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Areas of Potential Improvement for Hospitals' Patient-Safety Culture in Western Ethiopia.

ABSTRACT: Background:Patient-safety culture is an important component of health-care quality and currentlyan issue of high concern globally. In Ethiopia, little is known about patient-safety culture in hospitals. We assessed the patient-safety culture and associated factors among health-care workers in public hospitals of East Wollega Zone, western Ethiopia. Methods:This institution-based cross-sectional study was conducted among 421 health-care workers selected using simple random sampling from March 4 to March 29, 2019. A standardized measuring 12 patient safety-culture components was used for data collection. Data were cleaned and entered into EpiData version 3.1 and analysis done using SPSS version 25 (IBM). Bivariate and multivariate linear regression analyses were performed. Significance was set at 95% CI and p<0.05, and unstandardized ?-coefficients were used to measure extent of association. Results:This study revealed that the level of patient-safety culture was 49.2% and patient safety culture-component scores ranged from 29.2% for nonpunitive responses to error to 77.9% for teamwork within a hospital unit. Age ?45 years (?=13.642, CI: 5.324-21.959; p=0.001), 1-5 years' experience at the current hospital (?=5.559, 95% CI 2.075-9.042; p=0.002), and working in general hospitals (?=11.988, 95% CI 7.233-16.743; p<0.001) and primary hospitals (?=6.408, 95% CI 2.192-10.624; p=0.003) were factors associated with better scores on patient-safety culture. Conclusion:Overall scores for patient-safety culture were low. Improving the current state of patient safety in public hospitals would require tailored interventions to address low-scoring components, such as nonpunitive responses to error.

SUBMITTER: Garuma M

PROVIDER: S-EPMC7425101 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Areas of Potential Improvement for Hospitals' Patient-Safety Culture in Western Ethiopia.

Garuma Melkamu M Woldie Mirkuzie M Kebene Feyera Gebissa FG

Drug, healthcare and patient safety 20200805

<h4>Background</h4>Patient-safety culture is an important component of health-care quality and currentlyan issue of high concern globally. In Ethiopia, little is known about patient-safety culture in hospitals. We assessed the patient-safety culture and associated factors among health-care workers in public hospitals of East Wollega Zone, western Ethiopia.<h4>Methods</h4>This institution-based cross-sectional study was conducted among 421 health-care workers selected using simple random sampling ...[more]

PMID: 32848480

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Project description:BackgroundDeveloping a patient safety culture was one of the recommendations made by the Institute of Medicine to assist hospitals in improving patient safety. In recent years, a multitude of evidence, mostly originating from developed countries, has been published on patient safety culture. One of the first efforts to assess the culture of safety in the Eastern Mediterranean Region was by El-Jardali et al. (2010) in Lebanon. The study entitled "The Current State of Patient Safety Culture: a study at baseline" assessed the culture of safety in Lebanese hospitals. Based on study findings, the objective of this paper is to explore the association between patient safety culture predictors and outcomes, taking into consideration respondent and hospital characteristics. In addition, it will examine the correlation between patient safety culture composites.MethodsSixty-eight hospitals and 6,807 respondents participated in the study. The study which adopted a cross sectional research design utilized an Arabic-translated version of the Hospital Survey on Patient Safety Culture (HSOPSC). The HSOPSC measures 12 patient safety composites. Two of the composites, in addition to a patient safety grade and the number of events reported, represented the four outcome variables. Bivariate and mixed model regression analyses were used to examine the association between the patient safety culture predictors and outcomes.ResultsSignificant correlations were observed among all patient safety culture composites but with differences in the strength of the correlation. Generalized Estimating Equations for the patient safety composite scores and respondent and hospital characteristics against the patient safety grade and the number of events reported revealed significant correlations. Significant correlations were also observed by linear mixed models of the same variables against the frequency of events reported and the overall perception of safety.ConclusionEvent reporting, communication, patient safety leadership and management, staffing, and accreditation were identified as major patient safety culture predictors. Investing in practices that tackle these issues and prioritizing patient safety is essential in Lebanese hospitals in order to improve patient safety. In addition, further research is needed to understand the association between patient safety culture and clinical outcomes.

Project description:IntroductionPatient safety culture is defined as the attitudes, perceptions, and values that staffs share within an organization related to patient safety. The safety of health care is now a major global concern. It is likely that millions of people suffer disabling injuries or death directly related to medical care. Particularly in developing and transitional countries, patient harm is a global public health problem. The objective of the study is to assess patient safety culture and associated factors among health care professionals working in public hospitals in Dessie town, North East Ethiopia, 2019.MethodsFacility based quantitative study was employed from March 15 -April 30, 2019 in public hospitals in Dessie town. Four hundred and twenty two health care professionals were recruited to complete a structured pretested self-administered questionnaire. The data was cleaned, coded and entered in to Epi Info-7 and exported to SPSS version 20. Data was further analyzed using bivariate and multivariate logistic regression analyses. Variables with P value of less than 0.05 in multivariate analysis were declared as statistically significant at 95% CI.ResultsOf the 422 recruited a total of 411 participants completed the survey with a response rate of 97.4%. Close to half (184(44.8%)) of the participants indicated good patient safety culture. Good patient safety culture was positively associated with working in primary hospital (AOR = 2.56, 95% CI = 1.56, 4.21). On the other hand, good patient safety culture was negatively associated with health professional's age between 25-34 year (AOR = 0.25, 95% CI = 0.08-0.74) and working in Pediatrics ward (AOR = 0.39, 95% CI = 0.17-0.9) and in emergency ward (AOR = O.25, 95%CI = 0.09-0.67).ConclusionThe overall level of patient safety culture was under 50%. Good patient safety culture had positive association with working in primary hospital and negative association with professionals' age between 25-29 year, 30-34 year and working in pediatrics and emergency ward. Implementing actions that support all dimensions of safety culture should be promoted at all levels of hospitals.

Project description:ObjectiveDespite having a detailed MRI-safety questionnaire check at the point of referral, we have encountered a significant number of near-misses with patients being identified with MRI-Unsafe devices at the time of appointments, making this an important safety hazard.Methods and materialsA two-part survey was performed to assess referrer compliance of asking MRI-questionnaires. 120 outpatients across 3 MRI sites were interviewed at the time of appointment to confirm whether their referrers completed the MRI questionnaires with them at the time of referral.Location:Department of Radiology, Ninewells Hospital, Perth Royal Infirmary and Stracathro Hospital in Scotland.ResultsOnly 50-55 % of patients confirmed that they were asked about presence of a pacemaker at the point of referral. Less than 50 % of patients reported being asked about other potential hazards.Suggested strategies for change: (1) Risk Alert-Sent to all MRI referrers in the organization. ( 2) Changes to MRI Safety Questionnaire. (3) Feedback mechanism to referrers-NHS trust website publications on number of recorded near-misses and wasted appointments due to MRI-safety issues. (4) Compulsory education/training of future referrers (junior doctors/allied health professionals). (5) Education of patients/public on MRI safety-Displaying patient information leaflets/posters in waiting areas of the hospital.Key measures for improvement: (1) Reduction in number of recorded near-misses. (2) System improvements, referrer and patient education, reduction of wasted MRI appointments and improvement of waiting-times for MRI appointments Effects of survey and conclusions: The survey highlights the possibility of inadequate referrer attention, and poor patient communication about MRI safety questionnaire with regards to potential hazards of MRI examination in presence of undeclared implants. It initiated several interventions resulting in improved patient safety, with no events in next 12 months, whilst promoting public and referrer's understanding of potential MRI safety issues. Such actions are recommended for all NHS centres across UK since there are significant similarities in functioning across UK.

Project description:AbstractAn organization's culture with regard to patient safety is important because it defines the beliefs and practices of the organization, and consequently its efficiency and productivity.Knowing the level of this and the factors that influence or not their dynamic represents a challenge, due to the degree of complexity and specificity of the elements involved.The aim of this study was to analyze predictors of patient safety culture in public and private hospitals and examining the factors that contribute to it, constructing a new and specific theoretical and methodological model.This study was carried out by reviewing medical records, detecting healthcare professionals directly involved in caring (N = 588), for patients in 2 public hospitals and 2 private hospitals in Venezuela (N = 566), conducting an "Analysis of Patient Safety Culture" questionnaire. The results were subsequently analyzed, derived 3 predictors factors and using a Patient Safety Culture Index (PSCI) for specific determination to evaluate patient safety culture level.The analysis showed that all hospitals had a "moderately unfavorable" PSCI (public = 52.96, private = 52.67, sig = 0.90). The PSCI was calculated by assessing the weight of the following factors in the index: occupational factors (factor loading = 32.03), communication factors (factor loading = 11.83), and organizational factors (factor loading = 9.10). Traumatology presented the lowest PSCI of all the care units, falling into the "unfavorable" category (36.48), and Laboratory the highest (70.02) (sig = 0.174), falling into the "moderately favorable" category. When analyzing professional groups, nurses had the highest PSCI, with a "moderately unfavorable" rating (PSCI = 61.1) and medical residents the lowest, falling into the "unfavorable" category (35.2). Adverse event reporting is determined by "management expectations and actions" (sig = 0.048) and "direct interaction with the patient" (sig = 0.049).The use of this theoretical and methodological approach in other contexts may provide a more objective system for identifying more specific needs and factors that influence in patient safety culture, and consequently, opportunities for improvement when constructing a patient safety culture in healthcare institutions. Efforts need to be made to improve safety culture in the hospitals studied, irrespective of whether they are public or private.

Project description:Measuring patient safety culture can provide insight into areas for improvement and help monitor changes over time. This study details the findings of a re-assessment of patient safety culture in a multi-site Medical City in Riyadh, Kingdom of Saudi Arabia (KSA). Results were compared to an earlier assessment conducted in 2012 and benchmarked with regional and international studies. Such assessments can provide hospital leadership with insight on how their hospital is performing on patient safety culture composites as a result of quality improvement plans. This paper also explored the association between patient safety culture predictors and patient safety grade, perception of patient safety, frequency of events reported and number of events reported.We utilized a customized version of the patient safety culture survey developed by the Agency for Healthcare Research and Quality. The Medical City is a tertiary care teaching facility composed of two sites (total capacity of 904 beds). Data was analyzed using SPSS 24 at a significance level of 0.05. A t-Test was used to compare results from the 2012 survey to that conducted in 2015. Two adopted Generalized Estimating Equations in addition to two linear models were used to assess the association between composites and patient safety culture outcomes. Results were also benchmarked against similar initiatives in Lebanon, Palestine and USA.Areas of strength in 2015 included Teamwork within units, and Organizational Learning-Continuous Improvement; areas requiring improvement included Non-Punitive Response to Error, and Staffing. Comparing results to the 2012 survey revealed improvement on some areas but non-punitive response to error and Staffing remained the lowest scoring composites in 2015. Regression highlighted significant association between managerial support, organizational learning and feedback and improved survey outcomes. Comparison to international benchmarks revealed that the hospital is performing at or better than benchmark on several composites.The Medical City has made significant progress on several of the patient safety culture composites despite still having areas requiring additional improvement. Patient safety culture outcomes are evidently linked to better performance on specific composites. While results are comparable with regional and international benchmarks, findings confirm that regular assessment can allow hospitals to better understand and visualize changes in their performance and identify additional areas for improvement.

Project description:BackgroundGlobally, Coronavirus disease-19 has created unprecedented challenges to public health. Healthcare workers (HCWs) are at risk of COVID-19 because of their profession. There are limited studies conducted in Ethiopia among HCWs regarding their compliance with COVID-19 preventive measures. Therefore, this study intended to assess HCWs' compliance with measures to prevent COVID-19, and its potential determinants in public hospitals in Western Ethiopia.MethodsA self-administered, multicenter hospital-based cross-sectional survey was proposed to 422 randomly selected HCWs working in seven public hospitals in Western Ethiopia identified as COVID-19 referral centers. Data were entered into Epi Data version 3.1 and analyzed using SPSS version 24. Binary logistic regression was used to identify potential determinants of outcome variables at p-value < 0.05.ResultsOut of 422 completed questionnaires, the overall HCWs' compliance with COVID-19 prevention is 22% (n = 404). In multivariate regression analysis, factors such as spending most of caring time at bedside (AOR = 1.94, 95%CI, 1.06-3.55), receiving training on infection prevention/COVID-19 (AOR = 1.86, 95%CI, 1.04-3.33), reading materials on COVID-19 (AOR = 2.04, 95%CI, 1.14-3.63) and having support from hospital management (AOR = 2.09, 95%CI, 1.20-3.64) were found to be significantly associated with COVID-19 preventive measures. Furthermore, inadequate supplies of appropriate personal protective equipment (83.2%), insufficient supportive medications (78.5%), and lack of provision of adequate ventilation (77.7%) were the barriers to COVID-19 prevention most frequently mentioned by participants.ConclusionOur findings highlight HCWs' poor compliance with COVID-19 preventive measures. Providing information and refreshing training to improve the level of healthcare workers' adherence with COVID-19 prevention is as imperative as increasing staff commitment to supply resources necessary to protect HCWs and to reduce healthcare-associated infections transmission of SARS-COV-2.

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Areas of Potential Improvement for Hospitals' Patient-Safety Culture in Western Ethiopia.

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Areas of Potential Improvement for Hospitals' Patient-Safety Culture in Western Ethiopia.

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