scholarly journals Implementation of Evidence-Based Patient Safety Practices: 4-Years’ Follow-up of a Nationwide Regulatory Intervention in Brazilian Hospitals

2022 ◽  
Author(s):  
Magda Machado de Miranda Costa ◽  
Heiko Thereza Santana ◽  
André Anderson de Carvalho ◽  
Ana Clara Ribeiro Bello dos Santos ◽  
Cleide Felicia de Mesquita Ribeiro ◽  
...  
Keyword(s):  
Patient Safety ◽  
Low Cost ◽  
Implementation Process ◽  
Evidence Based ◽  
Good Tool ◽  
Cross Sectional ◽  
Safety Practices ◽  
Process Indicators ◽  
Regulatory Interventions ◽  
Regulatory Intervention

Abstract Background: Regulatory interventions are widely recommended to improve the quality of health services, but there are few studies on the possible models and their effects. The aim of this study is to describe the implementation process and analyse the results of a nationwide regulatory intervention for the implementation of patient safety practices.Methods: Four nationwide annual cross-sectional assessments were conducted in Brazilian hospitals with Intensive Care Unit beds. The participants involved all facilities operating during 2016-2019 (average N=1,989). The regulatory intervention theory aimed to increase adherence to safe evidence-based practices through national annual assessment involving a set of 21 validated structure and process indicators related to patient safety practices. At moment 1(Risk assessment), data were collected to classify hospitals according to the risk. In the sequence, the Sanitary Surveillance Centers (VISAS) carried out the analysis of the information sent by the hospitals. VISAS classified services into three groups according to compliance with the composite adherence indicator: High (67-100%); Medium (34-66%); and Low Compliance (0-33%). Moment 2 (Risk management) used responsive actions according to the hospital’s classification. Results: The intervention resulted in six annual cyclic stages and, between 2016-2019, 782 (40.1%), 980 (49.0%), 1,093 (54.3%) and 1,255 (61.8%) hospitals participated, respectively. 17 of the 20 indicators with at least two measurements had a significant improvement after national interventions (p<0.05). The overall percentage of compliance increased from 70.7 to 84.1 (p<0.001) and the percentage of hospitals with high compliance increased from 59.1 to 83.0 (p<0.001).Conclusion: The regulatory intervention used was a good tool to strengthen the information system and government actions to promote patient safety. The set of low-cost interventions seems to be useful to prioritise hospitals at higher risk and to induce responsive measures to implement patient safety practices in the evaluated context, promoting the efficiency of the regulatory process.

scholarly journals Exploring Safety Aspects in Dental School Clinics Including Droplet Infection Prevention

2020 ◽  
Vol 8 (E) ◽  
pp. 509-515
Author(s):  
Asmaa Abdelnaby ◽  
Laila Mahmoud Kamel ◽  
Jylan Elguindy ◽  
Reham Yousri Elamir ◽  
Eman Elfar
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Infection Control ◽  
Dental Health ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Safety Practices ◽  
Preparedness Plan ◽  
Dental Schools

BACKGROUND: Health-care safety focuses on improving patient’s and worker’s safety in a safe working clinics’ environment and prevent infection transmission including droplet infections as seasonal influenza and novel coronavirus (COVID-19). Dental health-care personnel (DHCP) are the target of safety measures and are themselves responsible for elimination of preventable harm. Dental schools are expected to demonstrate the model for quality safe care. AIM: This study aims to achieve high-quality safe dental care at dental clinics, Faculty of Dentistry, Cairo University. METHODS: A cross-sectional survey study was conducted at two Dental Outpatient Clinics, Cairo University. Disk review of policies, observation checklists for practices and awareness questionnaires of DHCP were used. RESULTS: DHCP showed good awareness for most of infection control (IC) and X-ray safety items. However, there are no policies or procedures to control droplet infections in the clinics. The clinics were closed in the current COVID-19 pandemic. There were poor patient safety practices, hand hygiene compliance, and personal protective equipment (PPE) use except for protecting clothes and disposable gloves. Students showed better compliance for patient safety guidelines. Other safety policies were poorly communicated. CONCLUSION: There should be preparedness plan to deal with any droplet infection outbreak, epidemic or pandemic as COVID-19 in all dental settings. There is a need to initiate dental safety unit in dental schools to implement, communicate, train, and supervise all dental safety practices including infection control.

scholarly journals Making implementation programmes better.  Mixed-m​ethods case study of an implementation process for two evidence-based brief psychotherapies

2021 ◽  
Author(s):  
Lars H. Lindholm ◽  
Jorma Komulainen ◽  
Antero Lassila ◽  
Olli Kampman
Keyword(s):  
Mixed Methods ◽  
Scale Up ◽  
Implementation Process ◽  
Hybrid Design ◽  
Evidence Based ◽  
Clinical Practices ◽  
Cross Sectional ◽  
Implementation Outcomes ◽  
Evidence Based Treatments ◽  
Case Consultation

Abstract Background The Ostrobothnia Depression Programme (ODP) had a hybrid-design incorporating an implementation programme for two evidence-based treatments (EBTs), behavioural activation and motivational interviewing, and a study on their effectiveness. It was carried out regionally in secondary psychiatric care in a Finnish district. We evaluated the ODP through a mixed-methods analysis to extract organization- and programme-related knowledge to make future programmes more effective in terms of sustaining and scaling up the desired programme outcomes. Methods A cross-sectional mixed-methods survey was conducted with the programme addressees 4-5 months after the end of the ODP. The realization of case consultation groups analysed further by interviewing those responsible for them and making use of attendance lists. Results Out of 72 original programme addressees 33 completed the survey. The results showed that the ODP succeeded in initiating the desired change in clinical practices. Case consultations and training videos intended as reinforcers were underutilized. Deficits in the implementation plan and the hybrid design of the ODP jeopardized the maintenance of the implementation outcomes in the long term. Conclusions We discuss our results in light of the Normalization Process Theory (NPT) related sub-processes ‘implementation’, ‘embedding’ and ‘integration’. The complete training intervention in the target EBTs should comprise both workshops and non-optional case consultations. Access to case consultations should be made as convenient as possible. Means to decentralize the clinical support in everyday work should be elaborated in collaboration with the teams. Coaching team leaders to employ evidence-based active managerial practices that are connected e.g. to the concept of ‘transformational leadership’ would likely be fruitful. The original programme plan should be checked for means to sustain and scale up the implementation outcomes after the active programme phase.

Sources of Information About Gestational Weight Gain, Diet, and Exercise Among Brazilian Immigrant Women Living in the United States: A Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Ana Cristina Lindsay ◽  
Qun Le ◽  
Denise Lima Nogueira ◽  
Márcia Maria Tavares Machado ◽  
Mary L. Greaney
Keyword(s):  
United States ◽  
Immigrant Women ◽  
Low Cost ◽  
The United States ◽  
Easy Access ◽  
The Internet ◽  
Evidence Based ◽  
Cross Sectional ◽  
Diet And Exercise ◽  
First Time

BACKGROUND Background: Gestational weight gain (GWG) has been identified as one of the most important modifiable risk factors associated with short- and long-term health outcomes for both a woman and her newborn. Adoption of healthy lifestyles (e.g., diet, physical activity, etc.) during pregnancy has the potential to prevent excess GWG and reduce adverse health risks in pregnancy and beyond. Pregnant women’s access to accurate and evidence-based information about GWG, diet, and physical activity is key to promoting healthy GWG. Conclusions: To our knowledge currently no mHealth interventions are available in the United States for pregnant Brazilian immigrant women. The fact that women in our study were actively seeking information about GWG, diet, and exercise in the Internet suggests the potential for mHealth interventions to deliver linguistic and culturally tailored evidence-based information incorporating behavioral change practices through a low-cost, easy access method to this growing immigrant population in the United States. OBJECTIVE Objective: This study sought to assess sources used by first-time pregnant Brazilian women to seek information about GWG, diet, and exercise during pregnancy. METHODS Methods: Cross-sectional survey of first-time pregnant Brazilian women living in Massachusetts, United States. RESULTS Results: Eighty-six women participated in the study. The majority of the women were born in Brazil (96.5%; n = 83) and had lived in the United States for an average of 10.7 years (SD = 7.3). All women reported Portuguese as their primary language and 67.4% (n = 58) were classified as having low acculturation levels. The mean gestation was 27.5 weeks (SD = 5.6; range 14 – 38 weeks) and 25.6% (n = 22) self-reported being overweight pre-pregnancy. Overall, about two-thirds of the women had actively sought information about GWG (72.1%, n = 62), diet (79.1%, n = 68), and exercise (74.4%, n = 64) on the Internet during pregnancy. Adjusting for age, women who were classified as having low acculturation levels were more likely to seek information about GWG on the Internet (OR = 5.35 [CI: 1.08 – 26.50]; p = 0.04) compared to women who were classified as having high acculturation levels. Moreover, approximately 67% (n = 59), 71% (n = 61), and 52% (n = 45) of the women reported actively seeking information about GWG, diet, and exercise from family and friends, respectively. Women who self-reported being overweight pre-pregnancy were more likely to report seeking information about GWG (OR=2.94 [CI:1.07–8.06], p = 0.04) and less likely to report seeking information about diet (OR=0.27 [0.09–0.75], p = 0.01) and exercise (OR=0.30 [CI: 0.11–0.86], p = 0.02) from family and friends compared to women who self-reported normal weight pre-pregnancy. CONCLUSIONS Conclusions: To our knowledge currently no mHealth interventions are available in the United States for pregnant Brazilian immigrant women. The fact that women in our study were actively seeking information about GWG, diet, and exercise on the Internet suggests the potential for mHealth interventions to deliver linguistic and culturally tailored evidence-based information incorporating behavioral change practices through a low-cost, easy access method to this growing immigrant population in the United States.

scholarly journals Monitoring strategies on patient safety practices among healthcare providers at Nakuru county referral hospital, Kenya

2020 ◽  
Vol 7 (8) ◽  
pp. 2938
Author(s):  
Fancy J. Kipkech ◽  
Stanley M. Makindi ◽  
Joseph Juma
Keyword(s):  
Patient Safety ◽  
Clinical Care ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Referral Hospital ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Safety Practices ◽  
Monitoring Strategies

Background: Quality care is achieved through combined efforts which include integration of all the components within the healthcare delivery system. Patient safety is one of the dimensions of enhancing quality healthcare. It involves increasing the awareness about the errors made due to human factors in the process of delivering healthcare services that may lead to harm and other adverse effects.Methods: This study was on assessment of monitoring strategies on patient safety practices among healthcare providers at Nakuru County Referral Hospital, Kenya. The study was anchored on Donabedian model for assessment of quality of care. The study design was a descriptive cross-sectional study. The sampling technique was purposive, stratified random sampling and proportionate with a sample size of 310 healthcare providers drawn from various departments. Data collection tools were questionnaire, interview schedule and observational checklist. Quantitative data was analysed using descriptive statistics (mean, mode and standard deviation).Results: The results of the study indicated and concluded that there is adherence to standardized clinical care protocols and guidelines as well as continuous and constant surveillance with clear assessments and evaluation of patient safety practices, accurate collection, storage, analysis and sharing of information on patient safety issues.Conclusions: The paper recommends the need for policy reviews on healthcare so as to ensure that patient safety issues are reviewed so as to mitigate risks in handling patients. There is need to establish clear guidelines on monitoring and evaluation standards of patient safety practices.

Fakor Determinan yang Memengaruhi Budaya Keselamatan Pasien di RS Pemerintah Kabupaten Kuningan

1970 ◽  
Vol 4 (2) ◽  
Author(s):  
Lia Mulyati ◽  
Dedy Rachman ◽  
Yana Herdiana
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Work Satisfaction ◽  
Patient Safety Culture ◽  
Team Work ◽  
Chi Square ◽  
Cross Sectional ◽  
Work Related Stress ◽  
Work Related ◽  
Related Stress

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.

Penanganan Issu Terkait Keselamatan Pasien di Rumah Sakit

2020 ◽  
Author(s):  
Kristin Natal Riang Gea
Keyword(s):  
Patient Safety ◽  
Health Workers ◽  
Sampling Technique ◽  
Good Health ◽  
Bivariate Analysis ◽  
P Value ◽  
Patient Identification ◽  
Cross Sectional ◽  
The Right ◽  
The Relationship

AbstrakKeselamatan pasien merupakan dasar dari pelayanan kesehatan yang baik. Pengetahuan tenaga kesehatan dalam sasaran keselamatan pasien terdiri dari ketepatan identifikasi pasien, peningkatan komunikasi yang efektif, peningkatan keamanan obat yang perlu diwaspadai, kepastian tepat lokasi, prosedur, dan tepat pasien operasi, pengurangan risiko infeksi, pengurangan risiko pasien jatuh. Tujuan penelitian untuk mengetahui hubungan antara pengetahuan dengan penerapan keselamatan pasien pada petugas kesehatan di Puskesmas Kedaung Wetan Kota Tangerang. Metode Penelitian menggunakan deskriptif korelasi menggunakan pendekatan cross sectional. Populasi sebanyak 50 responden. Teknik pengambilan sampel menggunakan total sampling. Instrumen yang digunakan berupa lembar kuesioner. Teknik analisa diatas menggunakan analisa Univariat dan Bivariat. Hasil Penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien pada Petugas Kesehatan, dengan hasil, p value sebesar 0,013 &lt; 0,05 maka dapat disimpulkan bahwa ada Hubungan Pengetahuan dengan Penerapa Keselamatan Pasien pada Petugas Kesehatan. Kesimpulan penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien.. AbstrackPatient safety is the basis of good health services. Knowledge of health personnel in patient safety targets consists of accurate patient identification, increased effective communication, increased safety of the drug that needs to be watched, certainty in the right location, procedure, and precise patient surgery, reduction in risk of infection, reduction in risk of falling patients. The purpose of this study was to determine the relationship between knowledge and the application of patient safety to health workers in the Kedaung Wetan Health Center, Tangerang City. The research method uses descriptive correlation using cross sectional approach. The population is 50 respondents. The sampling technique uses total sampling. The instrument used was a questionnaire sheet. The analysis technique above uses Univariate and Bivariate analysis. The results of the study there is a Relationship of Knowledge with the Implementation of Patient Safety in Health Officers, with the result, p value of 0.013 &lt;0.05, it can be concluded that there is a Relationship between Knowledge and Patient Safety Implementation in Health Officers. The conclusion of the study is the Relationship between Knowledge and the Implementation of Patient Safety.Keywords Knowledge, Patient safety, Health workers

Therapeutic Aspects of Squill; An Evidence-Based Review

2020 ◽  
Vol 17 (3) ◽  
pp. 318-324 ◽  
Author(s):  
Khadije Saket ◽  
Jalil T. Afshari ◽  
Ehsan Saburi ◽  
Mahdi Yousefi ◽  
Roshanak Salari
Keyword(s):  
Side Effects ◽  
Traditional Medicine ◽  
Respiratory Diseases ◽  
Low Cost ◽  
Current Evidence ◽  
Evidence Based ◽  
Helminthic Infections ◽  
Traditional Persian Medicine ◽  
Healing Of Wounds ◽  
Bioactive Agents

From ancient times, medicinal plants have been usually utilized to treat many disorders, but today, interest in these herbs is again aroused, because of their fewer side effects and low-cost. In traditional medicine, for many diseases, various medicinal herbs have been suggested so far. Drimia maritime, also named squill, is an important medicinal plant for the treatment of many diseases, especially respiratory diseases. In the current evidence-based study, we conducted a review of the general characteristics, ingredients, administration form, and side effects of squill in traditional medicine. For this purpose, traditional Persian medicine literatures and electronic databases were examined including PubMed, Scopus, and Google Scholar. Many compounds are isolated from D.maritima, including scillaren, scillirubroside, scillarenin, and bufadienolide glycosides. Oxymel is the most commonly used form of squill for various diseases, especially respiratory diseases. Besides, squill has been used in the treatment of cardiovascular, digestive, and dermatological disorders, it is also used against various cancer cells for its antioxidant and cytotoxic properties. Moreover, there is relatively reliable evidence of its benefits for bacterial and helminthic infections, rheumatism, edema, gout, abortion induction, healing of wounds and urine induction. It seems that supplementary studies are required to explore the bioactive agents and their effective mechanisms.

Evidence-based eHealth interventions for caregivers of people with dementia (Myinlife and Partner in Balance): Evaluation of implementations in municipality contexts (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
Marjolein Elizabeth de Vugt
Keyword(s):  
Self Efficacy ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Successful Implementation ◽  
Evidence Based ◽  
Multiple Sources ◽  
Target Groups ◽  
Face To Face ◽  
People With Dementia ◽  
Implementation Context

BACKGROUND Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context to implement these interventions, due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in eight municipalities in the Euregion Meuse-Rhine. OBJECTIVE This study’s objectives were to (1.) evaluate this implementation and (2.) investigate determinants of successful implementation. METHODS This study collected eHealth usage data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials, based on the Measurement Instrument for Determinants of Implementation (MIDI). This data from multiple sources and perspectives was integrated and analysed to form a total picture of the municipality implementation process. RESULTS The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, three municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The two Partner in Balance municipalities that did not consider the implementation to be successful, viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and the target groups. Successful implementations were linked to implementer self-efficacy CONCLUSIONS The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols, as part of standard implementation materials for municipalities and organisations implementing Myinlife and Partner in Balance.

Sign in / Sign up

Export Citation Format

Share Document