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Isaac D, Li Y, Wang Y, Jiang D, Liu C, Fan C, Boah M, Xie Y, Ma M, Shan L, Gao L, Jiao M. Healthcare workers perceptions of patient safety culture in selected Ghanaian regional hospitals: a qualitative study. BMC Psychol 2024; 12:272. [PMID: 38750584 PMCID: PMC11094925 DOI: 10.1186/s40359-024-01628-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 02/27/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Patient safety culture is an integral part of healthcare delivery both in Ghana and globally. Therefore, understanding how frontline health workers perceive patient safety culture and the factors that influence it is very important. This qualitative study examined the health workers' perceptions of patient safety culture in selected regional hospitals in Ghana. OBJECTIVE This study aimed to provide a voice concerning how frontline health workers perceive patient safety culture and explain the major barriers in ensuring it. METHOD In-depth semi-structured interviews were conducted with 42 health professionals in two regional government hospitals in Ghana from March to June 2022. Participants were purposively selected and included medical doctors, nurses, pharmacists, administrators, and clinical service staff members. The inclusion criteria were one or more years of clinical experience. Interviews were recorded and transcribed. Thematic analysis was used to identify themes. RESULT The health professionals interviewed were 38% male and 62% female, of whom 54% were nurses, 4% were midwives, 28% were medical doctors; lab technicians, pharmacists, and human resources workers represented 2% each; and 4% were critical health nurses. Among them, 64% held a diploma and 36% held a degree or above. This study identified four main areas: general knowledge of patient safety culture, guidelines and procedures, attitudes of frontline health workers, and upgrading patient safety culture. CONCLUSIONS This qualitative study presents a few areas for improvement in patient safety culture. Despite their positive attitudes and knowledge of patient safety, healthcare workers expressed concerns about the implementation of patient safety policies outlined by hospitals. Healthcare professionals perceived that curriculum training on patient safety during school education and the availability of dedicated officers for patient safety at their facilities may help improve patient safety.
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Affiliation(s)
| | - Yuanheng Li
- Harbin Medical University, Harbin, Heilongjiang, China
| | - Yushu Wang
- Northeastern University, Shenyang, Liaoning, China
| | - Deyou Jiang
- Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Chenggang Liu
- Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Chao Fan
- Third Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Michael Boah
- School of Public health University for Development studies, Tamale, Ghana
| | - Yuzhuo Xie
- Harbin Medical University, Harbin, Heilongjiang, China
| | - Mingxue Ma
- Harbin Medical University, Harbin, Heilongjiang, China
| | - Linghan Shan
- Harbin Medical University, Harbin, Heilongjiang, China.
| | - Lei Gao
- Harbin Medical University, Harbin, Heilongjiang, China.
| | - Mingli Jiao
- Harbin Medical University, Harbin, Heilongjiang, China.
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Jafari MJ, Mostafazadeh P, Mojebi MR, Nemati-Vakilabad R, Mirzaei A. Identifying predictors of patient safety competency based on sleep quality in student faculty of nursing and midwifery during the internship period: a multidisciplinary study. BMC Nurs 2024; 23:67. [PMID: 38267940 PMCID: PMC10807159 DOI: 10.1186/s12912-024-01725-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Ensuring patient safety is of paramount importance in healthcare services. Sleep disorders not only have detrimental effects on the health of healthcare students but also significantly impair their performance, leading to an increased risk of medication errors. These errors can pose a grave threat to the safety and well-being of patients. It is crucial to address and mitigate sleep disorders among internship healthcare students to safeguard the quality of care and minimize potential patient harm. OBJECTIVES This study aimed to investigate the predictors of Patient Safety Competency (PSC) based on the sleep quality of internship healthcare students. METHODS A study was conducted on 331 students from the Ardabil School of Nursing and Midwifery at Ardabil University of Medical Sciences in northwest Iran from August to December 2022. The participants were selected by stratified random sampling. Data were collected using a demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Health Professional Education in Patient Safety Survey (H-PEPSS). The collected data were analyzed using SPSS software version 22.0. Person correlation coefficients were used to examine the relationship between PSC level, its dimensions, and sleep quality, while multiple linear regression was conducted to identify the predictors of PSC. RESULTS The competency of nurses in patient safety was average in both classroom and clinical settings. However, their ability to work as a team with other healthcare professionals scored the lowest. In addition, the quality of sleep was found to be a predictor of patient safety competency among healthcare students during their internships. CONCLUSIONS It is important to note that healthcare students tend to have moderate patient safety competence (PSC), which is positively correlated with their sleep quality. Therefore, it is vital to identify the key factors that directly affect PSC. This would enable nursing and midwifery faculty administrators to take preventive measures to enhance patient safety competence in both classroom and clinical settings. Additionally, organizing educational workshops that engage students and improve their sleep quality could improve patient care. Practical courses are recommended for health professionals and students in clinical settings to enhance patient safety competencies. Additionally, student internships should receive hands-on training to improve teamwork and rest conditions.
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Affiliation(s)
- Mohammad Javad Jafari
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Pouya Mostafazadeh
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Reza Mojebi
- Students Research Committee, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Reza Nemati-Vakilabad
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Mirzaei
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
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Ghasempour M, Ghahramanian A, Zamanzadeh V, Valizadeh L, Onyeka TC, Asghari Jafarabadi M. Senior nursing student's confidence in learnt competencies and perceptions of patient safety competency: a multisite cross-sectional study. BMJ Open 2023; 13:e070372. [PMID: 37612112 PMCID: PMC10450063 DOI: 10.1136/bmjopen-2022-070372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVE Nursing students' attainment of patient safety (PS) competency has always been a global concern among health and educational organisations. Therefore, this study was conducted to determine senior nursing students' confidence of their PS competencies, and associated predictive factors. DESIGN Cross-sectional study. SETTING Four faculties from the nursing faculties of East Azerbaijan province. PARTICIPANTS 253 senior nursing students in Iran. PRIMARY AND SECONDARY OUTCOME MEASURES Using the modified version of the Health Professional Education Patient Safety Survey, data related to the level of confidence of nursing students in acquired competencies in seven sociocultural dimensions of PS in classroom learning and clinical settings were collected. In addition, the predictors of the patient's safety competencies were identified by linear regression statistics. RESULTS Mean scores of all dimensions of PS competencies both in the classroom and in clinical settings were higher than 3.11 (out of 5). The nursing students were most confident in their learning of 'understanding human and environmental factors' in the classroom and the clinical setting. Nursing students displayed the least confidence in learning 'work in teams with other health professionals' in both the classroom and the clinical settings. Type of university, prior experience with PS competencies education, and coverage of PS competency issues in the curriculum predicted the students' perceived competency scores in the classroom (R2=0.53, p<0.001). Also, perceived competence in the clinical settings was predicted by the variables of reporting errors to personnel and peers and the type of university (R2=0.65, p<0.001). CONCLUSION Study findings emphasise the role of learning environments and educational experiences of nursing students especially the clinical environment, clinical instructors and the hidden curriculum in improving safety competence. Nursing educators can use this information to revise and develop the undergraduate nursing curriculum, paying close attention to lesson plans and content in relation to teaching safety issues.
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Affiliation(s)
- Mostafa Ghasempour
- Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Akram Ghahramanian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Vahid Zamanzadeh
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid-Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Leila Valizadeh
- Department of Pediatric Nursing, Shahid-Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Tonia C Onyeka
- Department of Anaesthesia/Pain & Palliative Care Unit, College of Medicine, University of Nigeria, Ituku-Ozalla, Nigeria
| | - Mohammad Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, Melbourne, Victoria, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Psychiatry, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Lawal BK, Mohammed S. Integrating patient safety education into pharmacy curriculum in Nigeria. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:583-585. [PMID: 36355916 DOI: 10.1093/ijpp/riac085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/13/2022] [Indexed: 11/12/2022]
Abstract
Recognition has been given to patient safety and healthcare quality as central components of a functional health system which has resulted in increased advocacy for elaborate patient safety content in education and training programmes for health professionals. The World Health Organisation's patient safety curriculum is an evidence-based framework that provides a valuable resource for the training of healthcare professionals in enhancing patient safety. Other international organisations have also advocated for the need to restructure healthcare professionals' education to include the concept of patient safety. The ideal time to initiate patient safety education is suggested to be during schooling through curricula that inculcate learning from adverse events. This will prepare pharmacy students as future healthcare professionals who will become better prepared for clinical practice leading to improved healthcare quality and safety.
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Affiliation(s)
- Basira Kankia Lawal
- Department of Clinical Pharmacy and Pharmacy Management, Kaduna State University, Kaduna, Nigeria
| | - Shafiu Mohammed
- Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Nigeria.,Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
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Vogt L, Stoyanov S, Bergs J, Schröder H, Drachsler H, Klasen M, Sopka S. Are the World Health Organization's Patient Safety Learning Objectives Still Up-to-Date: A Group Concept Mapping Study. J Patient Saf 2022; 18:731-737. [PMID: 35175234 PMCID: PMC9698154 DOI: 10.1097/pts.0000000000000993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The World Health Organization (WHO) Patient Safety Curriculum Guide defines learning objectives for patient safety. Current implementation in healthcare education is insufficient. Possible explanations may be obsolescence and/or a shift in needs. We investigated whether overarching topics and specific learning objectives of the WHO Patient Safety Curriculum Guide are still up-to-date, their attributed importance, and their perceived difficulty to achieve. METHODS Experts on patient safety and medical education from 3 European countries were asked to suggest learning objectives concerning patient safety using group concept mapping. Following 3 successive steps, experts rated ideas by importance and difficulty to achieve. Correlation analyses investigated the relationship between those. Overarching topics of the learning goals (clusters) were identified with multivariate analysis. RESULTS A total of 119 statements about intended learning objectives on patient safety were generated, of which 86 remained for sorting and rating. Based on multivariate analyses, 10 overarching topics (clusters) emerged. Both the learning objectives and the overarching topics showed high correspondence with the WHO Patient Safety Curriculum Guide. Strong correlations emerged between importance and difficulty ratings for learning objectives and overarching topics. CONCLUSIONS The WHO Patient Safety Curriculum Guide's learning goals are still relevant and up-to-date. Remarkably, learning objectives categorized as highly important are also perceived as difficult to achieve. In summary, the insufficient implementation in medical curricula cannot be attributed to the content of the learning goals. The future focus should be on how the WHO learning goals can be implemented in existing curricular courses.
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Affiliation(s)
- Lina Vogt
- From the AIXTRA—Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen
- Clinic for Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | | | - Jochen Bergs
- Faculty of Medicine and Life Science, Hasselt University, Hasselt, Belgium
| | - Hanna Schröder
- Clinic for Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Aachen Institute for Rescue Management and Public Safety (ARS), Medical Faculty, RWTH Aachen, Aachen
| | - Hendrik Drachsler
- Open Universiteit, Heerlen, the Netherlands
- Goethe University, Frankfurt am Main
- DIPF I Leibniz Institute for Research and Information in Education, Frankfurt, Germany
| | - Martin Klasen
- From the AIXTRA—Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen
- Clinic for Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Saša Sopka
- From the AIXTRA—Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen
- Clinic for Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
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Ahmed FA, Asif F, Mubashir A, Aboumatar HJ, Hameed M, Haider A, Latif A. Incorporating Patient Safety and Quality Into the Medical School Curriculum: An Assessment of Student Gains. J Patient Saf 2022; 18:637-644. [PMID: 35532980 PMCID: PMC9422755 DOI: 10.1097/pts.0000000000001010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Global efforts are being made to improve health care standards and the quality of care provided. It has been shown through research that the introduction of patient safety (PS) and quality improvement (QI) concepts in the medical curriculum prepares medical students to face future challenges in their professional careers. PURPOSE This study aimed to evaluate how a brief course on QI and PS affects the knowledge, efficacy, and system thinking of medical students. METHODS A 5-day QI and PS intervention course was implemented at the Aga Khan University medical college for 98 third-year medical students in March 2021. This weeklong course of lectures, interactive sessions, and hands-on skill workshops was conducted before the students began their clinical rotations. Students' knowledge, self-efficacy, and system thinking were assessed with pretest and posttest. Students were also asked to write personal reflections and fill out a satisfaction survey at the end of the intervention. RESULTS Comparisons of pretest and posttest scores showed that the course significantly improved students' knowledge by a mean of 2.92 points (95% confidence interval, 2.30-3.53; P < 0.001) and system thinking by 0.16 points (95% confidence interval, 0.03-0.29; P = 0.018) of the maximum scores of 20 and 5 points, respectively. The students' self-assessment of PS knowledge also reflected statistically significant increases in all 9 domains ( P < 0.001). Students reported positive experiences with this course in their personal reflections. CONCLUSIONS The medical students exhibited increases in knowledge, self-efficacy, and system thinking after this weeklong intervention. The design of the course can be modified as needed and implemented at other institutions in low- and middle-income countries. A targeted long-term assessment of knowledge and attitudes is needed to fully evaluate the impact of this course.
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Affiliation(s)
- Fasih Ali Ahmed
- From the Center for Patient Safety, Aga Khan University, Karachi, Pakistan
| | - Fozia Asif
- From the Center for Patient Safety, Aga Khan University, Karachi, Pakistan
| | - Ayesha Mubashir
- From the Center for Patient Safety, Aga Khan University, Karachi, Pakistan
| | - Hanan J. Aboumatar
- Johns Hopkins University School of Medicine
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland
| | - Malika Hameed
- Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
| | - Adil Haider
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Asad Latif
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland
- Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
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Olazo K, Wang K, Sierra M, Barr-Walker J, Sarkar U. Preferences and perceptions of medical error disclosure among marginalized populations: A narrative review. Jt Comm J Qual Patient Saf 2022; 48:539-548. [DOI: 10.1016/j.jcjq.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 10/17/2022]
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Lecturer Support in the Implementation of a New Curriculum During the COVID-19 Pandemic. INTERCHANGE 2022; 53:243-259. [PMID: 35002058 PMCID: PMC8727085 DOI: 10.1007/s10780-021-09454-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/01/2021] [Indexed: 12/04/2022]
Abstract
The objective of the study was to assess the support provided to lecturers in the implementation of a new curriculum during the COVID-19 pandemic to suggest early intervention strategies that address resources and knowledge deficiency gaps that have a negative impact on curriculum implementation. A survey design was used in the study. A representative sample of 30 lecturers was randomly selected from 5 Faculty of Natural Resources Management and Agriculture departments to complete the questionnaire between June and July 2020. The majority of the lecturers agreed that they were involved in the curriculum development. There was affirmation on the issue of professional development, leadership’s support for lecturers’ curriculum implementation and adequate time for curriculum implementation. Similarly, there was collaboration between university leadership and lecturers to plan curriculum implementation. On the contrary, funds for research necessary for curriculum implementation, instructional materials and supplies and technological resources were not adequately supplied. Hence, the paper becomes critical as it highlights the unavailability of technological resources which play a crucial role in online teaching and learning during the COVID-19 pandemic.
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Ferorelli D, Benevento M, Vimercati L, Spagnolo L, De Maria L, Caputi A, Zotti F, Mandarelli G, Dell'Erba A, Solarino B. Improving Healthcare Workers' Adherence to Surgical Safety Checklist: The Impact of a Short Training. Front Public Health 2022; 9:732707. [PMID: 35211450 PMCID: PMC8860967 DOI: 10.3389/fpubh.2021.732707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/30/2021] [Indexed: 12/04/2022] Open
Abstract
Background Although surgery is essential in healthcare, a significant number of patients suffer unfair harm while undergoing surgery. Many of these originate from failures in non-technical aspects, especially communication among operators. A surgical safety checklist is a simple tool that helps to reduce surgical adverse events, but even if it is fast to fill out, its compilation is often neglected by the healthcare workers because of unprepared cultural background. The present study aims to value the efficacy of a free intervention, such as a short training about risk management and safety checklist, to improve checklist adherence. Methods In March 2019, the medical and nursing staff of the General Surgical Unit attended a two-lesson theoretical training concerning surgical safety and risk management tools such as the surgical safety checklist. The authors compared the completeness of the surgical checklists after and before the training, considering the same period (2 months) for both groups. Result The surgical safety checklists were present in 198 cases (70.97%) before the intervention and 231 cases (96.25%) after that. After the training, the compilation adherence increased for every different type of healthcare worker of the unit (surgeons, nurses, anesthetists, and scrab nurses). Furthermore, a longer hospitalization was associated with a higher surgical checklist adherence by the operators. Conclusions The results showed that a free and simple intervention, such as a two-lesson training, significantly stimulated the correct use of the surgical safety checklist. Moreover, the checklist adherence increased even for the operators who did not attend the training, maybe because of the positive influence of the colleagues' positive behaviors. As the results were promising with only two theoretical lessons, much more can be done to build a new safety culture in healthcare.
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Affiliation(s)
- Davide Ferorelli
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Marcello Benevento
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Luigi Vimercati
- Section of Occupational Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Lorenzo Spagnolo
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Luigi De Maria
- Section of Occupational Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Antonio Caputi
- Section of Occupational Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Fiorenza Zotti
- Section of Clinical Risk Management, Policlinico University Hospital of Bari, Bari, Italy
| | - Gabriele Mandarelli
- Section of Criminology and Forensic Psychiatry, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Alessandro Dell'Erba
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Biagio Solarino
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
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Corbally MT. The role of registered charities in the delivery of global surgery in low- and middle-income countries - a personal experience. Surgeon 2021; 20:41-47. [PMID: 34930698 DOI: 10.1016/j.surge.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
The world's resources are unequally divided. Investment in healthcare in Low- and Middle-Income Countries (LMICs) has traditionally involved vertical public health strategies with little emphasis on the delivery of safe and effective surgery and anesthesia. The past 20 years has witnessed greater awareness of the numbers of people who have no access to surgery, the morbidity and mortality of such limited access, and the cost to the individual and society if a solution is not found. Global surgery has become a hot topic and The Millennium Development Goals (MDG) and the Sustainable Development Goals (SDG) have underlined the importance of surgery in national health care plans. The harsh metrics reported by the Lancet Commission has framed the problem in more concrete terms and as of today, over 5 billion people lack access to safe surgery, over 143 million extra surgeries are needed annually to affect the imbalance and more than 15,000 children die each day in Sub Saharan Africa and Southeast Asia from preventable disease, including the lack of access to safe surgery. Horizontal integrated healthcare that includes surgical provision is the new norm, but its introduction is expensive and will need time. The ambition of universal healthcare access for all people (SDG) with a corresponding reduction in child and maternal mortality will be difficult for most governments. Altruistic, Non-Governmental Organizations (NGOs) are ideally placed to assist this goal but must introduce changes in practice to include onsite and off-site training, broad partnerships with other NGOs and academic bodies and greater advocacy with governments to ensure sustainability. NGOs should work in concert with local agencies, hospitals and governments to meet local needs.
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Affiliation(s)
- Martin T Corbally
- Royal College of Surgeons - Medical University Bahrain, King Hamad University Hospital, Kingdom of Bahrain.
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Patient safety: Knowledge and attitudes of medical and nursing students: Cross-sectional study. Nurse Educ Pract 2021; 53:103089. [PMID: 34049090 DOI: 10.1016/j.nepr.2021.103089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/22/2022]
Abstract
AIM The objective of this study to research medical and nursing students' level of knowledge of patient safety. BACKGROUND Patient safety represents the foundation of health care quality, while education represents a requirement which has to be fulfilled to achieve and maintain that quality. DESIGN The research was conducted as a descriptive/analytical cross-sectional survey, with medical and nursing students being the sample (n = 370). METHODS The research instrument was the WHO questionnaire "What is Patient Safety? ", which displayed good psychometric characteristics. RESULTS The research results indicate that the study department has a significant influence on the level of students' knowledge and attitudes to patient safety. Nursing students in their final academic year show statistically significantly higher level of knowledge in relation to the first year students. Medical students are not significantly different, in terms of the level of knowledge and attitudes, in their first and final academic years. CONCLUSIONS Knowledge and attitudes regarding patient safety shown by the students in this survey significantly contribute to the comprehension of the necessity of the implementation and development of patient safety course into the existing curricula and syllabi of all colleges and universities related to health care.
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Alser M, Böttcher B, Alfaqawi M, Jlambo A, Abuzubaida W, Abu-El-Noor N. Undergraduate medical students' attitudes towards medical errors and patient safety: a multi-center cross-sectional study in the Gaza Strip, Palestine. BMC MEDICAL EDUCATION 2020; 20:447. [PMID: 33213439 PMCID: PMC7678054 DOI: 10.1186/s12909-020-02375-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/10/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND In undergraduate medical education, patient safety concepts and understanding of medical errors are under-represented. This problem is more evident in low-income settings. The aim of this study was to explore undergraduate medical students' attitudes towards patient safety in the low-income setting of the Gaza Strip. METHODS A cross-sectional, descriptive study included medical students of the two medical schools in the Gaza Strip with 338 medical students completing the Attitudes to Patient Safety Questionnaire-IV (APSQ-IV), which examines patient attitudes in 29 items over 10 domains. Results are represented as means ± standard deviations for each item and domain as well as percentage of positive responses to specific items. RESULTS Medical students reported slightly positive patient safety attitudes (4.7 ± 0.5 of 7) with the most positive attitudes in the domains of situational awareness, importance of patient safety in the curriculum, error inevitability and team functioning. While no negative attitudes were reported, neutral attitudes were found in the domains of professional incompetence as a cause of error and error reporting confidence. Study year and gender had no significant association with patient safety attitudes, except for disclosure responsibility, where male students displayed significantly more positive attitudes. The study university was significantly associated with three of the 10 examined domains, all of which involved understanding of medical errors, for which students of University 2 (who had undergone limited patient safety training) held significantly more positive attitudes, compared with students of University 1 (who did not have structured patient safety training). CONCLUSION Medical students' patient safety attitudes were very similar among students from both universities, except for understanding of medical error, for which students, who had received structured training in this topic, displayed significantly more positive attitudes. This underlines the power of the 'hidden curriculum', where students adjust to prevalent cultures in local hospitals, while they do their clinical training. Furthermore, it highlights the need for a systematic inclusion of patient safety content in local undergraduate curricula.
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Affiliation(s)
- Mohammed Alser
- Faculty of Medicine, Islamic University of Gaza, PO Box 108, Remal, Gaza, Gaza Strip, Palestine
| | - Bettina Böttcher
- Faculty of Medicine, Islamic University of Gaza, PO Box 108, Remal, Gaza, Gaza Strip, Palestine.
| | - Maha Alfaqawi
- Nasser Medical Complex, Palestinian Ministry of Health, Khan Younis, Gaza Strip, Palestine
| | - Abdallah Jlambo
- Faculty of Medicine, Al-Azhar University, Gaza Strip, Palestine
| | | | - Nasser Abu-El-Noor
- Faculty of Medicine, Islamic University of Gaza, PO Box 108, Remal, Gaza, Gaza Strip, Palestine
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Davis R, D’Lima D. Building capacity in dissemination and implementation science: a systematic review of the academic literature on teaching and training initiatives. Implement Sci 2020; 15:97. [PMID: 33126909 PMCID: PMC7597006 DOI: 10.1186/s13012-020-01051-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 10/08/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The field of dissemination and implementation (D&I) science has grown significantly over recent years. Alongside this, an increased demand for training in D&I from researchers and implementers has been seen. Research describing and evaluating D&I training opportunities, referred to here as 'capacity building initiatives' (CBIs), can help provide an understanding of different methods of training as well as training successes and challenges. However, to gain a more detailed understanding of the evidence-base and how D&I CBIs are being reported in publications, a field-wide examination of the academic literature is required. METHODS Systematic review to identify the type and range of D&I CBIs discussed and/or appraised in the academic literature. EMBASE, Medline and PsycINFO were searched between January 2006 and November 2019. Articles were included if they reported on a D&I CBI that was developed by the authors (of each of the included articles) or the author's host institution. Two reviewers independently screened the articles and extracted data using a standardised form. RESULTS Thirty-one articles (from a total of 4181) were included. From these, 41 distinct D&I CBIs were identified which focussed on different contexts and professions, from 8 countries across the world. CBIs ranged from short courses to training institutes to being part of academic programmes. Nearly half were delivered face-face with the remainder delivered remotely or using a blended format. CBIs often stipulated specific eligibility criteria, strict application processes and/or were oversubscribed. Variabilities in the way in which the D&I CBIs were reported and/or evaluated were evident. CONCLUSIONS Increasing the number of training opportunities, as well as broadening their reach (to a wider range of learners), would help address the recognised deficit in D&I training. Standardisation in the reporting of D&I CBIs would enable the D&I community to better understand the findings across different contexts and scientific professions so that training gaps can be identified and overcome. More detailed examination of publications on D&I CBIs as well as the wider literature on capacity building would be of significant merit to the field.
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Affiliation(s)
- Rachel Davis
- Centre for Implementation Science, Health Service and Population Research Department, King’s College London, London, UK
| | - Danielle D’Lima
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Alfaqawi M, Böttcher B, Abuowda Y, Alaloul E, Elnajjar I, Elhout S, Abu-El-Noor M, Abu-El-Noor N. Treating patients in a safe environment: a cross-sectional study of patient safety attitudes among doctors in the Gaza Strip, Palestine. BMC Health Serv Res 2020; 20:388. [PMID: 32380987 PMCID: PMC7203848 DOI: 10.1186/s12913-020-05230-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/15/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Patient safety is important, as in increasingly complex medical systems, the potential for unintended harm to patients also increases. This study assessed the attitudes of doctors in the Gaza Strip towards patient safety and medical error. It also explored variables that impacted their attitudes. METHODS Doctors, working for at least 6 months in one of the four major government hospitals of the Gaza Strip, were invited to complete a 28-item, self-administered Arabic version of the Attitudes to Patient Safety Questionnaire III (APSQ-III); which assessed patient safety attitudes over nine domains, independent of the workplace. RESULTS A total of 150 doctors from four government hospitals participated in this study, representing 43.5% of all 345 doctors working in the four study hospitals at the time of the study. The mean age was 36.6 (±9.7) years. The majority (72.7%) were males, 28.7% worked in surgical, 26.7% in pediatric, 23.3% in medical, 16.7% in obstetrics and gynecology, and 4.7% in other departments. Most participants (62.0%) had never received patient safety training. The overall APSQ score was 3.58 ± 0.3 (of a maximum of 5). The highest score was received by the domain "Working hours as a cause of errors" (4.16) and the lowest score by "Importance of Patient Safety in the Curriculum" (3.25). Older doctors with more professional experience had significantly higher scores than younger doctors (p = 0.003), demonstrating more positive attitudes toward patient safety. Furthermore, patient safety attitudes became more positive with increasing years of experience in some domains. However, no significant impact on overall APSQ scores was found by workplace, specialty or whether the participants had received previous training about patient safety. CONCLUSION Doctors in Gaza demonstrated relatively positive patient safety attitudes in areas of "team functioning" and "working hours as a cause for error", but neutral attitudes in understanding medical error or patient safety training within the curriculum. Patient safety concepts appear to be acquired by doctors via informal learning over time in the job. Inclusion of such concepts into formal postgraduate curricula might improve patient safety attitudes among younger and less experienced doctors, support behaviour change and improve patient outcomes.
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Affiliation(s)
- Maha Alfaqawi
- Nasser Medical Complex, Palestinian Ministry of Health Khan Younis, Gaza Strip, Palestine
| | - Bettina Böttcher
- Nasser Medical Complex, Palestinian Ministry of Health Khan Younis, Gaza Strip, Palestine.
| | - Yousef Abuowda
- Faculty of Medicine, Islamic University of Gaza, PO Box 108, Remal Gaza, Gaza Strip, Palestine
| | - Enas Alaloul
- Alshifaa Medical Complex, Palestinian Ministry of Health, Gaza Strip, Palestine
| | - Ibrahem Elnajjar
- Faculty of Medicine, Islamic University of Gaza, PO Box 108, Remal Gaza, Gaza Strip, Palestine
| | - Somaya Elhout
- Alshifaa Medical Complex, Palestinian Ministry of Health, Gaza Strip, Palestine
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Giuliani M, Martimianakis MAT, Benstead K, Grau Eriksen J, Verfaillie C, Van Egten V, Umakanthan B, Driessen E, Frambach J. Exploring implementation of the ESTRO Core Curriculum at the national level. Radiother Oncol 2020; 147:118-122. [PMID: 32276192 DOI: 10.1016/j.radonc.2020.03.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/17/2020] [Accepted: 03/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Global curricula exist across medical specialties however, the factors which influence their implementation are not well understood. The purpose of this study is to report the perceived factors that impact the implementation of the ESTRO Core Curriculum. METHODS An anonymous, 37-item, survey was designed and distributed to the Presidents of the National Societies who have endorsed the ESTRO Core Curriculum (n = 29). The survey addressed perceptions about implementation factors related to context, process and curriculum change. The data was summarized using descriptive statistics. RESULTS Twenty-six (90%) National Societies completed the survey. One respondent perceived that the values of the training system of their country would be incompatible with the proposed ESTRO Core Curriculum. The most common contextual barriers to implementation was a lack of support from the government (57%), a lack of internal organizational support (35%) and a 'poor fit' between the ESTRO Core Curriculum and the broader political and economic context (35%). Perceived implementation process barriers included insufficient numbers of faculty (44%), poor coordination between the government and training institutions (48%), and a lack of an influential person leading the implementation (44%). Two barriers related to curriculum change were a lack of funding and lack of assessment tools. CONCLUSIONS The content and values espoused in the ESTRO Core Curriculum are endorsed across diverse geopolitical and sociocultural regions. Barriers to curricular implementation are identified at the organizational and systems level and include insufficient teaching faculty, lack of coordination and the need for influential leadership.
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Affiliation(s)
- Meredith Giuliani
- Radiation Medicine Program, Princess Margret Cancer Centre, Toronto, Canada.
| | | | - Kim Benstead
- Department of Paediatrics University of Toronto, Canada
| | | | - Christine Verfaillie
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark
| | | | | | - Erik Driessen
- MPH, Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Janneke Frambach
- School of Health Professions Education, Maastricht University, Netherlands
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Menezes AC, Penha CDS, Amaral FMA, Pimenta AM, Ribeiro HCTC, Pagano AS, Mata LRFD. Latino Students Patient Safety Questionnaire: cross-cultural adaptation for Brazilian nursing and medical students. Rev Bras Enferm 2020; 73:e20190621. [DOI: 10.1590/0034-7167-2019-0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 06/10/2020] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to perform a cross-cultural adaptation of the Latino Student Patient Safety Questionnaire for Brazilian Nursing and Medical students. Methods: methodological study carried out in six stages — forward translation, synthesis, back-translation, expert committee assessment, pre-test and reporting to the authors of the original instrument. Data at the expert committee and pre-test stages were collected and analyzed using the web platform e-Surv. The level of agreement adopted for the expert committee evaluation with 20 participants and the pre-test evaluation with 38 students was ≥ 90%. Results: the first evaluation round by the expert committee showed a <90% agreement for 21 out of the 26 questionnaire items, requiring adjustments. In the pre-test, three items in the instrument reached a <90% agreement and were revised to obtain the final version. Conclusions: the Brazilian version of the Latino Student Patient Safety Questionnaire instrument was considered culturally adapted to Brazilian Portuguese.
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Bottcher B, Abu-El-Noor N, Abuowda Y, Alfaqawi M, Alaloul E, El-Hout S, Al-Najjar I, Abu-El-Noor M. Attitudes of doctors and nurses to patient safety and errors in medical practice in the Gaza-Strip: a cross-sectional study. BMJ Open 2019; 9:e026788. [PMID: 31383695 PMCID: PMC6687030 DOI: 10.1136/bmjopen-2018-026788] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 06/17/2019] [Accepted: 07/10/2019] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES This study examined the attitudes of nurses and doctors to key patient safety concepts, evaluated differences and similarities between professional groups and assessed positive and negative attitudes to identify target areas for future training. SETTING Four major governmental hospitals in the Gaza-Strip. PARTICIPANTS A convenience sample of 424 nurses and 150 physicians working for at least 6 months in the study hospitals. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measures were mean scores with SD as measured for individual items and nine main patient safety domains assessed by the Attitudes to Patient Safety Questionnaire. Secondary outcome measures were the proportions of doctors and nurses, that gave a positive response to each item, represented as percentage of each group. RESULTS Nurses and doctors held moderately positive attitudes towards patient safety with five out of nine domain scores >3.5 of 5. Doctors showed slightly more positive attitudes than nurses, despite a smaller proportion of doctors having received patient safety training with 37.5% compared with 41.9% of nurses. Both professions displayed their most positive patient safety attitudes in the same domains ('team functioning' and 'working hours as a cause for error'), as well as their two most negative attitudes ('importance of patient safety in the curriculum' and 'professional incompetence as a cause of error'), demonstrating significant deficits in understanding medical errors. A specific challenge will be the negative attitudes of both professions towards patient safety training for wider dissemination of this content in the postgraduate curriculum. CONCLUSION Patient safety attitudes were moderately positive in both professional groups. Target of future patient safety training should be enhancing the understanding of error in medicine. Any training has to be motivating and relevant for clinicians, demonstrating its importance in ongoing professional learning.
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Affiliation(s)
- Bettina Bottcher
- Islamic University of Gaza, Faculty of Medicine, Gaza, State of Palestine
| | | | - Yousef Abuowda
- Islamic University of Gaza, Faculty of Medicine, Gaza, State of Palestine
| | - Maha Alfaqawi
- Islamic University of Gaza, Faculty of Medicine, Gaza, State of Palestine
| | - Enas Alaloul
- Palestinian Ministry of Health, Gaza, State of Palestine
| | - Somaya El-Hout
- Palestinian Ministry of Health, Gaza, State of Palestine
| | - Ibrahem Al-Najjar
- Islamic University of Gaza, Faculty of Medicine, Gaza, State of Palestine
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Johnston BE, Lou-Meda R, Mendez S, Frush K, Milne J, Fitzgerald T, Sexton JB, Rice H. Teaching patient safety in global health: lessons from the Duke Global Health Patient Safety Fellowship. BMJ Glob Health 2019; 4:e001220. [PMID: 30899564 PMCID: PMC6407551 DOI: 10.1136/bmjgh-2018-001220] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/27/2018] [Accepted: 01/19/2019] [Indexed: 11/23/2022] Open
Abstract
Health systems in low-income and middle-income countries (LMICs) have a high burden of medical errors and complications, and the training of local experts in patient safety is critical to improve the quality of global healthcare. This analysis explores our experience with the Duke Global Health Patient Safety Fellowship, which is designed to train clinicians from LMICs in patient safety, quality improvement and infection control. This intensive fellowship of 3-4 weeks includes (1) didactic training in patient safety and quality improvement, (2) experiential training in patient safety operations, and (3) mentorship of fellows in their home institution as they lead local safety programmes. We have learnt several lessons from this programme, including the need to contextualise training to local needs and resources, and to focus training on building interdisciplinary patient safety teams. Implementation challenges include a lack of resources and data collection systems, and limited recognition of the role of safety in global health contexts. This report can serve as an operational guide for intensive training in patient safety that is contextualised to global health challenges.
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Affiliation(s)
- Bria E Johnston
- Surgery and Global Health, Duke University Medical Center, Durham, North Carolina, USA
| | - Randall Lou-Meda
- Pediatric Nephrology Unit, Hospital Roosevelt de Guatemala, Guatemala, Guatemala
| | - Sindy Mendez
- Pediatric Nephrology Unit, Hospital Roosevelt de Guatemala, Guatemala, Guatemala
| | - Karen Frush
- Pediatrics, Duke University Medical Center, Durham, North Carolina, USA
| | - Judy Milne
- Patient Safety Office, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara Fitzgerald
- Pediatric Surgery, Duke University Hospital, Durham, North Carolina, USA
| | - J Bryan Sexton
- Patient Safety Center, Duke University Medical Center, Durham, North Carolina, USA
| | - Henry Rice
- Surgery and Global Health, Duke University Medical Center, Durham, North Carolina, USA
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Bohomol E. Patient safety education of the graduation in Nursing from the teaching perspective. ESCOLA ANNA NERY 2019. [DOI: 10.1590/2177-9465-ean-2018-0364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to identify contents related to Patient Safety contemplated in the curricular units of a Nursing undergraduate course, according to the teachers who work in it, and to know the teaching methodologies and evaluation strategies used. Method: descriptive case study, carried out with 15 professors of the Nursing undergraduate course of a Brazilian public institution, in 2014, who answered an online questionnaire. For data analysis, the guide of the World Health Organization was used as reference. Results: it was verified that patient safety contents are developed in the undergraduate course, referring to eight topics mentioned in the World Health Organization guide. There was a lack of contents of the topics “What is Patient Safety”, “Why applying human factors is important for Patient Safety”; and “Learning from errors to prevent harm”. The use of different teaching methodologies and evaluation strategies, both traditional and innovative, was identified. Conclusion and implications for the practice: the pedagogical project of the course must be revised, to align content, teaching methodologies and evaluation strategies and to promote the full development of this subject, both in the undergraduate Nursing course and in the other courses of the Health area.
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