[Out of hospital emergencies towards a safety culture]. / Las emergencias extrahospitalarias ante la cultura de seguridad.

OBJECTIVES: The aim of this study is to measure the degree of safety culture (CS) among healthcare professional workers of an out-of-hospital Emergency Medical Service. Most patient safety studies have been conducted in relation to the hospital rather than pre-hospital Emergency Medical Services. The objective is to analyze the dimensions with lower scores in order to plan futures strategies. MATERIAL AND METHODS: A descriptive study using the AHRQ (Agency for Healthcare Research and Quality) questionnaire. The questionnaire was delivered to all healthcare professionals workers of 061 Advanced Life Support Units of Aragón, during the month of August 2013. RESULTS: The response rate was 55%. Main strengths detected: an adequate number of staff (96%), good working conditions (89%), tasks supported from immediate superior (77%), teamwork climate (74%), and non-punitive environment to report adverse events (68%). Areas for improvement: insufficient training in patient safety (53%) and lack of feedback of incidents reported (50%). CONCLUSIONS: The opportunities for improvement identified focus on the training of professionals in order to ensure safer care, while extending the safety culture. Also, the implementation of a system of notification and registration of adverse events in the service is deemed necessary.

Las emergencias extrahospitalarias ante la cultura de seguridad / Out of hospital emergencies towards a safety culture

Objetivos. Estudiar el grado de cultura de seguridad (CS) de los profesionales en el ámbito de un servicio de urgencias extrahospitalarias. Analizar las dimensiones que reciben puntuaciones inferiores, con el fin de establecer futuras estrategias de actuación. Material y métodos. Estudio observacional, descriptivo, transversal en el que se distribuyó el cuestionario de la Agency for Healthcare Research and Quality (AHRQ) al universo muestral de los profesionales sanitarios que trabajan en las unidades de soporte vital avanzado del 061 de Aragón, durante el mes de agosto de 2013. Resultados. Se analizaron 80 cuestionarios (tasa de respuesta 55,55%). Principales fortalezas: adecuada dotación de personal (96%), buen clima laboral (89%), apoyo de superiores inmediatos (77%), trabajo en equipo (74%) y ambiente no punitivo hacia los eventos adversos (68%). Áreas de mejora: insuficiente formación en seguridad del paciente (53%), ausencia de feedback (50%). Conclusiones. Las oportunidades de mejora detectadas se centran en la formación de los profesionales, con el fin de procurar una asistencia más segura, extendiendo al mismo tiempo la cultura de seguridad. Así mismo se considera necesaria la puesta en marcha de un sistema de notificación y registro de eventos adversos en nuestro servicio (AU)

Objectives. The aim of this study is to measure the degree of safety culture (CS) among healthcare professional workers of an out-of-hospital Emergency Medical Service. Most patient safety studies have been conducted in relation to the hospital rather than pre-hospital Emergency Medical Services. The objective is to analyze the dimensions with lower scores in order to plan futures strategies. Material and methods. A descriptive study using the AHRQ (Agency for Healthcare Research and Quality) questionnaire. The questionnaire was delivered to all healthcare professionals workers of 061 Advanced Life Support Units of Aragón, during the month of August 2013. Results. The response rate was 55%. Main strengths detected: an adequate number of staff (96%), good working conditions (89%), tasks supported from immediate superior (77%), teamwork climate (74%), and non-punitive environment to report adverse events (68%). Areas for improvement: insufficient training in patient safety (53%) and lack of feedback of incidents reported (50%). Conclusions. The opportunities for improvement identified focus on the training of professionals in order to ensure safer care, while extending the safety culture. Also, the implementation of a system of notification and registration of adverse events in the service is deemed necessary (AU)

Opioid consumption in Spain--the significance of a regulatory measure.

OBJECTIVE: To investigate the impact of new regulatory measures on opioid consumption in Spain during the period 1985-1998. METHODS: A search in the ECOM (Especialidades Consumo de Medicamentos) database of the Ministry of Health was made for the 1985-1998 period. This database contains information about drug preparations prescribed in primary care in the National Health System in Spain. RESULTS: Since 1985-1998, the overall opioid consumption has increased tenfold, from 94.7 DDD (defined daily dose) per million inhabitants per day to more than 1000 DDD. For the five drugs that require a special prescription form (morphine, methadone, pethidine, tilidine and fentanyl), the consumption has increased 13.5-fold. CONCLUSION: A huge increase in opioid consumption has occurred. In this increase, changes in supply and, to a lesser extent, regulatory measures have played an important role.