A safety culture training program enhanced the perceptions of patient safety culture of nurse managers

Positive perceptions of patient safety culture are associated with lower rates of adverse events, but they have not been widely established in many health care organizations. The purpose of this study is to examine the impacts of a safety culture training program (SCTP) on enhancing the perceptions of patient safety in nurse managers. This was a quasi-experimental design. 83 nurse managers were recruited from five randomly selected 2nd level hospitals. Sixty-seven nurse managers received training under the educational SCTP. The Hospital Survey on Patient Safety Culture (HSPSC) and Chinese Safety Attitudes Questionnaire (C-SAQ) were administered just before and six months after the educational program. The data of hospital-acquired pressure ulcers, patient falls, and unplanned extubations were collected. The total positive scores of HSPSC were significantly improved and four dimensions of C-SAQ significantly increased six months after SCTP. The rate of patient falls and rate of hospital-acquired pressure ulcers decreased significantly six months post SCTP. In conclusion, nurse manager participation in a SCTP can enhance the perceptions of patient safety and reduce the rates of adverse events. More rigorous trials with larger numbers of participants and a control group are needed to strengthen the conclusions.     

Proposed regulations for enforcement of the Patient Safety and Quality Improvement Act of 2005

The Patient Safety and Quality Improvement "proposed rule" (2008) was published in the Federal Register on February 12, 2008. This "proposed rule," with a comment period extending to April 14, 2008, was created for the purpose of implementing specific facets of the Patient Safety and Quality Improvement Act of 2005; those dealing with the establishment of Patient Safety Organizations (PSOs), confidentiality protection for patient safety activities, and patient safety work product, and reporting by the Secretary of the Department of Health and Human Services (HHS) to Congress regarding successful strategies that have reduced medical errors and have thereby increased patient safety.     

对临床护士患者安全文化认知及影响因素的调查研究

目的：了解临床护士的患者安全文化认知现状及影响因素。方法使用汉化的“医院患者安全文化调查表”（Cronbach’sα系数为0．88）对378名临床护士进行调查。结果57．2％的临床护士对所在科室的患者安全总体评价为“优秀”（14．5％）或“很好”（42．7％）,70．6％在过去的1年里没有事件报告。患者安全文化平均积极应答率为61％,人员配置、对错误的非惩罚性反应、科室间协作3个维度平均积极应答率分别为40．3％,44．2％,47．2％。多元回归分析显示,工作科室、岗位、直接接触患者与否、科室工作年限影响临床护士对患者安全文化的认知。结论临床护士有积极的患者安全文化认知,但还须在护理人力补充、非惩罚性安全文化建设、科室间协作、事件上报领域有针对性地加以改进,以确保患者安全。     

Nurses' perceptions about patient safety culture in public hospital in Vietnam

AimThis paper is aimed to assess nurses' perceptions of patient safety culture in four public general hospitals in Hanoi, Vietnam.BackgroundPatient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of nurses' perceptions on existing hospital patient safety culture (PSC) is the first step to promote PSC.MethodsThe cross-sectional study surveyed 705 nurses utilizing the validated Hospital Survey on Patient Safety Culture (HSOPSC) in an online format.ResultsThe average positive response rate was high at 72.8 % and varied from 52.9 % to 93.4 %. The strongest areas are teamwork within units (93.7 %) and supervisor/manager expectations and actions promoting patient safety (85.0 %). The areas for improvement are staffing (52.9 %) and non-punitive response to error (57.6 %). The communication openness, staffing, frequency of events reported, lengths of services in hospital and unit are significant factors that predict the overall patient safety grade.ConclusionsInitiatives are necessary to improve response to errors, staffing, and error reporting. Nurse managers could develop and implement interventions and program to improve patient safety, including providing education related to patient safety culture, encouraging staff to notify incidents and avoiding punitive responses.     

Early warning scores: effective use

In June 2008, North Tees and Hartlepool Trust signed up to Patient Safety First. Our objectives were to put patients first and to develop a culture of patient safety. We implemented the intervention discussed here with the aim of preventing harm and reducing in-hospital cardiac arrest and mortality through earlier recognition and treatment of deteriorating patients. Acute illness is exacerbated by "failure to act" on recognised changes (Hillman et al, 2001). Analysis of serious patient safety incidents revealed that 11% of deaths were related to "deterioration not recognised or not acted upon" (National Patient Safety Agency, 2007a). The process can fail by not taking observations, not recognising early signs of deterioration, not communicating observations causing concern and not responding to concerns appropriately (NPSA, 2007b). We focused on improving all these areas.     

Building a safety culture

This is the first article in a series of seven based on the Seven Steps to Patient Safety (National Patient Safety Agency (NPSA) 2004a). It is aimed at enhancing nurses' and midwives' knowledge about patient safety, including strategies and tools that are available to improve the quality of health care. This article outlines the patient safety agenda and emphasises the importance of creating an open and fair culture in the NHS.     

Patient safety culture in nursing homes – a cross-sectional study among nurses and nursing aides caring for residents with diabetes

Background

Due to the high morbidity and disability level among diabetes patients in nursing homes, the conditions for caregivers are exceedingly complex and challenging. The patient safety culture in nursing homes should be evaluated in order to improve patient safety and the quality of care. Thus, the aim of this study was to examine the perceptions of patient safety culture of nursing personnel in nursing homes, and its associations with the participants’ (i) profession, (ii) education, (iii) specific knowledge related to their own residents with diabetes, and (iv) familiarity with clinical diabetes guidelines for older people.

Methods

Cross-sectional survey design. The study included 89 nursing home personnel (38 registered nurses and 51 nurse aides), 25 (28%) with advanced education, at two nursing homes. We collected self-reported questionnaire data on age, profession, education and work experience, diabetes knowledge and familiarity with diabetes guidelines. In addition, we applied the Nursing Home Survey on Patient Safety Culture instrument, with 42 items and 12 dimensions.

Results

In general, those with advanced education scored higher in all patient safety culture dimensions than those without, however statistically significant only for the dimensions “teamwork” (mean score 81.7 and 67.7, p?=?0.042) and “overall perceptions of resident safety” (mean score 90.0 and 74.3, p?=?0.016). Nursing personnel who were familiar with diabetes guidelines for older people had more positive perceptions in key areas of patient safety culture, than those without familiarity with the guidelines.

Conclusions

The findings from this study show that advanced education and familiarity with current diabetes guidelines was related to adequate evaluations on essential areas of patient safety culture in nursing homes.

     

Safe intrahospital transport of non-ICU patients

The Pennsylvania Patient Safety Reporting System is a confidential, statewide Internet reporting system to which all Pennsylvania hospitals, outpatient-surgery facilities, and birthing centers, as well as some abortion facilities, must file information on medical errors.Safety Monitor is a column from Pennsylvania's Patient Safety Authority, the authority that informs nurses on issues that can affect patient safety and presents strategies they can easily integrate into practice. For more information on the authority, visit www.patientsafetyauthority.org. For the original article discussed in this column or for other articles on patient safety, click on "Patient Safety Advisories" and then "Advisory Library" in the left-hand navigation menu.     

患者安全文化对护士第二受害者痛苦的影响研究

目的 探索患者安全文化对护士第二受害者痛苦的影响。 方法 于2018年10月—2019年1月便利选取中国中西部3个省6所三级甲等医院经历患者安全事件的执业护士2 897名作为调查对象,采用一般资料问卷、医院患者安全文化调查问卷、第二受害者经验及支持量表进行调查。 结果 患者安全文化影响护士作为第二受害者的心理痛苦、生理痛苦和职业自我效能。护士心理痛苦的主要影响因素有差错的非惩罚性反应、交接班与转科、不同科室间合作、对差错的沟通反馈和安全的整体感知;生理痛苦的主要影响因素有差错的非惩罚性反应、交接班与转科、不同科室间合作、员工配置和护士职务;职业自我效能的主要影响因素有差错的非惩罚性反应、不同科室间合作、安全的整体感知、交接班与转科和护士工作年限。 结论 护士的第二受害者痛苦受到患者安全文化的影响,其中非惩罚性安全文化、医院跨科室的团队合作、患者交接对护士作为第二受害者的痛苦有重要影响。     

Violence Prevention Training for ED Staff

The Pennsylvania Patient Safety Reporting System is a confidential, statewide Internet reporting system to which all Pennsylvania hospitals, outpatient-surgery facilities, and birthing centers, as well as some abortion facilities, must file information on medical errors. Safety Monitor is a column from Pennsylvania's Patient Safety Authority, the authority that informs nurses on issues that can affect patient safety and presents strategies they can easily integrate into practice. For more information on the authority, visit www.patientsafetyauthority.org. For the original article discussed in this column or for other articles on patient safety, click on "Patient Safety Advisories" and then "Advisory Library" in the left-hand navigation menu.     

The safe use of negative-pressure wound therapy

The Pennsylvania Patient Safety Reporting System is a confidential, statewide Internet reporting system to which all Pennsylvania hospitals, outpatient-surgery facilities, and birthing centers, as well as some abortion facilities, must file information on medical errors. Safety Monitor is a column from Pennsylvania's Patient Safety Authority, the authority that informs nurses on issues that can affect patient safety and presents strategies they can easily integrate into practice. For more information on the authority, visit www.patientsafetyauthority.org. For the original article discussed in this column or for other articles on patient safety, click on "Patient Safety Advisories" and then "Advisory Library" in the left-hand navigation menu.     

The perception of hospital safety culture and selected outcomes among nurses: An exploratory study

The objectives of this study were to examine nurses' perceptions of the hospital safety culture in Jordan and to identify the relationships between aspects of hospital safety culture and selected safety outcomes. Data from 242 registered nurses in five Jordanian hospitals were analyzed. Aspects of hospital safety culture and outcomes were measured using the Hospital Survey on Patient Safety Culture. Among various aspects of hospital safety culture, teamwork within units had the highest average percentage of positive responses (49.8%). Additionally, participants reported deficits in other aspects of safety culture, particularly in staffing and nonpunitive response to errors, with average percentages of positive responses of 30.4% and 30.7%, respectively. Pearson correlation analysis revealed that 9 of 10 subscales of hospital safety culture were significantly correlated to one or more of the hospital safety outcomes. The findings of this study can help policymakers and healthcare administrators identify the weaknesses and strengths of hospital safety issues in order to propose effective strategies to improve patient safety and quality of care.     

Managing risk in healthcare: understanding your safety culture using the Manchester Patient Safety Framework (MaPSaF)

Aim  To provide sufficient information about the Manchester Patient Safety Framework (MaPSaF) to allow healthcare professionals to assess its potential usefulness.
Background  The assessment of safety culture is an important aspect of risk management, and one in which there is increasing interest among healthcare organizations. Manchester Patient Safety Framework offers a theory-based framework for assessing safety culture, designed specifically for use in the NHS.
Conclusions  The framework covers multiple dimensions of safety culture, and five levels of safety culture development. This allows the generation of a profile of an organization's safety culture in terms of areas of relative strength and challenge, which can be used to identify focus issues for change and improvement.
Implications for nursing management  Manchester Patient Safety Framework provides a useful method for engaging healthcare professionals in assessing and improving the safety culture in their organization, as part of a programme of risk management.     

护理人员患者安全文化现状的研究

目的 调查护理人员患者安全文化认知现状,探索其影响因素,为推动患者安全文化建设、保障患者安全提供理论依据.方法 采用一般资料调查表、医院患者安全文化调查问卷对陕西省5所实施"5+1"S精益管理的三级甲等医院517名护理人员进行调查.结果 护理人员患者安全文化总均分为(3.76±0.41)分,积极反应率为76.21％处于...     

Development and testing of the patient safety test: current concepts

To explore patient safety concepts applicable to clinical teaching in the current healthcare environment, the Patient Safety Test was created. Patient Safety Test assists nursing faculty members to assess their knowledge of safety and quality information. The authors discussed test development, implementation, and results.     

Nurse burnout and patient safety outcomes: nurse safety perception versus reporting behavior

This article examines the relationship between nurse burnout and patient safety indicators, including both safety perceptions and reporting behavior. Based on the Conservation of Resources model of stress and burnout, it is predicted that burnout will negatively affect both patient safety perceptions and perceived likelihood of reporting events. Nurses from a Veteran's Administration hospital completed the Maslach Burnout Inventory and safety outcomes subset of measures from the Agency for Healthcare Research and Quality Patient Safety Culture measure. After controlling for work-related demographics, multiple regression analysis supported the prediction that burnout was associated with the perception of lower patient safety. Burnout was not associated with event-reporting behavior but was negatively associated with reporting of mistakes that did not lead to adverse events. The findings extend previous research on the relationship between burnout and patient outcomes and offer avenues for future research on how nurse motivation resources are invested in light of their stressful work environment.     

Involving and communicating with patients and the public

Patient safety incidents have physical and emotional consequences for those involved, including patients, carers, relatives and healthcare staff. This article, the fifth of seven in this series, focuses on Step Five of the Seven Steps to Patient Safety (National Patient Safety Agency (NPSA) 2004): involve and communicate with patients and the public. The article discusses how to communicate with patients and their carers who have been involved in a patient safety incident that led to moderate harm, severe harm or death.     

Achieving a safer health service: Part 1. Making safety a way of life

Patient safety incidents are a major problem in the health service and it is acknowledged that blaming and reprimanding staff for actual or potential mistakes does not encourage an open and safe culture in which to work. In the first paper in a three-part series the National Patient Safety Agency's seven key to steps to achieving patient safety are discussed.     

The role of patient safety culture in the causation of unintended events in hospitals

Aims and objectives. To examine whether the relationship between specialty and patient safety is mediated by safety culture. Background. Research has shown that patient safety in hospitals varies by specialty. The safety culture among healthcare professionals in hospital units is believed to influence safety performance. If there is a mediation effect of safety culture in the relationship between specialty and safety, then safety culture could explain why units vary in performance. Design. Cross‐sectional observational study in 28 units of 20 hospitals in the Netherlands. Units were of three specialties: emergency medicine, surgery and internal medicine. Methods. Safety culture was measured with the Dutch version of the Hospital Survey on Patient Safety Culture with 11 culture dimensions (n = 542; response 56%). Safety outcomes were types of unintended events (six types). Unintended events were collected through staff reporting (n = 1885 events). Data were examined using multilevel regression analysis. Results. The overall safety culture in the units did not mediate the relationship between specialty and the safety outcomes (event types), but three of the 11 dimensions showed significant mediation on one or more event types: non‐punitive response to error, hospital management support and willingness to report. Conclusions. Only a few safety culture dimensions mediated the relationship between specialty and some of the outcomes, with ‘willingness to report’ as the most important mediating factor. Our study did not give strong evidence that specialties differ in performance because of their safety cultures. More research into the causes of variation in patient safety between hospital units is needed. Relevance to clinical practice. Our study could not give support for the claim that safety culture is a key factor affecting patient safety.