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Hesgrove B, Zebrak K, Yount N, Sorra J, Ginsberg C. Associations between patient safety culture and workplace safety culture in hospital settings. BMC Health Serv Res 2024; 24:568. [PMID: 38698405 PMCID: PMC11065685 DOI: 10.1186/s12913-024-10984-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 04/11/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Strong cultures of workplace safety and patient safety are both critical for advancing safety in healthcare and eliminating harm to both the healthcare workforce and patients. However, there is currently minimal published empirical evidence about the relationship between the perceptions of providers and staff on workplace safety culture and patient safety culture. METHODS This study examined cross-sectional relationships between the core Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey 2.0 patient safety culture measures and supplemental workplace safety culture measures. We used data from a pilot test in 2021 of the Workplace Safety Supplemental Item Set, which consisted of 6,684 respondents from 28 hospitals in 16 states. We performed multiple regressions to examine the relationships between the 11 patient safety culture measures and the 10 workplace safety culture measures. RESULTS Sixty-nine (69) of 110 associations were statistically significant (mean standardized β = 0.5; 0.58 < standardized β < 0.95). The largest number of associations for the workplace safety culture measures with the patient safety culture measures were: (1) overall support from hospital leaders to ensure workplace safety; (2) being able to report workplace safety problems without negative consequences; and, (3) overall rating on workplace safety. The two associations with the strongest magnitude were between the overall rating on workplace safety and hospital management support for patient safety (standardized β = 0.95) and hospital management support for workplace safety and hospital management support for patient safety (standardized β = 0.93). CONCLUSIONS Study results provide evidence that workplace safety culture and patient safety culture are fundamentally linked and both are vital to a strong and healthy culture of safety.
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Affiliation(s)
| | | | | | | | - Caren Ginsberg
- Agency for Healthcare Research and Quality, Rockville, MD, USA
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Keicher F, Zirkel J, Leutritz T, König S. Combatting the occurrence of needle-stick injuries in a medical school: why is it still an issue? BMC Med Educ 2024; 24:312. [PMID: 38509544 PMCID: PMC10953246 DOI: 10.1186/s12909-024-05309-1] [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] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/13/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Needle-stick injuries (NSIs) pose a safety risk for healthcare workers with great potential for serious infections. The aim was to determine numbers and causes of NSIs as well as the frequency with which medical students report NSIs in the final stages of study. METHODS An online questionnaire was developed and made available in January and February 2023 to all undergraduate medical students (n = 423) in the last 1.5 years of their degree course at Würzburg University, Germany. RESULTS The response rate was 19.6% (n = 84). Among respondents, 27.4% (n = 23) reported at least one NSI. Occurrence was particularly frequent in surgery, obstetrics and gynaecology, and internal medicine. Assisting with procedures, suturing, and blood sampling were considered high-risk activities. Lack of concentration, distraction, and time pressure played a role in incidents. Respondents did not report 18.8% of NSIs with the main reasons being fear of the consequences, self-assessment of the injury as minor, or the opinion of supervisors that reporting was unnecessary. Students with previous practice on simulators or patients were significantly more likely to suffer NSIs. Instructions from occupational health specialists beforehand correlated with fewer NSIs. CONCLUSION We assume that trained students are more experienced in handling invasive procedures, leading to a greater adoption of corresponding activities and thus an increased risk of injuries in absolute numbers. This does not counter the need for didactic interventions prior to workplace-based training to raise awareness of NSI risks. Simultaneously, concepts must be developed and implemented to support reporting and alleviate fears regarding consequences.
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Affiliation(s)
- Franca Keicher
- Department of Paediatrics, University Hospital Würzburg, Würzburg, Bavaria, Germany.
| | - Janina Zirkel
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Bavaria, Germany
| | - Tobias Leutritz
- University Hospital Würzburg, Institute of Medical Teaching and Medical Education Research, Würzburg, Bavaria, Germany
| | - Sarah König
- University Hospital Würzburg, Institute of Medical Teaching and Medical Education Research, Würzburg, Bavaria, Germany
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Yu X, Gan T, Zhu Y, Wang M, Qian L, Lu Y. Management of Occupational Bloodborne Pathogen Exposure among Medical Personnel: a 4-Year Prospective Study. Jpn J Infect Dis 2023; 76:289-294. [PMID: 37258178 DOI: 10.7883/yoken.jjid.2022.492] [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] [Indexed: 06/02/2023]
Abstract
This study examined the management of occupational bloodborne pathogen exposure at a tertiary hospital in China. This prospective study was conducted at the Zhejiang Hospital of Traditional Chinese Medicine between January 2016 and December 2019. Data on bloodborne occupational exposure management were collected. In total, 460 exposures were reported. The majority of exposures (40.2 %) were from hepatitis B virus (HBV)-positive index patients. Of the 460 cases, 453 (98.5%) exposures were reported timeously, and 371 (80.7%) cases received emergency treatment response and management. Sixty-eight personnel (93.2%) received timely prophylaxis treatment. Only 82/113 (72.6%) personnel completed the recommended follow-up period. Outsourced personnel(P = 0.002) and interns (P = 0.011) were independent follow-up factors. Although adequate compliance was achieved with timely reporting and prophylactic medication, there is room for improvement in terms of emergency treatment response and follow-up compliance. Furthermore, HBV vaccination and improved follow-up with outsourced personnel are recommended.
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Affiliation(s)
- Xuxia Yu
- Department of Nosocomial Infection Management, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Tieer Gan
- Department of Nosocomial Infection Management, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Yuexian Zhu
- Department of Nosocomial Infection Management, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Minfang Wang
- Department of Nosocomial Infection Management, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Lili Qian
- Medical Laboratory, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), China
| | - Ye Lu
- Institute of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, China
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Sangji NF, Maqsood HA, Bouyer-Ferullo S, Chang DC, O'Malley C. Reducing Sharps Injuries in the Operating Rooms of an Academic Tertiary Care Center. Jt Comm J Qual Patient Saf 2023; 49:320-327. [PMID: 37068997 DOI: 10.1016/j.jcjq.2023.03.004] [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] [Received: 10/19/2022] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Data on the prevalence and distribution of operating room (OR) sterile field sharps injuries sustained by attending surgeons, residents, scrub nurses, and surgical technologists are limited. The goal of this study is to understand current practices, injuries, and reporting behavior at an academic center, implement interventions, and assess their effect on sharps safety and reporting. METHODS An electronic survey with questions pertaining to sharps handling practices, injuries, and reporting was e-mailed to 864 staff between July and September 2014. Adjusted analyses for risk of injury were performed. A follow-up survey was sent in January 2018, following the implementation of a shorter injury reporting form and a neutral zone. RESULTS The overall response rate was 49.3%, with 363 completed surveys. Of respondents, 44.9% reported injuries occurring in the preceding three years. Physicians comprised 65.1% of injured staff and sustained 68.8% of the total injuries. Compared to attending surgeons, residents had a similar likelihood of injury (odds ratio 0.9, 95% confidence interval [CI] 0.37-2.2), whereas scrub nurses (odds ratio 0.3, 95% CI 0.17-0.54) and technologists (odds ratio 0.3, 95% CI 0.14-0.76) had a lower likelihood. Half of those injured reported to Occupational Health Services. Of those who did not report, 46.4% stated that time was a limiting factor. Following the interventions, the incidence of injuries among survey respondents remained unchanged. However, 54.0% of respondents stated that it was easier to report injuries. CONCLUSION Attending surgeons and residents sustain the majority of OR sterile field sharps injuries and are the least likely to report them. Shorter reports made it easier to report the injuries.
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Behzadmehr R, Balouchi A, Hesaraki M, Alazmani Noodeh F, Rafiemanesh H, J Nashwan A, Behmaneshpour F, Rahdar M, Dastres M, Atharyan S, Jahantigh M, Malekshahi F. Prevalence and causes of unreported needle stick injuries among health care workers: a systematic review and meta-analysis. Rev Environ Health 2023; 38:111-123. [PMID: 34913621 DOI: 10.1515/reveh-2021-0148] [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] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Health care workers (HCWs) are exposed to needle needles daily. Despite individual studies, there is no statistics on the prevalence of unreported needle stick injuries (NSIs) have been reported. This study was performed to determine the prevalence and causes of unreported NSIs among HCWs. CONTENT In present systematic review and meta-analysis study, three international databases (Web of Science, Scopus, PubMed) were searched from January 1, 2000 to December 31, 2018. The random model was used to determine the prevalence of unreported needle stick among HCWs. SUMMARY AND OUTLOOK Forty-one studies performed on 19,635 health care workers entered the final stage. Based-on random effect model, pooled prevalence of unreported needle stick injuries was 59.9% (95% CI: 52.0, 67.7; I2=98.9%). The most common cause of unreported NSIs was: They were not worried about NSIs (n=12). The high prevalence of unreported needle sticks injuries indicates the urgency and necessity of paying attention to strategies to improve reporting among health workers.
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Affiliation(s)
- Razieh Behzadmehr
- Department of Radiology, Zabol University of Medical Sciences, Zabol, Iran
| | - Abbas Balouchi
- Department of Nursing, Iran University of Medical Sciences, Tehran, Iran
| | - Mehran Hesaraki
- Pediatric Department, Zabol University of Medical Sciences, Zabol, Iran
| | - Farshid Alazmani Noodeh
- Department of Critical Care Nursing, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Hosein Rafiemanesh
- Non-communicable Diseases Research Center, Department of Epidemiology and Biostatistics, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Abdulqadir J Nashwan
- Nursing for Education and Practice Development, Hamad Medical Corporation, Doha, Qatar
| | | | - Maliheh Rahdar
- Department of Nursing, School of Nursing and Midwifery, Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Majid Dastres
- Department of Nursing, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shahaboddin Atharyan
- Department of Nursing, School of Nursing and Midwifery, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Maryam Jahantigh
- Department of Nursing, School of Chabahar Nursing, Iranshahr University of Medical Sciences, Chabahar, Iran
| | - Frood Malekshahi
- Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Jones D, Alsbrooks K, Little A. Emergency provider preference for powered intraosseous devices and satisfaction with features improving safety, reliability, and ease-of-use. Expert Rev Med Devices 2023; 20:329-336. [PMID: 36919560 DOI: 10.1080/17434440.2023.2190019] [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] [Indexed: 03/16/2023]
Abstract
BACKGROUND Powered intraosseous (IO) systems are valuable devices for emergent situations, with limited data on user preferences. A simulation/survey-based study was conducted among emergency medical service (EMS) providers to evaluate attitudes toward general powered IO system features to measure preferences/satisfaction for the most-commonly used and a novel powered IO system (with a passive safety needle, battery life indicator, and snap-securement/dressing). RESEARCH DESIGN AND METHODS Forty-two EMS providers completed a simulated activity using both powered IO systems and a 30-item questionnaire, including multiple choice, free-text, ranking, and Likert-like questions. Ranking scores were reported using a scale of 0 (least important/satisfactory) to 100 (most important/satisfactory). Statistical significances were evaluated via Wilcoxon signed-rank sum test. RESULTS Providers indicated driver performance (mean score ± SD; 77.8 ± 27.5) and IO needle safety mechanism (63.1 ± 27.9) as the most important features. Participants reported significantly higher (p < 0.001) satisfaction with the novel IO system overall, and its needle safety, battery life indicator, securement/dressing, and ease-of-use. Powered driver performance satisfaction was similar and favorable for the novel (88.1 ± 18.2) and traditional (87.1 ± 15.3) systems. CONCLUSIONS These findings highlight the value of clinician/user input and demonstrate EMS providers are more satisfied with a powered IO system featuring design elements intended to enhance safety and ease-of-use.
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Affiliation(s)
- Drew Jones
- Department of Emergency Medicine, Advent Health East Orlando, Orlando, FL, USA
| | - Kimberly Alsbrooks
- Medical Affairs, Medication Delivery Solutions, Becton, Dickinson and Company, Franklin Lakes, NJ, USA
| | - Andrew Little
- Department of Emergency Medicine, Advent Health East Orlando, Orlando, FL, USA
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Richards H, Henderson T. Preventing Perioperative Sharps Injuries. AORN J 2022; 116:176-182. [PMID: 35880914 DOI: 10.1002/aorn.13751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/10/2022]
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Zebrak K, Yount N, Sorra J, Famolaro T, Gray L, Carpenter D, Caporaso A. Development, Pilot Study, and Psychometric Analysis of the AHRQ Surveys on Patient Safety Culture™ (SOPS ®) Workplace Safety Supplemental Items for Hospitals. Int J Environ Res Public Health 2022; 19:6815. [PMID: 35682402 DOI: 10.3390/ijerph19116815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 12/14/2022]
Abstract
Workplace safety is critical for advancing patient safety and eliminating harm to both the healthcare workforce and patients. The purpose of this study was to develop and test survey items that can be used in conjunction with the Agency for Healthcare Research and Quality (AHRQ) Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey to assess how the organizational culture in hospitals supports workplace safety for providers and staff. After conducting a literature review and background interviews with workplace safety experts, we identified key areas of workplace safety culture (workplace hazards, moving/transferring/lifting patients, workplace aggression, supervisor/management support for workplace safety, workplace safety reporting, and work stress/burnout) and drafted survey items to assess these areas. Survey items were cognitively tested and pilot tested with the SOPS Hospital Survey 2.0 among providers and staff in 28 U.S. hospitals. We conducted psychometric analysis on data from 6684 respondents. Confirmatory factor analysis results (item factor loadings and model fit indices), internal consistency reliability, and site-level reliability were acceptable for the 16 survey items grouped into 6 composite measures. Most composite measures were significantly correlated with each other and with the overall rating on workplace safety, demonstrating conceptual convergence among survey measures. Hospitals and researchers can use the Workplace Safety Supplemental items to assess the dimensions of organizational culture that support provider and staff safety and to identify both strengths and areas for improvement.
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Korkmaz N, Çiçek Şentürk G, Tekin A, Gürbüz Y, Sevinç G, Tütüncü EE, Şencan İ. Rates of Underreported Needlestick and Sharps Injuries among Healthcare Workers in Turkey; in the Light of Infection Control Committee Data. Int J Qual Health Care 2022; 34:6548206. [PMID: 35285914 DOI: 10.1093/intqhc/mzac012] [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: 08/19/2021] [Revised: 12/03/2021] [Accepted: 03/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Doctors and nurses are frequently exposed to needlestick and sharps injuries (NSIs) because of their work. It is estimated that NSIs are more common than the reported rates to Infection Control Committee. The purpose of this study was to determine the incidence and reporting rates of NSIs in our hospital. METHODS After their consent forms were obtained for the questionnaire, 670 doctors and nurses were interviewed face-to-face by the Infection Control Committee nurse. The questionnaire consisted of 22 questions, and the answers were recorded. The questions were on demographic data and injuries. The data of NSIs, whose active surveillance was made in our hospital since 2005 and in the last 1 year were also analyzed retrospectively. RESULTS A total of 119 (17%) out of 670 people who participated in the study had at least one NSIs; 43 (36%) of the 119 people were doctors, and 76 (63.9%) were nurses. The most common injuries among doctors were found in assistant doctors (60%). No statistically significant differences were detected between the doctors and nurses in terms of injury status (p=0.398). The most common injuries were found in surgical clinics, and a significant difference was detected here when compared to other clinics. The data that 20 (17%) of the 118 people who were injured by the NSIs reported the injury were obtained from the Infection Control Committee database. CONCLUSION It is seen that injuries are high in surgical clinics and assistant doctors who have high work stress and workload. There were more injuries with sharp objects than the expected rates in our hospital although the reports were made very rarely. First of all, we should determine strategies, especially education, to reduce injuries, and then remove the obstacles to unreported injuries. Activities of clinics with high reporting rates needs to be search and adapt them to our clinic.
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Affiliation(s)
- Nesibe Korkmaz
- Department of Infectious and Clinical Microbiology Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Gönül Çiçek Şentürk
- Department of Infectious and Clinical Microbiology Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Asiye Tekin
- Hospital Infection Control Committee Nursing, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Yunus Gürbüz
- Department of Infectious and Clinical Microbiology Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ganime Sevinç
- Hospital Infection Control Committee Nursing, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Emin Ediz Tütüncü
- Department of Infectious and Clinical Microbiology Diseases, Kafkas University, Kars, Turkey
| | - İrfan Şencan
- Department of Infectious and Clinical Microbiology Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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