[What regulations have launched autonomous communities to going forward on patient safety culture in healthcare organizations?] / ¿Qué normativas han desarrollado las comunidades autónomas para avanzar en cultura de seguridad del paciente en sus organizaciones sanitarias?

INTRODUCTION: Patient Safety Culture is based on learning from incidents, developing preventive strategies to reduce the likelihood to happen and recognizing and accompanying those who have suffered unnecessary and involuntary harm derived from the health care received. To go ahead on patient safety culture entails facilitating the implementation of these behaviors and attitudes in healthcare professionals. Objective was to describe the regulations of some autonomous communities and national proposals for regulations changes. MATERIAL AND METHODS: Search of normative changes made in the autonomous communities of Catalonia, Navarra and the Basque Country. Proposals for legislative changes at national level were agreed. RESULTS: Activities and normative changes made in the autonomous communities of Catalonia, Navarre and the Basque Country are described and proposals for normative changes at the national level at short-term and long-term changes are made. In such a way that it is easier to advance in creating culture of patient safety in the whole National Health System CONCLUSION: Currently there is no global regulation that facilitates to advance in patient safety culture. Changes at the national legislation level are essential. It is at the Inter-territorial Council where the proposed legislative amendment should be defined, promoted by the representatives of the health systems of the autonomous communities.

[Adaptation of the Medical Office Survey on Patient Safety Culture (MOSPSC) tool]. / Adaptación de la herramienta del cuestionario Medical Office Survey on Patient Safety Culture (MOSPSC).

OBJECTIVE: To adapt the Medical Office Survey on Patient Safety Culture (MOSPSC) Excel(®) tool for its use by Primary Care Teams of the Spanish National Public Health System. METHODS: The process of translation and adaptation of MOSPSC from the Agency for Healthcare and Research in Quality (AHRQ) was performed in five steps: Original version translation, Conceptual equivalence evaluation, Acceptability and viability assessment, Content validity and Questionnaire test and response analysis, and psychometric properties assessment. After confirming MOSPSC as a valid, reliable, consistent and useful tool for assessing patient safety culture in our setting, an Excel(®) worksheet was translated and adapted in the same way. It was decided to develop a tool to analyze the "Spanish survey" and to keep it linked to the "Original version" tool. The "Spanish survey" comparison data are those obtained in a 2011 nationwide Spanish survey, while the "Original version" comparison data are those provided by the AHRQ in 2012. RESULTS: The translated and adapted tool and the analysis of the results from a 2011 nationwide Spanish survey are available on the website of the Ministry of Health, Social Services and Equality. It allows the questions which are decisive in the different dimensions to be determined, and it provides a comparison of the results with graphical representation. CONCLUSIONS: Translation and adaptation of this tool enables a patient safety culture in Primary Care in Spain to be more effectively applied.

Adaptación de la herramienta del cuestionario Medical Office Survey on Patient Safety Culture (MOSPSC) / Adaptation of the Medical Office Survey on Patient Safety Culture (MOSPSC) tool

Objetivo: Adaptar la herramienta Excel® del Medical Office Survey on Patient Safety Culture (MOSPSC) para su uso por los equipos de atención primaria del Sistema Nacional de Salud de España. Métodos: El proceso de traducción y adaptación del cuestionario MOSPSC de la Agency for Healthcare and Research in Quality (AHRQ) se realizó en 5 etapas: traducción de la versión original, evaluación de la equivalencia conceptual, valoración de la aceptabilidad y viabilidad, análisis de la validez del contenido y pilotaje del cuestionario adaptado y análisis de la respuesta y evaluación de las propiedades psicométricas. Tras comprobar que el cuestionario era un instrumento válido, fiable, consistente y útil para medir cultura de seguridad en nuestro ámbito, se procedió a la traducción y adaptación de la hoja de cálculo Excel® asociada con los mismos criterios. Se optó por desarrollar la herramienta para analizar la encuesta española «versión adaptada» y se conservó, vinculada, la herramienta en «versión original». En la «versión adaptada» se incluyeron como datos de comparación los del estudio realizado a nivel nacional en el año 2011, mientras que en la «versión original» los datos de comparación fueron los ofrecidos por la AHRQ en su informe de 2012. Resultados: La herramienta adaptada, así como los resultados de la explotación de la misma con el total de las encuestas del estudio nacional realizado en 2011, se encuentran disponibles en la página del Ministerio de Sanidad, Servicios Sociales e Igualdad. Permiten conocer las cuestiones más determinantes en las diferentes dimensiones y ofrecen, mediante representación gráfica, una comparación de resultados. Conclusiones: La traducción y adaptación de esta herramienta informática a nuestro entorno facilita difundir de una forma más eficiente la cultura de seguridad del paciente en atención primaria en España (AU)

Objective: To adapt the Medical Office Survey on Patient Safety Culture (MOSPSC) Excel® tool for its use by Primary Care Teams of the Spanish National Public Health System. Methods: The process of translation and adaptation of MOSPSC from the Agency for Healthcare and Research in Quality (AHRQ) was performed in five steps: Original version translation, Conceptual equivalence evaluation, Acceptability and viability assessment, Content validity and Questionnaire test and response analysis, and psychometric properties assessment. After confirming MOSPSC as a valid, reliable, consistent and useful tool for assessing patient safety culture in our setting, an Excel®worksheet was translated and adapted in the same way. It was decided to develop a tool to analyze the “Spanish survey” and to keep it linked to the “Original version” tool. The “Spanish survey” comparison data are those obtained in a 2011 nationwide Spanish survey, while the “Original version” comparison data are those provided by the AHRQ in 2012. Results: The translated and adapted tool and the analysis of the results from a 2011 nationwide Spanish survey are available on the website of the Ministry of Health, Social Services and Equality. It allows the questions which are decisive in the different dimensions to be determined, and it provides a comparison of the results with graphical representation. Conclusions: Translation and adaptation of this tool enables a patient safety culture in Primary Care in Spain to be more effectively applied (AU)

[Multicenter study of children's compliance to antibiotic treatment in primary care]. / Estudio multicéntrico sobre adhesión al tratamiento antibiótico en población infantil en atención primaria.

OBJECTIVES: To evaluate the degree of children's adherence to prescription of antibiotics and to determine factors linked to this adherence. DESIGN: Cross-sectional study, conducted through a telephone survey of parents of the children under study ten to fifteen days after the prescription of the antibiotic. SETTING: Thirty primary care centres in 6 Spanish provinces. PATIENTS AND OTHER PARTICIPANTS: Parents or guardians of children from 0 to 10 who attended the primary care centres between October 1998 and January 1999 for treatment of an acute infection and who were prescribed an oral antibiotic treatment with two or more daily doses. Interventions. The measuring instrument was the Morisky-Green test. MEASUREMENTS AND MAIN RESULTS: 2244 cases were studied. 1043 of them complied adequately (46.5%; 95% CI, 44.4-48.5). The factors associated with adherence were children's school situation, the age of parents or carers and the number of daily doses. CONCLUSIONS: Only half the children complied correctly with the treatment indicated. Pre-school children, those with parents or carers over 40 and those with a prescription of under three daily doses followed the treatment better. These factors need to be borne in mind by paediatricians when they prescribe an antibiotic.

Estudio multicéntrico sobre adhesión al tratamiento antibiótico en población infantil en atención primaria / Multi-centre study of children´s adherence to antibiotic treatment in primary care

Objetivo. Evaluar el grado de adhesión a la prescripción del tratamiento antibiótico infantil y determinar posibles factores asociados a dicha adhesión. Diseño. Estudio de corte transversal. Se llevó a cabo a través de una encuesta telefónica a los padres de los niños en estudio, 10-15 días después de la prescripción del antibiótico. Emplazamiento. Treinta centros de atención de primaria de 6 provincias españolas. Pacientes u otros participantes. Padres o responsables de niños de 0-10 años de edad que acudieron a los centros de atención primaria por un proceso infeccioso agudo y a los que se les prescribió un tratamiento antibiótico oral con una dosificación de 2 o más tomas diarias entre octubre de 1998 y enero de 1999. Intervenciones. El instrumento de medida fue el test de Morisky-Green. Mediciones y resultados principales. El número de casos estudiados fue de 2.244. De ellos cumplimentaron adecuadamente 1.043 (46,5 por ciento; IC del 95 por ciento, 44,4-48,5 por ciento). Los factores asociados con la adhesión fueron la situación escolar de los niños, la edad de los padres o cuidadores y el número de dosis diarias. Conclusiones. Tan sólo la mitad de los niños cumplió correctamente con el tratamiento indicado. Los niños que aún no acuden a la escuela, los que tienen padres o cuidadores mayores de 40 años y aquellos con una prescripción menor de 3 dosis diarias, realizan un mejor seguimiento del tratamiento, factores que habrán de ser tenidos en cuenta por los pediatras al prescribir un antibiótico (AU)