophyton Disseminating from the Feet of the Elderly.

OBJECTIVES: To grasp the colonization status of Trichophyton in terms of spreading rate, we investigated the intergenerational epidemiological difference in the spreading rate of Trichophyton from teenagers to the elderly aged over 65. In addition, the elderly people were divided into two groups: those living at nursing homes and those living at their homes. We compared the two groups in terms of the difference in the spreading rate of Trichophyton. METHODS: Spreading rate was investigated by identifying the fungi collected by the cotton swab sampling method. The correlation between the responses to the questionnaire survey, which was conducted after the sample collection, and the spreading rate of Trichophyton was analyzed. RESULTS: The spreading rate of Trichophyton was 23.3%. It was confirmed that the spreading rate in general adults was 9.1%, whereas that in elderly people was 40.8%, which is significantly high. Also, it was confirmed that T. mentagrophytes shows a higher spreading rate among general adults, whereas T. rubrum shows a higher spreading rate among the elderly. Between the elderly living at nursing homes and those living at their homes, although no statistically significant difference was confirmed, the former tended to show a higher spreading rate than the latter. Also, the results of this study showed that spreading rate of Trichophyton and the detachment of the skin of the toes were significantly related. CONCLUSIONS: We found that the risk of spreading of Trichophyton increases with age. Particularly among elderly people aged over 65, taking some actions that prevent the spread of tinea pedis is recommended.