Reporting system for critical incidents in cross-sectoral healthcare (CIRS-CS): pre-test of a reporting sheet and optimization of a reporting system

OBJECTIVE

Potential sources for errors or critical incidents in healthcare may arise not just within a healthcare facility, but also between healthcare facilities (e. g., in the communication between in- and outpatient care). This study aims to test the content validity of the reporting sheet and to optimize the cross-sectoral critical incident reporting system (CIRS-CS).

METHOD

The CIRS-CS was developed as a part of the project "solimed ePflegebericht" based on the expertise of the participating organizations as well as existing literature and existing reporting systems (e. g., the recommendations of the "German Coalition for Patient Safety"). In addition, a pre-test was conducted among the organizations participating in the "solimed ePflegebericht" to assess the content validity of the reporting sheet. Content validity was assessed using cognitive interviews (N=11) with health professionals. The interviews were conducted on the basis of predefined scenarios and probing questions.

RESULTS

The reporting sheet that was used for the pre-test consisted of 16 components such as reason for reporting/description of the problem, location of the patient at the time of reporting and suggested solution to the problem. The results of the pre-test indicated that participants found it challenging to relate to components such as In which type of healthcare service did the problem occur, What was the cause of the problem and Which factors contributed to the problem. For instance, some participants found it difficult to decide in which type of healthcare service (e. g., emergency care, routine care) the underlying problem occurred as this component could be reported from different perspectives, i. e. where the incident arose versus where the problem occurred. Thus, depending on the interpretation of this component, the participants questioned the feasibility since there was a lack of knowledge as to under which circumstances the incident arose.

CONCLUSION

The results of the pre-test of the CIRS-CS suggest that the description of the causes as well as potential solutions via the cross-sectoral reporting sheet is unfeasible and may be better approached with an interdisciplinary investigation team panel as part of the reporting system, in which the participating representatives are able to enter a structured dialogue based on the reported problems. Furthermore, the results indicate that investigation team panels enable an interprofessional exchange and may thus promote transparency between healthcare facilities. At this point, there is little research on the content validity of reporting sheets for cross-sectoral reporting systems. Hence, our results may contribute to the development of comprehensible and feasible cross-sectoral CIRS.

[Content validation of the questionnaire “The Management of Aggression in People with Dementia Attitude Questionnaire German Version” (MAPDAQ-G)]

BACKGROUND

Dementia is one of the most common diseases of aging and leads to an increased need for care. Caregivers' attitudes about aggression can influence their interaction with people with dementia. To examine this further, “The Management of Aggression in People with Dementia Attitude Questionnaire” (MAPDAQ) was developed for use in nursing homes in the United Kingdom. In Switzerland, the MAPDAQ has been translated into a German Version (MAPDAQ-G), but not yet tested for its validity and reliability.

AIM

Therefore the present study examined the content and face validity, comprehensibility and interpretability of MAPDAQ-G in a Swiss context.

METHODS

The review was based on expert surveys and interviews with caregivers in nursing homes and psychiatric hospitals.

RESULTS

According to experts, the optimised MAPDAQ-G is comprehensive (88 %) and shows good content validity (I-CVI = 0,6 – 0,1; S-CVI-Ave = 0,88). 15 items have been adapted and further validated by 16 nurses. Finally, apart from two items, the MAPDAQ-G is understood by nurses and can be interpreted consistently.

CONCLUSIONS

A questionnaire of this sort allows nurses to reflect in practice upon their own attitude with regard to the management of aggression in people with dementia and to influence the quality of care. The MAPDAQ-G should be statistically tested for validity and reliability using a larger sample.