Impact of Patient Safety Incidents Reported by the General Public in Korea.
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ABSTRACT: Objective
The study aimed to investigate the impacts of patient safety incident (PSI) experienced by the general public.Methods
We conducted a self-administered online survey, in which we examined the following experiences of the patients and the caregivers: the level of harm induced by PSIs, difficulties due to PSIs, posttraumatic stress disorder (PTSD), and posttraumatic embitterment disorder, etc. A χ test was performed to identify differences in difficulties because of the direct and indirect experience of PSIs. A 1-way analysis of variance was performed to identify the differences in the total PTSD and posttraumatic embitterment disorder scores according to the characteristics of PSIs.Results
Of the survey participants who indirectly experienced PSIs, 27.2% and 29.3% reported that they experienced sleep disorder and eating disorder, respectively. However, of the participants who directly experienced PSIs, 40.7% and 42.6% reported experiencing sleep disorder and eating disorder, respectively. The average PTSD scores of the participants who experienced permanent disability and death were 83.8 points for less than 6 months of elapsed time since the incident, 80.8 points for 6 months to less than 5 years, and 94.7 points for 5 years or more; they did not demonstrate a statistically significant difference (P = 0.217).Conclusions
This study suggested that the general public who experienced PSIs have numerous difficulties at the time of the incident and the trauma or the resentment of the general public does not quickly regress even if time passes.
SUBMITTER: Pyo J
PROVIDER: S-EPMC8612920 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:OBJECTIVES:Many countries and organizations have promoted the disclosure of patient safety incidents (DPSI). However, reporting frequency and quality of DPSI fall short of patient and caregiver' expectations. In this study, we examined the attitudes toward DPSI of the general public representing the Korean population. METHODS:Survey questions were developed based on a previous systematic review and qualitative research. Face-to-face interviews using paper-based questionnaires were conducted. We explored attitudes toward DPSI in various scenarios and opinions on methods to facilitate DPSI. RESULTS:Almost all participants answered that it is necessary to disclose major errors (99.9%) and near misses (93.3%). A total of 96.6% (675/699) agreed that "DPSI will lead physicians to pay more attention to patient safety in the future," and 94.1% (658/699) agreed that "DPSI will make patients and their caregivers trust the physician more." Although 79.7% (558/700) agreed that "apology law will limit patients' ability to prove physicians' negligence," 95.4% (668/700) agreed with "I support the introduction of apology law." Moreover, 90.6% (634/700) agreed with "I support the introduction of mandatory DPSI." CONCLUSIONS:This study showed the overwhelmingly positive attitude of the public toward DPSI. The positive opinion of the public about apology law suggests the possibility of introducing the disclosure policy coupled with legislation of apology law in South Korea.
| S-EPMC7046138 | biostudies-literature
Project description:PURPOSE: To consider wrong intraocular lens (IOL) implant events in cataract surgical care reported through a national incident reporting database. To propose potential solutions for such events where possible. METHODS: Thematic retrospective review of wrong IOL implantation incidents, as reported through clinical incident reporting methods in NHS care in England and Wales from 2003 to 2010, ascertained from database mining at the National Patient Safety Agency. RESULTS: In total, 164 patient safety incident (PSI) reports of wrong IOL implantation were located from the study period and considered. There were 47 reports where further surgical intervention was required. All, but one of these required IOL exchange surgery. A total of 62 reports did not provide any causal reason for the wrong IOL implantation and thus provide little if any potential learning. Inaccurate biometry (n=29), wrong IOL selection (n=21), transcription errors (n=10) and handwriting misinterpretations (n=7) were causal reasons reported and are thus potential areas for ophthalmic teams to review and improve practice. CONCLUSION: Although infrequent, biometry/IOL implant errors or wrong implants do occasionally occur during cataract care and are thus a threat to quality. There is room for improvement in incident reporting in NHS cataract care as root causation of error was usually lacking in the PSI reports. Nevertheless, lessons for improvement of care from a national incident reporting database for a frequently undertaken surgical procedure were found. Suggestions are proposed for improving quality by reducing wrong IOL problems in cataract care based on analysis of such reports.
| S-EPMC3178144 | biostudies-other
Project description:ObjectivesThe aim of this study was to investigate the scope and severity of the second victim problem among nurses by examining the experiences and effects of patient safety incidents (PSIs) on them.Participants/setting492 nurses who had experienced PSIs and provide direct care in South Korean medical institutions.DesignA cross-sectional study with anonymous online self-report questionnaires was conducted to nurses in order to examine the experiences and effects of PSIs. Scales measuring post-traumatic stress disorder (PTSD) and post-traumatic embitterment disorder (PTED) were used for a more quantitative examination of the effects of PSIs. A ?2 test was administered to find any difference in responses to difficulties due to PSIs between the direct and indirect experience of PSIs. Furthermore, linear regression analysis was conducted to investigate the factors related to scores on the PTSD and PTED scales.ResultsA statistically significant difference was observed for participants who reported having experienced sleeping disorders, with those with direct experience showing 42.4% sleeping disorders and indirect experience at 21.0%. Also, there was a statistically significant difference between the 34.3% with direct experience and the 22.1% with indirect experience regarding having considered duty or job changes (resignation). Regression analysis showed total PTSD scores for indirect experience at 11.97 points (95% CI: -17.31 to -6.63), lower than direct experience. Moreover, those who thought the medical error was not involved in PSI had a total PTED score 4.39 points (95% CI: -7.23 to -1.55) lower than those who thought it was involved.ConclusionsA considerable number of nurses experienced psychological difficulties due to PSIs at levels that could interfere with their work. The effect of PSIs on nurses with direct experience of PSIs was greater compared with those with indirect experience. There need to be psychological support programmes for nurses to alleviate the negative effects of PSIs.
| S-EPMC7783619 | biostudies-literature
Project description:BACKGROUND:Medical professionals who experience patient safety incidents (PSIs) are vulnerable to emotional pain and other difficulties; such individuals are referred to as "second victims." This study quantitatively examines the characteristics of physicians' experiences of PSIs, along with the consequent difficulties and levels of post-traumatic stress disorder (PTSD), and post-traumatic embitterment disorder (PTED) regarding the events. METHODS:An anonymous, self-report online survey was administered to physicians. This collected information regarding PSI characteristics (e.g., type, severity of harm) and impact (e.g., sleep disorder, consideration of career change), as well as participants' socio-demographic characteristics. Meanwhile, to quantitatively assess PSI impacts, PTSD and PTED scales were also administered. PSI characteristics and impacts were analyzed using frequency analysis, and the differing effects of indirect and direct PSI experience regarding consequent difficulties were analyzed using chi-square tests. Factors associated with PTSD and PTED scores were identified using linear regression. RESULTS:Of 895 physicians, 24.6% and 24.0% experienced PSI-induced sleep disorder and eating disorder, respectively. Moreover, 38.9% reported being overly cautious in subsequent similar situations, and 12.6% had considered changing jobs or career. Sleep disorder was significantly more common among participants who directly experienced a PSI (32.8%) than among those with indirect experience (15.3%; P < 0.001). Linear regression showed that indirectly involved physicians had a lower mean PTSD score (by 8.44; 95% confidence interval, -12.28 to -4.60) than directly involved physicians. CONCLUSION:This study found that many physicians experience PSI-induced physical symptoms and behavioral responses, and that the severity of these symptoms varies depending on the type of incident and degree of harm involved. Our findings can provoke more active discussion regarding programs for supporting second victims, and can also encourage the establishing of a system for addressing PSIs that have already occurred, such as through disclosure of PSIs.
| S-EPMC7200176 | biostudies-literature
Project description:BACKGROUND:Healthcare professionals who experience trauma due to patient safety incidents can be considered second victims, and they also suffer from various difficulties. In order to support second victims, it is necessary to determine the circumstances of the incidents in question, along with the symptoms that the victims are experiencing and the support they require. A qualitative study on healthcare professionals of various occupations, such as physicians and nurses working in Korea, was conducted, and the experiences and response methods and processes of second victims were examined. METHODS:In-depth interviews were conducted with 16 healthcare professionals (six physicians, eight nurses, and two pharmacists) who had experienced a patient safety incident. All interviews were recorded and transcribed, and the data analysis was conducted in accordance with Strauss and Corbin's grounded theory. Both open coding and axial coding were performed. Consolidated criteria for reporting qualitative research (COREQ) were applied in this study. RESULTS:The results of the open coding demonstrated that the experiences of second victims can be categorized into "the reactions of the first victim and surrounding people after the incident," "Influence of factors aside from the incident," "the initial complex responses of the participants to the incident," "open discussion of the incident," "the culture in medical institutions regarding early-stage incident response," "the coping responses of the participants after incidents," and "living with the incident." Then, the seven categories in the open coding stage were rearranged according to the paradigm model, and the reaction process of the second victims was analyzed through process analysis, being divided into the "entanglement stage," "agitating stage," "struggling stage," "managing stage," and "indurating stage." CONCLUSIONS:This research is significant because it provides a comprehensive understanding of second victims' experiences in the eastern region of Korea, by obtaining data using a qualitative research method. The findings of the study also highlight the five stages of the second victim response process, and can be used to design a specialized second victim support program in Korea.
| S-EPMC6366082 | biostudies-other
Project description:ObjectivesPrisoners use healthcare services three times more frequently than the general population with poorer health outcomes. Their distinct healthcare needs often pose challenges to safe healthcare provision. This study aimed to characterise patient safety incidents reported in prisons to guide practice improvement and identify health policy priorities.Design: We carried out an exploratory multi-method analysis of anonymised safety incidents from prisons.SettingSafety incidents had been reported to the National Reporting and Learning System by prisons in England between April 2018 and March 2019.ParticipantsReports were reviewed to identify any unintended or unexpected incident(s) which could have, or did, lead to harm for prisoners receiving healthcare.Main outcome measuresFree-text descriptions were examined to identify the type and nature of safety incidents, their outcomes and harm severity. Analysis was contextualised with subject experts through structured workshops to explain relationships between the most common incidents and contributory factors.ResultsOf 4112 reports, the most frequently observed incidents were medication-related (n = 1167, 33%), specifically whilst administering medications (n = 626, 54%). Next, were access-related (n = 559,15%), inclusive of delays in patients accessing healthcare professionals (n = 236, 42%) and managing medical appointments (n = 171, 31%). The workshops contextualised incidents involving contributing factors (n = 1529, 28%) into three key themes, namely healthcare access, continuity of care and the balance between prison and healthcare priorities.ConclusionsThis study highlights the importance of improving medication safety and access to healthcare services for prisoners. We recommend staffing level reviews to ensure healthcare appointments are attended, and to review procedures for handling missed appointments, communication during patient transfers and medication prescribing.
| S-EPMC10387805 | biostudies-literature
Project description:Objectives(1) To describe the epidemiology of patient safety (PS) incidents registered in an electronic notification system in primary care (PC) health centres; (2) to define a risk map; and (3) to identify the critical areas where intervention is needed.DesignDescriptive analytical study of incidents reported from 1 January to 31 December 2018, on the TPSC Cloud™ platform (The Patient Safety Company) accessible from the corporate website (Intranet) of the regional public health service.Setting24 Catalan Institute of Health PC health centres of the Tarragona region (Spain).ParticipantsProfessionals from the PC health centres and a Patient Safety Functional Unit.MeasurementsData obtained from records voluntarily submitted to an electronic, standardised and anonymised form. Data recorded: healthcare unit, notifier, type of incident, risk matrix, causal and contributing factors, preventability, level of resolution and improvement actions.ResultsA total of 1544 reports were reviewed and 1129 PS incidents were analysed: 25.0% of incidents did not reach the patient; 66.5% reached the patient without causing harm, and 8.5% caused adverse events. Nurses provided half of the reports (48.5%), while doctors reported more adverse events (70.8%; p < 0.01). Of the 96 adverse events, 46.9% only required observation, 34.4% caused temporary damage that required treatment, 13.5% required (or prolonged) hospitalization, and 5.2% caused severe permanent damage and/or a situation close to death. Notably, 99.2% were considered preventable. The main critical areas were: communication (27.8%), clinical-administrative management (25.1%), care delivery (23.5%) and medicines (18.4%); few incidents were related to diagnosis (3.6%).ConclusionsPS incident notification applications are adequate for reporting incidents and adverse events associated with healthcare. Approximately 75% and 10% of incidents reach the patient and cause some damage, respectively, and most cases are considered preventable. Adequate and strengthened risk management of critical areas is required to improve PS.
| S-EPMC8430626 | biostudies-literature
Project description:To introduce disclosure of patient safety incidents (DPSI) into a specific country, evidence of the effectiveness of DPSI is essential. Since such a disclosure policy has not been adopted in South Korea, hypothetical cases can be used to measure the effectiveness of DPSI. We evaluated the effectiveness of DPSI using hypothetical cases in a survey with a sample of the Korean general public. We used 8 hypothetical cases reflecting 3 conditions: the clarity of medical errors, the severity of harm, and conducting DPSI. Face-to-face interviews with 700 people using structured questionnaires were conducted. Participants were asked to read each hypothetical case and give remarks on the following: their judgment of a situation as a medical error and of the requirement for an apology, the willingness to revisit or recommend physicians, the intention to file a medical lawsuit and commence criminal proceedings against physicians, the level of trust in physicians, and the expected amount of compensation. The results indicated favorable findings in support of DPSI; DPSI reduced the likelihood of perceiving a situation as a medical error, promoted willingness to revisit and recommend physicians, and discouraged the intention to file a medical lawsuit and take commence criminal proceedings against physicians. Furthermore, DPSI increased patients' trust scores in physicians and reduced the expected amount of compensation. The general public had positive attitudes towards DPSI in South Korea. This result provides empirical evidence for reducing the psychological burden that the introduction of DPSI may have on health professionals.
| S-EPMC6002037 | biostudies-literature
Project description:ObjectivesThis study conducted a survey to examine how the general public in Korea perceives patient engagement for patient safety and to identify vulnerable groups and contents priorities of patient engagement education for the general public.MethodsWe developed a questionnaire based on previous studies and conducted one-on-one interviews with 600 individuals from the public. Then, we conducted descriptive statistical analyses (i.e., frequency, percentage, and averages) on the questionnaire items. Furthermore, we examined the individual differences of participants' sociodemographic characteristics in their responses to the questionnaire.ResultsThe general public's awareness regarding accreditation programs for healthcare organizations was still low (47.4%). Nearly 60% of participants said that they did not agree with the practice of telling their own names and dates of birth before treatment. Approximately 80% of the participants would not ask medical staff to confirm washing their hands. Only half of the participants were aware of medical dispute mediation and arbitration programs. Nearly 90% of the participants agreed that patient safety is important. However, on participants' confidence in making the correct choice and safety in their treatment, the average score was 68.7 of 100 points. Participants tended to be less confident about engaging in patient safety activities if they were older, less educated, or had poor health status.ConclusionsParticipants in this study believed that patient safety is an important issue, but they were not confident about choosing the correct medical institution or about receiving safe treatment.
| S-EPMC7781086 | biostudies-literature
Project description:BackgroundIncreasing evidence suggests that patient safety is a serious concern for older patients with long-term conditions. Despite this, there is a lack of research on safety incidents encountered by this patient group. In this study, we sought to examine patient reports of safety incidents and factors associated with reports of safety incidents in older patients with long-term conditions.MethodsThe baseline cross-sectional data from a longitudinal cohort study were analysed. Older patients (n=3378 aged 65 years and over) with a long-term condition registered in general practices were included in the study. The main outcome was patient-reported safety incidents including availability and appropriateness of medical tests and prescription of wrong types or doses of medication. Binary univariate and multivariate logistic regression analyses were undertaken to examine factors associated with patient-reported safety incidents.ResultsSafety incidents were reported by 11% of the patients. Four factors were significantly associated with patient-reported safety incidents in multivariate analyses. The experience of multiple long-term conditions (OR=1.09, 95% CI 1.05 to 1.13), a probable diagnosis of depression (OR=1.36, 95% CI 1.06 to 1.74) and greater relational continuity of care (OR=1.28, 95% CI 1.08 to 1.52) were associated with increased odds for patient-reported safety incidents. Perceived greater support and involvement in self-management was associated with lower odds for patient-reported safety incidents (OR=0.95, 95% CI 0.93 to 0.97).ConclusionsWe found that older patients with multimorbidity and depression are more likely to report experiences of patient safety incidents. Improving perceived support and involvement of patients in their care may help prevent patient-reported safety incidents.
| S-EPMC5729978 | biostudies-literature