Global journal on quality and safety in healthcare最新文献

Introduction: Patient safety is a global concern for both health professionals and the public. Research indicates that assessing patient safety culture can help improve patient safety outcomes. Nursing care strategically positions nurses at the center of patient safety promotion, and their proximity to patients makes them the drivers of patient safety. The actions of frontline staff in healthcare organizations have a notable influence on healthcare outcomes, particularly reporting of adverse events. This study aimed to evaluate the actions of frontline staff on adverse event reporting among nurses in three hospitals in the Savannah Region, Ghana.

Methods: A quantitative cross-sectional method was used to gather data from 210 respondents across three hospitals. Data were analyzed with descriptive statistics, Pearson correlation, and hierarchical linear regression.

Results: The findings revealed that teamwork within units had a good positive rating score of 82.9%. This was followed by teamwork across hospital units (68.0%) and handover of care (69.8%). Overall, nurses demonstrated a negative attitude toward adverse events reporting (37.3%). Furthermore, enacting safety practices that had a significant relationship with adverse events reporting were teamwork across units (r = .24, p < 0.001) and handover and transition of patient care (r = .19, p < 0.001). Again, the significant predictor of adverse events reporting was teamwork across units (β = .20, p < 0.001).

Conclusion: Nurses' perceptions of patient safety culture within and across hospital units as well as handover of patient care were positive. Though the attitude of nurses toward adverse event reporting was low, teamwork across hospital units significantly predicted adverse event reporting. Therefore, frontline staff should continually strengthen teamwork processes and handover practices to achieve the best healthcare outcomes.

Introduction: The introduction of the innovative group antenatal and postnatal care model into the private health sector in India has the potential to pivot the experiences of families during pregnancy and beyond. Growing evidence worldwide shows this model moves fragmented healthcare systems toward a more integrated model to improve quality in care and outcomes for mothers and children. The aim of this study was to better understand the challenges and benefits of implementation of the group model of antenatal care in the Indian private health sector for the purpose of improving quality of care.

Methods: Through a collaborative innovation project led by a master's student of public health and an international organization with expertise in implementing this model, an urban 35-bed private hospital in Pune was identified with readiness to explore the model with stakeholders, train hospital staff as facilitators, and initiate group antenatal care. Semi-structured interviews with facilitators, along with feedback from participants in cohorts and observation of the groups by the trainer, were done for qualitative analysis of themes related to the strengths and barriers in implementing the model.

Results: A total of 31 pregnant women participated in two cohorts over their second to third trimesters for group antenatal care with a team of three facilitators from November 2022 to June 2023. On review of experiences in implementing the model, the top strengths demonstrated were meeting of felt needs of the participants, high engagement, and relative advantage of the model. Challenges for implementation included for scheduling and attendance, adapting the model for compatibility, capacity-building, and need for more ongoing planning, monitoring, and evaluation.

Conclusions: Through this innovation project, important lessons were learned for robust planning for a future pilot study. Patient-centered and integrated antenatal care are markers of quality of care that this group model can bring not only in the private healthcare sector but throughout India.

Introduction: Managing chronic conditions such as endocrinology and diabetes requires consistent access to medications. Traditional methods of medication refill often involve in-person visits to healthcare providers or pharmacies, posing challenges for patients. Online medication refill services offer a promising solution to improve accessibility and convenience.

Methods: This is a digital-based solution using online medication refill services to enhance the management of endocrinology and diabetes medication refills. It examines the process of online medication refill, including patient registration, refill request submission, verification, provider input, processing, and pickup or delivery.

Results: Online medication refill services empower patients to easily request refills from the comfort of their homes, streamlining the refill process, and reducing walk-in pressure in clinics. The online medication refill with the option for home delivery option eliminates the need for patients to visit the hospital, further enhancing the patient experience. Before implementing the online medication refill solution, 26 patients will come to the clinic as walk-ins to request medication refills. The average waiting time for each patient is 45 minutes. Each provider will be interrupted for an average of 10 minutes to accommodate the request. The overall processing time required for each walk-in patient to submit the medication request is 1 hour on average. After implementing the online medication refill intervention, zero patients come to the clinic as walk-ins and hence, no interruption to the daily regular clinics. The overall processing time required for submitting the online medication request is now 2 minutes. These interventions promote medication adherence and patient engagement by facilitating access to medications and offering educational resources.

Conclusion: Online medication refill services represent a valuable tool in the comprehensive management of endocrinology and diabetes. They offer accessibility, convenience, and patient empowerment, potentially improving health outcomes and enhancing the overall patient experience.

Introduction: The World Health Organization (WHO) introduced the surgical safety checklist (SSC) to reduce postoperative morbidity and mortality; however, its use in low- and middle-income countries is still low.

Methods: We conducted a survey from January 2 to 22, 2024, in public hospitals' pediatric surgery departments and units in Senegal to assess the use of the WHO SSC or an adapted version.

Results: The participation rate was 100% (23 hospitals), with 11 second-level hospitals (47.8%) and 10 (43.5%) having at least two pediatric surgeons. All hospitals had an anesthetist nurse, and 18 hospitals (78.3%) had at least two scrub nurses. For the surgical workload, 14 hospitals (60.9%) had five to 10 surgical interventions weekly. Eleven hospitals (47.8%) had training on use of the SSC, and 8 of the 23 hospitals (34.8%) used the SSC. The WHO SSC nonutilization was mainly due to a lack of training in nine hospitals (60%) and SSC unavailability in five hospitals (33.3%). Members of 22 hospitals (95.6%) were available for training on use of the SSC.

Conclusion: The WHO SSC is poorly used in pediatric operating rooms of public hospitals in Senegal. The main reasons for nonutilization are remediable.

Introduction: Performance appraisal (PA) is essential for healthcare organizations. Highlighting the impact of the nursing PA system on nurses' work outcomes has the potential to significantly improve the quality of patient care. Understanding and enhancing the performance appraisal system is key to achieving this goal. This study aimed to assess the efficacy of the nursing PA system and its effect on nurses' work outcomes. It also compared the perceptions of PA among staff nurses (SNs), charge nurses (CNs), and head nurses (HNs), providing valuable insights into the dynamics of the nursing PA system.

Method: A cross-sectional, descriptive, and comparative design was adopted to assess the current nursing PA system.

Results: This study, which included 356 nurses, revealed significant differences in the perception of PA among nurses at all levels. The findings underscore the practical implications of the potential for more efficient use of PA to improve nurses' performance. SNs and CNs showed significant gender-based differences in PA effectiveness (p = 0.006) and efficiency (p = 0.034). The participant's age and years of nursing experience also had statistically significant effects on PA effectiveness (p = 0.006, p = 0.025, respectively).

Conclusion: This study's findings underscore the significant impact of inappropriate PA systems, inefficient instruments, and unskilled evaluators on organizational commitment, job satisfaction, maintaining a committed nursing workforce, and high-quality healthcare. The study also highlights the importance of effective performance appraisal systems in healthcare organizations. However, the study also emphasizes the crucial role of a mutual understanding between the appraiser and the appraisee. This understanding is a key factor in enhancing the efficacy of PA, thereby emphasizing its importance in the appraisal process.

Introduction: Electronic medical records (EMR) have been recognized as practical tools for the improvement of the quality and safety of healthcare despite their occasional use in hospitals worldwide. Epic is an integrated software suite with functionality ranging from patient administration through systems for healthcare providers to billing systems, integration to the primary health sector, and a facility for granting patients access to their data. The implementation process is complicated; creating effective methods requires understanding users' attitudes about these information technologies. This study aimed to develop and validate a questionnaire that measures the efficacy of using workflow during the EMR (Epic) implementation. Furthermore, it describes the nurses' views on the use of quality and satisfaction of workflow.

Methods: Following a literature review, an initial pool of 57 items was generated based on the following three primary constructs: use, quality, and user satisfaction with the tool's workflow. Internal consistency reliability was assessed by calculating Cronbach's alpha and correlation coefficients for construct validity.

Results: The final scale comprised 53 items corresponding to the following five distinct factors: use of workflow, information quality, service quality, use of EMR, and user satisfaction and the influence of workflow on clinical care. The full scale was assessed, and Cronbach's alpha of 0.95 was found. The construct validity was assessed using the Kaiser-Meyer-Olkin measure of sampling adequacy and Bartlett's Test of Sphericity (0.976). Construct validity was tested twice using Exploratory Factor Analysis-Principal Component Analysis.

Conclusion: The use of workflow, quality of information, quality of service, use of EMR, and user satisfaction scale have good reliability and validity and can be used to implement technology in healthcare.