scholarly journals Patient safety challenges in primary health care: a scoping review

2020 ◽  
Vol 73 (5) ◽  
Author(s):  
Carlise Rigon Dalla Nora ◽  
Mariur Gomes Beghetto

ABSTRACT Objectives: to identify the patient safety challenges described by health professionals in Primary Health Care. Methods: a scoping review was conducted on the LILACS, MEDLINE, IBECS, BDENF, and CINAHL databases, and on the Cochrane, SciELO, Pubmed, and Web of Science libraries in January 2019. Original articles on patient safety in the context of Primary Health Care by health professionals were included. Results: the review included 26 studies published between 2002 and 2019. Four categories resulted from the analysis: challenges of health professionals, administration challenges of health services, challenges with the patient and family, and the potential enhancing resources for patient safety. Conclusions: patient safety challenges for Primary Care professionals are multiple and complex. This study provides insight into resources to improve patient safety for health care professionals, patients, administrators, policy makers, educators, and researchers.

2020 ◽  
Vol 37 (6) ◽  
pp. 821-827
Author(s):  
Maria J Serrano-Ripoll ◽  
Joana Ripoll ◽  
Erica Briones-Vozmediano ◽  
Joan Llobera ◽  
Maria A Fiol-deRoque ◽  
...  

Abstract Background Patient feedback interventions are receiving increasing attention given their potential to improve health care provision. However, primary health care (PHC) professionals’ acceptability and perceived utility of this type of interventions remain largely unexplored. Objectives The aim of this study was to explore PHC professionals’ perceptions, opinions and suggestions about a patient feedback intervention currently being designed to improve patient safety in Spanish PHC centres. Methods We conducted an exploratory qualitative study with 43 PHC professionals. Information was obtained from three semi-structured interviews and four focus groups. All data were audio-recorded, transcribed and analyzed using content analysis by three analysts. Results The patient feedback intervention was acceptable to health care professionals, who perceived it as a useful strategy to improve health care processes and activate patients. A number of factors potentially limiting the acceptability and perceived utility of the intervention were identified (low patient safety culture, low patient-centred care orientation and limited credibility of patient feedback data). Recommendations for designing and implementing the proposed intervention in the Spanish PHC centres were identified in relation to the following areas: ‘collection and analysis of feedback data’; ‘feedback display’; ‘feedback delivery’ and; ‘implementation of safety improvement initiatives’. Conclusions Although the proposed intervention was generally perceived as useful and acceptable, our study identified a number of tensions about the practical aspects of using the patient-reported data and the credibility of the data and what actions would arise from its use. The intervention has been adapted to address these tensions before its formal evaluation in a randomized clinical trial.


2021 ◽  
Vol 36 (3) ◽  
pp. 362-369
Author(s):  
Katie A. Willson ◽  
Gerard J. FitzGerald ◽  
David Lim

AbstractObjective:This scoping review aims to map the roles of rural and remote primary health care professionals (PHCPs) during disasters.Introduction:Disasters can have catastrophic impacts on society and are broadly classified into natural events, man-made incidents, or a mixture of both. The PHCPs working in rural and remote communities face additional challenges when dealing with disasters and have significant roles during the Prevention, Preparedness, Response, and Recovery (PPRR) stages of disaster management.Methods:A Johanna Briggs Institute (JBI) scoping review methodology was utilized, and the search was conducted over seven electronic databases according to a priori protocol.Results:Forty-one papers were included and sixty-one roles were identified across the four stages of disaster management. The majority of disasters described within the literature were natural events and pandemics. Before a disaster occurs, PHCPs can build individual resilience through education. As recognized and respected leaders within their community, PHCPs are invaluable in assisting with disaster preparedness through being involved in organizations’ planning policies and contributing to natural disaster and pandemic surveillance. Key roles during the response stage include accommodating patient surge, triage, maintaining the health of the remaining population, instituting infection control, and ensuring a team-based approach to mental health care during the disaster. In the aftermath and recovery stage, rural and remote PHCPs provide long-term follow up, assisting patients in accessing post-disaster support including delivery of mental health care.Conclusion:Rural and remote PHCPs play significant roles within their community throughout the continuum of disaster management. As a consequence of their flexible scope of practice, PHCPs are well-placed to be involved during all stages of disaster, from building of community resilience and contributing to early alert of pandemics, to participating in the direct response when a disaster occurs and leading the way to recovery.


2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Franziska Maria Keller ◽  
Christina Derksen ◽  
Lukas Kötting ◽  
Martina Schmiedhofer ◽  
Sonia Lippke

Abstract Background Patient-centered care and patient involvement have been increasingly recognized as crucial elements of patient safety. However, patient safety has rarely been evaluated from the patient perspective with a quantitative approach aiming at making patient safety and preventable adverse events measurable. Objectives The objectives of this study were to develop and evaluate the psychometric properties of a questionnaire assessing patient safety by perceived triggers of preventable adverse events among patients in primary health-care settings while considering mental health. Methods Two hundred and ten participants were recruited through various digital and print channels and asked to complete an online survey between November 2019 and April 2020. Exploratory factor analysis was performed to identify domains of triggers of preventable adverse events affecting patient safety. Furthermore, a multi-trait scaling analysis was performed to evaluate internal reliability as well as item-scale convergent–discriminant validity. A multivariate analysis of covariance evaluated whether individuals below and above the symptom threshold for depression and generalized anxiety perceive triggers of preventable adverse events differently. Results The five factors determined were information and communication with patients, time constraints of health-care professionals, diagnosis and treatment, hygiene and communication among health-care professionals, and knowledge and operational procedures. The questionnaire demonstrated a good total and subscale internal consistency (α = 0.90, range = 0.75–0.88), good item-scale convergent validity with significant correlations between 0.57 and 0.78 (P < 0.05; P < 0.01) for all items with their associated subscales, and satisfactory item-scale discriminant validity between 0.14 and 0.55 (P > 0.05) with no significant correlations between the items and their competing subscales. The questionnaire further revealed to be a generic measure irrespective of patients’ mental health status. Patients older than 50 years of age perceived a significantly greater threat to their own safety compared to patients below that age. Conclusion The developed Perceptions of Preventable Adverse Events Assessment Tool (PPAEAT) exhibits good psychometric properties, which supports its use in future research and primary health-care practice. Further validation of the PPAEAT in different settings, languages and larger samples is needed. The results of this study need to be considered when assessing patient safety in the context of health-care research.


Medicina ◽  
2009 ◽  
Vol 45 (3) ◽  
pp. 238 ◽  
Author(s):  
Giedra Levinienė ◽  
Aušra Petrauskienė ◽  
Eglė Tamulevičienė ◽  
Jolanta Kudzytė ◽  
Liutauras Labanauskas

The objective of this study was to evaluate the knowledge and activities of Kaunas primary health care center professionals in promoting breast-feeding. Material and methods. A total of 84 general practitioners and 52 nurses participated in the survey, which was carried out in Kaunas primary health care centers in 2006. Data were gathered from the anonymous questionnaire. Results. Less than half of general practitioners (45.1%) and 65% of nurses were convinced that baby must be exclusively breast-fed until the age of 6 months, but only 21.6% of general practitioners and 27.5% of nurses knew that breast-feeding with complementary feeding should be continued until the age of 2 years and longer. Still 15.7% of general practitioners and 25% of nurses recommended pacifiers; 7.8% of general practitioners advised to breast-feed according to hours. Half of the health professionals recommended additional drinks between meals; onethird of them – to give complementary food for the babies before the age of 6 months. One-third (29.6%) of the health professionals surveyed recommended mothers to feed their babies more frequently in case the amount of breast milk decreased. Conclusions. The survey showed that knowledge of medical personnel in primary health care centers about the advantages of breast-feeding, prophylaxis of hypogalactia, and duration of breast-feeding was still insufficient.


2021 ◽  
Vol 31 (4) ◽  
Author(s):  
Marcelo Pereira da Rocha ◽  
Ingrid Soares Viana ◽  
Iago Freitas Vieira

Abstract The adoption of safe practices by health services drives out health harms and preventable deaths at all levels of health care. This study aimed to understand how patient safety actions are organized in the conception of primary health care professionals in a municipality in the state of Bahia. exploratory research, with a qualitative approach, was performed through in person and online interviews with two Nurses and three Dental Surgeons, with broad knowledge of the researched matter and working in traditional primary care and Family Health teams. Data were analyzed through content analysis. It was perceived that knowledge of the researched topic was insufficient and that there was a need for the matter to become part of the teams’ discussion agenda. The reports point out that, in the interviewees’ view, actions related to patient safety are not yet implemented in the researched location. It was identified the need for structuring actions aimed at preventing adverse events and institutionalizing safety in health care.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Sousa ◽  
C Wallace ◽  
J Farmer ◽  
F J Herkrath ◽  
A Bousquat

Abstract Background The Amazon region crosses the territorial borders of nine countries with a vast complexity of ecological and social relations. Outside of large and medium cities, this region comprises a mosaic of ranches, villages, farms, isolated houses and small towns scattered over a vast territory, in large part accessed only by waterway. Working with health in this region requires specific strategies that respect the dynamics of this place. This research aimed to reveal the challenges and innovations of Primary Health Care (PHC) in places outside the largest cities in the Amazon. Methods The scoping review methodology was applied to peer-reviewed articles. Six databases were searched to identify scientific papers published in English, Spanish and Portuguese between January 2000 and November 2019. The analytical strategy was to combine descriptive statistics and qualitative content analysis to extract from each article all the content related to the research questions. Results This review included 26 papers. The most frequent challenges reported in the studies were related to the way of working (8), specific training for professionals (5), leadership and governance (4) and infrastructure improvement (2). A smaller number of studies were dedicated to innovative experiences, which approached training and methodologies for health agents recruited in the communities (4), technologies to the services (2) and a river unit as a model to work in Amazon(1). Conclusions The challenges presented in this review indicate the need to build services that are more sensitive to Amazonian locations and the need to train professionals for this region. Also, it revealed innovations with positive impacts which can be taken as key lessons regarding the functioning of PHC in the Amazon. Key messages This research fills a knowledge gap about PHC in the Amazon. The challenges and innovations presented in the review provide insights to assist PHC policy makers and managers with the design and delivery of health services in the Amazon.


2017 ◽  
Author(s):  
Ilse Catharina Sophia Swinkels ◽  
Martine Wilhelmina Johanna Huygens ◽  
Tim M Schoenmakers ◽  
Wendy Oude Nijeweme-D'Hollosy ◽  
Lex van Velsen ◽  
...  

BACKGROUND Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful during this phase. Although many studies on barriers and facilitators were published in recent years, eHealth implementation still progresses only slowly. To further unravel the slow implementation process in primary health care and accelerate the implementation of eHealth, a 3-year Living Lab project was set up. In the Living Lab, called eLabEL, patients, health care professionals, small- and medium-sized enterprises (SMEs), and research institutes collaborated to select and integrate fully mature eHealth technologies for implementation in primary health care. Seven primary health care centers, 10 SMEs, and 4 research institutes participated. OBJECTIVE This viewpoint paper aims to show the process of adoption of eHealth in primary care from the perspective of different stakeholders in a qualitative way. We provide a real-world view on how such a process occurs, including successes and failures related to the different perspectives. METHODS Reflective and process-based notes from all meetings of the project partners, interview data, and data of focus groups were analyzed systematically using four theoretical models to study the adoption of eHealth in primary care. RESULTS The results showed that large-scale implementation of eHealth depends on the efforts of and interaction and collaboration among 4 groups of stakeholders: patients, health care professionals, SMEs, and those responsible for health care policy (health care insurers and policy makers). These stakeholders are all acting within their own contexts and with their own values and expectations. We experienced that patients reported expected benefits regarding the use of eHealth for self-management purposes, and health care professionals stressed the potential benefits of eHealth and were interested in using eHealth to distinguish themselves from other care organizations. In addition, eHealth entrepreneurs valued the collaboration among SMEs as they were not big enough to enter the health care market on their own and valued the collaboration with research institutes. Furthermore, health care insurers and policy makers shared the ambition and need for the development and implementation of an integrated eHealth infrastructure. CONCLUSIONS For optimal and sustainable use of eHealth, patients should be actively involved, primary health care professionals need to be reinforced in their management, entrepreneurs should work closely with health care professionals and patients, and the government needs to focus on new health care models stimulating innovations. Only when all these parties act together, starting in local communities with a small range of eHealth tools, the potential of eHealth will be enforced.


2021 ◽  
Vol 74 (suppl 2) ◽  
Author(s):  
Miriam Fernanda Sanches Alarcon ◽  
Daniela Garcia Damaceno ◽  
Bruna Carvalho Cardoso ◽  
Luzmarina Aparecida Doretto Braccialli ◽  
Viviane Boacnin Yoneda Sponchiado ◽  
...  

ABSTRACT Objective: to analyze the actions and suggestions of Primary Care professionals in relation to elder abuse. Method: this is a research with a qualitative approach based on the realization of focus groups with professionals from Primary Health Care in a city in the interior of São Paulo. The methodological stance of Hermeneutic-Dialectic thinking (HD) was adopted. Results: two themes were listed: Actions taken by health professionals and Suggestions for improving care for elderly victims of violence. Final considerations: professionals emphasized the need to implement new resources and improve the functioning of existing ones, so that comprehensive care is possible, in order to prevent and intervene in the important social and public health problem that violence represents.


2018 ◽  
Author(s):  
Francesc X Marin-Gomez ◽  
Francesc Garcia Cuyas ◽  
Ramon Reig-Bolano ◽  
Jacobo Mendioroz ◽  
Pere Roura-Poch ◽  
...  

BACKGROUND Several studies have been conducted to analyze the role social networks play in communication between patients and health professionals. However, there is a shortage of studies in relation to communication among primary health professionals, in a professional context, using the various mobile phone apps available. OBJECTIVE The objective of our study was to explore mobile phone social networking app use among primary health care professionals for work-related purposes, by comparing the most widely used apps in the market. METHODS We undertook a cross-sectional study using an anonymous Web survey among a convenience sample of 1635 primary health care professionals during August and September 2017. RESULTS Of 483 participants in the survey, 474 (98.1%, 95% CI 97.1%-99.4%) were health professionals who commonly accessed social networking sites and 362 (74.9%, 95% CI 71.1%-78.8%) accessed the sites in a work-related context. Of those 362 respondents, 219 (96.7%, 95% CI 94.8%-98.5%) preferred WhatsApp for both personal and professional uses. Of the 362 respondents who used social networking sites in a work-related context, 276 (76.2%, 95% CI 71.9%-80.6%) rated social networking sites as useful or very useful to solve clinical problems, 261 (72.1%, 95% CI 67.5%-76.7%) to improve their professional knowledge, and 254 (70.2%, 95% CI 65.5%-74.9%) to speed up the transmission of clinical information. Most of them (338/362, 94.8%, 95% CI 92.5%-97.0%) used social networking sites for interprofessional communications, and 204 of 362 (56.4%, 95% CI 51.2%-61.5%) used them for pharmacological-related consultations. CONCLUSIONS Health professionals frequently accessed social networking sites using their mobile phones and often for work-related issues. This trend suggests that social networking sites may be useful tools in primary care settings, but we need to ensure the security of the data transfer process to make sure that social networking sites are used appropriately. Health institutions need to increase information and training activities to ensure the correct use of these tools.


2021 ◽  
Vol 28 (98) ◽  
pp. 519-548
Author(s):  
Lucas Maia dos Santos ◽  
Márcio Augusto Gonçalves

Abstract This study aimed to examine and describe the perceptions of health professionals and managers about the main phenomena that influence resource allocation in primary health care. Adopting a qualitative approach, the field research was carried out in ten municipalities in Minas Gerais and involved eleven focus groups, six interviews and two semi-structured questionnaires in 2014 and 2015, and nine focus groups and five interviews in 2018, in which participated a total of 133 health professionals and managers. Other sources of evidence were also included, such as non-participating observations, photographs and documents from the Minas Gerais State Health Secretariat and the Ministry of Health. Based on the content analysis, eight categories of phenomena that influence resource allocation in PHC were obtained, derived from daily interactions between the population and health professionals and managers. Our findings show that primary health care is in a process of institutional change, dependent on the validity of actors and institutions, at different institutional levels. Among the determining factors affecting resource allocation in PHC, the main ones are the agency of the actors involved, the health service flow, the private sector, the medical corporatism, the influence of politicians, the municipal management capability, the infrastructure and groups of specific individuals.


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