Attitudes of doctors and nurses to patient safety and errors in medical practice in the Gaza-Strip: a cross-sectional study

Chinese Healthcare Workers' Knowledge, Attitudes, and Practices in Diabetic Kidney Management: A Multi-Centered Cross-Sectional Study

Background

Given the importance of diabetic kidney disease (DKD) management, this study aims to explore the knowledge, attitudes, and practices in disease management demonstrated by healthcare workers from the nephrology department.

Materials and Methods

This study is a multi-centered cross-sectional study, and adopts snowball sampling, with 530 healthcare workers being recruited to complete a questionnaire covering areas such as demographic characteristics, knowledge, attitude, and practices (KAP) of DKD management. This data was analyzed using descriptive statistics and binary logistics analysis.

Results

In this study, 530 healthcare workers were studied, including 94 doctors and 436 nurses. The participants were mainly from general tertiary hospitals in 14 provinces. For Chinese nurse, the results indicate that both poor knowledge level (Odds Ratio (OR) =0.63, 95% Confidence Interval (CI): 0.42-0.94) and having experience in further medical training in nephrology (OR=1.92, 95% CI: 1.20-3.08) are associated with the practice levels. For Chinese doctors, having not experience in further medical training in nephrology (OR=0.36, 95% CI: 0.15-0.83) are associated with their practice levels.

Conclusion

In summary, Chinese doctors and nurses in this study showed positive attitudes towards DKD management, but their knowledge and practical skills were lacking. This underscores a notable gap in achieving optimal DKD care. Notably, nurses' knowledge influenced their management practices, and additional nephrology training correlated with better engagement. To improve patient care, enhancing nephrology healthcare professional training and addressing knowledge-practice disparities are recommended.

Perceptions of Patient Safety Culture among Triage Nurses in the Emergency Department: A Cross-Sectional Study

The patient safety culture is key to ensuring patient safety in healthcare organizations. The triage environment is inherently demanding for patient safety and is characterized by high stress, rapid decision-making, and quick action. In several countries, including Slovenia, there is a lack of studies on the patient safety culture among triage nurses. This study aimed to assess the perceptions of the patient safety culture among triage nurses. A cross-sectional survey design was used. The Emergency Medical Services-Safety Attitudes Questionnaire, distributed to triage nurses, was used to collect data. A total of 201 triage nurses participated in this study. The results revealed that the overall average perception of the patient safety culture was 57.27% (SD = 57.27), indicating that the perception of the patient safety culture among triage nurses in the emergency department was non-positive and requires improvement. "Job Satisfaction" received the highest score (63.18%; SD = 17.19), while "Working Conditions" received the lowest (49.91%; SD = 17.37). The perception of positive and negative safety culture responses was statistically significant for age (χ2 (3) = 17.750, p ≤ 0.001), education (χ2 (2) = 6.957, p = 0.031) and length of working experience (χ2 (3) = 8.875, p = 0.031). The findings emphasize the significance of improving the safety culture in relation to several areas of patient care during the triage process. This research serves as a crucial foundation for enhancing patient safety in triage, providing quality care, and reducing adverse events.

Healthcare Professionals' Perception Regarding Patient Rights and Safety in Najran, Saudi Arabia

BACKGROUND

Patient safety and rights are the most crucial aspects of healthcare quality. In Saudi Arabia, there is a paucity of evidence concerning the perspectives of healthcare providers on the rights and safety of patients. Hence, this study aimed to assess the perceptions of healthcare providers toward patients' rights and safety in Najran, Saudi Arabia.

METHODOLOGY

A cross-sectional study was undertaken in Najran, Saudi Arabia, from December 2022 to October 2023, utilizing an online survey. This study included 307 healthcare providers who responded to the questionnaire via Google web link (Google LLC, Mountain View, California, United States).

RESULTS

The present research comprised 307 healthcare personnel, of whom 65.8% were male and possessed a variety of academic backgrounds. The participants exhibited a high level of support for patients' rights, as evidenced by their agreement with 88.4-90% of questions on a variety of dimensions; this demonstrated their dedication to providing patient-centered care. Concerning medical errors, a significant proportion of respondents (74.9-86.1%) exhibited comprehensive comprehension and a readiness to disclose such incidents. Diverse viewpoints surfaced regarding the attribution of errors, the necessity of reporting, and the accountability for disclosure. The interdependence of patient rights and attitudes towards patient safety was highlighted by substantial positive correlations.

CONCLUSION

The viewpoints of healthcare professionals regarding medical errors and patients' liberties were discussed in this study. Advocacy for patients' rights is indicative of a commitment to patient-centered care that prioritizes autonomy and transparency. Although most participants demonstrated a willingness to report medical errors and possess a solid comprehension of their causes, divergent views emerged regarding attribution and disclosure. The interrelation between patient rights and attitudes toward patient safety was supported by positive correlations. The significance of continuous education in healthcare to promote a safety culture and enhance patient-centric practices is underscored by these results. Future research is needed to investigate the effects of culturally tailored interventions on the attitudes and practices of healthcare providers in Najran with regard to patient rights and safety.

Comparison of Perceptions About Patient Safety Culture Between Physicians and Nurses in Public Hospitals in Vietnam

Introduction

Patient safety culture (PSC) is a vital component in ensuring high-quality and safe patient care. Assessment of physicians' and nurses' perceptions of existing hospital PSC is the first step to promoting PSC. This paper is aimed to assess physicians' and nurses' perceptions of PSC in 5 public general hospitals in Hanoi, Vietnam.

Methods

This cross-sectional study surveyed 410 physicians and 824 nurses utilizing the validated Hospital Survey on Patient Safety Culture in an online format.

Results

The composite positive physician's perception of PSC varied from 47.8 to 89.6% with the lowest composite score of patient safety for "staffing" (47.8%) and the highest composite score for "teamwork within units" (89.6%). The composite positive responses for perception among nurses varied from 51.3 to 94.2% with the lowest composite score of patient safety for "staffing" (51.3%) and the highest composite score for "teamwork within units" (94.2%).

Conclusion

The mean scores for "supervisor/manager expectations"; "staffing", "management support for patient safety", "teamwork across units", "handoffs and transitions" among nurses were significantly higher than that among physicians (p<0.05). About two-thirds of physicians and nurses reported no event in the past 12 months (62.8 and 71.7%, respectively). The nurses reported significantly higher patient grades (every good and excellent) than physicians (75% vs 67.1%, p <0.001). Hospitals could develop and implement intervention programs to improve patient safety, including providing interventions on teamwork and communication, encouraging staff to notify incidents, and avoiding punitive responses.

Patient safety culture awareness among healthcare providers in a tertiary hospital in Riyadh, Saudi Arabia

Patient safety is a serious concern in the health care industry. To enhance patient safety, healthcare providers are expected to minimize accidental harm to patients and enhance the quality of patient-centered care. The main objective of this study is to explore the awareness of the patient safety culture among healthcare providers. It is further intended to assess key fields and factors that hinder patient safety adoption and determine the effects of demographic factors on healthcare providers' awareness of patient safety culture. This study applied a cross-sectional quantitative design. It was conducted in a tertiary hospital in Riyadh, Saudi Arabia. The participants consisted of all healthcare providers working in a specific tertiary hospital in Saudi Arabia. A random sampling technique was applied in this study. The study sample size was 409 participants. A valid and reliable questionnaire was used to collect the required data. The T-tests, ANOVA. And regression was used. The study found that there is a moderate level of patient safety culture awareness among healthcare providers. Moreover, the findings also revealed that the age group “31–40” showed statistically different awareness levels as compared to the “more than 50 years' age group” (p = 0.012). Also, this study has found that gender and education have a significant influence on the awareness level of patient safety culture while position and work area have no influence on the awareness level of patient safety culture among healthcare providers. Managers in healthcare institutions should develop speeder response plans and make them part of the patient safety culture. Institutions offering bachelor's degrees and postgraduate in nursing should pay more attention to the subject of patient safety. The government healthcare sector, together with the private healthcare sector, should continuously train healthcare providers on patient safety procedures to improve the patient safety culture. Healthcare providers should be encouraged to report errors made during diagnosis or treatments to avoid them in the future.

Instruments for measuring patient safety competencies in nursing: a scoping review

Background

Patient safety competencies in nursing are essential for the quality of healthcare. To develop practices and collaboration in nursing care, valid instruments that measure competencies in patient safety are needed.

Objective

To identify instruments that measure the patient safety competencies of nurses.

Design

A scoping review.

Data sources

The Cochran Library, Epistemonikos, Eric, Ovid Medline, CINAHL, Embase and Web of Science databases were searched for articles reporting on instruments measuring patient safety competence in nursing. The search was limited to English peer-reviewed scientific papers published from January 2010 to April 2021.

Review method

A blinded selection of articles fulfilling the inclusion criteria was performed by two researchers based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Data were then extracted, synthesised and presented in tables and text.

Results

Our search identified 1,426 papers, of which 32 met the inclusion criteria. The selected papers described nine instruments, of which the ‘Health Professional Education in Patient Safety Survey’ was the most used instrument. The identified instruments comprised domains for patient safety skills, attitudes, knowledge, communication, teamwork and errors. The instruments had been tested for content (face) and construct validity as well as for reliability. However, sensitivity and responsiveness were rarely assessed.

Conclusions

Over the last decade, there has been a growing body of instruments aimed at measuring patient safety competencies among nurses. The future development of new instruments should consider including the important dimension of ethics in patient safety as well as evaluating the instrument’s responsiveness to be able to track changes over time.

Clinician attitude towards safety in medication management: a participatory action research study in an emergency department

OBJECTIVES

Edication management is a process in which medications are selected, procured, delivered, prescribed, reviewed, administered and monitored to assure high-quality patient care and safety. This paper explores clinicians' attitudes towards medication management which is both open to influence and strongly linked to successful changes in mediation behaviour. We aimed to investigate effects of engaging in participatory action research to improve emergency medicine clinicians' attitudes to safety in medication management.

SETTING

Emergency department of one university affiliated hospital.

PARTICIPANTS

A total of 85 clinicians including nurses and physicians partook as participants. Eight managers and clinicians participated as representatives.

DESIGN

Data are drawn from two-cycle participatory action research. Initially, a situation analysis on the current medication management and clinician views regarding medication management was conducted using three focus groups. Evaluation and reflection data were obtained through qualitative interviews. All qualitative data were analysed using content analysis.

RESULTS

Clinicians initially expressed negative attitudes towards existing and new plans for medication management, in that they were critical of current medication-related policy and procedures, as well as wary of the potential relevance and utility of potential changes to medication management. Through the action research, improvement actions were implemented including interprofessional courses, pharmacist-led interventions and the development of new guidelines regarding medication management. Participants and their representatives were engaged in all participatory action research stages with different levels of involvement. Extracted results from evaluation and reflection stages revealed that by engaging in the action research and practice new interventions, clinicians' attitude towards medication management was improved.

CONCLUSIONS

The results support the impact of participatory action research on enhancing clinicians' positive attitudes through their involvement in planning and implementing safety enhancing aspects of medication management.

Undergraduate medical students' attitudes towards medical errors and patient safety: a multi-center cross-sectional study in the Gaza Strip, Palestine

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.

Treating patients in a safe environment: a cross-sectional study of patient safety attitudes among doctors in the Gaza Strip, Palestine

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.