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1.
Clin Nurse Spec ; 34(2): 50-62, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32068633

RESUMO

Clinical alarm systems safety is a national healthcare concern in the United States. Physiologic monitors are the medical devices associated with the highest number of false and clinically insignificant alarms, producing alarm fatigue and a challenge to meet the national clinical alarm systems safety goal. Modern physiologic monitors are high-tech complex devices with multimeasurement modalities and high sensitivity for alarms. This complexity hinders safe operation of the monitors by nurses and appropriate management of associated alarms. Nurses need to integrate cognitive knowledge, psychomotor skills, and critical thinking to safely operate the monitors and support clinical decisions. Limited resources are available to support clinical education for nurses on physiologic monitor use and alarm management. This toolkit presents an educational framework for physiologic monitor use and alarm safety guided by adult learning principles. The components of the program are (1) knowledge, skills, and attitude of physiologic monitor use; (2) scenario-based learning model to support the knowledge, skills, and attitude necessary for safe monitor use; and (3) a framework for evaluating the educational program. Education should be ongoing and customized per facility to ensure safe use of complex technology and to decrease alarm fatigue, the leading cause of alarm-related sentinel events.


Assuntos
Alarmes Clínicos , Monitorização Fisiológica/enfermagem , Recursos Humanos de Enfermagem/educação , Gestão da Segurança/organização & administração , Humanos , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem
2.
Accid Anal Prev ; 134: 105351, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31715548

RESUMO

INTRODUCTION: Mindful organizing (also known as collective mindfulness) is a team level construct that is said to underpin the principles of high-reliability organizations (HROs), as it has shown to lead to almost error-free performance. While mindful organizing research has proliferated in recent years, studies on how to measure mindful organizing are scarce. Vogus and Sutcliffe (2007) originally validated a nine-item "Mindful Organizing Scale" but few subsequent validation studies of this scale exist. The present study aimed to validate a Spanish version of the Mindful Organizing Scale. METHOD: The sample included 47 teams (comprising of a total of 573 workers with an average team size of 12.19) from a Spanish nuclear power plant. A confirmatory factor analysis (CFA), reliability analysis, and an analysis of aggregation indices were carried out. A correlation analysis and CFA were used to further validate the scale in terms of its distinctiveness from, and relationship with, other team-related variables such as safety culture, team safety climate, and team learning. Finally, evidence of criterion-related validity was collected by testing the incremental validity of the mindful organizing scale in the association with various workplace safety outcomes (safety compliance and safety participation). RESULTS: The results confirmed a unidimensional structure of the scale and indicated satisfactory internal consistency. Aggregation of the scores to the team level was justified while significant positive correlations between mindful organizing and other team-related variables (safety culture, team safety climate, team learning) were found. Moreover, mindful organizing showed distinctiveness from safety culture, team safety climate and team learning. Finally, incremental validity of the scale was supported, as it shows to be associated with safety compliance and safety participation above and beyond other related constructs. CONCLUSIONS: The Spanish version of the Mindful Organizing Scale has shown to be a valid and reliable scale that can be used to measure mindful organizing. CONTRIBUTIONS: The validation of the unidimensional Spanish version of Vogus and Sutcliffe's (2007) Mindful Organizing Scale provides researchers and practitioners with a reliable and valid tool to use in Spanish speaking organizations to measure mindful organizing, which has been shown to result in more reliable performance. Theoretically, this study offers four contributions. Firstly, it validates a scale that operationalizes the 'mindful organizing' construct in a traditional high-reliability organization (nuclear power plant) which has never been done before. Secondly, it offers evidence that a mindful organizing scale can be validated in a new cultural context and language (Spanish) to any of the previous studies done before it. Thirdly, it adds to our understanding of mindful organizing's nomological network by distinguishing it from other team and safety-related variables. Lastly, it builds on current research showing sound psychometric properties of a one-dimensional, quantitative measure of mindful organizing.


Assuntos
Atenção Plena , Gestão da Segurança/organização & administração , Inquéritos e Questionários/normas , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Centrais Nucleares/organização & administração , Psicometria , Reprodutibilidade dos Testes , Traduções
3.
Accid Anal Prev ; 134: 105350, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31715549

RESUMO

Previous studies have acknowledged the impact of risk perception on safety behavior, but were largely controversial. This study aims to clarify this conflict and the mechanism through which risk perception can have an impact on safety behavior. From the perspective of the dual attribute of the job demand concept in job demands-resources theory, we posit that risk perception can be considered as a job hindrance or a job challenge depending on the context, thereby resulting in a negative or positive impact on safety behavior, respectively. The current research context is the construction industry and the hypotheses were tested using hierarchically nested data collected from 311 workers in 35 workgroups. Risk perception was demonstrated to be a job hindrance exerting a negative impact on safety behavior and safety motivation mediated this effect. In addition, two dimensions of group-level safety climate--supervisor's and coworkers'--were expected to alleviate or even reverse the detrimental effects of hindrance risk perception on safety motivation and on safety behavior via motivation. A moderation model and a first-stage moderated mediation model were established, respectively, for testing the moderating roles of safety climate in the relationship between risk perception and safety motivation, and in the indirect relationship of risk perception with safety behavior via motivation. Surprisingly, contrary to the hypotheses, when supervisor's safety climate changed from a low level to a high level, the impact of risk perception on safety motivation changed from positive to negative, and the negative effect of risk perception on safety behavior via safety motivation was not alleviated but worsened. As expected, for workers in a positive coworkers' safety climate, the negative effect of risk perception on motivation and the indirect negative effect of risk perception on behavior were both reversed to the positive. This indicates that coworkers' safety climate helped to change perceived risk from a job hindrance to a challenge. This research contributes to workplace risk perception and safety behavior research by theoretically viewing risk perception as a dual job hindrance-challenge concept and proposing two competing hypotheses concerning the impact of risk perception on safety behavior. The empirical investigation confirmed the hindrance attribute of risk perception in the construction context. It provides a theoretical framework and empirical evidence for future research to synthesize the conflict risk perception-safety behavior relationship. We also contribute to the literature by pointing out the potential negative role of certain supervisor safety activities such as paternalistic leadership in influencing employee safety.


Assuntos
Cultura Organizacional , Gestão da Segurança/organização & administração , Prevenção de Acidentes/métodos , Adulto , Indústria da Construção/organização & administração , Feminino , Humanos , Masculino , Motivação , Saúde do Trabalhador
4.
BMC Health Serv Res ; 19(1): 1008, 2019 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-31883512

RESUMO

BACKGROUND: Limited information is available regarding the patient safety culture in Chinese hospitals. This study aims to assess the patient safety culture in Peking University Cancer Hospital and to identify opportunities for improving the organization's safety culture. METHODS: A cross-sectional study was conducted in April 2018 and 2019, respectively. Data on patient safety culture were collected from clinical and administrative staffs using the Hospital Survey on Patient Safety Culture (HSOPSC). RESULTS: Twelve composite dimension variables were hierarchically clustered. Three highest positive response dimensions include 'Organizational Learning and continuous improvement' (92.9%), 'Teamwork within units' (89.7%), and 'Hospital management support for patient safety' (83.7%), while 3 lowest positive response dimensions included 'Frequency of events reported' (43.9%), 'Non-punitive response to error' (51.1%), 'Communication openness' (52.2%), and 'Staffing' (53.7%). Compared to the average scores of the United States, the scores of the Peking University Cancer Hospital was significantly lower on 'Communication openness' and 'Frequency of events reported'. After targeted continuous improvement based on results in 2018, all 12 dimensions surprisingly increased in the safety culture conducted in 2019. CONCLUSION: Inadequate feedback and communications about error and lack of communication openness are key challenges for patient safety in the delivery of care in this hospital. Results of this baseline survey indicate the need for a modified approach and attention to context when designing interventions aimed at improving the safety culture in this organization.


Assuntos
Institutos de Câncer , Segurança do Paciente , Melhoria de Qualidade , Gestão da Segurança , China , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde , Administração Hospitalar , Hospitais Universitários , Humanos , Masculino , Segurança do Paciente/normas , Gestão da Segurança/organização & administração , Inquéritos e Questionários
5.
Br J Nurs ; 28(19): 1266-1267, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31680570

RESUMO

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses several recent reports on patient safety and argues that we may be in danger of over-engineering the patient safety debate.


Assuntos
Segurança do Paciente , Medicina Estatal/organização & administração , Humanos , Publicações , Gestão da Segurança/organização & administração , Reino Unido
6.
BMC Health Serv Res ; 19(1): 836, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31727062

RESUMO

BACKGROUND: The objectives of this study are to test the psychometric properties of the safety attitudes and safety climate questionnaire Chinese simplified version (SAQ-CS), to test the safety attitudes of health professionals in tertiary hospitals in the Liaoning province and to explore the effects of demographic factors on safety attitudes. METHODS: The SAQ-CS was used to conduct a cross-sectional survey in nine tertiary hospitals in Liaoning province. RESULTS: Cronbach's alpha of each subscale of SAQ-CS were > 0.7, the values of GFI, TLI, and CFI were > 0.8, and RMSEA values ranged from 0.048-0.199. The mean of the safety attitudes of 2157 health professionals was 4.00, indicating a good safety attitude, with a positive response rate (% of items that scored ≥4) of 51.1%. The stress recognition subscale had the lowest score, with a mean of 2.73 and a positive response rate of 17.8%. A multiple linear regression equation revealed that demographic factors like gender, age, and training participation significantly affected the scores (ßgender > 0.06, ßage < - 0.08, ßtraining < - 0.07, p < 0.05). CONCLUSIONS: The psychometric properties of SAQ-CS are good and stable. Health professionals rate teamwork climate, safety climate, perception of management, and work conditions in Liaoning province are perceived as good; however, the stress of the health professionals is poor. To improve safety attitudes, it is necessary to not only reduce the stress of health professionals, but also to pay more attention to men, older health professionals, and health professionals who have not participated in safety training.


Assuntos
Atitude do Pessoal de Saúde , Hospitais/estatística & dados numéricos , Cultura Organizacional , Segurança do Paciente/estatística & dados numéricos , Gestão da Segurança/organização & administração , Inquéritos e Questionários/normas , Pesquisas sobre Serviços de Saúde/normas , Humanos , Psicometria
7.
Int J Health Care Qual Assur ; 32(8): 1113-1131, 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31566511

RESUMO

PURPOSE: Today, healthcare organizations focus mainly on development and implementation of patient safety strategic plan to improve quality and ensure safety of provided services. The purpose of this paper is to recommend potential strategies for successful implementation of patient safety program in Iranian hospitals based on a strengths, weaknesses, opportunities, threats (SWOT) analysis. DESIGN/METHODOLOGY/APPROACH: In this qualitative study, key informant interviews and documentation review were done to identify strength and weakness points of Iranian hospitals in addition to opportunities and threats facing them in successful implementation of a patient safety program. Accordingly, the research team formulated main patient safety strategies and consequently prioritized them based on Quantitative Strategic Planning Matrix (QSPM) matrix. FINDINGS: The study recommended some of the potential patient safety strategies including provision of education for employees, promoting a safety culture in hospitals, managerial support and accountability, creating a safe and high-quality delivery environment, developing national legislations for hospital staff to comply with patient safety standards and developing a continuous monitoring system for quality improvement and patient safety activities to ensure the achievement of predetermined goals. PRACTICAL IMPLICATIONS: Developing a comprehensive and integrated strategic plan for patient safety based on accurate information about the health system's weaknesses, strengths, opportunities and threats and trying to implement the plan in accordance with patient safety principles can help hospitals achieve great success. ORIGINALITY/VALUE: Ministry of Health and Medical Education (MOHME) conducted a national study to recommend potential strategies for successful implementation of patient safety in Iranian hospitals based on a SWOT analysis and QSPM matrix.


Assuntos
Segurança do Paciente/normas , Melhoria de Qualidade , Gestão da Segurança , Humanos , Entrevistas como Assunto , Irã (Geográfico) , Corpo Clínico Hospitalar/educação , Desenvolvimento de Programas , Pesquisa Qualitativa , Gestão da Segurança/organização & administração
8.
Br J Nurs ; 28(19): 1166-1167, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31647742

RESUMO

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses several recent reports on patient safety and argues that we may be in danger of over-engineering the patient safety debate.


Assuntos
Segurança do Paciente , Medicina Estatal/organização & administração , Humanos , Publicações , Gestão da Segurança/organização & administração , Reino Unido
9.
J Athl Train ; 54(8): 843-851, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31536387

RESUMO

The Second Safety in College Football Summit resulted in interassociation consensus recommendations for three paramount safety issues in collegiate athletics: (1) independent medical care for collegiate athletes; (2) diagnosis and management of sport-related concussion; and (3) year-round football practice contact for collegiate athletes. This document, the fourth arising from the 2016 event, addresses the prevention of catastrophic injury, including traumatic and non-traumatic death, in collegiate athletes. The final recommendations in this document are the result of presentations and discussions on key items that occurred at the summit. After those presentations and discussions, endorsing organisation representatives agreed on 18 foundational statements that became the basis for this consensus paper that has been subsequently reviewed by relevant stakeholders and endorsing organisations. This is the final endorsed document for preventing catastrophic injury and death in collegiate athletes. This document is divided into the following components. (1) Background-this section provides an overview of catastrophic injury and death in collegiate athletes. (2) Interassociation recommendations: preventing catastrophic injury and death in collegiate athletes-this section provides the final recommendations of the medical organisations for preventing catastrophic injuries in collegiate athletes. (3) Interassociation recommendations: checklist-this section provides a checklist for each member school. The checklist statements stem from foundational statements voted on by representatives of medical organisations during the summit, and they serve as the primary vehicle for each member school to implement the prevention recommendations. (4) References-this section provides the relevant references for this document. (5) Appendices-this section lists the foundational statements, agenda, summit attendees and medical organisations that endorsed this document.


Assuntos
Traumatismos em Atletas , Gestão da Segurança , Medicina Esportiva , Universidades/normas , Traumatismos em Atletas/classificação , Traumatismos em Atletas/prevenção & controle , Consenso , Humanos , Gestão da Segurança/métodos , Gestão da Segurança/organização & administração , Medicina Esportiva/métodos , Medicina Esportiva/normas , Estudantes , Estados Unidos
10.
Pflege ; 32(5): 259-266, 2019.
Artigo em Alemão | MEDLINE | ID: mdl-31538876

RESUMO

Safety Walk Rounds - Clinical unit visits with a focus on patient safety Abstract. Background: Safety Walk Rounds are a promising strategy to promote the safety culture and optimising patient safety. The purpose of this study was to explore patient safety attributes in various clinical areas including recommendations for improvement and leadership support. Methods: Safety Walk Rounds were conducted by the chief patient safety officer based on a structured questions format to open patient safety dialogues with clinicians at the ward level. Field notes were utilized for thematic analyses and topic categorization. Results: A total of 187 clinicians (64 % nursing staff, 19 % physicians, 17 % other health care professionals) participated on the Safety Walk Rounds. The discussion findings are presented in five categories: Events & circumstances (potentially) harmful for patients; safety culture; need for local action, as well as the need for leadership support to provide safe care. Conclusion and outlook: Safety Walk Rounds across the hospitals' clinical areas delivered insight into patient safety issues and safety culture with its caregiver's engagement to provide safe care as well as action points for future improvement including leadership support.


Assuntos
Unidades Hospitalares/organização & administração , Segurança do Paciente , Gestão da Segurança/organização & administração , Humanos , Liderança
11.
Int J Med Inform ; 131: 103932, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31557700

RESUMO

BACKGROUND: Poorly designed infusion pumps can lead to user errors and adverse incidents. Therefore, assessments of their usability and performance that can inform managerial decisions about the selection of appropriate medical devices are essential. OBJECTIVE: This study aimed to identify design deficiencies and evaluate the usability and performance of four infusion pump models and thus inform decisions about infusion pump selection. METHODS: Four evaluators evaluated the interface designs of the pumps according to a series of design principles in a heuristic evaluation in order to identify pump design deficiencies. Additionally, 60 registered nurses participated in simulated use testing to perform a series of tasks using the pumps in order to examine the pump performances. Outcome measures included task completion time, frequency of deviations, frequency of requests for assistance, and nurses' perceptions. RESULTS: Design issues identified included system status visibility, information access, and error prevention. The results of simulated use testing favored some pumps over others, depending on which outcome measures were considered. CONCLUSIONS: Heuristic evaluations and simulated use testing can provide information about the basic usability of medical devices and related operational issues. However, practitioners should select appropriate evaluation principles, testing tasks, and outcome measures based on the tested medical devices and contexts.


Assuntos
Segurança de Equipamentos/métodos , Heurística , Bombas de Infusão/estatística & dados numéricos , Erros Médicos/prevenção & controle , Enfermeiras e Enfermeiros/estatística & dados numéricos , Garantia da Qualidade dos Cuidados de Saúde/normas , Gestão da Segurança/organização & administração , Simulação por Computador , Segurança de Equipamentos/normas , Humanos , Variações Dependentes do Observador
12.
BMC Health Serv Res ; 19(1): 550, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31387582

RESUMO

BACKGROUND: Providing safe care helps to reduce mortality, morbidity, length of hospital stay and cost. Patient safety is highly linked to attitudes of health care providers, where those with more positive attitudes achieve higher degrees of patient safety. This study aimed to assess attitudes of nurses working in governmental hospitals in the Gaza-Strip toward patient safety and to examine factors impacting their attitudes. METHODS: This is a cross-sectional, descriptive study with a convenient sample of 424 nurses, working in four governmental hospitals. The Attitudes to Patient Safety Questionnaire III, a validated tool consisting of 29 items that assesses patient safety attitudes across nine main domains, was used. RESULTS: Nurses working in governmental hospitals showed overall only slightly positive attitudes toward patient safety with a total score of 3.68 on a 5-point Likert scale, although only 41.9% reported receiving patient safety training previously. The most positive attitudes to patient safety were found in the domains of 'working hours as a cause of error' and 'team functioning' with scores of 3.94 and 3.93 respectively, whereas the most negative attitudes were found in 'importance of patient safety in the curriculum' with a score of 2.92. Most of the study variables, such as age and years of experience, did not impact on nurses' attitudes. On the other hand, some variables, such as the specialty and the hospital, were found to significantly influence reported patient safety attitudes with nurses working in surgical specialties, showing more positive attitudes. CONCLUSION: Despite the insufficient patient safety training received by the participants in this study, they showed slightly positive attitudes toward patient safety with some variations among different hospitals and departments. A special challenge will be for nursing educators to integrate patient safety in the curriculum, as a large proportion of the participants did not find inclusion of patient safety in the curriculum useful. Therefore, this part of the curriculum in nurses' training should be targeted and developed to be related to clinical practice. Moreover, hospital management has to develop non-punitive reporting systems for adverse events and use them as an opportunity to learn from them.


Assuntos
Atitude do Pessoal de Saúde , Enfermeiras e Enfermeiros/psicologia , Segurança do Paciente/normas , Gestão da Segurança/normas , Adulto , Árabes , Estudos Transversais , Feminino , Política de Saúde , Hospitais Públicos , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio , Enfermeiras e Enfermeiros/normas , Gestão da Segurança/organização & administração , Inquéritos e Questionários
13.
Int J Health Care Qual Assur ; 32(7): 1081-1097, 2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31411092

RESUMO

PURPOSE: For many years, the concept of safety culture has attracted researchers from all over the world, and more particularly in the area of healthcare services. The purpose of this paper is to measure safety culture dimensions in order to improve and promote healthcare in Algeria. DESIGN/METHODOLOGY/APPROACH: The used approach consists of getting a better understanding of healthcare safety culture (HSC) by measuring the perception of healthcare professionals in order to guide promotion actions. For this, the Hospital Survey on Patient Safety Culture questionnaire was used in a pilot hospital setting where it was distributed on a number of 114 health professionals chosen by stratified random sampling. FINDINGS: The results showed that the identified priority areas for HSC improvement help in establishing a trust culture and a non-punitive environment based on the system and not on the individual. ORIGINALITY/VALUE: Safety is recognized as a key aspect of service quality, thus measuring the HSC can help establish an improvement plan. In Algerian health facilities, this study is considered the first to examine perceptions in this particular area. The current results provide a baseline of strengths and opportunities for healthcare safety improvement, allowing the managers of this type of facilities to take steps that are more effective.


Assuntos
Atitude do Pessoal de Saúde , Administração Hospitalar , Cultura Organizacional , Segurança do Paciente/normas , Gestão da Segurança/organização & administração , Adulto , Argélia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Projetos Piloto , Qualidade da Assistência à Saúde/organização & administração , Medicina Estatal/organização & administração
14.
Int J Health Care Qual Assur ; 32(7): 1042-1054, 2019 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-31411093

RESUMO

PURPOSE: The purpose of this paper is to perform and report a systematic review of published research on patient safety attitudes of health staff employed in hospital emergency departments (EDs). DESIGN/METHODOLOGY/APPROACH: An electronic search was conducted of PsychINFO, ProQuest, MEDLINE, EMBASE, PubMed and CINAHL databases. The review included all studies that focussed on the safety attitudes of professional hospital staff employed in EDs. FINDINGS: Overall, the review revealed that the safety attitudes of ED health staff are generally low, especially on teamwork and management support and among nurses when compared to doctors. Conversely, two intervention studies showed the effectiveness of team building interventions on improving the safety attitudes of health staff employed in EDs. RESEARCH LIMITATIONS/IMPLICATIONS: Six studies met the inclusion criteria, however, most of the studies demonstrated low to moderate methodological quality. ORIGINALITY/VALUE: Teamwork, communication and management support are central to positive safety attitudes. Teamwork training can improve safety attitudes. Given that EDs are the "front-line" of hospital care and patients within EDs are especially vulnerable to medical errors, future research should focus on the safety attitudes of medical staff employed in EDs and its relationship to medical errors.


Assuntos
Atitude do Pessoal de Saúde , Serviço Hospitalar de Emergência/organização & administração , Segurança do Paciente , Recursos Humanos em Hospital/psicologia , Comunicação , Processos Grupais , Humanos , Liderança , Cultura Organizacional , Gestão da Segurança/organização & administração
15.
J Athl Train ; 54(8): 852-857, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415183

RESUMO

OBJECTIVE: To assist sideline medical staff and to augment detection of concussion in National Football League (NFL) players during preseason and regular season games via the use of certified athletic trainer (ATC) spotters. BACKGROUND: Detecting concussive injuries in contact-sport athletes can be a challenging task for health care providers on the sideline. Over the past 8 years, professional sport leagues have begun to use additional sets of eyes (medical spotters along with video review) to help identify athletes with possible concussive injuries. DESCRIPTION: The NFL first began a program using spotters in 2011, and the ATC Spotter Program has undergone systematic enhancements each year. This article describes the evolution of the ATC Spotter Program, the requirements and training of its participants, and the program data available to date. Directions for future improvement and research are addressed. CLINICAL ADVANTAGES: The use of ATC spotters stationed in the broadcast booth has enhanced the real-time detection of concussed players in the NFL.


Assuntos
Traumatismos em Atletas/diagnóstico , Concussão Encefálica/diagnóstico , Futebol Americano/lesões , Gestão da Segurança , Traumatismos em Atletas/etiologia , Concussão Encefálica/etiologia , Humanos , Desenvolvimento de Programas , Melhoria de Qualidade , Segurança , Gestão da Segurança/métodos , Gestão da Segurança/organização & administração , Estados Unidos
16.
J Clin Nurs ; 28(23-24): 4496-4503, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31408560

RESUMO

AIMS AND OBJECTIVES: To assess the perceptions of clinical practitioners regarding the different dimensions of patient safety culture in their hospital and examine the work-related predictors of patient safety culture perceptions. BACKGROUND: Patient safety is seen as a progressively critical focus in healthcare areas worldwide. Saudi Arabia aims to improve healthcare quality by providing access to healthcare for its increasing population. Hence, constantly assessing the patient safety culture of healthcare facilities in the country is imperative. DESIGN: One-sample correlational survey design. METHODS: The Hospital Survey of Patients' Safety Culture was used to survey the total population sample of 181 healthcare practitioners in a Saudi hospital from December 2018-January 2019. Strengths and weaknesses on PS culture were identified as perceived by the clinical practitioners. Regression analysis was performed to identify the work-related predictors of patient safety culture perceptions. The study followed the STROBE guideline. RESULTS: Nine of the 12 dimensions measured were identified as patient safety culture weaknesses, including 'management support for patient safety' (49.2%), 'teamwork across unit' (44.2%), 'frequency of events reporting' (43.1%), 'communication openness' (41.3%), 'overall perception of patient safety' (38.7%), 'supervisor/manager expectations and actions promoting patient safety' (32.9%), 'staffing' (23.7%), 'hospital handoffs and transitions' (19.6%) and 'non-punitive response to errors' (15.8%). None of the dimensions were identified as strengths by the respondents. Working hours per week and staff position were identified as significant predictors. CONCLUSIONS: The study underscores the urgent need to improve the patient safety culture of the hospital. RELEVANCE TO CLINICAL PRACTICE: Hospital administrators should highlight initiatives on positive patient safety impact plan for clinical practitioners and patients, such as monitoring, reporting and strictly adhering to hospital activities that reduce the risks associated with exposure to medical care.


Assuntos
Atitude do Pessoal de Saúde , Segurança do Paciente/normas , Qualidade da Assistência à Saúde/organização & administração , Gestão da Segurança/organização & administração , Adulto , Hospitais Públicos/normas , Humanos , Arábia Saudita , Inquéritos e Questionários
17.
J Nurs Adm ; 49(9): 418-422, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31436739

RESUMO

The need for continuous observation (1:1) of patients for safety precautions, including fall risk, elopement risk, confusion, and aggressive behavior, is highly variable, and it is therefore difficult to plan accurate staffing levels. The high variability in determining when 1:1 staffing for safety is indicated, and for how long, leads to resource strain and high cost to the hospital. A multidisciplinary team analyzed current processes for assigning, monitoring, and discontinuing safety 1:1 care for nonsuicidal patients using Six Sigma methodologies. The team implemented a standardized weaning process to reduce the duration of time on continuous observation and a standardized 4-hour reassessment using a behavior observation-tracking tool to validate the continued need for 1:1 coverage. The interventions resulted in reducing average monthly safety 1:1 staffing hours by 25.6% and saving an estimated $142 000 annually across 6 units. Phase 2 of the project integrated the observation-tracking tool and reassessment check-in into the hospital's electronic medical record for improved tracking and documentation.


Assuntos
Monitoramento Ambiental/economia , Monitoramento Ambiental/métodos , Segurança do Paciente/economia , Gestão da Segurança/economia , Gestão da Segurança/organização & administração , Gestão da Qualidade Total/organização & administração , Eficiência Organizacional , Humanos , Pennsylvania , Projetos Piloto
18.
Nurs Outlook ; 67(6): 765-775, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31378414

RESUMO

BACKGROUND: The abundant knowledge on nursing students' competencies in clinical safety, and the multiple approaches adopted make it difficult to obtain an overview of the current status of this question. PURPOSE: To review the literature on undergraduate nursing students' safety competencies during their clinical placements. METHOD: A scoping review was carried out. Searches were executed in PubMed, CINAHL, WOS, MEDES, and websites of relevant organizations. The framework proposed by the Joanna Briggs Institute was adopted. FINDINGS: A total of 43 studies were selected for the final sample. The review identified four major topics: the presence of adverse events in clinical placements, the acquisition of competencies in clinical safety, student experiences regarding clinical safety, and pedagogical approaches for clinical safety. DISCUSSION: Nursing students encounter adverse events and clinical safety incidents throughout their clinical training. Faculties should assign the highest priority to this question, due to its importance in the creation of a culture of safety.


Assuntos
Competência Clínica , Bacharelado em Enfermagem/organização & administração , Segurança do Paciente , Preceptoria/organização & administração , Gestão da Segurança/organização & administração , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
19.
Int J Health Care Qual Assur ; 32(6): 941-957, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31282257

RESUMO

PURPOSE: According to literature, interruptions during drug administration lead to a significant proportion of medication errors. Evidence on the effectiveness of interventions to reduce interruption is still limited. The purpose of this paper is to explore main reasons for interruptions during drug administration rounds in a geriatric ward of an Italian secondary hospital and test the effectiveness of a combined intervention. DESIGN/METHODOLOGY/APPROACH: This is a pre and post-intervention observational study based on direct observation. All nurse staff (24) participated to the study that lead to observe a total of 44 drug dispensing rounds with 945 drugs administered to 491 patients in T0 and 994 drugs to 506 patients in T1. FINDINGS: A significant reduction of raw number of interruptions (mean per round from 17.31 in T0 to 9.09 in T1, p<0.01), interruptions/patient rate (from 0.78 in T0 to 0.40 in T1, p<0.01) and interruptions/drugs rate (from 0.44 in T0 to 0.22 in T1, p<0.01) were observed. Needs for further improvements were elicited (e.g. a greater involvement of support staff). PRACTICAL IMPLICATIONS: Nurse staff should be adequately trained on the risks related to interruptions during drug administration since routine activity is at high risk of distractions due to its repetitive and skill-based nature. ORIGINALITY/VALUE: A strong involvement of both MB and leadership, together with the frontline staff, helped to raise staff motivation and guide a bottom-up approach, able to identify tailored interventions and serve concurrently as training instrument tool.


Assuntos
Erros de Medicação/prevenção & controle , Sistemas de Medicação no Hospital/organização & administração , Melhoria de Qualidade , Gestão da Segurança/organização & administração , Idoso , Simulação por Computador , Geriatria , Humanos , Itália , Recursos Humanos de Enfermagem no Hospital/organização & administração , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
20.
Am J Health Syst Pharm ; 76(6): 353-359, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-31361842

RESUMO

PURPOSE: The process and methods used in an impact assessment of a centralized pharmacy call center on community pharmacy employee patient safety climate perceptions, telephone distractions/interruptions, and prescription filling efficiency are described. SUMMARY: A broad-based team designed a multi-faceted, pre-post call center implementation analysis that included multiple change assessment measures. First, yearly administration of the Agency for Healthcare Research and Quality Community Pharmacy Survey on Patient Safety Culture was used to assess patient safety climate based on employee perceptions of a safe working environment and potential for errors due to interruptions and distractions. Evaluative measures of staff workload that assessed telephone interference with prescription filling activities pre and 3 months post implementation included (1) the NASA Task Load Index, (2) multi-tasking observations through shadowing of pharmacists and technicians to count number of interruptions/distractions per prescription "touched," and (3) self-reported work sampling to assess proportional time estimates of clinical, professional, and technical activities. Finally, pharmacy efficiency and prescription filling capacity were assessed using operational measures (prescriptions filled, patients served, phone call volume changes, prescription rework counting). Data analysis included summary statistics, Student's t-test, and chi-square analysis, as appropriate, in addition to assessing convergence and agreement among measures. Every evaluative method showed a positive outcome from call center implementation, although individual pharmacies may have accrued greater benefit from call reduction than others. CONCLUSION: Multiple analysis methods can be used to evaluate the impact of workflow changes.


Assuntos
Call Centers/organização & administração , Serviços Comunitários de Farmácia/organização & administração , Erros de Medicação/prevenção & controle , Segurança do Paciente , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Eficiência Organizacional/estatística & dados numéricos , Implementação de Plano de Saúde , Humanos , Auditoria Administrativa/estatística & dados numéricos , Comportamento Multitarefa , Farmacêuticos/organização & administração , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Técnicos em Farmácia/organização & administração , Técnicos em Farmácia/psicologia , Técnicos em Farmácia/estatística & dados numéricos , Papel Profissional/psicologia , Avaliação de Programas e Projetos de Saúde , Gestão da Segurança/organização & administração , Inquéritos e Questionários/estatística & dados numéricos , Telefone , Estados Unidos , United States Agency for Healthcare Research and Quality , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
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