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Impact of Patient Safety Culture on Missed Nursing Care and Adverse Patient Events.

ABSTRACT: BACKGROUND:A strong patient safety culture (PSC) may be associated with improved patient outcomes in hospitals. The mechanism that explains this relationship is underexplored; missed nursing care may be an important link. PURPOSE:The purpose of this study was to describe relationships among PSC, missed nursing care, and 4 types of adverse patient events. METHODS:This cross-sectional study employed primary survey data from 311 nurses from 29 units in 5 hospitals and secondary adverse event data from those same units. Analyses include analysis of variance and regression models. RESULTS:Missed nursing care was reported to occur at an occasional level (M = 3.44, SD = 0.24) across all 29 units. The PSC dimensions explained up to 30% of the variance in missed nursing care, 26% of quality of care concerns, and 15% of vascular access device events. Missed care was associated with falls (P < .05). CONCLUSIONS:Prioritized actions to enhance PSC should be taken to reduce missed nursing care and adverse patient outcomes.

SUBMITTER: Hessels AJ

PROVIDER: S-EPMC6561834 | biostudies-literature | 2019 Oct/Dec

REPOSITORIES: biostudies-literature

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Impact of Patient Safety Culture on Missed Nursing Care and Adverse Patient Events.

Hessels Amanda J AJ Paliwal Mani M Weaver Susan H SH Siddiqui Deeba D Wurmser Theresa A TA

Journal of nursing care quality 20191001 4

<h4>Background</h4>A strong patient safety culture (PSC) may be associated with improved patient outcomes in hospitals. The mechanism that explains this relationship is underexplored; missed nursing care may be an important link.<h4>Purpose</h4>The purpose of this study was to describe relationships among PSC, missed nursing care, and 4 types of adverse patient events.<h4>Methods</h4>This cross-sectional study employed primary survey data from 311 nurses from 29 units in 5 hospitals and secondar ...[more]

PMID: 30550496

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Project description:BackgroundPatient safety is a leading item on the policy agenda of both major international health organizations and advanced countries generally. The quantitative description of the phenomena has given rise to intense concern with the issue in institutions and organizations, leading to a number of initiatives and research projects and the promotion of patient safety culture, with training becoming a priority both in Spain and internationally. To date, most studies have been conducted in a hospital setting, even though primary care is the type most commonly used by the public, in our experience. Our study aims to achieve the following:--Assess the registry of adverse events as an education tool to improve patient safety culture in the Family and Community Teaching Units of Galicia.--Find and analyze educational tools to improve patient safety culture in primary care.--Evaluate the applicability of the Hospital Survey on Patient Safety Culture by the Agency for Healthcare Research and Quality, Spanish version, in the context of primary health care.Design and methodsDesignExperimental unifactorial study of two groups, control and intervention.Study populationTutors and residents in Family and Community Medicine in last year of studies in Galicia, Spain.SampleFrom the population universe through voluntary participation. Twenty-seven tutor-resident units in each group required, randomly assigned.InterventionResidents and their respective tutor (tutor-resident pair) in teaching units on Family and Community Medicine from throughout Galicia will be invited to participate. Tutor-resident pair that agrees to participate will be sent the Hospital Survey on Patient Safety Culture. Then, tutor-resident pair will be assigned to each group--either intervention or control--through simple random sampling. The intervention group will receive specific training to record the adverse effects found in patients under their care, with subsequent feedback, after receiving instruction on the process. No action will be taken in the control group. After the intervention has ended, the survey will once again be provided to all participants.Outcome measuresChange in safety culture as measured by Hospital Survey on Patient Safety CultureCONSORT Extension for Non-Pharmacologic Treatments 2008 was applied.DiscussionThe most significant limitations on the project are related to selecting a tool to measure the safety environment, the training calendar of residents in Family and Community Medicine in last year of studies and the no-answer bias inherent to research conducted through self-administered surveys.The development and application of a safety culture in the health sector, specifically in primary care, is as yet limited. Thus, identifying the strengths and weaknesses in the safety environment may assist in designing strategies for improvement in the primary care health centers of our region.Trial registrationISRCTN: ISRCTN41911128.

Project description:BackgroundPatient safety culture is an important factor in determining hospitals' ability to address and reduce the occurrence of adverse events (AEs). However, few studies have reported on the impact of nurses' perceptions of patient safety culture on the occurrence of AEs. Our study aimed to assess the association between nurses' perception of patient safety culture and their perceived proportion of adverse events.MethodsA cross-sectional survey was carried out among 2295 nurses employed in thirty-two teaching hospitals in Iran. Nurses completed the Persian version of the hospital survey of patients' safety culture between October 2018 and September 2019.ResultsPositive Response Rates of overall patient safety culture was 34.1% and dimensions of patient safety culture varied from 20.9 to 43.8%. Also, nurses estimated that the occurrence of six adverse events varied from 51.2-63.0% in the past year. The higher nurses' perceptions of "Staffing", "Hospital handoffs and transitions", "Frequency of event reporting", "Non-punitive response to error", "Supervisor expectation and actions promoting safety", "Communication openness", "Organizational learning continuous improvement", "Teamwork within units", and "Hospital management support patient safety" were significantly related to lower the perceived occurrence at least two out of six AEs (OR = 0.69 to 1.46).ConclusionsOur findings demonstrated that nurses' perception regarding patient safety culture was low and the perceived occurrence of adverse events was high. The research has also shown that the higher level of nurses' perception of patient safety culture was associated with lowered occurrence of AEs. Hence, managers could provide prerequisites to improve patient safety culture and reduce adverse events through different strategies, such as encouraging adverse events' reporting and holding training courses for nurses. However, further research is needed to assess how interventions addressing patient safety culture might reduce the occurrence of adverse events.

Project description:BackgroundPromoting medication adherence is a recognized challenge for prescribers. In this study, we examine whether lower medication adherence is associated with adverse safety events in individuals with decreased estimated glomerular filtration rates (eGFRs).Study designCross-sectional baseline analysis of prospective cohort.Setting & participantsBaseline analysis of the Safe Kidney Care (SKC) Cohort Study, a prospective study of individuals with eGFRs<60 mL/min/1.73 m(2) intended to assess the incidence of disease-specific safety events. Kidney transplant recipients were excluded.PredictorSelf-reported medication adherence based on responses to 3 questions ascertaining degree of medication regimen adherence.OutcomesAdverse safety events were self-reported at baseline (class I events), such as hypoglycemia or fall thought to be related to a medication, or detected incidentally during the baseline visit (class II events), for example, hypotension or hyperkalemia. Potential drug-related problems (DRPs) were determined by analyzing participants' medications with respect to dosing guidelines based on their screening eGFRs at the time of medication reporting.MeasurementsRelationship between medication adherence and disease-specific patient safety events.ResultsOf 293 SKC participants, 154 (53%) were classified as having lower medication adherence. After multivariable adjustment, lower medication adherence was significantly associated with a class I or II safety event (prevalence ratio [PR], 1.21; 95% CI, 1.04-1.41) and potential DRPs (PR, 1.29; 95% CI, 1.02-1.63). Lower medication adherence was also significantly associated with multiple (≥2) class I events (PR, 1.71; 95% CI, 1.18-2.49), multiple class I or II events (PR, 1.35; 95% CI, 1.04-1.76), and multiple potential DRPs (PR, 2.11; 95% CI, 1.08-2.69) compared with those with higher medication adherence.LimitationsUse of self-reported medication adherence rather than pharmacy records. Clinical relevance of detected safety events is unclear.ConclusionsLower medication adherence is associated with adverse safety events in individuals with eGFRs<60 mL/min/1.73 m(2).

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Impact of Patient Safety Culture on Missed Nursing Care and Adverse Patient Events.

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Impact of Patient Safety Culture on Missed Nursing Care and Adverse Patient Events.

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