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Gómez-Moreno C, Vélez-Vélez E, Garrigues Ramón M, Rojas Alfaro M, García-Carpintero Blas E. Patient safety in surgical settings: A study on the challenges and improvement strategies in adverse event reporting from a nursing perspective. J Clin Nurs 2024; 33:2324-2336. [PMID: 38308406 DOI: 10.1111/jocn.17047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/06/2023] [Accepted: 01/19/2024] [Indexed: 02/04/2024]
Abstract
AIMS To explore adverse event reporting in the surgical department through the nurses' experiences and perspectives. DESIGN An exploratory, descriptive qualitative study was conducted with a theoretical-methodological orientation of phenomenology. METHODS In-depth interviews were conducted with 15 nurses, followed by an inductive thematic analysis. RESULTS Themes include motives for reporting incidents, consequences, feelings and motivational factors. Key facilitators of adverse event reporting were effective communication, knowledge sharing, a non-punitive culture and superior feedback. CONCLUSION The study underscores the importance of supportive organisational culture for reporting, communication and feedback mechanisms, and highlights education and training in enhancing patient safety. IMPLICATIONS It suggests the need for strategies that foster incident reporting, enhance patient safety and cultivate a supportive organisational culture. IMPACT This study provides critical insights into adverse event reporting in surgical departments from nurses' lived experience, leading to two primary impacts: It offers specific solutions to improve adverse event reporting, which is crucial for surgical departments to develop more effective and tailored reporting strategies. The research underscores the importance of an open, supportive culture in healthcare, which is vital for transparent communication and effective reporting, ultimately advancing patient safety. REPORTING METHOD The study followed the Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative Research guidelines. PATIENTS OR PUBLIC CONTRIBUTION No patients or public contribution.
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Affiliation(s)
- Cristina Gómez-Moreno
- Fundación Jiménez Díaz School of Nursing - Health Research Institute-Fundación, Jiménez Díaz University Hospital - UAM (IIS-FJD, UAM), Madrid, Spain
| | - Esperanza Vélez-Vélez
- Fundación Jiménez Díaz School of Nursing - Health Research Institute-Fundación, Jiménez Díaz University Hospital - UAM (IIS-FJD, UAM), Madrid, Spain
| | - Marta Garrigues Ramón
- Fundación Jiménez Díaz School of Nursing - Health Research Institute-Fundación, Jiménez Díaz University Hospital - UAM (IIS-FJD, UAM), Madrid, Spain
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Chen Y, He Y, Wang P, Jiang F, Du Y, Cheung MY, Liu H, Liu Y, Liu T, Tang YL, Zhu J. The association between the adverse event reporting system and burnout and job satisfaction of nurses: Workplace violence as a mediator. Int Nurs Rev 2024. [PMID: 38650586 DOI: 10.1111/inr.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/25/2024] [Indexed: 04/25/2024]
Abstract
AIMS This study aims to explore the association between the implementation of the adverse event reporting system (AERS), burnout, and job satisfaction among psychiatric nurses, with a focus on examining the mediating effect of workplace violence from patients. BACKGROUND Many organizational and personal factors contribute to burnout and job satisfaction experienced by nurses. AERS, serving as a key component of organizational-level quality improvement system, impacts the overall workplace wellness of nurses. METHODS A national sample of 9,744 psychiatric nurses from 41 psychiatric hospitals across 29 provinces in China participated. Burnout was measured by the Maslach Burnout Inventory. Job satisfaction was measured using the Minnesota Satisfaction Questionnaire. Workplace violence was assessed by nurses' experience of verbal and physical violence. Multilevel linear regression analyses were carried out to examine if AERS impacts burnout and job satisfaction and to identify the mediating role of workplace violence. RESULTS AERS was positively associated with job satisfaction, but negatively with burnout and workplace violence. Workplace violence exhibited a positive association with burnout and a negative association with job satisfaction. Mediation analyses indicated that the associations between AERS, burnout, and job satisfaction were mediated by workplace violence. CONCLUSIONS The application of AERS is associated with a reduction in workplace violence in hospitals, which contributes to the diminished burnout and heightened job satisfaction among psychiatric nurses. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY The study highlights the importance of organizational efforts and mechanisms in promoting nurses' well-being. It is necessary for hospital management to create a safe workplace through the implementation of AERS.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- School of Medicine, Tsinghua University, Beijing, China
| | - Yanrong He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Peicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- School of Medicine, Tsinghua University, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Yanrong Du
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | | | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, Georgia, USA
- Addiction Psychiatry Fellowship Program, Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Alalaween MA, Karia N. The predictive power of electronic reporting system utilization on voluntary reporting of near-miss incidents among nurses: A PLS-SEM approach. Belitung Nurs J 2024; 10:15-22. [PMID: 38425684 PMCID: PMC10900056 DOI: 10.33546/bnj.2805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/07/2023] [Accepted: 12/15/2023] [Indexed: 03/02/2024] Open
Abstract
Background Patient safety is crucial in healthcare, with incident reporting vital for identifying and addressing errors. Near-miss incidents, common yet underreported, serve as red flags requiring attention. Nurses' underreporting, influenced by views and system usability, inhibits learning opportunities. The Electronic Reporting System (ERS) is a modern solution, but its effectiveness remains unclear. Objective This study aimed to investigate the role of the ERS in enhancing the voluntary reporting of near-miss (VRNM) incidents among nurses. Methods A cross-sectional study was conducted in the Al Dhafra region of the United Arab Emirates, involving 247 nurses from six hospitals. Data were collected using a questionnaire between April 2022 and August 2022. Structural Equation Modelling Partial Least Square (SEM-PLS) was employed for data analysis. Results The average variance extracted for the ERS construct was 0.754, indicating that the common factor accounted for 75.4% of the variation in the ERS scores. The mean ERS score was 4.093, with a standard deviation of 0.680. For VRNM, the mean was 4.104, and the standard deviation was 0.688. There was a positive correlation between ERS utilization and nurses' willingness to report near-miss incidents. Additionally, our research findings suggest a 66.7% relevance when applied to various hospital settings within the scope of this study. Conclusion The findings suggest that adopting a user-friendly reporting system and adequate training on the system's features can increase reporting and improve patient safety. Additionally, these systems should be designed to be operated by nursing staff with minimal obstacles.
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Affiliation(s)
| | - Noorliza Karia
- School of Management, Universiti Sains Malaysia, Penang, Malaysia
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Barnsteiner J, Disch J, Johnson M, Spector N. Applying Principles of a Fair and Just Culture to a Student Scenario. J Nurs Educ 2023; 62:139-145. [PMID: 36881886 DOI: 10.3928/01484834-20230109-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND This article reviews national efforts toward promoting fair and just cultures in schools of nursing. A real-life vignette in which a nursing student made a medication error is presented, and the nursing program contacted the nursing regulatory body for advice on how to handle the situation. METHOD A framework was used to analyze the causes of the error. Commentary is offered regarding how applying the principles of a fair and just culture could improve student performance and advance the school's culture to reflect one that was fair and just. RESULTS A fair and just culture requires a commitment of all leaders and faculty within a school of nursing. Administrators and faculty must recognize that errors are part of the learning process, that errors can be minimized but not eliminated, and that learning can occur from each incident to prevent similar occurrences in the future. CONCLUSION Academic leaders must engage faculty, staff, and students in a dialogue about the principles of a fair and just culture to develop a tailored plan of action. [J Nurs Educ. 2023;62(3):139-145.].
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Ward CS, Mangion D. Nurses' attitudes and barriers to incident reporting in Malta's acute general hospital. Br J Nurs 2023; 32:194-200. [PMID: 36828572 DOI: 10.12968/bjon.2023.32.4.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Although the science of patient safety has been developed and implemented widely, there remains a large gap in the understanding of the chain of events that lead to safety incidents, as well as their cost to patients, healthcare staff and the organisation as a whole. The aim of the study was to evaluate nurses' knowledge and awareness of the local incident reporting system at Malta's acute general hospital. A quantitative, descriptive cross-sectional design was used and data were collected from nurses through an online survey. A total of 323 questionnaires were received with a response rate of 23%. Various shortages within the local setting were identified, including lack of feedback and awareness of the system. Therefore, it is suggested that incident reporting should be given a higher profile on the organisation's agenda and incorporate employed members of staff rather than volunteers.
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Affiliation(s)
- Corinne Scicluna Ward
- Senior Lecturer, Faculty of Health Sciences, Nursing Department, University of Malta
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Hafezi A, Babaii A, Aghaie B, Abbasinia M. The relationship between patient safety culture and patient safety competency with adverse events: a multicenter cross-sectional study. BMC Nurs 2022; 21:292. [PMID: 36319970 DOI: 10.1186/s12912-022-01076-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
Abstract
Background Patient safety culture and patient safety competency could be associated with adverse events (AEs). This study aimed to investigate the associations between nurses’ perceptions of patient safety culture, patient safety competency, and AEs. Methods A cross-sectional study was carried out among 338 nurses employed in three university hospitals in Qom, Iran between 17 August 2021 and 12 November 2021. Data were collected using three questionnaires: patient safety culture, patient safety competency, and AEs. Data were analyzed using SPSS-21 software. A multiple logistic regression model was used to analyze the data. Results The results of this study showed that medication errors were significantly associated with “frequency of events reported” (OR = 0.706, P = 0.012), “supervisor/manager expectations and actions promoting patient safety” (OR = 0.733, P = 0.048), and “management support for patient safety” (OR = 0.755, P = 0.012). Pressure ulcers were significantly associated with “supervisor/manager expectations and actions promoting patient safety” (OR = 0.729, P = 0.039), “handoffs and transition” (OR = 0.707, P = 0.034), and “comfort speaking up about patient safety” (OR = 0.614, P = 0.016). Falls were significantly associated with “teamwork within units” (OR = 0.735, P = 0.031), “feedback and communication about error” (OR = 0.756, P = 0.046), and “handoffs and transition” (OR = 0.660, P = 0.012). The use of restraints for ≥8 hr. was significantly associated with “management support for patient safety” (OR = 0.701, P = 0.021). Conclusions According to the results of this study, AEs are associated with some dimensions of patient safety culture and patient safety competency. Further research is needed to confirm these findings and identify interventions to reduce the occurrence of AEs.
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Dolansky MA, Barg-Walkow L, Barnsteiner J, McGaffigan P, Oster CA, Schumann MJ, Spencer T, Chenot T, Johnson LE, Burke KG. A Call to Action Following the RaDonda Vaught Case: A Culture of Safety and High-Reliability Organizations. J Nurses Prof Dev 2022; 38:329-332. [PMID: 36306486 DOI: 10.1097/nnd.0000000000000945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
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Zhao X, Shi C, Zhao L. Nurses' Intentions, Awareness and Barriers in Reporting Adverse Events: A Cross-Sectional Survey in Tertiary Hospitals in China. Risk Manag Healthc Policy 2022; 15:1987-1997. [PMID: 36329826 PMCID: PMC9624208 DOI: 10.2147/rmhp.s386458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/20/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose This study explored nurses’ intentions, awareness and barriers in reporting adverse events in tertiary hospitals in China. We also analyzed its associated factors to increase the chance to evaluate preventable errors, enhance care delivery, and improve patient outcomes. Patients and Methods A cluster sampling method was used to recruit 1382 nurses from two tertiary hospitals in Chenzhou and Handan City. An online structured questionnaire was used to collect data, which included general information questionnaire (eight questions), reporting awareness questionnaire (eight items with scores ranging from 0 to 8), reporting intention questionnaire (15 items with scores ranging from 0 to 15), and reporting barriers questionnaire (22 items with scores ranging from 22 to 110). Results We received 1565 completed questionnaires from 1734 potential participants (a response rate of 90.25%), with 1382 valid questionnaires, yielding an effective rate of 88.31%. The scores of reporting awareness, reporting intention, and reporting barriers in adverse events for nurses in tertiary hospitals were 8 (1), 15 (0), and 83.04 (±12.21) out of 110, respectively. Reporting awareness and barriers to adverse events were positively correlated with nurses’ intention to report adverse events (rs = 0.237 and 0.361, respectively; P < 0.001). Regression analyses showed that reporting awareness and barriers in adverse events and professional title influenced nurses’ intention to report adverse events (P < 0.05) in tertiary hospitals. Conclusion Nurses in tertiary hospitals have a strong intention to report adverse events. The higher the reporting awareness of adverse events or the fewer perceived reporting barriers, the stronger the nurses’ intention to report. Hospital managers should deliver patient safety education and training for nurses, to increase their reporting awareness and decrease their perceived reporting barriers, improve their intention to report adverse events.
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Affiliation(s)
- Xiaoying Zhao
- Handan First Hospital, Handan, 056000, People’s Republic of China
| | - Chunhong Shi
- School of Nursing, Xiangnan University, Chenzhou, People’s Republic of China,Affiliated Hospital of Xiangnan University, Chenzhou, 423000, People’s Republic of China,Correspondence: Chunhong Shi, School of Nursing, Xiangnan University, 889 Chenzhou Avenue, Suxian District, Chenzhou, 423000, People’s Republic of China, Tel +86 15907354840, Fax +86-735-2325007, Email
| | - Lihua Zhao
- Handan First Hospital, Handan, 056000, People’s Republic of China
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Jarošová D, Zeleníková R, Plevová I, Mynaříková E, Kachlová M. Differences in the Incidence of Adverse Events in Acute Care Hospitals: Results of a Multicentre Study. Int J Environ Res Public Health 2022; 19:ijerph19095238. [PMID: 35564632 PMCID: PMC9105439 DOI: 10.3390/ijerph19095238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/28/2022]
Abstract
Background: Adverse events are indicators of patient safety and quality of care. Adverse events clearly have negative impacts on healthcare system costs. Organizational and unit characteristics are not very often studied in relation to adverse events. The aim of the study was to find the differences in the incidence of adverse events and healthcare-associated infections in hospitalized patients in Czech acute care hospitals according to type of hospital and type of unit. Methods: This cross-sectional multicentre study was conducted in 105 acute care medical and surgical units located in 14 acute care hospitals throughout the Czech Republic. The data on adverse events and healthcare-associated infections were reported monthly by nurse researchers. The data were collected from June 2020 to October 2020. Results: The incidence of healthcare-associated infections, pressure ulcers, and medication errors was significantly lower in large hospitals. Statistically significant differences have been further found between the incidence of pressure ulcers (<0.001), falls without injury (<0.001), and falls with injury (<0.001) in surgical and medical units. More pressure ulcers, falls without injury, and falls with injury have been reported in surgical units. Conclusion: The type of hospital and type of unit affected the incidence of adverse events at acute care hospitals. To reduce adverse events, a systematic adverse event measurement and reporting system should be promoted.
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Affiliation(s)
- Darja Jarošová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, 701 03 Ostrava, Czech Republic; (D.J.); (I.P.); (M.K.)
| | - Renáta Zeleníková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, 701 03 Ostrava, Czech Republic; (D.J.); (I.P.); (M.K.)
- Correspondence:
| | - Ilona Plevová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, 701 03 Ostrava, Czech Republic; (D.J.); (I.P.); (M.K.)
| | - Eva Mynaříková
- Department of Nursing Care, University Hospital Ostrava, 708 00 Ostrava, Czech Republic;
| | - Miroslava Kachlová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, 701 03 Ostrava, Czech Republic; (D.J.); (I.P.); (M.K.)
- Department of Nursing Care, University Hospital Ostrava, 708 00 Ostrava, Czech Republic;
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