scholarly journals Patient Safety Through Nursing Documentation: Barriers Identified by Healthcare Professionals and Students

2021 ◽  
Vol 3 ◽  
Author(s):  
Jorunn Bjerkan ◽  
Victor Valderaune ◽  
Rose Mari Olsen
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Information Exchange ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Elderly Care ◽  
Clinical Information ◽  
Organizational Factors ◽  
Care Practice ◽  
Patient Documentation

Background: Although access to accurate patient documentation is recognized as a prerequisite for delivering of safe and continuous municipal elderly care, healthcare professionals often fail to provide comprehensive clinical information in an accurate and timely manner. The aim of this study was to understand the perceptions of healthcare professionals and healthcare students regarding existing barriers to patient safety through the performance of documentation practices.Methods: Using a qualitative, exploratory design, this study conducted six focus group interviews with nurses and social educators (n = 12) involved in primary care practice and nursing and social educator bachelor’s degree students from a University College (n = 11). Data were analyzed using qualitative content analysis.Results: Four themes emerged from the analysis, which described barriers to patient safety and quality in documentation practices: “Individual factors,” “Social factors,” “Organizational factors,” and “Technological factors.” Each theme also included several sub-themes.Conclusion: According to the findings, several barriers negatively influenced documentation practices and information exchange, which may place primary care patients in a vulnerable and exposed situation. To achieve successful documentation, increased awareness and efforts by the individual professional are necessary. However, primary care services must facilitate the achievement of these goals by providing adequate resources, clear mission statements, and understandable policies.

scholarly journals Physician factors associated with increased risk for complaints in primary care emergency services: a case – control study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Svein Zander Bratland ◽  
Valborg Baste ◽  
Knut Steen ◽  
Esperanza Diaz ◽  
Svein Gjelstad ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Safety ◽  
Emergency Services ◽  
Medical Training ◽  
Organizational Factors ◽  
Case Control ◽  
Study Patient ◽  
Increased Risk ◽  
Patient Safety Incidents

Abstract Background Patient safety incidents defined as any unintended or unexpected incident that could have or were judged to have led to patient harm, are reported as relatively common. In this study patient complaints have been used as an indicator to uncover the occurrence of patient safety incidents in primary care emergency units (PCEUs) in Norway. Methods Ten PCEUs in major cities and rural parts of Norway participated. These units cover one third of the Norwegian population. A case-control design was applied. The case was the physician that evoked a complaint. The controls were three randomly chosen physicians from the same PCEU as the physician having evoked the complaint. The following variables regarding the physicians were chosen: gender, citizenship at, and years after authorization as physician, and specialty in general practice. The magnitude of patient contact was defined as the workload at the PCEU. The physicians’ characteristics and workload were extracted from the medical records from the fourteen-day period prior to the consultation that elicited the complaint. The rest of the variables were then obtained from the Norwegian physician position register. Logistic regression was used to estimate odds ratio for complaints both unadjusted and adjusted for the independent variables. The data were analyzed using SPSS (Version25) and STATA. Results A total of 78 cases and 217 controls were included during 18 months (September 1st 2015 till March 1st 2017). The risk of evoking a complaint was significantly higher for physicians without specialty in general practice, and lower for those with medium low and medium high workload compared to physicians with no duty during the fourteen-day period prior to the index consultation. The limited strength of the study did not make it possible to assess any correlation between workload and the other variables (physician’s gender, seniority and citizenship at time of authorization). Conclusions Continuous medical training and achieving the specialty in general practice were decisively associated with a reduced risk for complaints in primary care emergency services. Future research should focus on elements promoting quality of care such as continuing education, duty rosters and other structural and organizational factors.

OP08 Using Real World Data To Support National Postmarketing Surveillance

2018 ◽  
Vol 34 (S1) ◽  
pp. 3-3
Author(s):  
Yeqin Zuo ◽  
Bernie Mullen ◽  
Rachel Hayhurst ◽  
Karen Kaye ◽  
Renee Granger ◽  
...  
Keyword(s):  
Primary Care ◽  
Real World ◽  
National Level ◽  
Clinical Information ◽  
Health Priorities ◽  
Care Practice ◽  
Postmarketing Surveillance ◽  
Care Practices ◽  
Primary Care Practices ◽  
Tract Infections

Introduction:While medicines and medical tests are developed in a controlled clinical trial environment, postmarketing surveillance in the real world can be challenging. MedicineInsight—a database of longitudinal patient-level clinical information from primary care practices in Australia—is a novel program that collects primary care data to improve postmarketing surveillance at a national level.Methods:MedicineInsight collects de-identified clinical information from primary care practice information systems using data extraction tools. MedicineInsight currently includes 3.6 million regular patients of 3,300 family physicians (general practitioners) from 650 primary care practices across Australia. MedicineInsight data include longitudinal clinical information on diagnosis and medicines (dose, strength, route of administration, medication switches over time, adverse events, and allergies), and pathology testing data. A series of observational studies was developed for postmarketing surveillance of management of a range of health priorities including type 2 diabetes mellitus (T2DM), chronic obstructive pulmonary disease (COPD), depression, and antibiotics use.Results:Forty-four percent of patients with T2DM in the MedicineInsight database did not have a recorded hemoglobin A1c result and thirty-one percent did not have a recorded blood pressure reading in the previous 6 months. While guidelines recommend a stepwise approach to the initiation of COPD therapy, forty-nine percent of patients with COPD (with or without asthma) were prescribed dual therapy at initiation and a small number (4.5 percent) were prescribed triple therapy. Between 2011 and 2015, the annual rate of antidepressant prescribing per 1,000 family physician encounters increased by eight percent. High volumes of antibiotics were prescribed for respiratory tract infections in Australian primary care, notwithstanding guideline recommendations that antibiotics are not recommended in most cases.Conclusions:Large scale, real-world clinical data from primary care practices can play an important role in postmarketing surveillance at a national level.

Healthcare professionals’ adoption and use of a clinical information system (CIS) in primary care: Insights from the Da Vinci study

2012 ◽  
Vol 81 (2) ◽  
pp. 73-87 ◽  
Author(s):  
Isabelle Vedel ◽  
Liette Lapointe ◽  
Marie-Thérèse Lussier ◽  
Claude Richard ◽  
Johanne Goudreau ◽  
...  
Keyword(s):  
Primary Care ◽  
Information System ◽  
Healthcare Professionals ◽  
Da Vinci ◽  
Clinical Information System ◽  
Clinical Information

scholarly journals How to monitor patient safety in primary care? Healthcare professionals' views

JRSM Open ◽  
2016 ◽  
Vol 7 (8) ◽  
pp. 205427041664804 ◽  
Author(s):  
R Samra ◽  
J Car ◽  
A Majeed ◽  
C Vincent ◽  
P Aylin
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Healthcare Professionals

scholarly journals Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e020870 ◽  
Author(s):  
Rebecca Lauren Morris ◽  
Susan Jill Stocks ◽  
Rahul Alam ◽  
Sian Taylor ◽  
Carly Rolfe ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
National Survey ◽  
Healthcare Professionals ◽  
Primary Care Patient ◽  
Research Priorities ◽  
Care Patient ◽  
Nominal Group ◽  
Safety Research ◽  
Research Questions

ObjectivesTo identify the top 10 unanswered research questions for primary care patient safety research.DesignA modified nominal group technique.SettingUK.ParticipantsAnyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions.Main outcomesA top 10, and top 30, future research questions for primary care patient safety.Results443 research questions were submitted by 341 patients and 86 healthcare professionals, through a national survey. After checking for relevance and rephrasing, a total of 173 questions were collated into themes. The themes were largely focused on communication, team and system working, interfaces across primary and secondary care, medication, self-management support and technology. The questions were then prioritised through a national survey, the top 30 questions were taken forward to the final prioritisation workshop. The top 10 research questions focused on the most vulnerable in society, holistic whole-person care, safer communication and coordination between care providers, work intensity, continuity of care, suicide risk, complex care at home and confidentiality.ConclusionsThis study was the first national prioritisation exercise to identify patient and healthcare professional priorities for primary care patient safety research. The research priorities identified a range of important gaps in the existing evidence to inform everyday practice to address primary care patient safety.

scholarly journals Protocol for a non-randomised feasibility study evaluating a codesigned patient safety guide in primary care

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039752
Author(s):  
Rebecca L Morris ◽  
Kay Gallacher ◽  
Mark Hann ◽  
Carly Rolfe ◽  
Nicola Small ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Health Service ◽  
Healthcare Professionals ◽  
Patient Empowerment ◽  
Service Utilisation ◽  
Two Phase ◽  
Ethical Approval ◽  
General Practices ◽  
The Uk

IntroductionPatients and carers should be active partners in patient safety with healthcare professionals and be empowered to use personalised approaches to identify safety concerns and work together to prevent them. This protocol paper details a study to examine the feasibility of a multicomponent intervention to involve patients and/or carers in patient safety in primary care in the UK.Methods and analysisThis is a two-phase, non-randomised feasibility mixed methods pragmatic study of a patient safety guide for primary care (PSG-PC). 8 general practices will recruit 120 patient and/or carer participants. All patient and/or carer participants will receive the PSG-PC. It will examine the feasibility and acceptability of the PSG-PC in primary care settings in patients aged 18 years or older who attend appointments at general practice with health professionals four or more times per year as either patients or carers. It will identify secondary outcomes for improving patient safety, health status and patient empowerment, and reducing health service utilisation over 6 months between baseline and 6-month follow-ups. The findings will inform whether a main effectiveness trial is feasible and, if so, how it should be designed, and how many patients and practices will be needed. The study will be undertaken between January 2020 and September 2021.Ethics and disseminationEthical approval was obtained from the National Health Service London-West London and Gene Therapy Advisory Committee Research Ethics Committee (reference: 19/LO/1289). Research findings will be disseminated with participating general practices and shared in a range of different ways to engage different audiences, including presenting at international and national conferences, publishing in open-access, peer-reviewed journals and facilitating dissemination workshops within local communities with patients, carers and healthcare professionals.Trial registration numberISRCTN90222092.

scholarly journals Exploring healthcare professionals’ views of the acceptability of delivering interventions to promote healthy infant feeding practices within primary care: a qualitative interview study

2020 ◽  
pp. 1-24
Author(s):  
Elaine Toomey ◽  
Caragh Flannery ◽  
Karen Matvienko-Sikar ◽  
Ellinor K Olander ◽  
Catherine Hayes ◽  
...  
Keyword(s):  
Primary Care ◽  
Infant Feeding ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Healthy Infant ◽  
Valuable Insight ◽  
Practice Nurses ◽  
Telephone Interviews ◽  
Affective Attitude ◽  
Qualitative Interview Study

Abstract Objective: Early-life nutrition plays a key role in establishing healthy lifestyles and preventing chronic disease. This study aimed to 1) explore healthcare professionals’ (HCP) opinions on the acceptability of and factors influencing the delivery of interventions to promote healthy infant feeding behaviours within primary care, and 2) identify proposed barriers/enablers to delivering such interventions during vaccination visits, to inform the development of a childhood obesity prevention intervention. Design: A qualitative study design was employed using semi-structured telephone interviews. Data were analysed using qualitative content analysis; findings were also mapped to the Theoretical Framework of Acceptability (TFA). Setting: Primary care in Ireland Participants: 21 primary care-based HCPs: 5 practice nurses, 7 general practitioners, 3 public health nurses, 3 community dietitians and 3 community medical officers. Results: The acceptability of delivering interventions to promote healthy infant feeding within primary care is influenced by the availability of resources, HCPs’ roles and priorities, and factors relating to communication and relationships between HCPs and parents. Proposed barriers and enablers to delivering interventions within vaccination visits include; time constraints versus opportunistic access, existing relationships and trust between parents and practice nurses, and potential communication issues. Barriers/enablers mapped to TFA constructs of Affective Attitude, Perceived Effectiveness and Self-Efficacy. Conclusions: This study provides a valuable insight into HCPs perspectives of delivering prevention-focused infant feeding interventions within primary care settings. While promising, factors such as coordination and clarity of HCP roles and resource allocation need to be addressed to ensure acceptability of interventions to HCPs involved in delivery.

scholarly journals FAMILY CAREGIVER SCREENING IN PRIMARY CARE: CLINICIAN AND CAREGIVER PERSPECTIVES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S207-S207
Author(s):  
Catherine Riffin
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Qualitative Content Analysis ◽  
Care Plan ◽  
Care Practice ◽  
Community Based ◽  
Multidisciplinary Practice ◽  
Depth Interviews ◽  
Community Based Services

Abstract Despite broad appreciation of family caregivers’ relevance to older adults’ health care, few primary care-based interventions have incorporated mechanisms to facilitate systematic caregiver identification, screening, and support. Actionable knowledge regarding how such interventions may be incorporated into clinical practice is remarkably limited. This study used in-depth interviews to elucidate clinicians’ (N=25) and caregivers’ (N=20) perspectives on and suggestions for integrating caregiver screening into primary care practice. Transcripts were analyzed using qualitative content analysis. Participants emphasized the importance of tailoring the caregiver screening intervention to local circumstances and to patient and caregiver preferences. They advocated for an action-oriented approach that would link identified risks with a concrete plan for follow-up (e.g., referral to training) and outcomes relevant to the patient’s care plan. Overall, participants advised that integrating the intervention into practice would require the support of multidisciplinary practice staff, stronger connections between medical and community-based services, and appropriate reimbursement for clinicians.

Decision Aids in the United States: the Patient Response

2015 ◽  
Vol 5 (3) ◽  
pp. 105-111
Author(s):  
Richard Wexler ◽  
Bethany S. Gerstein ◽  
Charles Brackett ◽  
Lyle J. (LJ) Fagnan ◽  
Kathleen M. Fairfield ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Decision Making ◽  
Formal Education ◽  
Decision Aids ◽  
Clinical Information ◽  
The United States ◽  
Care Practice ◽  
Or Education ◽  
Patient Response

Background:  In the United States and elsewhere, a growing chorus of voices is calling for the routine use of patient decision aids (DAs) and shared decision making (SDM) in day-to-day care.  A frequently cited barrier to this approach is the belief that many patients will not be able to understand key clinical information and/or prefer to delegate decision making to providers.  These beliefs, often held by providers, are thought to be particularly applicable to elderly and less educated patients.Objectives: To test the perception that older and less educated patients will not value or benefit from DAs.Research design: Self-administered questionnaires completed by patients after viewing DAs.Subjects: 3001 patients in six primary care practice sites facing one of sixteen common medical decisions.Measures: Amount of DA viewed, knowledge about medical tests or treatments, DA rating, and importance of receiving DAs from providers.Results: Across age and education level, higher self-reported exposure to the DAs was associated with higher knowledge scores. Those over 65 and those who had not attended college had knowledge gains at least has high as those in other groups. There were no statistically significant differences by age or education in patient assessment of the importance of using DAs.Conclusions: Patients in primary care settings in the U.S. learn from DAs, rate them highly, and believe that providers should make them available in ways that are mainly independent of patient age or formal education.

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