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1.
Enferm. actual Costa Rica (Online) ; (46): 58440, Jan.-Jun. 2024. tab
Artículo en Portugués | LILACS, BDENF - Enfermería, SaludCR | ID: biblio-1550243

RESUMEN

Resumo Introdução: A Cultura de Segurança do Paciente é considerada um importante componente estrutural dos serviços, que favorece a implantação de práticas seguras e a diminuição da ocorrência de eventos adversos. Objetivo: Identificar os fatores associados à cultura de segurança do paciente nas unidades de terapia intensiva adulto em hospitais de grande porte da região Sudeste do Brasil. Método: Estudo transversal do tipo survey e multicêntrico. Participaram 168 profissionais de saúde de quatro unidades (A, B, C e D) de terapia intensiva adulto. Foi utilizado o questionário "Hospital Survey on Patient Safety Culture". Considerou-se como variável dependente o nível de cultura de segurança do paciente e variáveis independentes aspectos sociodemográficos e laborais. Foram usadas estatísticas descritivas e para a análise dos fatores associados foi elaborado um modelo de regressão logística múltipla. Resultados: Identificou-se associação entre tipo de hospital com onze dimensões da cultura de segurança, quanto à função a categoria profissional médico, técnico de enfermagem e enfermeiro foram relacionadas com três dimensões; o gênero com duas dimensões e tempo de atuação no setor com uma dimensão. Conclusão: Evidenciou-se que o tipo de hospital, categoria profissional, tempo de atuação no setor e gênero foram associados às dimensões de cultura de segurança do paciente.


Resumen Introducción: La cultura de seguridad del paciente se considera un componente estructural importante de los servicios, que favorece la aplicación de prácticas seguras y la reducción de la aparición de acontecimientos adversos. Objetivo: Identificar los factores asociados a la cultura de seguridad del paciente en unidades de terapia intensiva adulto en hospitales de la región Sudeste del Brasil. Metodología: Estudio transversal de tipo encuesta y multicéntrico. Participaron 168 profesionales de salud de cuatro unidades (A, B, C y D) de terapia intensiva adulto. Se utilizó el cuestionario "Hospital Survey on Patient Safety Culture". Se consideró como variable dependiente el nivel de cultura de seguridad del paciente y variables independientes los aspectos sociodemográficos y laborales. Fueron usadas estadísticas descriptivas y, para analizar los factores asociados, fue elaborado un modelo de regresión logística múltiple. Resultados: Se identificó asociación entre tipo de hospital con once dimensiones de cultura de seguridad del paciente. En relación a la función, personal médico, técnicos de enfermería y personal de enfermería fueron asociados con tres dimensiones, el género con dos dimensiones y tiempo de actuación con una dimensión en el modelo de regresión. Conclusión: Se evidenció que el tipo de hospital, función, tiempo de actuación en el sector y género fueron asociados a las dimensiones de la cultura de seguridad del paciente.


Abstract Introduction: Patient safety culture is considered an important structural component of the services, which promotes the implementation of safe practices and the reduction of adverse events. Objective: To identify the factors associated with patient safety culture in adult intensive care units in large hospitals in Belo Horizonte. Method: Cross-sectional survey and multicenter study. A total of 168 health professionals from four units (A, B, C and D) of adult intensive care participated. The questionnaire "Hospital Survey on Patient Safety Culture" was used. The patient's level of safety culture was considered as a dependent variable, and sociodemographic and labor aspects were the independent variables. Descriptive statistics were used and a multiple logistic regression model was developed to analyze the associated factors. Results: An association was identified between the type of hospital and eleven dimensions of the safety culture. In terms of function, the doctors, nursing technicians, and nurse were related to three dimensions; gender with two dimensions, and time working in the sector with one dimension. Conclusion: It was evidenced that the type of hospital, function, time working in the sector, and gender were associated with the dimensions of patient safety culture.


Asunto(s)
Humanos , Masculino , Femenino , Seguridad del Paciente , Unidades de Cuidados Intensivos , Brasil , Indicadores de Calidad de la Atención de Salud/normas
4.
Chiropr Man Therap ; 32(1): 15, 2024 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-38741191

RESUMEN

BACKGROUND: The Global Patient Safety Action Plan, an initiative of the World Health Organization (WHO), draws attention to patient safety as being an issue of utmost importance in healthcare. In response, the World Federation of Chiropractic (WFC) has established a Global Patient Safety Task Force to advance a patient safety culture across all facets of the chiropractic profession. This commentary aims to introduce principles and call upon the chiropractic profession to actively engage with the Global Patient Safety Action Plan beginning immediately and over the coming decade. MAIN TEXT: This commentary addresses why the chiropractic profession should pay attention to the WHO Global Patient Safety Action Plan, and what actions the chiropractic profession should take to advance these objectives. Each strategic objective identified by WHO serves as a focal point for reflection and action. Objective 1 emphasizes the need to view each clinical interaction as a chance to improve patient safety through learning. Objective 2 urges the implementation of frameworks that dismantle systemic obstacles, minimizing human errors and strengthening patient safety procedures. Objective 3 supports the optimization of clinical process safety. Objective 4 recognizes the need for patient and family engagement. Objective 5 describes the need for integrated patient safety competencies in training programs. Objective 6 explains the need for foundational data infrastructure, ecosystem, and culture. Objective 7 emphasizes that patient safety is optimized when healthcare professionals cultivate synergy and partnerships. CONCLUSIONS: The WFC Global Patient Safety Task Force provides a structured framework for aligning essential considerations for patient safety in chiropractic care with WHO strategic objectives. Embracing the prescribed action steps offers a roadmap for the chiropractic profession to nurture an inclusive and dedicated culture, placing patient safety at its core. This commentary advocates for a concerted effort within the chiropractic community to commit to and implement these principles for the collective advancement of patient safety.


Asunto(s)
Comités Consultivos , Quiropráctica , Seguridad del Paciente , Organización Mundial de la Salud , Humanos , Salud Global
7.
Radiography (Lond) ; 30(3): 1014-1020, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38704978

RESUMEN

INTRODUCTION: Medical imaging examinations that make use of ionising radiation provide valuable information towards patient management. Literature suggests that there is a significant rise in the number of patient referrals for such examinations. The concept "individual patient radiation dose tracking" (IPRDT) is introduced to optimise radiation monitoring. Many countries across the globe explored and implemented methods to enhance and promote the justification and optimisation principles essential for patient radiation safety. In South Africa (SA), however, attention to IPRDT is limited. METHODS: A qualitative research design was employed. Radiographers in the Western Cape Province of SA were purposefully sampled for participation in one-on-one, semi-structured interviews. Thematic analysis was applied to the transcribed interview data. RESULTS: This paper presents a theme developed from the radiographer cohort of ten (10) participants. The theme: the need for creating awareness and implementing legislative support structures, was developed from the data, with the following supporting subthemes: 1) stakeholder awareness and 'buy-in' 2) continuous professional development and 3) mandated practice. CONCLUSION: This study provides findings that are of value for patient radiation safety in SA by giving a voice to local stakeholders. Other countries that are conducting similar research investigations toward the integration of an IPRDT model, method, or framework, may also benefit from these findings. IMPLICATIONS FOR PRACTICE: The effective integration of IPRDT into the clinical environment requires unison amongst the relevant stakeholders and clarity on the various professionals' roles and responsibilities. The findings of this study furthermore suggest the involvement of regulatory organisations for the provision of a mandated form of practice at national and international levels.


Asunto(s)
Investigación Cualitativa , Dosis de Radiación , Humanos , Sudáfrica , Seguridad del Paciente , Entrevistas como Asunto , Masculino , Femenino , Monitoreo de Radiación/métodos , Actitud del Personal de Salud , Protección Radiológica
8.
Semin Perinatol ; 48(3): 151902, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38692996

RESUMEN

The American Academy of Pediatrics (AAP) Standards for Levels of Neonatal Care, published in 2023, highlights key components of a Neonatal Patient Safety and Quality Improvement Program (NPSQIP). A comprehensive Neonatal Intensive Care Unit (NICU) quality and safety infrastructure (QSI) is based on four foundational domains: quality improvement, quality assurance, safety culture, and clinical guidelines. This paper serves as an operational guide for NICU clinical leaders and quality champions to navigate these domains and develop their local QSI to include the AAP NPSQIP standards.


Asunto(s)
Unidades de Cuidado Intensivo Neonatal , Seguridad del Paciente , Mejoramiento de la Calidad , Humanos , Unidades de Cuidado Intensivo Neonatal/normas , Unidades de Cuidado Intensivo Neonatal/organización & administración , Seguridad del Paciente/normas , Recién Nacido , Garantía de la Calidad de Atención de Salud , Guías de Práctica Clínica como Asunto , Estados Unidos , Cultura Organizacional , Administración de la Seguridad/normas , Administración de la Seguridad/organización & administración
9.
Crit Care Clin ; 40(3): 583-598, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38796229

RESUMEN

The hospital rapid response system (RRS) is a patient safety and quality intervention that responds quickly to clinical deteriorations on general wards with the goal of preventing cardiopulmonary arrests, reducing hospital mortality, and facilitating triage and level of care escalations. The RRS is one of the first organized, and systematic, elements of the "ICU without walls" model. RRSs have been shown to be effective in preventing deterioration to cardiopulmonary arrest on general hospital wards and reducing total and unexpected hospital mortality. Recent studies have demonstrated that this benefit can be enhanced through targeted improvements and modifications of existing RRSs.


Asunto(s)
Paro Cardíaco , Equipo Hospitalario de Respuesta Rápida , Humanos , Equipo Hospitalario de Respuesta Rápida/normas , Equipo Hospitalario de Respuesta Rápida/organización & administración , Paro Cardíaco/terapia , Mortalidad Hospitalaria , Unidades de Cuidados Intensivos/organización & administración , Seguridad del Paciente/normas , Triaje
14.
Int Emerg Nurs ; 74: 101457, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38744106

RESUMEN

INTRODUCTION: The current crisis of emergency department overcrowding demands novel approaches. Despite a growing body of patient flow literature, there is little understanding of the work of emergency nurses. This study explored how emergency nurses perform patient flow management. METHODS: Constructivist grounded theory and situational analysis methodologies were used to examine the work of emergency nurses. Twenty-nine focus groups and interviews of 27 participants and 64 hours of participant observation across four emergency departments were conducted between August 2022 and February 2023. Data were analyzed using coding, constant comparative analysis, and memo-writing to identify emergent themes and develop a substantive theory. FINDINGS: Patient flow management is the work of balancing department resources and patient care to promote collective patient safety. Patient safety arises when care is ethical, efficient, and appropriately weighs care timeliness and comprehensiveness. Emergency nurses use numerous patient flow management strategies that can be organized into five tasks: information gathering, continuous triage, resource management, throughput management, and care oversight. CONCLUSION: Patient flow management is complex, cognitively demanding work. The central contribution of this paper is a theoretical model that reflects emergency nurses'conceptualizations, discourse, and priorities. This model lays the foundation for knowledge sharing, training, and practice improvement.


Asunto(s)
Enfermería de Urgencia , Servicio de Urgencia en Hospital , Grupos Focales , Teoría Fundamentada , Humanos , Femenino , Servicio de Urgencia en Hospital/organización & administración , Adulto , Masculino , Investigación Cualitativa , Entrevistas como Asunto , Persona de Mediana Edad , Seguridad del Paciente
15.
BMJ Open Qual ; 13(2)2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38749539

RESUMEN

INTRODUCTION: In situ simulation (ISS) enables multiprofessional healthcare teams to train for real emergencies in their own working environment and identify latent patient safety threats. This study aimed to determine ISS impact on teamwork, technical skill performance, healthcare staff perception and latent error identification during simulated medical emergencies. MATERIALS AND METHODS: Unannounced ISS sessions (n=14, n=75 staff members) using a high-fidelity mannequin were conducted in medical, paediatric and rehabilitation wards at Stepping Hill Hospital (Stockport National Health Service Foundation Trust, UK). Each session encompassed a 15 min simulation followed by a 15 min faculty-led debrief. RESULTS: The clinical team score revealed low overall teamwork performances during simulated medical emergencies (mean±SEM: 4.3±0.5). Linear regression analysis revealed that overall communication (r=0.9, p<0.001), decision-making (r=0.77, p<0.001) and overall situational awareness (r=0.73, p=0.003) were the strongest statistically significant predictors of overall teamwork performance. Neither the number of attending healthcare professionals, their professional background, age, gender, degree of clinical experience, level of resuscitation training or previous simulation experience statistically significantly impacted on overall teamwork performance. ISS positively impacted on healthcare staff confidence and clinical training. Identified safety threats included unknown location of intraosseous kits, poor/absent airway management, incomplete A-E assessments, inability to activate the major haemorrhage protocol, unknown location/dose of epinephrine for anaphylaxis management, delayed administration of epinephrine and delayed/absence of attachment of pads to the defibrillator as well as absence of accessing ALS algorithms, poor chest compressions and passive behaviour during simulated cardiac arrests. CONCLUSION: Poor demonstration of technical/non-technical skills mandate regular ISS interventions for healthcare professionals of all levels. ISS positively impacts on staff confidence and training and drives identification of latent errors enabling improvements in workplace systems and resources.


Asunto(s)
Grupo de Atención al Paciente , Humanos , Reino Unido , Masculino , Femenino , Grupo de Atención al Paciente/normas , Grupo de Atención al Paciente/estadística & datos numéricos , Hospitales Generales/estadística & datos numéricos , Competencia Clínica/estadística & datos numéricos , Competencia Clínica/normas , Entrenamiento Simulado/métodos , Entrenamiento Simulado/estadística & datos numéricos , Entrenamiento Simulado/normas , Hospitales de Distrito/estadística & datos numéricos , Adulto , Seguridad del Paciente/normas , Seguridad del Paciente/estadística & datos numéricos
16.
BMC Psychol ; 12(1): 272, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38750584

RESUMEN

BACKGROUND: Patient safety culture is an integral part of healthcare delivery both in Ghana and globally. Therefore, understanding how frontline health workers perceive patient safety culture and the factors that influence it is very important. This qualitative study examined the health workers' perceptions of patient safety culture in selected regional hospitals in Ghana. OBJECTIVE: This study aimed to provide a voice concerning how frontline health workers perceive patient safety culture and explain the major barriers in ensuring it. METHOD: In-depth semi-structured interviews were conducted with 42 health professionals in two regional government hospitals in Ghana from March to June 2022. Participants were purposively selected and included medical doctors, nurses, pharmacists, administrators, and clinical service staff members. The inclusion criteria were one or more years of clinical experience. Interviews were recorded and transcribed. Thematic analysis was used to identify themes. RESULT: The health professionals interviewed were 38% male and 62% female, of whom 54% were nurses, 4% were midwives, 28% were medical doctors; lab technicians, pharmacists, and human resources workers represented 2% each; and 4% were critical health nurses. Among them, 64% held a diploma and 36% held a degree or above. This study identified four main areas: general knowledge of patient safety culture, guidelines and procedures, attitudes of frontline health workers, and upgrading patient safety culture. CONCLUSIONS: This qualitative study presents a few areas for improvement in patient safety culture. Despite their positive attitudes and knowledge of patient safety, healthcare workers expressed concerns about the implementation of patient safety policies outlined by hospitals. Healthcare professionals perceived that curriculum training on patient safety during school education and the availability of dedicated officers for patient safety at their facilities may help improve patient safety.


Asunto(s)
Actitud del Personal de Salud , Seguridad del Paciente , Investigación Cualitativa , Humanos , Ghana , Femenino , Masculino , Adulto , Personal de Salud/psicología , Cultura Organizacional , Administración de la Seguridad/organización & administración , Hospitales , Conocimientos, Actitudes y Práctica en Salud , Persona de Mediana Edad
17.
Br J Hosp Med (Lond) ; 85(4): 1-9, 2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-38708976

RESUMEN

Patient safety in healthcare remains a top priority. Learning from safety events is vital to move towards safer systems. As a result, reporting systems are recognised as the cornerstone of safety, especially in high-risk industries. However, in healthcare, the benefits of reporting systems in promoting learning remain contentious. Though the strengths of these systems, such as promoting a safety culture and providing information from near misses are noted, there are problems that mean learning is missed. Understanding the factors that both enable and act as barriers to learning from reporting is also important to consider. This review, considers the effectiveness of reporting systems in contributing to learning in healthcare.


Asunto(s)
Aprendizaje , Seguridad del Paciente , Humanos , Gestión de Riesgos/métodos , Errores Médicos/prevención & control , Atención a la Salud/normas , Administración de la Seguridad
18.
Sci Rep ; 14(1): 11436, 2024 05 19.
Artículo en Inglés | MEDLINE | ID: mdl-38763944

RESUMEN

Safe delivery of care is a priority in dentistry, while basic epidemiological knowledge of patient safety incidents is still lacking. The objectives of this study were to (1) classify patient safety incidents related to primary dental care in Denmark in the period 2016-2020 and study the distribution of different types of dental treatment categories where harm occurred, (2) clarify treatment categories leading to "nerve injury" and "tooth loss" and (3) assess the financial cost of patient-harm claims. Data from the Danish Dental Compensation Act (DDCA) database was retrieved from all filed cases from 1st January 2016 until 31st December 2020 pertaining to: (1) The reason why the patient applied for treatment-related harm compensation, (2) the event that led to the alleged harm (treatment category), (3) the type of patient-harm, and (4) the financial cost of all harm compensations. A total of 9069 claims were retrieved, of which 5079 (56%) were found eligible for compensation. The three most frequent categories leading to compensation were "Root canal treatment and post preparation"(n = 2461, 48% of all approved claims), "lack of timely diagnosis and initiation of treatment" (n = 905, 18%) and "surgery" (n = 878, 17%). Damage to the root of the tooth accounted for more than half of all approved claims (54.36%), which was most frequently a result of either parietal perforation during endodontic treatment (18.54%) or instrument fracture (18.89%). Nerve injury accounted for 16.81% of the approved claims. Total cost of all compensation payments was €16,309,310, 41.1% of which was related to surgery (€6,707,430) and 20.4% (€3,322,927) to endodontic treatment. This comprehensive analysis documents that harm permeates all aspects of dentistry, especially in endodontics and surgery. Neglect or diagnostic delays contribute to 18% of claims, indicating that harm does not solely result from direct treatment. Treatment harm inflicts considerable societal costs.


Asunto(s)
Bases de Datos Factuales , Enfermedad Iatrogénica , Seguridad del Paciente , Humanos , Enfermedad Iatrogénica/epidemiología , Enfermedad Iatrogénica/economía , Dinamarca , Atención Odontológica/economía , Odontología , Daño del Paciente/economía
19.
Pharmacoepidemiol Drug Saf ; 33(6): e5819, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38783417

RESUMEN

PURPOSE: This study aimed to perform a nationwide analysis of medication errors (MEs) from hospitals using national reporting system data and to compare the ME patterns among different age groups. METHODS: We analyzed medication-related incidents in acute care hospitals reported to the Korean Patient Safety Reporting and Learning System (KOPS), which is a patient safety reporting system, from July 2016 to December 2020. The stages of the medication use process, type of errors, medication class involved in MEs, and degree of harm were analyzed. RESULTS: Among a total of 5071 medication-related incidents, 37.7% (1911 cases) were incidents that caused patient harm and 1.2% caused long-term, permanent, and fatal harm. The proportion of medication-related incidents that resulted in harm was the highest among the <1-year-old age group (67 cases, 51.5%), followed by the elderly (≥ 65 years) (828 cases, 40.9%). The cases leading to patient death were most frequently reported in patients aged ≥65 years. Medication-related incidents occurred mainly in the administration stage (2954 cases, 58.3%), and wrong dose was the most frequently reported ME type. The most prevalent medication class occurring in the 20-64-year age group (256 cases, 11.7%) was 'antibacterials for systemic use', whereas 'contrast media' (236 cases, 11.6%) and 'blood substitutes and perfusion solutions' (98 cases, 19.3%) were the most prevalent drug classes in the ≥65- and <20-year-old age groups, respectively. CONCLUSIONS: It is necessary to establish guidelines for the prevention of medication-related incidents according to the medication use process and patient age group.


Asunto(s)
Errores de Medicación , Seguridad del Paciente , Humanos , Errores de Medicación/estadística & datos numéricos , Anciano , República de Corea/epidemiología , Persona de Mediana Edad , Adulto , Preescolar , Adulto Joven , Niño , Lactante , Factores de Edad , Seguridad del Paciente/estadística & datos numéricos , Adolescente , Sistemas de Registro de Reacción Adversa a Medicamentos/estadística & datos numéricos , Masculino , Hospitales/estadística & datos numéricos , Femenino , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Anciano de 80 o más Años
20.
J Int Med Res ; 52(5): 3000605241253728, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38770564

RESUMEN

OBJECTIVE: To assess Lebanese medical students' attitudes towards patient safety and medical error disclosure. METHODS: This was a cross-sectional study involving medical students from seven different medical schools in Lebanon. The participants completed the Attitudes to Patient Safety Questionnaire (APSQ-III) online, which consists of 26 items across nine key patient safety domains. Items were scored from 1 (strongly disagree) to 5 (strongly agree). Demographic data were also collected. RESULTS: Of the 549 students enrolled in the study, 325 (59%) were female and 224 (41%) were male. More than half (287, 52%) were aged between 20 and 22 years and 95% were Lebanese. The overall attitude of students towards patient safety was positive (3.59 ± 0.85) with the most positive attitudes in the domains of 'Team functioning' followed by 'Working hours as an error cause'. More positive attitudes were perceived among male students in the domains of 'Professional incompetence as an error cause' and 'Disclosure responsibility' whereas more positive attitudes were seen in female students in the domain of 'Working hour as an error cause'. Older medical students had more positive attitudes in the domain of 'Team functioning' than younger students. CONCLUSION: Medical students in Lebanon had an overall positive attitude towards patient safety. These findings may be used to guide improvements in patient safety education and enhance patient-centred care in medical institutions in Lebanon.


Asunto(s)
Actitud del Personal de Salud , Errores Médicos , Seguridad del Paciente , Estudiantes de Medicina , Humanos , Femenino , Masculino , Estudiantes de Medicina/psicología , Líbano , Estudios Transversales , Errores Médicos/psicología , Adulto Joven , Adulto , Encuestas y Cuestionarios , Revelación
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