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1.
Rev. enferm. UERJ ; 29: e55404, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1177546

RESUMO

Objetivo: planejar ações estratégicas para a melhoria da qualidade do cuidado e segurança do paciente em Unidade de Pronto Atendimento. Método: pesquisa descritiva, de abordagem qualitativa, desenvolvida em uma Unidade de Pronto Atendimento de um município do sul do Brasil, entre setembro de 2018 e fevereiro de 2019, tendo como participantes os enfermeiros dessa unidade. Utilizou-se como referencial metodológico a Pesquisa Convergente Assistencial, a logicidade do Planejamento Estratégico Situacional e a ferramenta 5W3H. Foram realizadas oficinas com os participantes, para escolha de problemas na segurança do paciente, proposição de melhorias, adequação e aprovação de planos de ação. Para análise dos dados utilizou-se o software R e grafos de similitude. Resultados: os problemas "comunicação" e "número insuficiente de profissionais" foram escolhidos por 24 enfermeiros, sugerindo cinco propostas, detalhadas em seis planos de ação. Conclusão: o planejamento estratégico situacional permitiu planejar ações estratégicas de melhoria na assistência que são de governabilidade dos enfermeiros.


Objective: to plan strategic actions to improve the quality of care and patient safety in the Emergency Care Unit. Method: this qualitative, descriptive, exploratory study was conducted in an Emergency Care Unit in a municipality in south Brazil, from September 2018 to February 2019, with the unit's nurses as participants. The methodological frame of reference was given by Convergent Care Research, the logic of Situational Strategic Planning, and the 5W3H tool. Workshops were held with the participants to choose problems in patient safety, propose improvements, and adaptation and approval of action plans. Data were analyzed using R software and similarity graphs. Results: nurses chose the problems "communication" and "too few staff" and made five proposals, detailed in six action plans. Conclusion: by situational strategic planning, strategic actions under nurses' governance were planned to improve care.


Objetivo: planificar acciones estratégicas para mejorar la calidad de la atención y la seguridad del paciente en la Unidad de Atención de Emergencias. Método: investigación descriptiva, con un enfoque cualitativo, desarrollada en una Unidad de Atención de Emergencias de una ciudad del sur de Brasil, entre septiembre de 2018 y febrero de 2019, cuyas participantes fueron las enfermeras de esta unidad. El marco metodológico utilizado fue la Investigación Convergente de Atención, la lógica de la Planificación Estratégica Situacional y la herramienta 5W3H. Se llevaron a cabo talleres con los participantes para elegir problemas en la seguridad del paciente, proponer mejoras, adecuación y aprobación de planes de acción. El software R y los gráficos similares se utilizaron para el análisis de datos. Resultados: los problemas de "comunicación" e "número insuficiente de profesionales" fueran elegidos por 24 enfermeras; se sugieren entonces cinco propuestas, detalladas en seis planes de acción. Conclusión: la planificación estratégica situacional permitió planificar acciones estratégicas para mejorar la atención que rigen las enfermeras.


Assuntos
Humanos , Masculino , Feminino , Qualidade da Assistência à Saúde , Planejamento Estratégico , Enfermagem em Emergência , Segurança do Paciente , Assistência Ambulatorial , Brasil , Centros de Saúde , Epidemiologia Descritiva , Pesquisa Qualitativa , Enfermeiras e Enfermeiros
2.
Rev. enferm. UERJ ; 29: e56113, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224567

RESUMO

Objetivo: descrever a escolha do parto domiciliar planejado acompanhado por enfermeira obstétrica em um centro urbano de grande porte, na perspectiva de mulheres brasileiras. Métodos: estudo qualitativo guiado pela Grounded Theory. Foram entrevistadas dez mulheres com idade entre 20 e 41 anos que tiveram parto domiciliar planejado acompanhadas por enfermeiras obstétricas. As participantes foram recrutadas por meio de rede social, acessando um grupo de mulheres que escreveram sobre seu parto domiciliar. Resultados: Emergiram duas categorias: Não vendo possibilidade de parir naturalmente no ambiente hospitalar e Pensando na segurança do parto domiciliar planejado. O hospital representou vários aspectos desfavoráveis como intervenções desnecessárias e solidão. As mulheres consideravam o lar um lugar seguro para parir, conectado aos cuidados de enfermeiras obstétricas. Conclusão: há mulheres que não desejam parir no hospital, preferindo parir em casa e do ponto de vista dos direitos humanos e dos cuidados desmedicalizados, as enfermeiras obstétricas devem apoiar as mulheres nessa sua decisão.


Objective: to describe the choice of planned homebirth attended by a nurse midwife in a large urban centre, from the perspective of Brazilian women. Methods: in this Grounded Theory study, ten women aged 20 to 41 years, who had a planned homebirth accompanied by a nurse midwife, were interviewed. Participants were recruited through a social network by accessing a group of women who wrote about their homebirth. Results: two categories emerged: seeing no possibility of giving birth naturally in the hospital environment; and thinking about the safety of a planned homebirth. Hospital represented several unfavourable aspects, such as unnecessary interventions and loneliness. Women thought of home as a safe place to give birth, connected with nurse midwife care. Conclusion: there are women who do not wish to give birth in hospital, but prefer to give birth at home and, from the point of view of human rights and de-medicalized care, nurse midwives should support women in their decision.


Objetivo: describir la elección del parto domiciliario planificado con enfermera obstétrica en un gran centro urbano, desde la perspectiva de mujeres brasileñas. Métodos: estudio cualitativo guiado por la Grounded Theory. Se entrevistó a diez mujeres entre 20 y 41 años que tuvieron parto domiciliario planificado, siendo acompañadas de enfermeras obstétricas. Las participantes fueron reclutadas a través de red social, accediendo a un grupo de mujeres que escribieron sobre su parto en domicilio. Resultados: surgieron dos categorías: las que no veían posibilidad de dar a luz naturalmente en el hospital y las que pensaron en la seguridad del parto domiciliario planificado. El hospital representó varios aspectos desfavorables como intervenciones innecesarias y soledad. Las mujeres consideraban que el hogar era un ambiente seguro para dar a luz, vinculado al cuidado de enfermeras obstétricas. Conclusión: hay mujeres que no desean dar a luz en el hospital, prefieren hacerlo en casa y, desde el punto de vista de los derechos humanos y de los cuidados sin la intervención de un médico, las enfermeras obstétricas deben apoyarlas en esa decisión.


Assuntos
Humanos , Feminino , Adulto , Saúde da Mulher , Parto , Gestantes/psicologia , Parto Domiciliar/enfermagem , Enfermeiras Obstétricas , Percepção , Teoria de Enfermagem , Entrevista , Segurança do Paciente , Parto Domiciliar/psicologia , Parto Normal/enfermagem , Parto Normal/psicologia
3.
BMC Med Educ ; 21(1): 467, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470626

RESUMO

This correspondence article aims to outline the importance of an integrated clinical component within Quality Improvement education in response to the recently published article by Shah et al.. The Quality Improvement and Patient Safety workshops described in the above study were compared with the Quality Improvement module experienced by medical students at King's College London. The key difference between the two methods of teaching Quality Improvement was the clinical project undertaken by King's College Students, which helped students gain an appreciation of the pitfalls of instigating change in a clinical environment. The authors feel that this arguably more authentic experience could have benefited the students in the study in making them feel better equipped to use the skills learned in the theoretical workshops in their later careers.


Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Currículo , Humanos , Segurança do Paciente , Melhoria de Qualidade
4.
Korean J Med Educ ; 33(3): 227-232, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34474529

RESUMO

PURPOSE: This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19. METHODS: In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods. RESULTS: In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item "Patients are not really aware of how safe their care is" had a lower score in 2020 than in 2019. CONCLUSION: Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.


Assuntos
Atitude do Pessoal de Saúde , COVID-19/epidemiologia , Segurança do Paciente , Estudantes de Medicina/psicologia , Adulto , Feminino , Humanos , Masculino , Pandemias , República da Coreia/epidemiologia , SARS-CoV-2 , Inquéritos e Questionários
5.
J Nurs Educ ; 60(9): 526-528, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34467816

RESUMO

BACKGROUND: In response to the development of the Quality and Safety Education for Nurses (QSEN) competencies and noting lower standardized test scores, nursing faculty at a midwestern United States university developed three safety and quality labs throughout a traditional baccalaureate curriculum. METHOD: These labs intentionally integrated the QSEN competencies and occurred over three semesters of the nursing program. Students' learning activities aligned with the QSEN competencies and were leveled across the labs. RESULTS: Throughout all the labs, all six QSEN competencies provided a framework for students to learn the knowledge, skills, and attitudes essential to the profession of nursing. Students spent most of their time in the labs learning the QSEN competency of safety, followed by teamwork and collaboration, quality improvement, patient-centered care, informatics, and evidenced-based practice. CONCLUSION: The QSEN competencies provided a framework to teach pre-licensure nursing students the knowledge, skills, and attitudes essential in the profession of nursing. Safety and Quality I focused on foundational skills and individual patient safety. Safety and Quality II introduced intermediate skills with an emphasis on safety. The third and final lab introduced students to advanced quality improvement, teamwork and collaboration, and system safety. After the completion of the labs, the students stated they had gained knowledge and confidence in the application of all six QSEN competencies. [J Nurs Educ. 2021;60(9):526-528.].


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Educação Baseada em Competências , Currículo , Humanos , Segurança do Paciente , Assistência Centrada no Paciente , Melhoria de Qualidade
6.
BMC Health Serv Res ; 21(1): 931, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34493278

RESUMO

BACKGROUND: The Norwegian Board of Health Supervision aims to contribute to the improvement of quality and patient safety in the healthcare services. Planned audits were performed to investigate how 12 selected Norwegian obstetric units reported and analyzed adverse events as the part of their quality assurance and patient safety work. METHODS: Serious adverse events coded as birth asphyxia, shoulder dystocia and severe postpartum hemorrhage that occurred during 2014 (the most recent year for which the quality assured data were available) were obtained from the Medical Birth Registry of Norway. The obstetric units were asked to submit medical records, internal adverse events reports, and their internal guidelines outlining which events should be reported to the quality assurance system. We identified the adverse events at each obstetric unit that were reported internally and/or to the central authorities. Two obstetricians carried out an evaluation of each event reported. RESULTS: Five hundred fifty-three serious adverse events were registered among 17,323 births that took place at the selected units. Twenty-one events were excluded because of incorrect coding or missing information. Eight events were registered in more than one category, and these were distributed to the category directly related to injury or adverse outcome. Nine of twelve (75 %) obstetric units had written guidelines describing which events should be reported. The obstetric units reported 49 of 524 (9.3 %) serious adverse events in their internal quality assurance system and 39 (7.4 %) to central authorities. Of the very serious adverse events, 29 of 149 (19.4 %) were reported. Twenty-three of 49 (47 %) reports did not contain relevant assessments or proposals for improving quality and patient safety. CONCLUSIONS: This study showed that adverse event reporting and analyses by Norwegian obstetric units, as a part of quality assurance and patient safety work, are suboptimal. The reporting culture and compliance with guidelines need to be improved substantially for better safety in patient care, risk mitigation and clinical quality assurance.


Assuntos
Asfixia Neonatal , Hemorragia Pós-Parto , Feminino , Humanos , Recém-Nascido , Noruega/epidemiologia , Segurança do Paciente , Gravidez , Sistema de Registros
7.
Rev Saude Publica ; 55: 56, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34495253

RESUMO

OBJECTIVE: Evaluating safety culture in the perception of professionals working in public hospitals of the Unified Health System (SUS) of Distrito Federal, Brazil, three years after the implementation of the National Patient Safety Program (PNSP). METHODS: Analytical cross-sectional study conducted in eleven public hospitals using the Safety Attitudes Questionnaire (SAQ) in electronic format. Stratified sampling was estimated according to the proportion of the total number of professionals in each hospital, as well as the representativeness of each professional group. The results of the total score and domains equal to or greater than 75 were considered positive. Descriptive and inferential analyses of professional groups and hospitals were carried out. RESULTS: 909 professionals participated. The total score by professional group was negative (62.5 to 69.5) and the domains differed statistically in all cases. The eleven hospitals had a negative total score (61.5 to 68.6). The domains to attain positive performance were job satisfaction, stress recognition and teamwork climate. The lowest results were in working conditions and management perception domains, for which none of the hospitals had an average above 75. Differences were also found for domain means across hospitals, except in management perception. DISCUSSION: Three years after the implementation of PNSP, the safety culture in eleven hospitals evaluated was weak, although the domains of job satisfaction, stress recognition and teamwork climate had positive results. The results can contribute to decision-making by managers, as safety culture is an essential element in the implementation of patient safety policy.


Assuntos
Atitude do Pessoal de Saúde , Cultura Organizacional , Brasil , Estudos Transversais , Hospitais Públicos , Humanos , Satisfação no Emprego , Segurança do Paciente , Percepção , Gestão da Segurança , Inquéritos e Questionários
8.
Exp Clin Transplant ; 19(8): 753-762, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34407747

RESUMO

Vaccines are among some of the most efficacious medical and public health methods ever employed to contain a pandemic, in addition to providing protective and preventive measures. Evaluation of vaccineassociated adverse events through experimentation and empirical evidence is an integral part ofthoroughly assessing the safety of vaccines before authorization of their widespread use. History has highlighted the importance of continuous search for possible vaccine-related adverse effects and vaccine-induced immunogenicity long afterlicensure, suggesting that a primary concern with new vaccines is not only efficacy but also safety, particularly overthe long term. Many of the various anti-COVID-19 vaccines have used different types of technology, with some being introduced for the first time or rushed shortly into testing, bypassing animal experimentations. They have been adopted for use through emergency use authorizations, leading to a less than optimal collection of broad data on safety, immunogenicity, effectiveness, and time span of protection, as well as short follow-up of few months, despite many infectious disease experts arguing thatit takes 10 years to develop a vaccine. Given the valid concerns on well-recognized short-term and long-term safety issues, such as antibody-dependent enhancement and other processes like molecular mimicry and potential genomic transformation, the experimental nature of the vaccination process, the limited shortterm follow-up in the main trials, and the dismissal by law of pharma companies and health care providers from any medico-legal responsibilities, the application of an informed consent should become not only a necessity but also mandatory by law in accordance with all declarations on human rights. Such information should be provided to every potential recipient in the form of an official written digital consent prior to the registration for or the receipt of the vaccine.


Assuntos
Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Ensaios Clínicos como Assunto , Aprovação de Drogas , Consentimento Livre e Esclarecido , Vacinação , COVID-19/imunologia , COVID-19/virologia , Vacinas contra COVID-19/efeitos adversos , Humanos , Segurança do Paciente , Medição de Risco , Resultado do Tratamento , Vacinação/efeitos adversos
10.
Rev Esc Enferm USP ; 55: e03779, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34346971

RESUMO

OBJECTIVE: To compare the nursing technicians' perception with the nurses' self-perception of the exercise of nurses' coaching leadership and to check the influence of this leadership model on the safety climate and on the team's satisfaction. METHOD: This is a correlational study, carried out with 85 nurses and 85 nursing technicians, using the Questionnaire on the Nurse's Self-Perception of Leadership Exercise, the Questionnaire on Nursing Technicians' and Assistants' Perception of Leadership Exercise, and the subscales Safety climate and Satisfaction at Work. The relations among the professionals' responses were assessed using the Mann Whitney test and Spearman's coefficient. RESULTS: Nurses achieved higher means in the four dimensions of coaching Leadership, and in three, the differences were significant (p < 0.05). The dimensions of Coaching Leadership obtained positive and significant correlations with the subscales Safety Climate and Satisfaction, the majority being of moderate magnitude. CONCLUSION: Nurses' self-perception regarding the exercise of leadership was more positive than the technicians' assessment. The more the nurse exercises the dimensions of Coaching Leadership, the better the team's safety climate and satisfaction.


Assuntos
Tutoria , Recursos Humanos de Enfermagem no Hospital , Humanos , Satisfação no Emprego , Liderança , Segurança do Paciente , Satisfação do Paciente , Inquéritos e Questionários
11.
Int J Qual Health Care ; 33(3)2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34405231

RESUMO

BACKGROUND: A major barrier to safety improvement in primary care is a lack of safety data. The aims of this systematic meta-review (registration: CRD42021224367) were to identify systematic reviews of studies that examine methods of measuring and monitoring safety in primary care; classify the methods of measuring and monitoring safety in the included systematic reviews using the five safety domains of Vincent et al.'s framework and use this information to make recommendations for improving the measurement and monitoring of safety in primary care. METHODS: Four databases (Medline, Academic Search Complete, Web of Science and CINAHL) and the grey literature were screened in November 2020, with searches updated in January 2021. Systematic reviews were included if they addressed the measurement of patient safety in primary care and were published in English. Studies were assessed using the Critical Appraisal Skills Programme for systematic reviews. RESULTS: A total of 6904 papers were screened, with 13 systematic reviews included. A commonly reported method of measuring 'past harm' was through patient record review. The most frequent methods for assessing the 'reliability of safety critical processes' were checklists, observations and surveys of staff. Methods used to assess 'sensitivity to operations' included observation, staff surveys, interviews, focus groups, active monitoring and simulated patients. Safety climate surveys were a commonly used as an approach to assess 'anticipation and preparedness'. A number of the reviews concluded that safety data could, and should, be used for 'integration and learning'. The main limitation of the meta-review was that it was of systematic reviews only. CONCLUSIONS: Many of the methods for measuring and monitoring safety are readily available, quick to administer, do not require external involvement and are inexpensive. However, there is still a need to improve the psychometric properties of many measures. Researchers must support the development of psychometrically sound safety measures that do not over burden primary care practitioners. Policymakers must consider how primary care practitioners can be supported to implement these measures.


Assuntos
Segurança do Paciente , Atenção Primária à Saúde , Lista de Checagem , Humanos , Reprodutibilidade dos Testes , Revisões Sistemáticas como Assunto
12.
Artigo em Inglês | MEDLINE | ID: mdl-34444229

RESUMO

This study analyzed trends in patient safety incidents (PSIs) and the factors associated with the PSIs by analyzing 2017-2019 Patient Safety Report data in Korea. We extracted 2940 records in 2017, 5889 in 2018, and 7386 in 2019, from hospitals with more than 200 beds, and used all 16,215 cases for analysis. SPSS 25.0 was used for a multi-nominal logistic regression analysis. The PSI trend analysis, the standardized Jonckheere-Terpstra test was significant. On analyzing the probability of adverse events based on near misses, the significant variables were patient age, the season when PSIs occurred, incident reporter, hospital size, the location of PSIs, the type of PSIs, and medical department. Additionally, the factors that were likely to precipitate sentinel events based on near misses were patient sex, patient age, incident reporter, the type of PSIs, and medical department. To prevent sentinel events in PSIs, female and older patients are required to pay close attention. Moreover, it is necessary to establish a patient safety reporting system in which not only all medical personnel, but also patients, generally, can actively participate in patient safety activities and report voluntarily.


Assuntos
Hospitais , Segurança do Paciente , Coleta de Dados , Feminino , Humanos , Erros Médicos , República da Coreia/epidemiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-34444360

RESUMO

BACKGROUND: Reducing incidents related to health care interventions to improve patient safety is a health policy priority. To strengthen a culture of safety, reporting incidents is essential. This study aims to define a patient safety risk map using the description and analysis of incidents within a primary care region with a prior patient safety improvement strategy organisationally developed and promoted. METHODS: The study will be conducted in two phases: (1) a cross-sectional descriptive observational study to describe reported incidents; and (2) a quasi-experimental study to compare reported incidents. The study will take place in the Camp de Tarragona Primary Care Management (Catalan Institute of Health). In Phase 1, all reactive notifications collected within one year (2018) will be analysed; during Phase 2, all proactive notifications of the second and third weeks of June 2019 will be analysed. Adverse events will also be assessed. Phases 1 and 2 will use a digital platform and the proactive tool proSP to notify and analyse incidents related to patient safety. EXPECTED RESULTS: To obtain an up-to-date, primary care patient safety risk map to prioritise strategies that result in safer practices.


Assuntos
Erros Médicos , Segurança do Paciente , Estudos Transversais , Atenção à Saúde , Humanos , Erros Médicos/prevenção & controle , Estudos Observacionais como Assunto , Atenção Primária à Saúde , Gestão de Riscos , Gestão da Segurança
14.
BMJ Open ; 11(8): e046699, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34348949

RESUMO

OBJECTIVES: This study aimed to quantify the presence of psychological safety (defined as an environment 'safe for interpersonal risk taking') in critical care staff, exploring the ways in which this manifested. DESIGN: Qualitative interview study incorporating a short quantitative survey. SETTING: Three intensive care units within one National Health Service Trust in London. PARTICIPANTS: Thirty participants were recruited from all levels of seniority and roles within the multidisciplinary team. A purposive sampling technique was used, with recruitment ceasing at the point of thematic saturation. INTERVENTIONS: Semistructured interviews explored attitudes towards psychological safety and contained a quantitative assessment measuring the climate of psychological safety present. RESULTS: Twenty-eight participants agreed that it was easy to ask for help, with 20 agreeing it is safe to take a risk on the team, demonstrating a strong perception of psychological safety in this group.Our thematic analysis highlighted areas where the context influenced an individual's psychological safety including personality, culture and leadership. Possible negative consequences of psychological safety included distraction and fatigue for the team leader. We demonstrated that speaking up can be influenced by motivations other than patient safety, such as undermining or self-promotion. CONCLUSIONS: Our data demonstrate reassuring levels of psychological safety within the participants studied. This allowed us to explore in depth the participant experience of working within a psychologically safe environment. We add to the current literature by uniquely demonstrating there can be negative consequences to a psychologically safe environment in the healthcare setting. We expand on the influence of context on psychological safety by developing a model, allowing leaders to identify which elements of context can be modified in order to promote speaking up. Team leaders can use these data to help foster a culture of openness, innovation and error prevention while minimising the risk of negative implications.


Assuntos
Segurança do Paciente , Medicina Estatal , Cuidados Críticos , Humanos , Liderança , Pesquisa Qualitativa
15.
BMJ Open ; 11(8): e045377, 2021 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-34385231

RESUMO

OBJECTIVES: Measuring staff perspectives on patient safety culture (PSC) can identify areas of concern that, if addressed, could lead to improvements in healthcare. To date, there is no validated measure to assess PSC that has been tested and adapted for use in Bosnia and Herzegovina (BiH). This research addresses the gap in the evidence through the psychometric assessment of the Agency for Healthcare Research and Quality's: 'Hospital Survey on Patient Safety Culture' (HSOPSC), to determine its suitability for the health system in BiH. SETTING: Nine hospitals. PARTICIPANTS: Healthcare professionals (n=1429); nurse (n=823), doctors (n=328), other clinical personnel (n=111), non-clinical personnel (n=60), other (n=64), no response (n=43). PRIMARY AND SECONDARY OUTCOME MEASURES: A translated version of HSOPSC was used to conduct psychometric evaluation including exploratory factor analysis and confirmatory factor analysis (CFA). Comparison between the original HSOPSC and the newly adapted 'Hospital Survey on Patient Safety Culture for Bosnia and Herzegovina' (HSOPSC-BiH) was carried out. RESULTS: Compared with the original survey, which has 12 factors (42 items), the adapted survey consisted of 9 factors (29 items). The following factors from the original survey were not included in their original form: Communication Openness, Feedback and Communications about error, Overall Perceptions of Patient Safety and Organisational learning-Continuous Improvement. The results of the CFA for HSOPSC-BiH showed a better model fit compared with the original HSOPSC. The absolute and relative fit indices showed excellent model adjustment. CONCLUSIONS: The BiH version of Hospital Survey on Patient Safety Culture demonstrated satisfactory psychometric properties, with acceptable to good internal consistency and construct validity. Therefore, we recommend the HSOPSC-BiH as a basis for assessing PSC in BiH. This survey could provide insight into patient safety concerns in BiH so that strategies to overcome these issues could be formulated and implemented.


Assuntos
Cultura Organizacional , Gestão da Segurança , Atitude do Pessoal de Saúde , Bósnia e Herzegóvina , Pesquisa sobre Serviços de Saúde , Hospitais , Humanos , Segurança do Paciente , Psicometria , Inquéritos e Questionários
16.
New Bioeth ; 27(3): 266-284, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34355660

RESUMO

Babylon 5, like other great sci-fi franchises, touched on important ethical questions. Two ethical conundrums relating to the series' main characters included providing life-saving treatment to a child against their parents' wishes and potential involvement with a highly beneficial but morally dubious medication. I use these cases to discuss some aspects of the COVID-19 vaccines' development and roll-out, demonstrating that people (be it patients or clinicians) might object to some vaccines due to reasonable ethics and safety-based concerns rather than due to an anti-vaxxer mind-set. I highlight that it would be disingenuous to lump these two groups of objections together for not all objections to specific vaccines are objections to vaccination in general. Rather, governments and pharmaceutical companies should seriously engage with the concerns of reasonable objectors to provide citizens with the appropriate products and ensure large vaccination uptake - in the case of COVID-19 this should include giving patients the choice of the product they will be inoculated with.


Assuntos
COVID-19/prevenção & controle , Consciência , Recusa do Médico a Tratar/ética , Vacinas contra COVID-19/administração & dosagem , Criança , Drama , Humanos , Princípios Morais , Segurança do Paciente
17.
Medicine (Baltimore) ; 100(29): e26269, 2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34398001

RESUMO

ABSTRACT: Variables derived from the cardiopulmonary exercise test (CPX) provide objective information regarding the exercise capacity of children with cerebral palsy (CP), which can be used as the basis for exercise recommendations. Performing maximal CPX might not be appropriate, safe, or practical for children with CP. In the present study, the safety and feasibility of symptom-limited CPX using the modified Naughton protocol, a submaximal protocol, were investigated in children with CP, Gross Motor Function Classification System (GMFCS) level I or II. The present study included 40 children aged 6 to 12 years with CP who underwent symptom-limited CPX. CPX was performed to measure cardiopulmonary fitness using a treadmill with a modified Naughton protocol. Motor capacity was assessed using the Gross Motor Function Measure (GMFM), Pediatric Balance Scale (PBS), Timed Up and Go (TUG) test, and 6-minute walk test. Thirty-seven children with CP successfully completed testing without any adverse events during or immediately after CPX (dropout rate 7.5%). The reason for test termination was dyspnea (51.4%) or leg fatigue (48.6%). Based on the respiratory exchange ratio (RER), 21 of 37 (56.8%) children chose premature termination. The relationship between the reason for test termination and RER was not statistically significant (Spearman rho = 0.082, P = .631). CPX exercise time was strongly correlated with GMFM (Spearman rho = 0.714) and moderate correlation with PBS (Spearman rho = 0.690) and TUG (Spearman rho = 0.537). Peak oxygen uptake during CPX showed a weak correlation with GMFM and a moderate correlation with PBS. This study revealed that symptom-limited CPX using the modified Naughton protocol was safe and feasible for children with CP and GMFCS level I or II.


Assuntos
Paralisia Cerebral/classificação , Teste de Esforço/normas , Paralisia Cerebral/epidemiologia , Distribuição de Qui-Quadrado , Criança , Eletrocardiografia/métodos , Teste de Esforço/métodos , Teste de Esforço/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Segurança do Paciente , República da Coreia/epidemiologia
18.
J Psychiatr Pract ; 27(4): 245-253, 2021 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-34398574

RESUMO

Telehealth has been rapidly deployed in the environment of the Coronavirus 2019 (COVID-19) pandemic to help meet critical mental health needs. As systems of care use telehealth during the pandemic and evaluate the future of telehealth services beyond the crisis, a quality and safety framework may be useful in weighing important considerations for using telehealth to provide psychiatric and behavioral health services within special populations. Examining access to care, privacy, diversity, inclusivity, and sustainability of telehealth to meet behavioral and psychiatric care needs in geriatric and disadvantaged youth populations can help highlight key considerations for health care organizations in an increasingly electronic health care landscape.


Assuntos
COVID-19 , Serviços de Saúde Mental , Segurança do Paciente , Psiquiatria , Melhoria de Qualidade , Telemedicina , Adolescente , Idoso , COVID-19/epidemiologia , Humanos , Serviços de Saúde Mental/normas , Serviços de Saúde Mental/tendências , Psiquiatria/normas , Psiquiatria/tendências , SARS-CoV-2 , Telemedicina/normas , Telemedicina/tendências
19.
Medicine (Baltimore) ; 100(30): e26731, 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34397710

RESUMO

ABSTRACT: The World Health Organization Surgical Safety Checklist was developed to improve communication in perioperative care, reduce mortality and complications of patients, and ensure the consistent use of procedures for safe surgery. Despite the increased awareness of the checklist, the implementation compliance is reported as low and the degree of completeness varies. This study aimed to explore the possible supportive factors for the effective implementation and to identify potential awareness and barriers to its implementation in gynecological and obstetrical operation.A survey using a cross-sectional design that included surgeons, anesthetists, and operating room nurses was performed. We used an online link to distribute the survey to all eligible surgical team members in our hospital. The survey contained various aspects of perceptions on the Surgical Safety Checklist and an open-ended question that allowed respondents to offer their opinions on the topic.The overall self-reported awareness of the checklist within each professional group was high. The awareness of surgeons was lower than that of operating room nurses, particularly in the Time-out section. Most participants believed that operating room nurses ranked the highest compliance to the protocols, while surgeons stayed the lowest. Active leadership with experienced operating room nurses, good training for surgical team members, and simplification of the checklist would be the positive factors for the effective implementation.Although there is a high acceptance and adequate self-reported awareness of the Surgical Safety Checklist, it is not always possible to implement it successfully. Our findings suggest that with experienced and effective leadership, barriers to implementation can be overcome. With positive perception and commitment, the Surgical Safety Checklist is easy to implement and it can make a profound improvement on the safety of surgical care. Moreover, a strategy of repetitive training and assessment on the part of the involved health care professionals may be necessary to further improve patients' safety during surgery.


Assuntos
Lista de Checagem , Procedimentos Cirúrgicos em Ginecologia/normas , Procedimentos Cirúrgicos Obstétricos/normas , Equipe de Assistência ao Paciente/normas , Segurança do Paciente/normas , Adulto , Conscientização , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
Soins ; 66(858): 11-13, 2021 Sep.
Artigo em Francês | MEDLINE | ID: mdl-34462061

RESUMO

Safe nursing staffing and patient safety are closely related. A systematic review of the literature was carried out, comparing the number of falls in elderly inpatients in medical-surgical wards with these staffing levels. A review of scientific articles, selected through a keyword search of several electronic databases, showed a direct, although not significant, association between improved nurse staffing and a decrease in the number of falls in elderly inpatients.


Assuntos
Recursos Humanos de Enfermagem no Hospital , Admissão e Escalonamento de Pessoal , Idoso , Hospitais , Humanos , Segurança do Paciente , Recursos Humanos
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