scholarly journals Assessing patient safety culture and its associated factors in 12 emergencies across Tunisia

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
W Aouicha ◽  
M Tlili ◽  
M B e n Dhiab ◽  
A Mtiraoui ◽  
S Chelbi ◽  
...  

Abstract Background Although the emergency departments (EDs) are the front line of the public health system, they are considered high-risk environments because of the shocking frequency of adverse events, within. Developing safety culture among EDs professionals, as a strategic focus, remains a priority. The purpose of this study is to measure safety culture in EDs and to determine its associated factors. Methods This is a cross-sectional and multicenter study, conducted among professionals from all the EDs of public and private healthcare institutions in central Tunisia. It was conducted from June to September 2017. The instrument tool used was the self-administered Hospital Survey On Patient Safety Culture questionnaire translated and validated by the CCECQA. Data entry and analysis were performed using SPSS 20.0 and Epi info 6. Also, ethical considerations were taken into account. Results In total, the study included 442 participants from 12 ED, with a participation rate of 80.35%. All the ten dimensions of safety culture were all to be improved. As for 'teamwork within units', it scored the highest with 46%, however, the lowest scores were attributed to 'the frequency of reported adverse events' (19.6%) followed by 'the non-punitive response to error' (19.8%). Private EDs have shown significantly higher scores regarding nine safety culture dimensions. Also, the size of the hospital was significantly associated with all dimensions of the safety culture. Conclusions This study has shown that the level of safety culture needs to be improved in public and private EDs and also underlines the importance of developing the safety culture and the implementation of safety and quality management systems. Key messages Patient safety culture is to be improved in Tunisian emergencies, although it is significantly more developed in private settings. A punitive culture still reigns in Tunisian healthcare context.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M A Tlili ◽  
W Aouicha ◽  
H Lamine ◽  
E Taghouti ◽  
M B e n Dhiab ◽  
...  

Abstract Background The intensive care units are a high-risk environments for the occurrence of adverse events with serious consequences. The development of patient safety culture is a strategic focus to prevent these adverse events and improve patient safety and healthcare quality. This study aimed to assess patient safety culture in Tunisian intensive care units and to determine its associated factors. Methods It is a multicenter, descriptive cross-sectional study, among healthcare professionals of the intensive care units in the Tunisian center. The data collection was spread over a period of 2 months (October-November 2017). The measuring instrument used is the validated French version of the Hospital Survey On Patient Safety Culture questionnaire. Data entry and analysis was carried out by the Statistical Package for Social Sciences (SPSS 20.0) and Epi Info 6.04. Chi-square test was used to explore factors associated with patient safety culture. Results A total of 404 professionals participated in the study with a participation rate of 81.94%, spread over 10 hospitals and 18 units. All dimensions were to be improved. The overall perception of safety was 32.35%. The most developed dimension was teamwork within units with a score of 47.87% and the least developed dimension was the non-punitive response to error (18.6%). The patient safety culture was significantly more developed in private hospitals in seven of the 10 dimensions. Participants working in small units had a significantly higher patient safety culture. It has been shown that when workload is reduced the patient safety culture was significantly increased. Conclusions This study has shown that the patient safety culture still needs to be improved and allowed a clearer view of the safety aspects requiring special attention. Thus, improving patient safety culture. by implementing the quality management and error reporting systems could contribute to enhance the quality of healthcare provided to patients. Key messages The culture of culpability is the main weakness in the study. Encouraging event reporting and learning from errors s should be priorities in hospitals to enhance patient safety and healthcare quality.


2021 ◽  
Author(s):  
Monica Susana Chirinos ◽  
Carola Orrego ◽  
Cesar Montoya ◽  
Rosa Sunol

Background: Fostering the understanding of the relationship between the prevalence of adverse events (AEP), the patient safety culture of healthcare professionals (PSC) and patient safety perception (PSP) could be an important step to operationalizing patient safety through an integration of different perspectives. Objective: To assess the relationship between AE Prevalence, Patient Safety Culture and Patient Safety Perception. Method: Cross-sectional, ex post facto comparative study on a single sample of patients. The prevalence and severity of adverse events were measured through a review of medical records (using the Modular Review Form (MRF2). Healthcare professional patient safety culture was determined using the Hospital Survey on Patient Safety Culture (HSOPSC) and patient perception of safety through the Hospital Care Safety Perceptions Questionnaire (HCSPQ). Correlation tests were used to compare the three dimensions. Population: 556 medical records and patients were studied for the prevalence and patient safety perception study, and 397 of the healthcare providers involved in the care of these patients were surveyed for the patient safety culture study, at 2 public and 2 private hospitals. Results: An inverse association was observed between AE prevalence and its severity and Patient Safety Culture Index (rho=-0.8) and Patient Safety Perception Index (rho=-0.6). No association was identified between Patient Safety Culture and Patient Safety Perception (rho=0.0001). No statistical differences were identified by hospital type. Conclusions: The joint analysis of AEP, PSC and PSP, in the same sample, offers an interesting and useful perspective on the associations between the variables studied; no correlation pattern was observed between the variables.


2019 ◽  
Vol 42 (1) ◽  
pp. 32-40 ◽  
Author(s):  
Yonghee Han ◽  
Ji-Su Kim ◽  
YeJi Seo

This study aims to examine the associations between nurses’ perceptions of patient safety culture, patient safety competency, and adverse events. Using convenience sampling, we conducted a cross-sectional study from February to May 2018 in two university hospitals. Furthermore, we performed multiple logistic regression to examine associations between patient safety culture, patient safety competency, and adverse events. Higher mean scores for “communication openness” in patient safety culture were significantly correlated with lower rates for pressure ulcers and falls; furthermore, higher mean scores for “working in teams with other health professionals” in patient safety competency were significantly correlated with reductions in ventilator-associated pneumonia. We recommend that a well-structured hospital culture emphasizing patient safety and continuation of in-service education programs for nurses to provide high-quality, clinically safe care is required. Moreover, further research is required to identify interventions to improve patient safety culture and competency and reduce the occurrence of adverse events.


1970 ◽  
Vol 4 (2) ◽  
Author(s):  
Lia Mulyati ◽  
Dedy Rachman ◽  
Yana Herdiana

Budaya keselamatan merupakan kunci untuk mendukung tercapainya peningkatan keselamatan dan kesehatan kerja dalam organisasi. Upaya membangun budaya keselamatan merupakan langkah pertama dalam mencapai keselamatan pasien. Terdapat beberapa faktor yang berkontribusi dalam perkembangan budaya keselamatan yaitu; sikap baik individu maupun organisasi, kepemimpinan, kerja tim, komunikasi dan beban kerja. Penelitian ini bertujuan mengetahui faktor determinan yang berhubungan dengan terciptanya budaya keselamatan pasien di RS Pemerintah Kabupaten Kuningan. Teknik pengambilan sampel yang digunakan incidental sampling 88 orang perawat pelaksana. Rancangan penelitian menggunakan survey analitik dengan pendekatan cross sectional, uji hipotesis digunakan Chi Square dan regresi logistik ganda. Hasil penelitian menunjukan terdapat pengaruh yang signifikan antara persepsi terhadap manajemen (p 0.0005, odd rasio 21.3), dukungan tim kerja (p 0.0005, odd rasio 13.34), stress kerja (p 0.006, odd rasio 3.94), kepuasan kerja (nilai p 0. 002) dengan budaya keselamatan pasien. Tidak terdapat pengaruh yang signifikan kondisi kerja dengan budaya keselamatan pasien dengan nilai p 0.507. Berdasarkan analisis multuvariat diperoleh persepsi terhadap manajemen menjadi factor determinan dengan nilai p 0.000 < α 0.05. Simpulan; unsur pimpinan memiliki pengaruh yang signifikan dalam menciptakan budaya keselamatan pasien. Pimpinan memiliki kewenangan dalam menerapkan system yang berlaku dalam organisasi, oleh karena itu gaya kepemimpinan, teknik komunikasi serta kemampuan manajerial merupakan suatu hal yang sangat perlu diperhatikan dalam menciptakan atmosfer kerja yang kondusif sebagai upaya terciptanya budaya keselamatan pasien. Berdasarkan hasil penelitian bahwa model kepemimpinan transformasional merupakan model yang sesuai diterapkan untuk meningkatkan budaya keselamatan pasien, pelatihan keterampilan komunikasi efektif serta pengembangan model pendidikan antar profesi sebagai upaya peningkatan kemampuan kolaborasi.Kata kunci:Budaya keselamatan pasien, stress kerja, kepuasan kerja.Determinant factors that are Influencing Patient Safety Culture in a Government-owned Hospitals in Kuningan Regency AbstractSafety culture is a key to support the achievement of occupational health and safety in an organization. An effort to build safety culture is the first step in ensuring patient safety. There are some factors that contribute in the development of safety culture, namely, individual and organizational attitude, leadership, team work, communication, and work load. This study aimed to identify the determinant factors that are related to achievement of patient safety culture in a government-owned hospital in Kuningan Regency. Eighty eight samples of nurses were recruited using incidental sampling technique. The research design was using cross sectional study, the hypothesis testing were using Chi Square and multiple logistic regression. The results showed that there were significant influenced between perception towards management (p= 0.0005, odd rasio 21.3), team work support (p= 0.0005, odd rasio 13.34), work-related stress (p= 0.006, odd rasio 3.94), work satisfaction (p= 0. 002) with patient safety culture. There was not significant influenced between work condition and patient safety (p= 0.507). The multivariate analysis showed that perception towards management was the determinant factor for patient safety culture (p 0.000 < α 0.05). In conclusion, leaders have significant influence in creating patient safety culture. Leaders have authority to implement systems in the organization. Therefore, leadership style, communication technique, and managerial ability are important in order to create a conducive atmosphere for developing patient safety culture. As recommendation, transformational leadership is a model that is appropriate to be applied in order to increase patient safety culture, trainings of effective communication and inter-professional education model are also needed to increase the collaboration skills among health professionals.Keywords:Patient safety culture, work-related stress, work satisfaction.


2021 ◽  
Vol 10 (1) ◽  
pp. e001183
Author(s):  
Anders Schram ◽  
Charlotte Paltved ◽  
Karl Bang Christensen ◽  
Gunhild Kjaergaard-Andersen ◽  
Hanne Irene Jensen ◽  
...  

ObjectivesThis study aimed to investigate staff’s perceptions of patient safety culture (PSC) in two Danish hospitals before and after an in situ simulation intervention.DesignA repeated cross-sectional intervention study.SettingTwo Danish hospitals. Hospital 1 performs emergency functions, whereas hospital 2 performs elective functions.ParticipantsA total of 967 healthcare professionals were invited to participate in this study. 516 were employed in hospital 1 and 451 in hospital 2. Of these, 39 were trained as simulation instructors.InterventionA 4-day simulation instructor course was applied. Emphasis was put on team training, communication and leadership. After the course, instructors performed simulation in the hospital environment. No systematic simulation was performed prior to the intervention.Main outcome measuresThe Safety Attitude Questionnaire investigating PSC was applied prior to the intervention and again 4 and 8 weeks after intervention. The proportion of participants with a positive attitude and mean scale scores were measured as main outcomes.ResultsThe response rate varied from 63.6% to 72.0% across surveys and hospitals. Baseline scores were generally lower for hospital 1. The proportion of staff with positive attitudes in hospital 1 improved by ≥5% in five of six safety culture dimensions, whereas only two dimensions improved by ≥5% in hospital 2. The mean scale scores improved significantly in five of six safety culture dimensions in hospital 1, while only one dimension improved significantly in hospital 2.ConclusionsSafety attitude outcomes indicate an improvement in PSC from before to after the in situ simulation intervention period. However, it is possible that an effect is more profound in an acute care hospital versus an elective setting.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chih-Hsuan Huang ◽  
Ying Wang ◽  
Hsin-Hung Wu ◽  
Lee Yii-Ching

PurposeThe aims of this study are to (1) evaluate physicians and nurses' perspectives on patient safety culture amid the COVID-19 pandemic and (2) integrate the emotional exhaustion of physicians and nurses into an evaluation of patient safety culture to provide insights into appropriate implications for medical care.Design/methodology/approachPatient safety culture was assessed with the Chinese version of the Safety Attitudes Questionnaire. Confirmatory factor analysis was conducted to validate the structure of the data (i.e. reliability and validity), and Pearson's correlation analysis was performed to identify relationships between safety-related dimensions.FindingsSafety climate was strongly associated with working conditions and teamwork climate. In addition, working conditions was highly correlated with perceptions of management and job satisfaction, respectively. It is worth noting that the stress and emotional exhaustion of the physicians and nurses during this epidemic were high and needed attention.Practical implicationsFor healthcare managers and practitioners, team-building activities, power of public opinions, IoT-focused service, and Employee Assistance Programs are important implications for inspiring the patient safety-oriented culture during the period of the COVID-19 pandemic.Originality/valueThis paper considers the role of emotional state into patient safety instrument, a much less understood but equally important dimension in the field of patient safety.


2016 ◽  
Vol 5 (4) ◽  
pp. 20
Author(s):  
Olena Mazurenko ◽  
Jason Richter ◽  
Abby Swanson-Kazley ◽  
Eric Ford

Background: Patient satisfaction has always been an area of focus for hospitals, but gained particular importance due to the changes in the Centers for Medicare and Medicaid reimbursement policies. Hospital managers and clinicians interact with patients in different ways and have different perspectives on safety culture, yet little is known about how that impacts patient satisfaction.Objective: To examine how the agreement between clinicians and management perspectives on patient safety culture is related to patient satisfaction by employing cross-sectional design with linear regressions.Methods: Two data sets were used: 2012 Hospital Survey on Patient Safety Culture and 2012 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The dependent variables were: overall rating of the hospital experience and willingness to recommend a hospital. The independent variables were four safety culture domains: communication openness, feedback, and communication about errors, teamwork within units, and teamwork between units.Results: The results suggest that manager and clinician agreement on high levels of communication openness, feedback and communication about errors, teamwork between units, and teamwork across units were positively and significantly associated with overall patient satisfaction and willingness to recommend. Additionally, more favorable perceptions about patient safety culture by only clinicians yielded similar findings.Conclusions: For policymakers, measuring managers and clinicians’ perceptions on patient safety culture may provide a valuable indicator of patient satisfaction throughout the country. While managers are more likely to have the power to devote resources to patient safety initiatives, they may not adequately judge culture in their unit and should take into account the perspectives of clinicians who have a more frontline perspective.


2020 ◽  
Vol 6 (1) ◽  
pp. 62-71
Author(s):  
Ernawaty Siagian

Pemberi layanan kesehatan harus mengutamakan keamanan pasien sebagai perioritas. Sebagai tenagakesehatan dengan jumlah terbesar, perawat mempunyai andil besar dalam meningkatkan budayakeselamatan pasien di rumah sakit. Penting untuk mengkaji penerapan budaya keselamatan pasien padaperawat, sehingga hasilnya dapat dijadikan acuan dalam melakukan perbaikan.Penelitian descriptivecomparative cross sectional design dilakukan kepada 50 responden perawat dari instalasi gawat darurat,Hemodialisa, Instalasi pasien rawat jalan dan ruang operasi dengan menggunakan instrument HospitalSurvey of Patient safety Culture (HSOPCS) yang terdiri dari 12 dimensi. Uji statistic Mann Whitneydigunakan untuk mengetahui apakah terdapat perbedaan penerapan antara staff pelaksana dan incharge,antara head nurse dan kepala ruangan.Hasil penelitian menunjukkan nilai rata-rata respon positif dari 12dimensi yang diberikan oleh staf pelaksana (74,6%). Ada 5 dimensi yang perlu di tingkatkan yaitupersepsi tentang keselamatan pasien secara menyeluruh (70,5%), harapan dan tindakan manajer dalammeningkatkan keselamatan pasien (65,7%), respon tidak menghukum terhadap kesalahan (48,6%),staffing (70,5%) serta overan dan transisi (65,7%). Sementara incharge mempunyai nilai rata-rata (79,4%). Ada 4 dimensi yang perlu ditingkatkan yaitu frekuensi pelaporan insiden(66,7%), persepsi tentangkeselamatan pasien secara menyeluruh (55,6%), harapan dan tindakan manajer dalam meningkatkankeselamatan pasien (41,7%),dan staffing (66,7%). Pada head nurse nilai rata-rata respon positif dari 12dimensi (76,7%). Ada 5 dimensi yang perlu ditingkatkan yaitu persepsi tentang keselamatan pasien secaramenyeluruh (62,5%), harapan dan tindakan manajer dalam meningkatkan keselamatan pasien (65,6%),respon tidak menghukum terhadap kesalahan (50%), kerjasama tim antar unit (68,8%) serta overran dantransisi (56,3%). Pada kepala ruangan nilai rata-rata respon positif dalam 12 dimensi (88,6%). Ada 1dimensi yang perlu ditingkatkan yaitu respon tidak menghukum terhadap kesalahan (66,7%). Terdapatperbedaan yang signifikan antara staf pelaksana dengan incharge, antara head nurse dengan kepalaruangan dalam penerapan budaya keselamatan pasien. Dengan meningkatkan penerapan budayakeselamatan pasien diharapkan perawat dapat memberikan perawatan yang komprehensif, berbasisevidence dan berpusat pada kebutuhan pasien sehingga keselamatan pasien dirumah sakit dapat tercapai.Kata Kunci: Budaya keselamatan pasien, Perawat, HSOPSC


2020 ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

Abstract Background: Patient safety in hospitals is being jeopardized, since too many patients experience adverse events. Most of these adverse events arise from human factors, such as inefficient teamwork and communication failures, and the incidence of adverse events is greatest in the surgical area. Previous research has shown the effect of team training on patient safety culture and on different areas of teamwork. Limited research has investigated teamwork in surgical wards. The aim of this study was to evaluate the professional and organizational outcomes of a team training intervention among healthcare professionals in a surgical ward after 6 and 12 months. Systems Engineering Initiative for Patient Safety 2.0 was used as a conceptual framework for the study.Methods: This study had a pre-post design with measurements at baseline and after 6 months and 12 months of intervention. The intervention was conducted in a urology and gastrointestinal surgery ward in Norway, and the study site was selected based on convenience and the leaders’ willingness to participate in the project. Survey data from healthcare professionals were used to evaluate the intervention. The organizational outcomes were measured by the unit-based sections of the Hospital Survey of Patient Safety Culture Questionnaire, and professional outcomes were measured by the TeamSTEPPS Teamwork Perceptions Questionnaire and the Collaboration and Satisfaction about Care Decisions in Teams Questionnaire. A paired t-test, a Wilcoxon signed-rank test, a generalized linear mixed model and linear regression analysis were used to analyze the data.Results: After six months, improvements were found in organizational outcomes in two patient safety dimensions. After 12 months, improvements were found in both organizational and professional outcomes, and these improvements occurred in three patient safety culture dimensions and in three teamwork dimensions. Furthermore, the results showed that one of the significant improved teamwork dimensions “Mutual Support” was associated with the Patient Safety Grade, after 12 months of intervention.Conclusion: These results demonstrate that the team training program had effect after 12 months of intervention. Future studies with larger sample sizes and stronger study designs are necessary to examine the causal effect of a team training intervention in this context.Trial registration number: ISRCTN13997367 (retrospectively registered)


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