Strong patient safety culture is a cornerstone to sustained safety improvements. This cross-sectional study explored nurses’ perceptions about patient safety culture. Identified areas of strength included non-punitive responses to errors and teamwork, and areas for improvement focused on supervisor and manager expectations, responses, and actions to promote safety and open communication. The authors highlight the importance of measuring patient safety culture in order to improve hospitals’ patient safety improvement practices, overall performance and quality of healthcare delivery.
Bamberger E, Bamberger P. BMJ Qual Saf. 2022;Epub Apr 15.
Disruptive behaviors are discouragingly present in health care. This commentary discusses evidence examining the impact of unprofessional behaviors on safety and clinical care. The authors suggest areas of exploration needed to design reduction efforts such as teamwork, the Safety I mindset and targeting of the root influences of impropriety.
Katz-Navon T, Naveh E. Health Care Manage Rev. 2022;47:e41-e49.
Balancing autonomy and supervision is an ongoing challenge in medical training. This study explored how residents’ networking with senior physicians influences advice-seeking behaviors and medical errors. Findings suggest that residents made fewer errors when they consulted with fewer senior physicians overall and consulted more frequently with focal senior physicians (i.e., physicians sought out by other residents frequently for consults).
Shao Q, Wang Y, Hou K, et al. J Adv Nurs. 2021;77:4005-4016.
Patient suicide in all settings is considered a never event. Nurses caring for the patient may experience negative psychological symptoms following inpatient suicide. This review identified five themes based on nurses’ psychological experiences: emotional experience, cognitive experience, coping strategies, self-reflection, and impact on self and practice. Hospital administrators should develop education and support programs to help nurses cope in the aftermath of inpatient suicide.
Denning M, Goh ET, Tan B, et al. PLoS One. 2021;16:e0238666.
This cross-sectional study conducted from March to June 2020 measured anxiety, depression, and burnout in clinicians working in the United Kingdom, Poland, and Singapore. Approximately 70% of respondents reported feeling anxious, depressed and/or burnt out. Burnout was significantly inversely correlated with being tested for COVID-19 and perceiving high levels of safety. These findings highlight the importance of supporting staff well-being and proactive COVID-19 testing.
Goh HS, Tan V, Chang J, et al. J Nurs Care Qual. 2021;36:e63-e68.
Incident reporting systems are a common method for hospitals to detect patient safety events, but prior research has questioned whether these systems improve outcomes. Conducted in a nursing home, this study found that an existing incident reporting system redesigned to facilitate double-loop learning could improve nurses’ patient safety awareness and workplace practices, which could improve patient outcomes and safety.
Lee SE, Dahinten VS. J Nurs Scholarsh. 2020;52:544-552.
This descriptive study used data from the AHRQ Survey on Patient Safety Culture to explore the effects of safety culture on nurses’ perceptions of safety. The researchers found that all 11 safety culture factors were associated with nurse-perceived patient safety; staffing adequacy and hospital management support were the strongest predictors of perceived patient safety.
Denning M, Goh ET, Scott A, et al. Int J Environ Res Public Health. 2020;17:7034.
This study used the Safety Attitudes Questionnaire to evaluate the impact of COVID-19 on safety culture at a large UK teaching hospital compared to baseline scores collected in 2017. Overall, respondents reported more positive perceptions of safety; training and support for redeployment were associated with higher perceptions of safety. However, the analysis identified a significant decrease in error reporting after the onset of the COVID-19 pandemic.
Sim MA, Ti LK, Mujumdar S, et al. J Patient Saf. 2022;18:e189-e195.
This article describes the implementation of a hospital-wide patient safety strategy aimed at reducing hospital-wide adverse events at a single large hospital in Singapore. The strategy included establishing interdisciplinary patient safety teams to identify areas of preventable harm, determine root causes, improve departmental accountability, and leveraging simulation training. Over a 7-year period, adverse event rates decreased significantly (as did the incidence of preventable adverse events and the incidence of events resulting in permanent harm, the use of life-sustaining interventions, or death.
Perea-Pérez B, Labajo-González E, Acosta-Gío AE, et al. J Patient Saf. 2020;16.
Based on malpractice claims data in Spain, the authors propose eleven recommendations to mitigate preventable adverse events in dentistry. These recommendations include developing a culture of safety, improving the quality of clinical records, safe prescribing practices, using checklists in oral surgical procedures, and having an action plan for life-threatening emergencies in the dental clinic.
Abdallah W, Johnson C, Nitzl C, et al. J Health Organ Manag. 2019;33:695-713.
Organizations are encouraged to learn from failure. The authors surveyed hospital pharmacists to explore how organizational learnings relates to safety culture and found that the strongest contributors to safety culture were organizations prioritizing and supporting training and education.
Cheng H-C, Yen AM-F, Lee Y-H. J Dent Sci. 2019;14:263-268.
Patient safety events are common in dentistry, but it has been challenging for dental healthcare workers to establish a robust patient safety culture. This study used a cross-sectional survey to assess the safety attitudes among dentists and dental hygienists. Safety attitudes were high overall, but attitudes differed significantly by dentist characteristics. A 2016 Perspective on Safety in Dentistry offers more background on this topic.
This interview study examined multiple stakeholder perspectives, including patients, nurses, trainees, and attending physicians, on safety and dignity in health care settings. They cited the importance of safety culture and reported experiencing dilemmas in supporting safety and dignity in the hospital. The authors suggest that graduate medical education explicitly incorporate these concepts.
Halperin O, Bronshtein O. Nurse Educ Pract. 2019;36:34-39.
Underreporting of safety events and near misses in the health care setting has been well described and is one of the challenges in using data from incident reporting systems to measure safety. Researchers surveyed nursing students and clinical instructors to identify barriers to reporting and found that fear of negative consequences was a major factor.
Prior research on the relationship between culture of safety and adverse events has produced conflicting results. Using culture of safety survey data from five long-term care facilities, researchers found an association between improved safety culture scores and a decreased risk of certain adverse events.
George D, Hassali MA, Hss A-S. JMIR Hum Factors. 2018;5:e12232.
This mixed-methods study examined the usability of a mobile application for reporting medication errors at a referral hospital in Malaysia. Usability improved over each of the three cycles of testing and iterative redesign, but physician and nurse testers expressed concern about whether the safety culture supported reporting.
This validation study translated and adapted the Safety Attitudes Questionnaire, a safety culture measurement tool, into Gujarati and implemented it in four private hospitals in India. The authors found that safety culture was similar among the hospitals, even in comparisons between urban and rural settings.
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