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Gleeson L, McNamara J, Donworth E, Crowley E, Delaney A, Sahm L, O'Mahony D, Russell N, Byrne S. Healthcare provider perceptions of safety culture: A multi-site study using the safety attitudes questionnaire. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100228. [PMID: 36793798 PMCID: PMC9922969 DOI: 10.1016/j.rcsop.2023.100228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
Introduction Patient safety culture, the way in which members of a healthcare organisation think about and prioritise safety, has been linked to positive patient outcomes. The aim of this study was to use the Safety Attitudes Questionnaire (SAQ) to measure the safety culture in a variety of healthcare settings located in the province of Munster of Ireland. Methods The SAQ was applied in six healthcare settings in the Munster province of Ireland between December 2017 and November 2019. The attitudes of healthcare staff towards six domains of safety culture were assessed over 32 Likert-scaled items. The mean, median, interquartile range and percent positive scores for each domain were calculated for the study population, and subgroup analyses were carried out between study sites and professions. Results for each setting were compared to international benchmarking data. Chi-Squared tests were used to determine whether study site or profession were related to domain scores. Reliability analysis was carried out using Cronbach's alpha. Results Study participants (n = 1749) comprising doctors, pharmacists, nurses, and healthcare assistants, were found to have positive attitudes towards patient safety culture but scored poorly in the domains Working Conditions and Perceptions of Management. Perceptions of safety culture were more positive in smaller healthcare settings, and amongst nurses and HCAs. The survey had acceptable internal consistency. Conclusions In this study investigating the safety culture of healthcare organisations in Ireland, study participants had generally positive attitudes towards the safety culture in their organisation, however working conditions, perceptions of management, and medication incident reporting were identified as key areas for improvement.
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Affiliation(s)
- L.L. Gleeson
- School of Pharmacy, University College Cork, Ireland
| | - J. McNamara
- School of Pharmacy, University College Cork, Ireland
| | - E. Donworth
- School of Pharmacy, University College Cork, Ireland
| | - E.K. Crowley
- School of Pharmacy, University College Cork, Ireland
| | | | - L. Sahm
- School of Pharmacy, University College Cork, Ireland
| | | | | | - S. Byrne
- School of Pharmacy, University College Cork, Ireland
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O'Connor P, O'Malley R, Kaud Y, Pierre ES, Dunne R, Byrne D, Lydon S. A scoping review of patient safety research carried out in the Republic of Ireland. Ir J Med Sci 2023; 192:1-9. [PMID: 35122620 PMCID: PMC8817163 DOI: 10.1007/s11845-022-02930-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/19/2022] [Indexed: 02/04/2023]
Abstract
Maintaining the highest levels of patient safety is a priority of healthcare organisations. However, although considerable resources are invested in improving safety, patients still suffer avoidable harm. The aims of this study are: (1) to examine the extent, range, and nature of patient safety research activities carried out in the Republic of Ireland (RoI); (2) make recommendations for future research; and (3) consider how these recommendations align with the Health Service Executive's (HSE) patient safety strategy. A five-stage scoping review methodology was used to synthesise the published research literature on patient safety carried out in the RoI: (1) identify the research question; (2) identify relevant studies; (3) study selection; (4) chart the data; and (5) collate, summarise, and report the results. Electronic searches were conducted across five electronic databases. A total of 31 papers met the inclusion criteria. Of the 24 papers concerned with measuring and monitoring safety, 12 (50%) assessed past harm, 4 (16.7%) the reliability of safety systems, 4 (16.7%) sensitivity to operations, 9 (37.5%) anticipation and preparedness, and 2 (8.3%) integration and learning. Of the six intervention papers, three (50%) were concerned with education and training, two (33.3%) with simplification and standardisation, and one (16.7%) with checklists. One paper was concerned with identifying potential safety interventions. There is a modest, but growing, body of patient safety research conducted in the RoI. It is hoped that this review will provide direction to researchers, healthcare practitioners, and health service managers, in how to build upon existing research in order to improve patient safety.
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Affiliation(s)
- Paul O'Connor
- Department of General Practice, School of Medicine, National University of Ireland Galway, 1 Distillery Road, Galway, Co, Ireland.
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland.
| | - Roisin O'Malley
- Department of General Practice, School of Medicine, National University of Ireland Galway, 1 Distillery Road, Galway, Co, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
| | - Yazeed Kaud
- Department of General Practice, School of Medicine, National University of Ireland Galway, 1 Distillery Road, Galway, Co, Ireland
- Department of Public Health, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Emily St Pierre
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Rosie Dunne
- James Hardiman Library, National University of Ireland Galway, Galway, Ireland
| | - Dara Byrne
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Sinéad Lydon
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
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Rotta ALO, Souza LPD, Carvalho MDSGV, Silva APD, Bandeira AG, Urbanetto JDS. Análise da convergência do Safety Attitudes Questionnaire e do Hospital Survey on Patient Safety Culture. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2021-0379pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivos: analisar a cultura de segurança do paciente a partir da percepção dos profissionais de enfermagem de um hospital universitário, por meio da avaliação da convergência entre o Safety Attitudes Questionnaire e o Hospital Survey on Patient Safety Culture. Métodos: estudo transversal, com 434 profissionais de enfermagem. A coleta dos dados ocorreu mediante aplicação de ambos os instrumentos. Utilizou-se estatística descritiva e inferencial. Resultados: no Hospital Survey on Patient Safety Culture, a dimensão “trabalho em equipe no âmbito das unidades” foi considerada uma área forte da segurança do paciente. No Safety Attitudes Questionnaire, os domínios “satisfação no trabalho” e “percepção de estresse” atingiram o escore para boa cultura de segurança. A percepção de cultura de segurança do paciente se correlaciona, em ambos os instrumentos, com magnitude elevada. Conclusões: os dois instrumentos convergem para uma avaliação semelhante da cultura de segurança do paciente.
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Rotta ALO, de Souza LP, Carvalho MDSGV, da Silva AP, Bandeira AG, Urbanetto JDS. Analysis of the convergence of the Safety Attitudes Questionnaire and the Hospital Survey on Patient Safety Culture. Rev Bras Enferm 2022; 76:e20210379. [PMID: 36542049 PMCID: PMC9749772 DOI: 10.1590/0034-7167-2021-0379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 08/08/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES to analyze patient safety culture from nursing professionals' perception at a university hospital, by assessing the convergence between the Safety Attitudes Questionnaire and the Hospital Survey on Patient Safety Culture. METHODS a cross-sectional study, with 434 nursing professionals. Data collection took place through the application of both instruments. Descriptive and inferential statistics were used. RESULTS in the Hospital Survey on Patient Safety Culture, the "teamwork within the units" dimension was considered a strong area of patient safety. In the Safety Attitudes Questionnaire, the "job satisfaction" and "perception of stress" domains reached the score for a good safety culture. Patient safety culture perception is correlated, in both instruments, with high magnitude. CONCLUSIONS the two instruments converge towards a similar assessment of patient safety culture.
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Affiliation(s)
- Ana Laura Olsefer Rotta
- Pontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Paulo de Souza
- Pontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Amanda Pestana da Silva
- Pontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil
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Savva G, Merkouris A, Charalambous A, Papastavrou E. Omissions and Deviations From Safe Drug Administration Guidelines in 2 Medical Wards and Risk Factors: Findings From an Observational Study. J Patient Saf 2022; 18:e645-e651. [PMID: 34508041 DOI: 10.1097/pts.0000000000000913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to record the type and frequency of errors, with an emphasis on omissions, during administration of medicines to inpatients and to investigate associated factors. METHODS This was a descriptive observational study. The medication process in 2 medical wards was observed by 2 observers using a structured observation form. χ2 Test, Kruskal-Wallis test, and regression analysis were used to explore associations between factors and errors. RESULTS From the 665 administrations observed, a total of 2371 errors were detected from which 81.2% were omissions and 18.8% were errors of commission. Omissions in the infection prevention guidelines (46.6%) and in the 5 rights of medication safety principles (35.8%) were a predominant finding. In particular, omitting to hand wash before administering a drug (98.4%), omitting to disinfect the site of injection (37.7%), and omitting to confirm the patient's name (74.4%) were the 3 most frequently observed omissions. Documentation errors (13.1%) and administration method errors (4.5%) were also detected. Regression analysis has shown that the therapeutic class of the drug administered and the number of medicines taken per patient were the 2 factors with a statistical significance that increased the risk of a higher number of errors being detected. CONCLUSIONS Errors during drug administration are still common in clinical practice, with omissions being the most common type of error. In particular, omissions in the basic infection and safety regulations seem to be a very common problem. The risk of a higher number of errors being made is increased when a cardiovascular drug is administered and when the number of medicines administered per patient is increased.
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Affiliation(s)
| | - Anastasios Merkouris
- From the Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | | | - Evridiki Papastavrou
- From the Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Schram A, Paltved C, Lindhard MS, Kjaergaard-Andersen G, Jensen HI, Kristensen S. Patient safety culture improvements depend on basic healthcare education: a longitudinal simulation-based intervention study at two Danish hospitals. BMJ Open Qual 2022; 11:bmjoq-2021-001658. [PMID: 35256353 PMCID: PMC8905901 DOI: 10.1136/bmjoq-2021-001658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background A growing body of evidence supports the existence of an association between patient safety culture (PSC) and patient outcomes. PSC refers to shared perceptions and attitudes towards norms, policies and procedures related to patient safety. Existing literature shows that PSC varies among health professionals depending on their specific profession and specialty. However, these studies did not investigate whether PSC can be improved. This study investigates whether length of education is associated with improvements in PCS following a simulation intervention. Methods From April 2017 to November 2018, a cross-sectional intervention study was conducted at two regional hospitals in Denmark. Two groups with altogether 1230 health professionals were invited to participate. One group included nurses, midwives and radiographers; the other group included doctors. A train-the-trainer intervention approach was applied consisting of a 4-day simulation instructor course that emphasised team training, communication and leadership. Fifty-three healthcare professionals were trained as instructors. After the course, instructors performed in situ simulation in their own hospital environment. Outcomes The Safety Attitude Questionnaire (SAQ), which has 6 dimensions and 32 items, was used to collect main outcome variables. All employees from both groups were surveyed before the intervention and again four and nine months after the intervention. Results Mean baseline scores were higher among doctors than among nurses, midwives and radiographers for all SAQ dimensions. At the second follow-up, four of six dimensions improved significantly (p ≤ 0.05) among nurses, midwives and radiographers, whereas no dimensions improved significantly among doctors. Conclusion Over time, nurses, midwives and radiographers improved more in PSC attitudes than doctors did.
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Affiliation(s)
- Anders Schram
- Corporate HR, Midtsim, Central Denmark Region, Aarhus, Denmark
| | | | | | - Gunhild Kjaergaard-Andersen
- Department of Regional Health Research, Soenderborg Hospital, University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Hanne Irene Jensen
- Department of Anaesthesiology and Intensive Care, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Department of Regional Health Research, University of Southern Denmark Odense Campus Library, Odense, Denmark
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Kyriacou Georgiou M, Merkouris A, Hadjibalassi M, Sarafis P, Kyprianou T. Correlation Between Teamwork and Patient Safety in a Tertiary Hospital in Cyprus. Cureus 2021; 13:e19244. [PMID: 34877219 PMCID: PMC8642670 DOI: 10.7759/cureus.19244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 11/05/2022] Open
Abstract
Background Over time, the multidimensional nature of the safety culture in the healthcare field has led to great efforts to improve quality and create tools aiming at enhancing safety. In particular, emphasis has been placed on teamwork and the safety climate. There is a strong relationship between these two complex elements, which interact to improve the safety climate and reduce patient-safety issues. In this study, "teamwork" includes the perceptions of the health professionals collaborating within a health team to provide safe patient care, and "safety climate" refers to the professional commitment to patient safety. Objective This article assesses health professionals' perceptions of both patient-safety issues and teamwork in their hospital work environment after the development and implementation of a comprehensive quality-assurance system. Methods This descriptive correlation study is based on anonymous and self-completed questionnaires obtained after the development and implementation of a comprehensive quality assurance system in the wards and departments of Nicosia General Hospital. The research sample consisted of the health professionals who participated in the working groups that implemented the quality assurance system. We used the questionnaire's sociodemographic data and the Safety Attitudes Questionnaire (SAQ) developed in the Deepening our Understanding of Quality Improvement in Europe program, focusing on two factors: Teamwork and the safety climate. Results While teamwork received a positive score (>75%), the same did not occur for the safety climate (68.60%). Women typically rated the safety climate more positively than men, who mostly gave negative ratings (p = 0.005). There was a statistically significant difference (p = 0.011) in the scores between participants aged 24-44 and those aged 45-54, with the latter reporting higher teamwork scores. The participants' educational levels also played important roles in their responses, with university graduates (BSc) providing more positive teamwork scores than those with a master's degree (p = 0.018). Conclusions Our research revealed that the health professionals of Nicosia General Hospital perceived the teamwork climate as positive, in contrast to the safety climate. The results highlight the need not only to intervene in all the areas covered by the SAQ to improve the safety climate but also to keep encouraging teamwork to obtain better results.
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Affiliation(s)
- Mary Kyriacou Georgiou
- Quality Assurance Department, Nicosia General Hospital, Nicosia, CYP.,School of Health Sciences, Cyprus University of Technology, Limassol, CYP
| | | | | | | | - Theodoros Kyprianou
- Medicine, University of Nicosia, Nicosia, CYP.,Respiratory and Intensive Care Medicine, King's College Hospital NHS Trust, London, GBR
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Carneiro AS, Dalmolin GDL, Magnago TSBDS, Moreira LP, Costa ED, Andolhe R. Patient safety culture in critical and non-critical areas: a comparative study. Rev Esc Enferm USP 2021; 55:e20210141. [PMID: 34643640 DOI: 10.1590/1980-220x-reeusp-2021-0141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/02/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE to compare the perception of patient safety culture among health workers from critical and non-critical areas. METHOD cross-sectional study with health workers from critical and non-critical areas of a large hospital. Data collection used a characterization instrument and the Safety Attitudes Questionnaire. The analysis was performed in the Predictive Analytics Software Statistic®. RESULTS a total of 393 workers participated, predominantly women, over 43 years old, nursing technicians, with a partner, and children. Results indicated that the areas have a negative perception of patient safety (66.5%, ±12.7 critical; 63.5%, ±14.4 non-critical). Only job satisfaction had a positive score (83.0%, ±15.9 critical; 80.1%, ±17.5 non-critical). There was a relationship between being a worker in critical areas and having a positive perception of the unit's management (p = 0.041). CONCLUSION both areas have a negative perception of the safety culture. Although critical areas have obtained more positive evaluations, the results did not show statistical significance when compared to non-critical areas.
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Affiliation(s)
| | | | | | - Laura Prestes Moreira
- Universidade Federal de Santa Maria, Departamento de Enfermagem, Santa Maria, RS, Brazil
| | - Eduarda Dalla Costa
- Universidade Federal de Santa Maria, Departamento de Enfermagem, Santa Maria, RS, Brazil
| | - Rafaela Andolhe
- Universidade Federal de Santa Maria, Departamento de Enfermagem, Santa Maria, RS, Brazil
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Prates CG, Caregnato RCA, Magalhães AMMD, Pai DD, Urbanetto JDS, Moura GMSSD. Patient safety culture in the perception of health professionals: A mixed methods research study. Rev Gaucha Enferm 2021. [DOI: 10.1590/1983-1447.2021.20200418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
ABSTRACT Objective: To analyze the patient safety culture perceived by health professionals working in a hospital and to understand the elements influencing it. Methods: A sequential explanatory mixed methods study, conducted in 2017 in two interrelated stages in a hospital. The quantitative stage was carried out by applying the questionnaire to 618 professionals and the qualitative stage, with ten, using the focus group technique. The analysis was descriptive statistics for the quantitative data and of content for the qualitative data. Subsequently, the data were submitted to integrated analysis. Results: Of the 12 dimensions, seven were considered weak, the most critical being “non-punitive response to error” with 28.5% of positive answers. Bureaucratic, poorly designed and uncoordinated processes, regional decisions, communication failures, hierarchy, overload, punishment and judicialization were related to the perception. Conclusions: The patient safety culture was considered weak, and elements related to work organization, people management and legal risk influenced this negative perception.
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Affiliation(s)
- Cassiana Gil Prates
- Hospital Ernesto Dornelles, Brasil; Universidade Federal do Rio Grande do Sul, Brasil
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