Patients Safety Culture: A Baseline Assessment Of Nurses\u27 Perceptions In A Saudi Arabia Hospital

ABSTRACT PATIENT SAFETY CULTURE: A BASELINE ASSESSMENT OF NURSES\u27 PERCEPTIONS IN A SAUDI ARABIA HOSPITAL by AHMAD E. ABOSHAIQAH May 2010 Advisor: Dr. Stephen J. Cavanagh Major: Nursing Degree: Doctor of Philosophy Patient safety (the avoidance and prevention of patient injuries or adverse events resulting from the processes of health care delivery) has become a major academic and public concern in healthcare. In order to promote and sustain a culture of safety in a healthcare organization, healthcare professionals stress the need to understand both individual and system contributions to error events. However, in Saudi Arabia, little is known about nurses\u27 perceptions of patient safety culture. The purpose of this research is to identify the systems factors that Registered Nurses (RNs) perceive as contributing to a culture of patient safety and to study the effects these perceptions have on nurses\u27 participation and engagement in the patient safety culture at King Fahad Medical City (KFMC), Saudi Arabia. King\u27s conceptual system was utilized as the theoretical framework for this study. This study used a quantitative research methodology with a descriptive/correlation design. The sample of this study was registered RNs at KFMC, Saudi Arabia. The Hospital Survey on Patient Safety Culture (HSOPSC) instrument was used to measure perceptions of nurses on patient safety culture. Copies of the surveys were distributed to 600 RNs. A total of 500 questionnaires were returned. Among these returned questionnaires, 55 were excluded because they had missing responses on more than one complete section of the questionnaire. The total response rate for this study was 83%. Overall, 52% of the nurses positively perceived patient safety culture at KFMC, which is considered an opportunity for improvement according to AHRQ\u27s definition of areas needing improvement. Nurses responded most positively to two dimensions, hospital management support for patient safety and organizational learning. Nurses responded most negatively to the dimensions of hospital handoffs and transitions, communication openness, non-punitive response to error, and supervisor/manager expectations and actions promoting patient safety. There were significant differences between nurses\u27 perceptions of patient safety culture and gender, age, years of experience, Arabic vs. non-Arabic speaking, and length of shift; but astonishingly, for level of education, the results were not significantly correlated to any of the HSOPSC dimensions. Findings from this study provide a description of the current status of patient safety at King Fahad Medical City from the nurses\u27 perspective. The findings will not only provide a baseline from which to work, but they will help raise safety awareness throughout the organization and identify areas most in need of improvement. Findings will lead to the development of interventions to improve patient safety in Saudi Arabia hospitals

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

Compiles peer-reviewed research and literature reviews on issues regarding patient safety and quality of care, ranging from evidence-based practice, patient-centered care, and nurses' working conditions to critical opportunities and tools for improvement

An Evidence-Based Evaluation of Medication Barcode Scanning Acceptance in a Community Hospital

Barcode scanning during medication administration is a powerful tool to prevent errors and support patient safety. In spite of the significant patient safety benefits, there is a lack of adoption and acceptance of barcode scanning. The purpose of this project was to implement an evidence-based assessment, utilizing a survey instrument based on the technology acceptance model, to understand adoption and acceptance of barcode scanning at a community hospital. Forty-four people, 38 nurses and 8 respiratory therapists, participated in the survey. Data analyses were performed using descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and Spearman\u27s rho tests. The subscales for the intention to use barcode scanning and the influence of others were rated highest by the survey participants. The subscales for the training and technical support received the lowest ratings. There were significant differences among the departments on the subscale scores, with the acute inpatient area reporting the highest subscale ratings and the surgical services/procedural area reporting the lowest subscale ratings. There were no differences in the scores for the survey subscales in regards to participants\u27 age and years of computer use at work and at home. There were several themes identified related to barcode scanning issues and concerns. Recommendations to address the survey results and the barcode scanning issues were developed

Impact of Leader Rounds on Perceptions of the Culture of Safety

A culture of safety in healthcare settings supports a caring environment and practices that produce quality patient outcomes. Leadership is instrumental in creating a culture of safety. The purpose of this quantitative pretest-posttest design project was to determine if the implementation of leader rounds in an acute care hospital had an impact on staff nurses’ perceptions of safety culture as measured by the Safety Attitudes Questionnaire. The setting was a midsize acute care hospital with a target population of dayshift nurses working in the telemetry service line. Leader rounds were conducted over a six-week timeline by the department director. Data analysis was conducted using a paired-samples t test. The major finding of this study was a reduction in the post safety score after the implementation of leader rounds; however, it was not statistically significant. There are significant factors that may explain the findings in this study. The leaders conducting rounds were middle management rather than executive-level leaders. The staff exposure to leader rounds showed that only a small minority of staff had participated in leader rounds over the six-week time frame. Lastly, during the study period, the hospital units experienced a heavy influx of COVID-19 patients, resulting in higher acuity patients and a higher than normal volume of acutely ill patients on these units. Despite the drop in perception of a culture of safety, a majority of the participants wanted leader rounds to continue. Hospital leaders should continue to evaluate the role of rounding absent a population crisis and with modifications to ensure staff participation

A Learning Health Sciences Approach to Understanding Clinical Documentation in Pediatric Rehabilitation Settings

The work presented in this dissertation provides an analysis of clinical documentation that challenges the concepts and thinking surrounding missingness of data from clinical settings and the factors that influence why data are missing. It also foregrounds the critical role of clinical documentation as infrastructure for creating learning health systems (LHS) for pediatric rehabilitation settings. Although completeness of discrete data is limited, the results presented do not reflect the quality of care or the extent of unstructured data that providers document in other locations of the electronic health record (EHR) interface. While some may view imputation and natural language processing as means to address missingness of clinical data, these practices carry biases in their interpretations and issues of validity in results. The factors that influence missingness of discrete clinical data are rooted not just in technical structures, but larger professional, system level and unobservable phenomena that shape provider practices of clinical documentation. This work has implications for how we view clinical documentation as critical infrastructure for LHS, future studies of data quality and health outcomes research, and EHR design and implementation. The overall research questions for this dissertation are: 1) To what extent can data networks be leveraged to build classifiers of patient functional performance and physical disability? 2) How can discrete clinical data on gross motor function be used to draw conclusions about clinical documentation practices in the EHR for cerebral palsy? 3) Why does missingness of discrete data in the EHR occur? To address these questions, a three-pronged approach is used to examine data completeness and the factors that influence missingness of discrete clinical data in an exemplar pediatric data learning network will be used. As a use-case, evaluation of EHR data completeness of gross motor function related data, populated by providers from 2015-2019 for children with cerebral palsy (CP), will be completed. Mixed methods research strategies will be used to achieve the dissertation objectives, including developing an expert-informed and standards-based phenotype model of gross motor function data as a task-based mechanism, conducting quantitative descriptive analyses of completeness of discrete data in the EHR, and performing qualitative thematic analyses to elicit and interpret the latent concepts that contribute to missingness of discrete data in the EHR. The clinical data for this dissertation are sourced from the Shriners Hospitals for Children (SHC) Health Outcomes Network (SHOnet), while qualitative data were collected through interviews and field observations of clinical providers across three care sites in the SHC system.PHDHlth Infrastr & Lrng Systs PhDUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/162994/1/njkoscie_1.pd

Digital assessment in the clinical workplace : Design, implementation, opportunities, challenges

Peer reviewe

Designing and implementing online assessment in the clinical workplace

Peer reviewe