scholarly journals Exploring patient safety outcomes for people with learning disabilities in acute hospital settings: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047102
Author(s):  
Gemma Louch ◽  
Abigail Albutt ◽  
Joanna Harlow-Trigg ◽  
Sally Moore ◽  
Kate Smyth ◽  
...  
Keyword(s):  
Learning Disabilities ◽  
Patient Safety ◽  
Adverse Events ◽  
Grey Literature ◽  
Good Practice ◽  
Hospital Setting ◽  
Eligibility Criteria ◽  
Infant Outcomes ◽  
Safety Outcomes

ObjectivesTo produce a narrative synthesis of published academic and grey literature focusing on patient safety outcomes for people with learning disabilities in an acute hospital setting.DesignScoping review with narrative synthesis.MethodsThe review followed the six stages of the Arksey and O’Malley framework. We searched four research databases from January 2000 to March 2021, in addition to handsearching and backwards searching using terms relating to our eligibility criteria—patient safety and adverse events, learning disability and hospital setting. Following stakeholder input, we searched grey literature databases and specific websites of known organisations until March 2020. Potentially relevant articles and grey literature materials were screened against the eligibility criteria. Findings were extracted and collated in data charting forms.Results45 academic articles and 33 grey literature materials were included, and we organised the findings around six concepts: (1) adverse events, patient safety and quality of care; (2) maternal and infant outcomes; (3) postoperative outcomes; (4) role of family and carers; (5) understanding needs in hospital and (6) supporting initiatives, recommendations and good practice examples. The findings suggest inequalities and inequities for a range of specific patient safety outcomes including adverse events, quality of care, maternal and infant outcomes and postoperative outcomes, in addition to potential protective factors, such as the roles of family and carers and the extent to which health professionals are able to understand the needs of people with learning disabilities.ConclusionPeople with learning disabilities appear to experience poorer patient safety outcomes in hospital. The involvement of family and carers, and understanding and effectively meeting the needs of people with learning disabilities may play a protective role. Promising interventions and examples of good practice exist, however many of these have not been implemented consistently and warrant further robust evaluation.

scholarly journals Learning disability market position statements, are they fit for purpose?

2017 ◽  
Vol 22 (4) ◽  
pp. 198-205 ◽  
Author(s):  
Sarah Broadhurst ◽  
Keri Landau
Keyword(s):  
Learning Disabilities ◽  
Learning Disability ◽  
Good Practice ◽  
Market Position ◽  
Content Type ◽  
Fit For Purpose ◽  
Potential Impact ◽  
Senior Officers ◽  
Market Shaping

Purpose The purpose of this paper is to review whether current learning disability market position statements (MPS) are actually helping to shape the market and explore their implications for people with learning disabilities and their families. Design/methodology/approach Published learning disability MPS were identified via the Institute of Public Care’s MPS database. The quality of the MPS was analysed using a good practice checklist developed by a range of stakeholders. Findings Learning disability MPS are not currently fit for purpose. They demonstrate that local authorities are not fully engaging in their market-shaping duties, as required under The Care Act 2014. It is suggested that this is in part due to the lack of recognition that market shaping is a council-wide responsibility and can only be successful if senior officers across the council (and their partners) acknowledge this and are held accountable. Unless this happens, people with learning disabilities will continue to lack the enablers that support them to lead the lives they choose in their communities. Originality/value This is the first review of the quality and potential impact of learning disability MPS.

scholarly journals Scoping review of mental health in prisons through the COVID-19 pandemic

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046547
Author(s):  
Luke Johnson ◽  
Kerry Gutridge ◽  
Julie Parkes ◽  
Anjana Roy ◽  
Emma Plugge
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Grey Literature ◽  
Well Being ◽  
Health Impact ◽  
Poor Quality ◽  
Eligibility Criteria ◽  
Prison Staff ◽  
The Impact

ObjectiveTo examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff.DesignScoping review.Data sourcesPubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies.Eligibility criteria for selection of studiesAll papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers.ResultsOf 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons.ConclusionsIt is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.

scholarly journals Segurança do paciente em hemodiálise

2018 ◽  
Vol 12 (12) ◽  
pp. 3360
Author(s):  
Renata De Paula Faria Rocha ◽  
Diana Lúcia Moura Pinho
Keyword(s):  
Quality Of Life ◽  
Patient Safety ◽  
Adverse Events ◽  
Renal Disease ◽  
Nursing Care ◽  
Descriptive Study ◽  
Virtual Library ◽  
Calidad De Vida ◽  
Article Analysis

RESUMOObjetivo: analisar a literatura acerca da segurança do paciente em hemodiálise. Método: trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa, por meio de pesquisa em artigos publicados entre os anos de 2006 a 2016, em português, inglês ou espanhol; coletados nas bases de dados Medline, Lilacs, BDENF e Biblioteca Virtual SciELO e os resultados apresentado em figura. Resultados: compôs-se a amostra deste estudo por seis artigos. Agruparam-se as informações após a análise dos artigos, em três categorias: segurança do paciente em hemodiálise; fatores que afetam a segurança do paciente em hemodiálise e estratégias para a segurança do paciente em hemodiálise. Conclusão: torna-se importante que a equipe da hemodiálise aprofunde os seus conhecimentos acerca da segurança do paciente para atuar, de forma proativa, na prevenção de eventos adversos garantindo, assim, a segurança do paciente e uma melhor qualidade de vida ao paciente com doença renal crônica em tratamento hemodialítico. Descritores: Segurança do Paciente; Enfermagem; Diálise Renal; Cuidados de Enfermagem; Enfermagem em Nefrologia; Avaliação em Enfermagem.ABSTRACT Objective: to analyze the literature on the safety of patients on hemodialysis. Method: this is a bibliographical, descriptive study, of integrative review type, through research in articles published between the years 2006 to 2016, in Portuguese, English or Spanish; collected in the databases Medline, Lilacs, BDENF and SciELO Virtual Library and the results presented in figure. Results: the sample of this study was composed by six articles. The information after article analysis was grouped into three categories: patient safety on hemodialysis; factors that affect patient safety on hemodialysis and strategies for patient safety on hemodialysis. Conclusion: it is important that the hemodialysis team deepens their knowledge about patient safety to proactively act in the prevention of adverse events, thus ensuring patient safety and a better quality of life for patients with illness renal disease on hemodialysis. Descriptors: Patient Safety; Nursing; Renal Dyalisis; Nursing Care; Nephrology Nursing; Nursing Assessment.RESUMEN Objetivo: analizar la literatura acerca de la seguridad del paciente en hemodiálisis. Método: se trata de un estudio bibliográfico y descriptivo, revisión de tipo integrador, a través de los artículos de investigación publicados entre 2006 a 2016, en portugués, Inglés o Español; recogidos en las bases de datos Medline, Lilacs, BDENF y Biblioteca Virtual SciELO y los resultados presentados en figura. Resultados: se compuso la muestra de este estudio por seis artículos. Se agruparon las informaciones después del análisis de los artículos, en tres categorías: seguridad del paciente en hemodiálisis; factores que afectan la seguridad del paciente en hemodiálisis y estrategias para la seguridad del paciente en hemodiálisis. Conclusión: es importante que el equipo de la hemodiálisis profundice sus conocimientos acerca de la seguridad del paciente para actuar de forma proactiva en la prevención de eventos adversos garantizando así la seguridad del paciente y una mejor calidad de vida al paciente con enfermedad renal crónica en tratamiento hemodialítico. Descriptores: Seguridad del Paciente; Enfermería; Diálisis Renal; Atención de Enfermería; Enfermería en Nefrología; Evaluación en Enfermería.

scholarly journals Safety culture in the context of operating room: Nurses' perception regarding notification of errors/adverse events

2018 ◽  
Vol 9 (3) ◽  
pp. 40
Author(s):  
Teresa Vinagre ◽  
Rita Marques
Keyword(s):  
Patient Safety ◽  
Pilot Study ◽  
Adverse Events ◽  
Operating Room ◽  
Safety Culture ◽  
Continuous Training ◽  
Operating Room Nurses ◽  
Quantitative Descriptive ◽  
Probabilistic Sample

The notification of errors/adverse events is one of the central aspects for the quality of care and patient safety. The purpose of this pilot study is to analyse the safety culture of the operating room in relation to the errors/adverse events and their notification, in the nurses’ perception. It is a quantitative, descriptive-exploratory pilot study. A survey “Nurses’ Perception regarding Notification of Errors/Adverse Events” was applied, consisting of 8 closed questions to an intentional non-probabilistic sample consisting of 43 nurses working in the operating room of a private hospital in Lisbon. The results showed that only 51.2% of the adverse events that caused damage to patients were always notified by the nurses. Of the various adverse events occurred, 60.5% were not reported, justified by “lack of time”. There was also a negative correlation between professional experience and the frequency of error notification (p < .05). The factors referred as those that contributed most to the occurrence of errors were, pressure to work quickly (100.0%), lack of human resources (86.0%), demotivation (86.0%), professional inexperience and hourly overload (83.7%), lack of knowledge (74.4%) and communication failures (65.1%). The perception of Patient Safety was assessed by the majority of participants as “acceptable”. In conclusion, it was evident the reduced notification of adverse events in the operation room so it becomes crucial to focus on the continuous training of health professionals, as well as work on the error, to increase a safety culture with quality.

scholarly journals Patient safety initiatives in obstetrics: a rapid review

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020170 ◽  
Author(s):  
Jesmin Antony ◽  
Wasifa Zarin ◽  
Ba’ Pham ◽  
Vera Nincic ◽  
Roberta Cardoso ◽  
...  
Keyword(s):  
Patient Safety ◽  
Healthcare Providers ◽  
Audit And Feedback ◽  
Rapid Review ◽  
Secondary Outcome ◽  
Provider Education ◽  
Eligibility Criteria ◽  
Clinician Education ◽  
Study Selection ◽  
Safety Outcomes

ObjectivesThis review was commissioned by WHO, South Africa-Country office because of an exponential increase in medical litigation claims related to patient safety in obstetrical care in the country. A rapid review was conducted to examine the effectiveness of quality improvement (QI) strategies on maternal and newborn patient safety outcomes, risk of litigation and burden of associated costs.DesignA rapid review of the literature was conducted to provide decision-makers with timely evidence. Medical and legal databases (eg, MEDLINE, Embase, LexisNexis Academic, etc) and reference lists of relevant studies were searched. Two reviewers independently performed study selection, abstracted data and appraised risk of bias. Results were summarised narratively.InterventionsWe included randomised clinical trials (RCTs) of QI strategies targeting health systems (eg, team changes) and healthcare providers (eg, clinician education) to improve the safety of women and their newborns. Eligible studies were limited to trials published in English between 2004 and 2015.Primary and secondary outcome measuresRCTs reporting on patient safety outcomes (eg, stillbirths, mortality and caesarean sections), litigation claims and associated costs were included.ResultsThe search yielded 4793 citations, of which 10 RCTs met our eligibility criteria and provided information on over 500 000 participants. The results are presented by QI strategy, which varied from one study to another. Studies including provider education alone (one RCT), provider education in combination with audit and feedback (two RCTs) or clinician reminders (one RCT), as well as provider education with patient education and audit and feedback (one RCT), reported some improvements to patient safety outcomes. None of the studies reported on litigation claims or the associated costs.ConclusionsOur results suggest that provider education and other QI strategy combinations targeting healthcare providers may improve the safety of women and their newborns during childbirth.

scholarly journals Effects of health information technology on patient outcomes: a systematic review

2015 ◽  
Vol 23 (5) ◽  
pp. 1016-1036 ◽  
Author(s):  
Samantha K Brenner ◽  
Rainu Kaushal ◽  
Zachary Grinspan ◽  
Christine Joyce ◽  
Inho Kim ◽  
...  
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
Clinical Decision ◽  
Cochrane Library ◽  
Health It ◽  
Term Care ◽  
Safety Outcomes

Abstract Objective To systematically review studies assessing the effects of health information technology (health IT) on patient safety outcomes. Materials and Methods The authors employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement methods. MEDLINE, Cumulative Index to Nursing Allied Health (CINAHL), EMBASE, and Cochrane Library databases, from 2001 to June 2012, were searched. Descriptive and comparative studies were included that involved use of health IT in a clinical setting and measured effects on patient safety outcomes. Results Data on setting, subjects, information technology implemented, and type of patient safety outcomes were all abstracted. The quality of the studies was evaluated by 2 independent reviewers (scored from 0 to 10). A total of 69 studies met inclusion criteria. Quality scores ranged from 1 to 9. There were 25 (36%) studies that found benefit of health IT on direct patient safety outcomes for the primary outcome measured, 43 (62%) studies that either had non-significant or mixed findings, and 1 (1%) study for which health IT had a detrimental effect. Neither the quality of the studies nor the rate of randomized control trials performed changed over time. Most studies that demonstrated a positive benefit of health IT on direct patient safety outcomes were inpatient, single-center, and either cohort or observational trials studying clinical decision support or computerized provider order entry. Discussion and Conclusion Many areas of health IT application remain understudied and the majority of studies have non-significant or mixed findings. Our study suggests that larger, higher quality studies need to be conducted, particularly in the long-term care and ambulatory care settings.

scholarly journals The optimisation of noninvasive ventilation in amyotrophic lateral sclerosis: a systematic review

2019 ◽  
Vol 54 (3) ◽  
pp. 1900261 ◽  
Author(s):  
David O'Brien ◽  
Theocharis Stavroulakis ◽  
Susan Baxter ◽  
Paul Norman ◽  
Stephen Bianchi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Amyotrophic Lateral Sclerosis ◽  
Noninvasive Ventilation ◽  
Grey Literature ◽  
Multidisciplinary Care ◽  
Future Research ◽  
Eligibility Criteria ◽  
Respiratory Management ◽  
Lateral Sclerosis

BackgroundNoninvasive ventilation (NIV) prolongs survival and quality of life in amyotrophic lateral sclerosis (ALS); however, its benefits depend upon the optimisation of both ventilation and adherence. We aimed to identify factors associated with effective initiation and ongoing use of NIV in ALS to develop evidence-based guidance and identify areas for further research.MethodsWe searched 11 electronic databases (January 1998 to May 2018) for all types of quantitative and qualitative studies. Supplementary grey literature searches were conducted. Records were screened against eligibility criteria, data were extracted from included studies and risk of bias was assessed. We present findings using a narrative synthesis.ResultsWe screened 2430 unique records and included 52 quantitative and six qualitative papers. Factors reported to be associated with NIV optimisation included coordinated multidisciplinary care, place of initiation, selection of interfaces, ventilator modes and settings appropriate for the individual patient, and adequate secretion management. The literature indicated that patients with significant bulbar dysfunction can still derive considerable benefit from NIV if their needs are met. Research emphasises that obstructive airway events, mask leak and uncontrolled secretions should be addressed by adjustments to the interface and machine settings, and the concomitant use of cough augmentation.ConclusionThis review highlights that NIV optimisation requires an individualised approach to respiratory management tailored to the differing needs of each patient. Ultimately, this should lead to improved survival and quality of life. This review expands on recommendations in current international guidelines for NIV use in ALS and identifies areas for future research.

scholarly journals Effectiveness of interventions for the prevention of occupational violence against professionals in health services: a protocol for a systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036558
Author(s):  
Caroline Vieira Cláudio Okubo ◽  
Renata Cristina Campos Pereira Silveira ◽  
Maria José Quina Galdino ◽  
Daiane Rubinato Fernandes ◽  
Aline Aparecida Oliveira Moreira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Cochrane Review ◽  
Health Sector ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Occupational Violence

IntroductionOccupational violence affects several categories of workers; however, the health sector category has been considered at a high risk, exposing workers to physical and psychological abuse. Thus, occupational violence has decreased the quality of care in health service. This review aims to evaluate the effectiveness of interventions for the prevention and reduction of occupational violence against health professionals.Methods and analysisThis protocol is consistent with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Searches will be conducted in PubMed, Embase, Cochrane Library, LILACS, Web of Science, Scopus, CINAHL and LIVIVO along with a comprehensive review of grey literature. The search will be conducted on August 1 st 2020, without language and time restrictions. Following the eligibility criteria, two independent reviewers will select the titles and abstracts and subsequently screen the full articles. If necessary, a third reviewer will assess any disagreements. All references will be imported into EndNote, and any duplicates will be removed. The data will be extracted using an extraction-based form from Cochrane. Statistical analyses will be performed using the software Cochrane Review Manager, and a meta-analysis will be performed if possible for the statistical combination of at least two studies. The risk of bias of the randomised clinical trials will be evaluated by the Risk of Bias tool from Cochrane, and the risk of bias of the non-randomised intervention studies will be evaluated using the Downs and Black scale. The quality of the evidence and strength of the classification recommendations will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation.Ethics and disseminationThis review will not evaluate individual patient information and therefore does not require ethical approval. The results will be disseminated through publications in peer-reviewed journals, presentations at conferences and the doctoral thesis of the leading author.PROSPERO registration numberCRD42018111383.

scholarly journals Nurses’ Perceptions on the Implementation of a Safe Drug Administration Protocol and Its Effect on Error Notification

2021 ◽  
Vol 18 (7) ◽  
pp. 3718
Author(s):  
Francisco Miguel Escandell-Rico ◽  
Juana Perpiñá-Galvañ ◽  
Lucía Pérez-Fernández ◽  
Ángela Sanjuán-Quiles ◽  
Piedras Albas Gómez-Beltrán ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Adverse Events ◽  
Intervention Group ◽  
Surgical Units ◽  
Event Notification ◽  
The Mean ◽  
Nurses Perceptions ◽  
Administration Protocol

Patient safety and quality of care are fundamental pillars in the health policies of various governments and international organizations. The purpose of this study is to evaluate nurses’ perceptions on the degree of implementation of a protocol for the standardization of care and to measure its influence on notification of adverse events related to the administration of medications. This comparative study used data obtained from questionnaires completed by 180 nurses from medical and surgical units. Our analyses included analysis of variance and regression models. We observe that the responses changed unevenly over time in each group, finding significant differences in all comparisons. The mean response rating was increased at 6 months in the intervention group, and this level was maintained at 12 months. With the new protocol, a total of 246 adverse events and 481 incidents without harm was reported. Thus, actions such as the use of protocols and event notification systems should be implemented to improve quality of care and patient safety.

scholarly journals Adverse events in psychiatry: a national cohort study in Sweden with a unique psychiatric trigger tool

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lena Nilsson ◽  
Madeleine Borgstedt-Risberg ◽  
Charlotta Brunner ◽  
Ullakarin Nyberg ◽  
Urban Nylén ◽  
...  
Keyword(s):  
Patient Safety ◽  
Cohort Study ◽  
Adverse Events ◽  
Psychiatric Care ◽  
Treatment Plan ◽  
Age Groups ◽  
Trigger Tool ◽  
Safety Research ◽  
National Cohort

Abstract Background The vast majority of patient safety research has focused on somatic health care. Although specific adverse events (AEs) within psychiatric healthcare have been explored, the overall level and nature of AEs is sparsely investigated. Methods Cohort study using a retrospective record review based on a two-step trigger tool methodology in the charts of randomly selected patients 18 years or older admitted to the psychiatric acute care departments in all Swedish regions from January 1 to June 30, 2017. Hospital care together with corresponding outpatient care were reviewed as a continuum, over a maximum of 3 months. The AEs were categorised according to type, severity and preventability. Results In total, the medical records of 2552 patients were reviewed. Among the patients, 50.4% were women and 49.6% were men. The median (range) age was 44 (18–97) years for women and 44.5 (18–93) years for men. In 438 of the reviewed records, 720 AEs were identified, corresponding to the AEs identified in 17.2% [95% confidence interval, 15.7–18.6] of the records. The majority of AEs resulted in less or moderate harm, and 46.2% were considered preventable. Prolonged disease progression and deliberate self-harm were the most common types of AEs. AEs were significantly more common in women (21.5%) than in men (12.7%) but showed no difference between age groups. Severe or catastrophic harm was found in 2.3% of the records, and the majority affected were women (61%). Triggers pointing at deficient quality of care were found in 78% of the records, with the absence of a treatment plan being the most common. Conclusions AEs are common in psychiatric care. Aside from further patient safety work, systematic interventions are also warranted to improve the quality of psychiatric care.

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