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1.
Bull World Health Organ ; 98(3): 206-211, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32132755

RESUMO

Problem: Rapid growth in the use of medical devices has drawn attention to gaps in the systematic monitoring of medical device-associated adverse events in India. Approach: Implementation of national regulations on medical devices started in January 2018. Supported by a nationwide network of monitoring centres, the Indian Pharmacopoeia Commission coordinates adverse event reports from manufacturers, legal representatives and patients or users. The commission follows-up and reviews reports with subject expert groups and sends recommendations on necessary action to the national regulatory authority. Local setting: Before 2015, no systematic structure was in place to collate adverse events associated with medical devices. Several reports of deaths and hospitalization due to faulty hip implants, cardiac stents and poor-quality devices prompted the health ministry to launch the materiovigilance programme. Relevant changes: From July 2015 to October 2019, the commission received 1931 adverse event reports, mostly from marketing authorization holders; 1277 were serious events. Reporting increased markedly after 2017. Cardiac stents were the most reported device (926 events; 47.95%). To encourage a culture of reporting, the commission has raised awareness about the programme among stakeholders, developed user-friendly reporting tools and guidelines, and conducted training for hospital personnel on medical device adverse event reporting. Lessons learnt: Regular training to stakeholders develops a sense of responsibility towards reporting medical device adverse events and ensures quality data reporting. Reporters must be assured that reporting adverse events does not have any legal implications for them and given acknowledgement of their role in high-quality device associated adverse event reporting.


Assuntos
Equipamentos e Provisões/efeitos adversos , Equipamentos e Provisões/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Segurança de Equipamentos , Humanos , Índia , Notificação de Abuso , Vigilância de Produtos Comercializados , Sistema de Registros , Gestão da Segurança/legislação & jurisprudência
2.
PLoS One ; 15(1): e0227609, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31935238

RESUMO

In order to quantitatively analyze the influence of different traffic conditions on highway crash risk, a method of crash risk assessment based on traffic safety state division is proposed in this paper. Firstly, the highway crash data and corresponding traffic data of upstream and downstream are extracted and processed by using the matched case-control method to exclude the influence of other factors on the model. Secondly, considering the weight of traffic volume, speed and occupancy, a multi-parameter fusion cluster method is applied to divide traffic safety state. In addition, the quantitative relationship between different traffic states and highway crash risk is analyzed by using Bayesian conditional logistic regression model. Finally, the results of case study show that different traffic safety conditions are in different crash risk levels. The highway traffic management department can improve the safety risk management level by focusing on the prevention and control of high-risk traffic safety conditions.


Assuntos
Acidentes de Trânsito/prevenção & controle , Medição de Risco/métodos , Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Teorema de Bayes , Planejamento Ambiental , Humanos , Modelos Logísticos , Medição de Risco/estatística & dados numéricos , Segurança , Gestão da Segurança/estatística & dados numéricos
3.
J Safety Res ; 70: 59-69, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31848010

RESUMO

INTRODUCTION: Integrating safety climate research with signaling theory, we propose that individual perceptions of safety climate signal the importance of safety in the organization. Specifically, we expect that three work-related organizational practices (training effectiveness, procedure effectiveness, and work pressure) relate to the broader risk control system in the workplace via individual perceptions of safety climate as a broad management signal. Further, we expect this broad management signal interacts with a local environmental signal (co-worker commitment to safety) to amplify or diminish perceived system safety effectiveness. METHOD: In a field study of oil and gas workers (N = 219; Study 1), we used mediation modeling to determine the relationships between work-related organizational practices, perceived safety climate, and perceived safety system effectiveness. In a field study of railway construction workers (N = 131; Study 2), we used moderated mediation modeling to explore the conditional role of co-worker commitment to safety. RESULTS: We found that training effectiveness, procedure effectiveness, and work pressure predicted perceived system safety effectiveness indirectly via perceived safety climate (Studies 1 and 2) and that these indirect paths are influenced by co-worker commitment to safety (Study 2). CONCLUSIONS: Findings suggest that perceived safety climate is driven in part by work practices, and that perceived safety climate (from managers) and co-worker commitment to safety (from the local environment) interact to shape workplace safety system effectiveness. Practical applications: The insight that training, procedures, and work pressure are meaningful predictors of perceived safety climate as a signal suggests that organizations should be cognizant of the quality of work-related practices for safety. The insight we offer on the competing versus complimentary nature of managerial safety signals (perceived safety climate) and co-worker safety signals (co-worker commitment to safety) could also be used by safety personnel to develop safety interventions directed in both areas.


Assuntos
Indústria de Petróleo e Gás/estatística & dados numéricos , Cultura Organizacional , Percepção , Ferrovias/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Local de Trabalho/psicologia , Modelos Teóricos
4.
J Safety Res ; 70: 181-191, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31847993

RESUMO

INTRODUCTION: Workplace accidents and injuries can be quite costly to both individual employees and their organizations. While safety climate (i.e., perceptions of policies and procedures related to safety that should reflect an organization's value of safety) has been established as a predictor of safety behaviors, less research has considered the possible negative pressures that could result from an environment that emphasizes safety. Though organizations may intend to create a positive safety climate, concerns about being treated differently if an employee were to be involved in a safety incident may result in unintended, but detrimental safety and health outcomes. METHOD: This study investigated the stigma associated with being involved in a safety-related incident in relation to self-reported safety behaviors and psychological health outcomes. The data were acquired through a two-wave prospective design, surveying workers from Amazon Mechanical Turk (MTurk; N = 528) who indicated they were exposed to at least one physical work stressor (e.g., heavy lifting; air quality; standing for extended periods) a few times each month or more. RESULTS: When controlling for safety climate, safety stigma was related to decreased safety compliance and poorer psychological health. There was a marginally significant interaction between safety stigma and safety motivation in relation to safety compliance. CONCLUSIONS: These findings suggest that experiencing pressure to work safely, for fear of being evaluated negatively, may actually come at the cost of employees' safety compliance and psychological health. Practical applications: These results may be useful in assessing and intervening to improve an organization's safety climate. Organizations should closely examine the climate for safety to ensure that positive aspects of safety are not undermined by a stigmatizing pressure associated with safety in the work environment.


Assuntos
Acidentes de Trabalho/psicologia , Gestão da Segurança/estatística & dados numéricos , Estigma Social , Local de Trabalho/psicologia , Acidentes de Trabalho/estatística & dados numéricos , Humanos , Estudos Prospectivos , Gestão da Segurança/normas , Autorrelato
5.
Artigo em Inglês | MEDLINE | ID: mdl-31878293

RESUMO

Road traffic crashes (RTCs) are one of the most critical public health problems worldwide. The WHO Global Status Report on Road Safety suggests that the annual fatality rate (per 100,000 people) due to RTCs in the Kingdom of Saudi Arabia (KSA) has increased from 17.4 to 27.4 over the last decade, which is an alarming situation. This paper presents an overview of RTCs in the Eastern Province, KSA, from 2009 to 2016. Key descriptive statistics for spatial and temporal distribution of crashes are presented. Statistics from the present study suggest that the year 2012 witnessed the highest number of crashes, and that the region Al-Ahsa had a significantly higher proportion of total crashes. It was concluded that the fatality rate for the province was 25.6, and the mean accident to injury ratio was 8:4. These numbers are substantially higher compared to developed countries and the neighboring Gulf states. Spatial distribution of crashes indicated that a large proportion of severe crashes occurred outside the city centers along urban highways. Logistic regression models were developed to predict crash severity. Model estimation analysis revealed that crash severity can be attributed to several significant factors including driver attributes (such as sleep, distraction, overspeeding), crash characteristics (such as sudden deviation from the lane, or collisions with other moving vehicles, road fences, pedestrians, or motorcyclists), and rainy weather conditions. After critical analysis of existing safety and infrastructure situations, various suitable crash prevention and mitigation strategies, for example, traffic enforcement, traffic calming measures, safety education programs, and coordination of key stakeholders, have been proposed.


Assuntos
Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Acidentes de Trânsito/tendências , Planejamento Ambiental/normas , Guias como Assunto , Gestão da Segurança/estatística & dados numéricos , Gestão da Segurança/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Países Desenvolvidos , Feminino , Previsões , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Arábia Saudita , Adulto Jovem
6.
BMC Health Serv Res ; 19(1): 677, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533699

RESUMO

BACKGROUND: The psychological and professional impact of adverse events on doctors and nurses is well-established, but limited data has emerged from low- and middle-income. This article reports the experiences of being involved in a patient safety event, incident reporting and organisational support available to assist health professionals in Viet Nam to learn and recover. METHOD: Doctors and nurses (1000) from all departments of a 1500-bed surgical and trauma hospital in Viet Nam were invited to take part in a cross-sectional survey. The survey explored respondents' involvement in adverse events and/or near miss, their emotional, behavioural and coping responses, experiences of organisational incident reporting, and the learning and/or other consequences of the event. Survey items also assessed the availability of organisational support including peer support and mentorship. RESULTS: Of the 497 respondents, 295 (59%) experienced an adverse event in which a patient was harmed, of which 86 (17%) resulted in serious patient harm. 397 (80%) of respondents experienced a near miss, with 140 of these (28%) having potential for serious harm. 386 (77%) reporting they had been affected professionally or personally in some way, with impacts to psychological health (416; 84%), physical health (388; 78%), job satisfaction (378; 76%) and confidence in their ability (276; 56%) commonly reported. Many respondents were unable to identify local improvements (373; 75%) or organisation-wide improvements following safety events (359; 72%) and 171 (34%) admitted that they had not reported an event to their organisation or manager that they should have. CONCLUSIONS: Health professionals in Viet Nam report impacts to psychological and physical health as a result of involvement in safety events that reflect those of health professionals internationally. Reports of limited organisational learning and improvement following safety events suggest that patient safety culture is underdeveloped in Viet Nam currently. In order to progress work on patient safety cultures and incident reporting in Viet Nam, health professionals will need to be convinced not only that they will not be exposed to punitive action, but that learning and positive changes will occur as a result of reporting safety events.


Assuntos
Erros Médicos/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Adaptação Psicológica , Adolescente , Adulto , Criança , Pré-Escolar , Aconselhamento , Estudos Transversais , Emoções , Feminino , Pessoal de Saúde/psicologia , Hospitais , Humanos , Lactente , Recém-Nascido , Aprendizagem , Masculino , Pessoa de Meia-Idade , Médicos/estatística & dados numéricos , Gestão de Riscos , Inquéritos e Questionários , Vietnã , Adulto Jovem
7.
Rev Lat Am Enfermagem ; 27: e3167, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432920

RESUMO

OBJECTIVE: analyze the safety culture of multidisciplinary teams from three neonatal intensive care units of public hospitals in Minas Gerais, Brazil. METHOD: a cross-sectional survey conducted with 514 health professionals, using the Hospital Survey on Patient Safety Culture; data were subjected to a descriptive statistical analysis in software R-3.3.2. RESULTS: the findings showed that none of the dimensions had a positive response score above 75% to be considered as a strength area. The dimension 'Nonpunitive response to error' was classified as a critical area of the patient safety culture, present in 55.45% of the responses. However, areas with potential for improvements were identified, such as 'Teamwork within units' (59.44%) and 'Supervisor/manager's expectations and actions to promote patient safety' (49.90%). CONCLUSION: none of the dimensions was considered as a strength area, which indicates safety culture has not been fully implemented in the evaluated units. A critical look at the weaknesses of the patient safety process is recommended in order to seek strategies for the adoption of a positive safety culture to benefit patients, family members and health professionals.


Assuntos
Hospitais Públicos/estatística & dados numéricos , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Hospitais Públicos/normas , Humanos , Unidades de Terapia Intensiva Neonatal/normas , Masculino , Cultura Organizacional , Equipe de Assistência ao Paciente/normas , Segurança do Paciente/normas , Qualidade da Assistência à Saúde/normas , Qualidade da Assistência à Saúde/estatística & dados numéricos , Gestão da Segurança/normas , Estatísticas não Paramétricas , Inquéritos e Questionários , Fatores de Tempo , Carga de Trabalho/estatística & dados numéricos , Adulto Jovem
8.
Rev Bras Enferm ; 72(4): 1001-1006, 2019 Aug 19.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31432958

RESUMO

OBJECTIVE: To investigate the sources and causes of interruptions during the medication administration process performed by a nursing team and measure its frequency, duration and impact on the team's workload. MÉTODOS: This is an observational study that timed 121 medication rounds (preparation, administration and documentation) performed by 15 nurses and nine nursing technicians in a Neonatal Intensive Care Unit in the countryside of the state of São Paulo. RESULTADOS: 63 (52.1%) interruptions were observed. In each round, the number of interruptions that happened ranged from 1-7, for 127 in total; these occurred mainly during the preparation phase, 97 (76.4%). The main interruption sources were: nursing staff - 48 (37.8%) - and self-interruptions - 29 (22.8%). The main causes were: information exchanges - 54 (42.5%) - and parallel conversations - 28 (22%). The increase in the mean time ranged from 53.7 to 64.3% (preparation) and from 18.3 to 19.2% (administration) - p≤0.05. CONCLUSÃO: Interruptions in the medication process are frequent, interfere in the workload of the nursing team and may reflect on the safety of care.


Assuntos
Sistemas de Medicação/normas , Cuidados de Enfermagem/psicologia , Cuidados de Enfermagem/normas , Carga de Trabalho/normas , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Unidades de Terapia Intensiva Neonatal/organização & administração , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Erros de Medicação/enfermagem , Erros de Medicação/prevenção & controle , Sistemas de Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Gestão da Segurança/métodos , Gestão da Segurança/normas , Gestão da Segurança/estatística & dados numéricos , Fatores de Tempo , Estudos de Tempo e Movimento , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
9.
Rev Bras Enferm ; 72(3): 767-773, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269144

RESUMO

OBJECTIVE: To evaluate nurse safety culture in a teaching hospital, as well as to verify differences in the safety culture dimensions between services. METHOD: cross-sectional, quantitative study, conducted from October to December 2015, in a university hospital. The instrument Hospital Survey on Patient Safety Culture was applied. RESULTS: A total of 195 nurses from four different services participated in the study. Significant difference between services were identified for five dimensions of safety culture: organizational learning (P=0.012); return of information and communication about error (P=0.014); management support for patient safety (P=0.001); general perceptions about patient safety (P=0.005); and frequency of event notification (P=0.003). CONCLUSION: The medical clinic service had the highest statistical difference between the dimensions. These evaluations allow managers to identify the differences between the same hospital's services, serving as a warning and assisting in the services' improvement.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Serviços de Enfermagem/normas , Gestão da Segurança/normas , Adulto , Atitude do Pessoal de Saúde , Brasil , Estudos Transversais , Feminino , Hospitais Universitários/organização & administração , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/normas , Enfermeiras e Enfermeiros/estatística & dados numéricos , Serviços de Enfermagem/estatística & dados numéricos , Cultura Organizacional , Gestão da Segurança/estatística & dados numéricos , Estatísticas não Paramétricas , Inquéritos e Questionários
10.
Nurse Educ Pract ; 38: 1-6, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31163311

RESUMO

Patient safety is crucial to healthcare quality. It is important to assess the nursing students' safety attitudes to identify the weaknesses for developing education program and fostering students' engagement in patient safety practices. This study aimed to assess attitudes towards patient safety culture among postgraduate nursing students in China, and explore the factors that affect their safety attitudes and the relationships of safety attitudes and safety-related behaviors. This study used a cross-sectional survey design. A convenience sample of 231 postgraduate nursing students from ten medical universities in China completed the Chinese version of Safety Attitude Questionnaire, including six domains: teamwork climate, safety climate, perceptions of management, job satisfaction, working conditions and stress recognition. The mean scores of the six domains ranged from 65.22 to 70.75 on a 100-point scale. Percentages of positive responses for the six domains were below 55%, with the two lowest percentages for working conditions (35.9%) and safety climate (30.7%). Significantly lower domain scores were found in students with younger age, no work experience, higher workload and received safety education. There were positive correlations between the six domains and safety-related behaviors except for stress recognition. Nursing educators should focus more on the improvement of patient safety education and establishment of supportive work environment to enhance postgraduate nursing students' attitudes towards safety culture.


Assuntos
Atitude do Pessoal de Saúde , Cultura Organizacional , Segurança do Paciente/normas , Gestão da Segurança/normas , Estudantes de Enfermagem/psicologia , Adulto , China , Estudos Transversais , Educação de Pós-Graduação em Enfermagem/métodos , Educação de Pós-Graduação em Enfermagem/estatística & dados numéricos , Feminino , Humanos , Masculino , Segurança do Paciente/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e Questionários
11.
Rev Saude Publica ; 53: 42, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31066820

RESUMO

OBJECTIVE: Analyze if the patient safety culture among professionals in the primary health care differs among health care teams. METHODS: Cross-sectional and quantitative study conducted in April and May 2017, in a city in Southern Brazil. A total of 144 professionals who responded to the questionnaire "Survey on Patient Safety Culture in Primary Health Care" participated in the study. Data were analyzed in the Statistical Analysis Software program and expressed in percentage of positive responses. The ethical principles established for research with human beings were applied. RESULTS: Patient safety culture is positive among 50.81% of the professionals, and the dimensions "your health service" (63.39%) and "patient safety and quality" (61.22%) obtained the highest average of positive responses. Significant differences were found between the family health and oral health teams (α = 0.05 and p < 0.05), in the dimensions "patient safety" (p = 0.0274) and "work at the health service" (p = 0.0058). CONCLUSIONS: We concluded that, although close to the average, patient safety culture among professionals in the Primary Health Care is positive and that there are differences in safety culture between family health and oral health teams in comparison with the primary health care teams.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Valores de Referência , Estatísticas não Paramétricas , Inquéritos e Questionários
13.
Environ Res ; 172: 522-528, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30852455

RESUMO

BACKGROUND: This study aimed to develop a questionnaire-based tool measuring the safety climate in vineyards and to assess its psychometric properties. METHODS: A literature search was conducted to identify the dimensions and items that constitute the safety culture construct in various occupational sectors and to draft a conceptual framework. Content validity appraisal was performed by 16 farm managers or pesticide operators. The resulting preliminary conceptual framework consisted of 9 dimensions and 42 questions. Then, a telephone survey was conducted in the French Aquitaine (Bordeaux) region with 312 vineyard workers. Item-total correlation tests, Cronbach's alpha analysis and a principal component analysis were performed to confirm the unidimensionality of the scale under construction. Structural equation modeling (SEM) techniques were used to verify the model hypothesized from the exploratory analyses and to determine how well it fits the data. RESULTS: Exploratory analyses resulted initially in a 9-dimension, 20-item safety climate questionnaire. Internal consistency proved good with a Cronbach's alpha equal to 0.81. The SEM approach suggested two dimension groupings for a better fit of the data (7 dimensions operationalized through the same 20 items). Internal model parameters showed that the more influential dimensions of safety climate were Management commitment, Communication and feedback, Rules and practices, and Knowledge (all standardized path coefficients ≥ 0.7). CONCLUSIONS: Owing to its good psychometric properties, we hope this score will help in drawing up relevant interventions aimed at improving safety culture, raising pesticide risk awareness, and hopefully inducing more sustainable practices in the medium-term future.


Assuntos
Fazendas , Cultura Organizacional , Gestão da Segurança , Fazendas/estatística & dados numéricos , Humanos , Psicometria , Reprodutibilidade dos Testes , Gestão da Segurança/estatística & dados numéricos , Inquéritos e Questionários
14.
Aerosp Med Hum Perform ; 90(4): 396-404, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30922428

RESUMO

INTRODUCTION: In the United States, the proportion of Helicopter Emergency Medical Service (HEMS) fatal accidents remained unchanged despite an overall decreasing accident rate. Previous research showed night HEMS operations influenced fatal outcomes. Pilots with <6 yr of HEMS domain task experience (low-DTE) had a higher likelihood of a night operational accident in conditions associated with adverse weather. This study sought to determine whether a difference existed between day and night fatal accident rates and identify influences contributing to night fatal HEMS accidents. Any risk factors identified will be used for a risk analysis to inform future operational safety of the night visual flight rule (VFR) HEMS transport system.METHODS: Historical accident data and industry hours were obtained. Both pilot DTE groups (low and high) and mission VFR and instrument flight rule (IFR) capability were identified using data from 32 night VFR operational fatal HEMS accidents. Accidents were stratified by loss of control and controlled flight into terrain, pilot DTE, and flight rule capability. The effectiveness of both DTE groups and both flight rule capabilities were measured using system safety risk analysis techniques.RESULTS: Night fatal accident rates were statistically different from daytime. Low-DTE pilots and the VFR capability combination had the highest likelihood of night operational nonsurvivable accident.CONCLUSION: Low-DTE pilots and the VFR capability were the least effective mission combination to avoid hazardous conditions at night and maintain spatial orientation, respectively. The analysis identified measures to reduce likelihood of night fatal operational accidents.Aherne BB, Zhang C, Chen WS, Newman DG. Systems safety risk analysis of fatal night Helicopter Emergency Medical Service accidents. Aerosp Med Hum Perform. 2019; 90(4):396-404.


Assuntos
Acidentes Aeronáuticos/prevenção & controle , Medicina Aeroespacial/organização & administração , Resgate Aéreo/organização & administração , Gestão da Segurança/organização & administração , Tempo (Meteorologia) , Acidentes Aeronáuticos/mortalidade , Medicina Aeroespacial/estatística & dados numéricos , Resgate Aéreo/estatística & dados numéricos , Humanos , Orientação Espacial/fisiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Gestão da Segurança/estatística & dados numéricos , Fatores de Tempo , Estados Unidos
15.
Pract Radiat Oncol ; 9(4): e407-e416, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30826480

RESUMO

PURPOSE: Incident learning systems (ILSs) require substantial time and effort to maintain, risking staff burnout and ILS disuse. Herein, we assess the durability of ILS-associated safety culture improvements and ILS engagement at 5 years. METHODS AND MATERIALS: A validated survey assessing safety culture was administered to all staff of an academic radiation oncology department before starting ILS and annually thereafter for 5 years. The survey consists of 70 questions assessing key cultural domains, overall patient safety grade, and barriers to incident reporting. A χ2 test was used to compare baseline scores before starting the ILS (pre-ILS) with the aggregate 5 years during which ILS was in use (with ILS). ILS engagement was measured by the self-reported number of ILS entries submitted in the previous 12 months. RESULTS: The survey response rate was ≥68% each year (range, 68%-80%). High-volume event reporting was sustained (4673 reports; average of 0.9 ILS entries per treatment course). ILS engagement increased, with 43% of respondents submitting reports during the 12 months pre-ILS compared with 64% with ILS in use (P < .001). Significant improvements (pre- vs. with-ILS) were observed in the cultural domains of patient safety perceptions (25% vs 39%; P < .03), and responsibility and self-efficacy (43% vs 60%; P < .01). The overall patient safety grade of very good or excellent significantly increased (69% vs 85%; P < .01). Significant reductions were seen in the following barriers to error reporting: embarrassment in front of colleagues, getting colleagues into trouble, and effect on department reputation. CONCLUSIONS: Comprehensive incident learning was sustained over 5 years and is associated with significant durable improvements in metrics of patient safety culture.


Assuntos
Segurança do Paciente/estatística & dados numéricos , Gestão de Riscos/métodos , Gestão da Segurança/estatística & dados numéricos , Humanos , Aprendizagem , Fatores de Tempo
16.
Respir Investig ; 57(3): 238-244, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30738922

RESUMO

BACKGROUND: The safety management committee of the Japan Society for Respiratory Endoscopy (JSRE) conducted national surveys to clarify the state of diagnostic and therapeutic bronchoscopy in 2016. METHODS: Questionnaire forms were mailed to 532 JSRE-accredited facilities throughout Japan. We surveyed the actual condition of clinical practice and cases of bronchoscopy during 2016. RESULTS: Four hundred and thirty-three facilities responded giving a response rate of 81.4%; 67.6% held more than 400 beds. The average number of board accredited senior Fellows and Fellows per facility was 1.9 and 3.2, respectively. Diagnostic bronchoscopy was performed in a hospitalized setting in 74.6% of all facilities. The radial type ultrasound probe was operated in 51.7% of all facilities. The number of facilities has markedly increased compared with that reported in the 2010 survey (19.6%). The bronchoscopic navigation system had been in operation in 41.7% of all facilities. Antithrombotic drugs were adjusted before biopsy in 96.8% of all facilities. For intravenous sedation, midazolam was the first choice in 76.9% of all facilities. Endobronchial ultrasound guided transbronchial lymph node needle aspiration (EBUS-TBNA) has become popular over the decade (19.6% in 2010 to 68.1% in 2016). The mean number of the board accredited senior Fellows and board accredited Fellows increased in comparison with that in 2010. As a new technique, radial type ultrasound-guided peripheral approach has become popular. CONCLUSIONS: Through this survey, the advanced safety of bronchoscopic examination has been secured in many facilities. A continuous monitoring of bronchoscopic practices with respect to safety management is recommended.


Assuntos
Broncoscopia/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Acreditação/estatística & dados numéricos , Broncoscopia/métodos , Sedação Consciente , Estudos Transversais , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/estatística & dados numéricos , Feminino , Fibrinolíticos/administração & dosagem , Humanos , Japão/epidemiologia , Linfonodos/patologia , Masculino , Midazolam/administração & dosagem , Segurança , Inquéritos e Questionários , Fatores de Tempo
17.
Int J Public Health ; 64(5): 755-762, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30603940

RESUMO

OBJECTIVES: Drowning is a public health challenge. Children of migrants may be at increased risk as parents may be unaware of local water safety issues. This study explores differences between Australian-born and migrant parents in Western Australia for: (1) swimming ability; (2) supervision; (3) water familiarisation; and (4) cardiopulmonary resuscitation (CPR) training. METHODS: A cross-sectional survey of parents and carers of children aged under 5 years residing in WA (n = 1506) captured demographics, knowledge of appropriate supervision, water safety knowledge and skills. Logistic regression was conducted. RESULTS: Migrants were significantly less likely to identify adequate supervision (p = 0.004); have participated in child water familiarisation programmes (p = 0.000); or perceived themselves as able swimmers (p = 0.000). Significantly less migrants had also undertaken CPR training (p = 0.000). CONCLUSIONS: Findings add to the small but growing body of literature highlighting the importance of tailored drowning prevention strategies for migrants in countries such as Australia with a strong aquatic culture.


Assuntos
Reanimação Cardiopulmonar/psicologia , Cuidadores/psicologia , Afogamento/prevenção & controle , Afogamento/psicologia , Poder Familiar/psicologia , Pais/psicologia , Migrantes/psicologia , Adulto , Austrália , Reanimação Cardiopulmonar/educação , Reanimação Cardiopulmonar/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Gestão da Segurança/estatística & dados numéricos , Inquéritos e Questionários , Migrantes/estatística & dados numéricos , Austrália Ocidental , Adulto Jovem
18.
Forensic Sci Med Pathol ; 15(1): 31-40, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30402743

RESUMO

In the United States of America, Medical Examiners and Coroners (ME/Cs) investigate approximately 20% of all deaths. Unexpected deaths, such as those occurring due to a deceased person under investigation for a highly infectious disease, are likely to fall under ME/C jurisdiction, thereby placing the ME/C and other morgue personnel at increased risk of contracting an occupationally acquired infection. This survey of U.S. ME/Cs' capabilities to address highly infectious decedents aimed to determine opportunities for improvement at ME/C facilities serving a state or metropolitan area. Data for this study was gathered via an electronic survey. Of the 177 electronic surveys that were distributed, the overall response rate was N = 108 (61%), with 99 of those 108 respondents completing all the questions within the survey. At least one ME/C responded from 47 of 50 states, and the District of Columbia. Select results were: less than half of respondents (44%) stated that their office had been involved in handling a suspected or confirmed highly infectious remains case and responses indicated medical examiners. Additionally, ME/C altered their personal protective equipment based on suspected versus confirmed highly infectious remains rather than taking an all-hazards approach. Standard operating procedures or guidelines should be updated to take an all-hazards approach, best-practices on handling highly infectious remains could be integrated into a standardized education, and evidence-based information on appropriate personal protective equipment selection could be incorporated into a widely disseminated learning module for addressing suspected or confirmed highly infectious remains, as those areas were revealed to be currently lacking.


Assuntos
Médicos Legistas/estatística & dados numéricos , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Infecções/estatística & dados numéricos , Doenças Profissionais/prevenção & controle , Autopsia , Restos Mortais , Contenção de Riscos Biológicos/estatística & dados numéricos , Humanos , Controle de Infecções/normas , Necrotério , Equipamento de Proteção Individual/estatística & dados numéricos , Competência Profissional , Gestão da Segurança/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
19.
Int J Risk Saf Med ; 30(1): 45-58, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30175986

RESUMO

BACKGROUND: Patient safety culture (PSC) as a main component of the organizational culture plays a key role in providing safe, effective and economic cares and services in healthcare organizations. PSC provides a way to assist hospitals in order to improve patient safety and prevent medical errors. OBJECTIVE: The present study aimed to measure PSC and healthcare professionals' attitude towards voluntary reporting of adverse events in two hospitals in Iran and to develop a hybrid intelligent approach for modeling PSC grades. METHODS: The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire and a two-part questionnaire were used for examining the PSC and healthcare professionals' attitude towards voluntary reporting of adverse events, respectively. Principal component analysis (PCA) was applied to extract of the main components in the HSOPSC questionnaire and to construct 12 dimensions of patient safety culture. The overall grade of patient safety culture was modeled using adaptive neuro-fuzzy inference systems (ANFIS) as a classification problem. RESULTS: Almost half of the participants have experienced a medical error and adverse events. The PSC grade was acceptable from the point of view of 55.5% and 50% of participants in hospital No.1 and hospital No.2, respectively. The overall accuracy of ANFIS in modeling overall grades of patient safety culture in both study hospitals was 0.84. Of those individuals gave an acceptable grade on patient safety culture in both study hospitals, more than 50% believed that all medical errors and near misses should be reported. CONCLUSIONS: The ANFIS algorithm was proposed for modeling and predicting of PSC for healthcare organizations. The results confirm the capability of the proposed model to predict patient safety grades in healthcare settings.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Pessoal de Saúde/psicologia , Erros Médicos/prevenção & controle , Erros Médicos/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Gestão da Segurança/organização & administração , Gestão da Segurança/estatística & dados numéricos , Adulto , Algoritmos , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Análise de Componente Principal , Inquéritos e Questionários
20.
J Safety Res ; 67: 107-116, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30553411

RESUMO

INTRODUCTION: Labor productivity and safety are important topics in the construction industry. Even so, the literature provides little information for project managers trying to determine how management strategies designed to improve labor productivity impact safety. METHOD: This research addresses the gap by measuring the impact of two groups of management strategies that involve human resource related management strategies and construction related management strategies related to safety performance in construction projects. Data were collected from 111 general construction projects through the survey. RESULTS: The results show that the relationship between the implemented management strategies and safety performance is nuanced with 'Communication' harming safety performance while implementation of 'Labor Management,' 'Supervision and Leadership,' 'Planning' and 'Management of Construction' strategies improve the level of safety performance. This study took a further step by measuring the impact of the interactions between the two groups of management strategies on safety performance. The results show that the interactions of construction and human related management strategies are not always in the favor of safety. Practical Applications: This paper adds to the literature on the relationship between productivity and safety in the construction industry. The research findings can assist project managers to improve labor productivity without harming the safety of laborers unintentionally.


Assuntos
Indústria da Construção/estatística & dados numéricos , Eficiência Organizacional/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Humanos , Nova Zelândia , Saúde do Trabalhador/normas , Gestão da Segurança/organização & administração
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