Association of GP wellbeing and burnout with patient safety in UK primary care: a cross-sectional survey

BackgroundGPs have particularly high levels of burnout and poor wellbeing. Although both are associated with poorer safety outcomes within secondary care, there have been no quantitative studies investigating this within primary care. Furthermore, little is known about how occupational demands, burnout and wellbeing, and patient safety are all associated.AimTo investigate whether occupational variables (demands and support) are associated with patient safety outcomes in general practice through their influence on GP burnout and wellbeing.Design and settingCross-sectional survey in the UK between March 2016 and August 2017.MethodA total of 232 practising GPs completed an online or paper survey measuring burnout, wellbeing, occupational demands and support, and patient safety.ResultsIn all, 93.8% of GPs were classed as likely to be suffering from a minor psychiatric disorder, 94.7% as suffering from mild (22.0%) or severe (72.7%) exhaustion, and 86.8% as having mild (37.9%) or severe (48.9%) disengagement. Structural equation modelling (SEM) analyses showed that spending a higher number of hours on administrative tasks and on call, and feeling less supported in their practice, was associated with lower wellbeing, which in turn was associated with a higher likelihood of having reported a near miss in the previous 3 months. A higher number of hours spent on administrative tasks, a higher number of patients seen per day, and feeling less supported were associated with higher burnout levels, which in turn was associated with worse perceptions of safety.ConclusionTo improve patient safety within general practice changes could be made at both practice and individual levels to promote a healthier work environment for staff and patients.

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Patient Safety Culture Assessment in Primary Care Settings in Greece

Healthcare ◽

10.3390/healthcare9070880 ◽

2021 ◽

Vol 9 (7) ◽

pp. 880

Author(s):

Ioannis Antonakos ◽

Kyriakos Souliotis ◽

Theodora Psaltopoulou ◽

Yannis Tountas ◽

Maria Kantzanou

Keyword(s):

Primary Care ◽

Patient Safety ◽

Safety Culture ◽

Health Professionals ◽

Improve Patient Safety ◽

Patient Safety Culture ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Survey Tool ◽

Primary Care Settings

Introduction: A positive safety culture is considered a pillar of safety in health organizations and the first crucial step for quality health services. In this context, the aim of this study was to set a reference evaluation for the patient safety culture in the primary health sector in Greece, based on health professionals’ perceptions. Methods: We used a cross-sectional survey with a 62% response rate (n = 459), conducted in primary care settings in Greece (February to May 2020). We utilized the “Medical Office Survey on Patient Safety Culture” survey tool from the Agency for Healthcare Research and Quality (AHRQ). The study participants were health professionals who interacted with patients from 12 primary care settings in Greece. Results: The most highly ranked domains were: “Teamwork” (82%), “Patient Care Tracking/Follow-up” (80% of positive scores), and “Organizational Learning” (80%); meanwhile, the lowest-ranked ones were: “Leadership Support for Patient Safety” (62%) and “Work Pressure and Pace” (46%). The other domains, such as “Overall Perceptions of Patient Safety and Quality” (77%), “Staff Training“ (70%), “Communication about Error” (70%), “Office Processes and Standardization” (67%), and “Communication Openness” (64%), ranked somewhere in between. Conclusions: A positive safety culture was identified in primary care settings in Greece, although weak areas concerning the safety culture should be addressed in order to improve patient safety.

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Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries

Primary Health Care Research & Development ◽

10.1017/s1463423621000657 ◽

2021 ◽

Vol 22 ◽

Author(s):

Peter P. Groenewegen ◽

Wienke G. W. Boerma ◽

Peter Spreeuwenberg ◽

Bohumil Seifert ◽

Willemijn Schäfer ◽

...

Keyword(s):

Primary Care ◽

General Practitioners ◽

Professional Training ◽

Institutional Development ◽

Task Shifting ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Independent Variables ◽

Nurse Prescribing ◽

Number Of Patients

Abstract Aim: To describe variation in task shifting from general practitioners (GPs) to practice assistants/nurses in 34 countries, and to explain differences by analysing associations with characteristics of the GPs, their practices and features of the health care systems. Background: Redistribution of tasks and responsibilities in primary care are driven by changes in demand for care, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill mix of primary care teams. However, these developments are hampered by barriers between professional domains, which can be rigid as a result of strict regulation, traditional attitudes and lack of trust. Methods: Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7200 GPs in 34 countries. The dependent variable ‘task shifting’ is measured through a composite score of GPs’ self-reported shifting of tasks. Independent variables at GP and practice level are: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are: institutional development of primary care; demand for and supply of care; nurse prescribing as an indicator for professional boundaries; professionalisation of practice assistants/nurses (indicated by professional training, professional associations and journals). Multilevel analysis is used to account for the clustering of GPs in countries. Findings: Countries vary in the degree of task shifting by GPs. Regarding GP and practice characteristics, use of electronic health record applications (as an indicator for innovativeness) and age of the GPs are significantly related to task shifting. These variables explain only little variance at the level of GPs. Two country variables are positively related to task shifting: nurse prescribing and professionalisation of primary care nursing. Professionalisation has the strongest relationship, explaining 21% of the country variation.

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Sleep in General Practice: A Cross-Sectional Survey of Primary Care Across India

10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a6236 ◽

2019 ◽

Author(s):

A.G. Ghoshal ◽

R. Dhar ◽

I. Halder ◽

S. Ghosh ◽

A. Ghoshal

Keyword(s):

Primary Care ◽

General Practice ◽

Cross Sectional Survey ◽

Cross Sectional

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Nurses’ Knowledge, Attitude, and Fall Prevention Practices at South Korean Hospitals: A Cross-Sectional Survey

10.21203/rs.3.rs-20233/v3 ◽

2020 ◽

Author(s):

Mi-young Cho ◽

Sun Joo Jang

Keyword(s):

Patient Safety ◽

Fall Prevention ◽

Improve Patient Safety ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevention Education ◽

Patient Falls ◽

Prevention Activities ◽

Nurses Knowledge ◽

Fall Prevention Education

Abstract Background: Fall-prevention activities are nursing interventions which are designed to improve patient safety. The introduction of evaluations of medical institutions and an increase in medical litigation has led institutions to emphasize the importance of fall-prevention activities. The current situation regarding falls among patients in small and medium-sized hospitals is poorly understood. This study assessed knowledge and attitudes regarding falls, and fall-prevention activities of nurses working in small- and medium-sized hospitals. Methods: Nurses (N= 162) from seven small- and medium-sized hospitals participated in the study. Data on participants’ characteristics, education regarding patient falls, knowledge of stretcher cart use, attitudes regarding patient falls, and fall-prevention activities were collected from August 1 to September 1, 2016. Results: Nurses’ knowledge of patient falls was positively correlated with their experience with inpatient falls. Furthermore, nurses’ attitudes regarding falls were influenced by their nursing experience and fall prevention education. Attitudes positively correlated with fall-prevention activities, but knowledge did not. Nurses’ attitudes regarding patient falls were correlated with fall-prevention activities. Conclusion: Hospitals should develop incentive programs to improve nurses’ attitudes which are based on their subjective norms and tailored to each hospital’s specific circumstances to ensure engagement in fall prevention activities. In short, we recommend that consistent, repeated, and custom fall-prevention education should be implemented in small- and medium-sized hospitals to promote engagement in fall-prevention activities. Patient safety activities in small- and medium-sized hospitals can be enhanced by creating an environment that encourages active and self-directed participation in developing fall-prevention strategies using motivation and rewards.

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Nurses’ knowledge, attitude, and fall prevention practices at south Korean hospitals: a cross-sectional survey

BMC Nursing ◽

10.1186/s12912-020-00507-w ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Mi-young Cho ◽

Sun Joo Jang

Keyword(s):

Patient Safety ◽

Fall Prevention ◽

Improve Patient Safety ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevention Education ◽

Patient Falls ◽

Prevention Activities ◽

Nurses Knowledge ◽

Fall Prevention Education

Abstract Background Fall-prevention activities are nursing interventions which are designed to improve patient safety. The introduction of evaluations of medical institutions and an increase in medical litigation has led institutions to emphasize the importance of fall-prevention activities. The current situation regarding falls among patients in small and medium-sized hospitals is poorly understood. This study assessed knowledge and attitudes regarding falls, and fall-prevention activities of nurses working in small- and medium-sized hospitals. Methods Nurses (N = 162) from seven small- and medium-sized hospitals participated in the study. Data on participants’ characteristics, education regarding patient falls, knowledge of stretcher cart use, attitudes regarding patient falls, and fall-prevention activities were collected from August 1 to September 1, 2016. Results Nurses’ knowledge of patient falls was positively correlated with their experience with inpatient falls. Furthermore, nurses’ attitudes regarding falls were influenced by their nursing experience and fall prevention education. Attitudes positively correlated with fall-prevention activities, but knowledge did not. Nurses’ attitudes regarding patient falls were correlated with fall-prevention activities. Conclusion Hospitals should develop incentive programs to improve nurses’ attitudes which are based on their subjective norms and tailored to each hospital’s specific circumstances to ensure engagement in fall prevention activities. In short, we recommend that consistent, repeated, and custom fall-prevention education should be implemented in small- and medium-sized hospitals to promote engagement in fall-prevention activities. Patient safety activities in small- and medium-sized hospitals can be enhanced by creating an environment that encourages active and self-directed participation in developing fall-prevention strategies using motivation and rewards.

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The effect of patient safety culture on nurses’ near-miss reporting intention: the moderating role of perceived severity of near misses

Journal of Research in Nursing ◽

10.1177/1744987120979344 ◽

2021 ◽

Vol 26 (1-2) ◽

pp. 6-16

Author(s):

Yi Yang ◽

Huaping Liu

Keyword(s):

Patient Safety ◽

Safety Culture ◽

Improve Patient Safety ◽

Patient Safety Culture ◽

Working Environment ◽

Near Miss ◽

Cross Sectional Survey ◽

Near Misses ◽

Perceived Severity ◽

The Relationship

Background Reporting near misses is a practical approach to improve the confounding challenge of patient safety. Evidence suggests that patient safety culture and the characteristics of errors might have important impacts on reporting. No studies, however, have examined the relationships among patient safety culture, perceived severity of near misses and near-miss reporting. Aims To explore the relationship between patient safety culture and nurses’ near-miss reporting intention, and examine the potential moderating effect the perceived severity of near misses might have on this relationship. Methods Using a cross-sectional survey, data were collected with three validated survey instruments completed by 920 Registered Nurses in eight tertiary hospitals in China. Multiple regression analysis tested relationships among the variables. Results Nurses reported a moderate–high level of near-miss reporting intention. Patient safety culture was positively associated with nurses’ near-miss reporting intention. Perceived severity of near misses did not significantly moderate the relationship between patient safety culture and reporting intention. Conclusions Nurses generally showed a positive willingness to report near misses. A specific near-miss management and education system within a learning, supportive working environment are key components to improve reporting intention among nurses which could significantly improve patient safety.

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Effectiveness of New Tools to Define an Up-to-Date Patient Safety Risk Map: A Primary Care Study Protocol

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168612 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8612

Author(s):

Montserrat Gens-Barberà ◽

Cristina Rey-Reñones ◽

Núria Hernández-Vidal ◽

Elisa Vidal-Esteve ◽

Yolanda Mengíbar-García ◽

...

Keyword(s):

Primary Care ◽

Patient Safety ◽

Improve Patient Safety ◽

Primary Care Patient ◽

Phase 1 ◽

Care Patient ◽

Risk Map ◽

Improvement Strategy ◽

Cross Sectional ◽

Safety Risk

Background: Reducing incidents related to health care interventions to improve patient safety is a health policy priority. To strengthen a culture of safety, reporting incidents is essential. This study aims to define a patient safety risk map using the description and analysis of incidents within a primary care region with a prior patient safety improvement strategy organisationally developed and promoted. Methods: The study will be conducted in two phases: (1) a cross-sectional descriptive observational study to describe reported incidents; and (2) a quasi-experimental study to compare reported incidents. The study will take place in the Camp de Tarragona Primary Care Management (Catalan Institute of Health). In Phase 1, all reactive notifications collected within one year (2018) will be analysed; during Phase 2, all proactive notifications of the second and third weeks of June 2019 will be analysed. Adverse events will also be assessed. Phases 1 and 2 will use a digital platform and the proactive tool proSP to notify and analyse incidents related to patient safety. Expected Results: To obtain an up-to-date, primary care patient safety risk map to prioritise strategies that result in safer practices.

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Nurses’ Knowledge, Attitude, and Fall Prevention Practices at South Korean Hospitals: A Cross-Sectional Survey

10.21203/rs.3.rs-20233/v2 ◽

2020 ◽

Author(s):

Mi-young Cho ◽

Sun Joo Jang

Keyword(s):

Patient Safety ◽

Fall Prevention ◽

Improve Patient Safety ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevention Education ◽

Patient Falls ◽

Prevention Activities ◽

Nurses Knowledge ◽

Fall Prevention Education

Abstract Background: Fall-prevention activities are nursing interventions which are designed to improve patient safety. The introduction of evaluations of medical institutions and an increase in medical litigation has led institutions to emphasize the importance of fall-prevention activities. The current situation regarding falls among patients in small and medium-sized hospitals is poorly understood. This study assessed knowledge and attitudes regarding falls, and fall-prevention activities of nurses working in small- and medium-sized hospitals. Methods: Participants were 162 nurses from seven small- and medium-sized hospitals. Data on participants’ characteristics, education regarding patient falls, knowledge of stretcher cart use, attitudes regarding patient falls, and fall-prevention activities were collected from August 1 to September 1, 2016. Results: Nurses’ knowledge of patient falls was positively correlated with their experience with inpatient falls. Furthermore, nurses’ attitudes regarding falls were influenced by their nursing experience and fall prevention education. Attitudes positively correlated with fall-prevention activities, but knowledge did not. Nurses’ attitudes regarding patient falls were correlated with fall-prevention activities. Conclusion: Hospitals should develop incentive programs to improve nurses’ attitudes which are based on their subjective norms and tailored to each hospital’s specific circumstances to ensure engagement in fall prevention activities. In short, we recommend that consistent, repeated, and custom fall-prevention education should be implemented in small- and medium-sized hospitals to promote engagement in fall-prevention activities. Patient safety activities in small- and medium-sized hospitals can be enhanced by creating an environment that encourages active and self-directed participation in developing fall-prevention strategies using motivation and rewards.

Download Full-text