7 research outputs found

    Correlation between safety attitudes and early adoption of cognitive aids in the German culture sphere: a multicenter survey study

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    Background: Cognitive Aids (checklists) are a common tool to improve patient safety. But the factors for their successful implementation and continuous use are not yet fully understood. Recent publications suggest safety culture to play a key role in this context. However, the effects on the outcome of implementation measures remain unclear. Hospitals and clinics that are involved in cognitive aid development and research might have significantly different safety cultures than their counterparts, resulting in skewed assessments of proper implementation. Therefore, the objective of this study was to assess the correlation between cognitive aid implementation and safety attitudes of staff members in early adopting and later adopting clinics. Methods: An online survey of the Safety Attitudes Questionnaire (SAQ) was carried out in German anaesthesiology departments during the initial implementation of a new checklist for emergencies during anesthesia (“eGENA” app). Subsequently an analysis between subgroups (“eGENA” app usage and occupation), with Kruskal–Wallis- and Mann–Whitney-U-Tests was carried out for the general SAQ, as well as it six subscales. Results: Departments that introduced “eGENA” app (Median 3,74, IQR 0,90) reported a significantly higher median SAQ (U (NeGENA = 6, Nnon eGENA = 14) = 70,0, z = 2,31, p = 0,02, r = 0,516) than their counterparts (Median 2,82, IQR 0,77) with significant differences in the dimensions teamwork climate, work satisfaction, perception of management and working conditions. Conclusion: Early adopters of cognitive aids are likely to show a significantly higher perception of safety culture in the SAQ. Consequently, successful implementation steps from these settings might not be sufficient in different clinics. Therefore, further investigation of the effects of safety culture on cognitive aid implementation should be conducted

    20 years after To Err Is Human : A bibliometric analysis of ‘the IOM report's’ impact on research on patient safety

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    Modern safety science owes much of its current theories and practical approaches to the critical analysis of socio-technological disasters in the nuclear, chemical, maritime, and aviation industries at the end of the 1970 s and in the 1980 s. The medical field by contrast, was not challenged by a single high profile event, but by the release of a single report by the Institute of Medicine in 1999: To Err is Human – Building a Safer Health System. The report expanded the level of conversation and concern about patient injuries in health care and led to an unprecedented provision of research grants in patient safety research, essentially launching the academic base for that work. Twenty years later, it is a good time to analyze how this seminal work was received in the academic literature, which authors and institutions had the greatest research activity, which national and international collaborations ensued, and how the ideas presented in To Err Is Human might have affected the academic discourse in the two decades to follow. To meet this aim, a bibliometric analysis was performed on all publications from 2000 to 2019 where the authors referenced To Err Is Human as part of their scientific argument. 20.494 documents were retrieved. The majority of patient safety related research was carried out by researchers from North America, with little international collaboration. Over the years, the thematic scope of the research diversified from the IOM report's initial focus in many directions. Contrary to what might be expected from the IOM report's central objectives, research on a systems approach to patient safety and on incident reporting were underrepresented. From a safety science perspective, the report narrowed the diversity of the patient safety discourse rather than enlarging it by favoring the theoretical framework proposed by James Reason over other, equally valid ones

    El Diario de Pontevedra : periĂłdico liberal: Ano XLII NĂșmero 12622 - 1927 febreiro 7

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    Abstract Background Lack of familiarity with the content of current guidelines is a major factor associated with non-compliance by clinicians. It is conceivable that cognitive aids with regularly updated medical content can guide clinicians’ task performance by evidence-based practices, even if they are unfamiliar with the actual guideline. Acute hyponatraemia as a consequence of TURP syndrome is a rare intraoperative event, and current practice guidelines have changed from slow correction to rapid correction of serum sodium levels. The primary objective of this study was to compare the management of a simulated severe gynaecological transurethral resection of the prostate (TURP) syndrome under spinal anaesthesia with either: an electronic cognitive aid, or with management from memory alone. The secondary objective was to assess the clinical relevance and participant perception of the usefulness of the cognitive aid. Methods Anaesthetic teams were allocated to control (no cognitive aid; n = 10) or intervention (cognitive aid provided; n = 10) groups. We identified eight evidence-based management tasks for severe TURP syndrome from current guidelines and subdivided them into acute heart failure (AHF)/pulmonary oedema tasks (5) and acute hyponatraemia tasks (3). Implementation of the treatment steps was measured by scoring task items in a binary fashion (yes/no). To assess whether or not the cognitive aid had prompted a treatment step, participants from the cognitive aid group were questioned during debriefing on every single treatment step. At the end of the simulation, session participants were asked to complete a survey. Results Teams in the cognitive aid group considered evidence-based treatment steps significantly more often than teams of the control group (96% vs. 50% for ‘AHF/pulmonary oedema’ p < 0.001; 79% vs. 12% for ‘acute hyponatraemia’ p < 0.001). Without the cognitive aid, performance would have been comparable across both groups. Nurses, trainees, and consultants derived equal benefit from the cognitive aid. Conclusions The cognitive aid improved the implementation of evidence-based practices in a simulated intraoperative scenario. Cognitive aids with current medical content could help to close the translational gap between guideline publication and implementation in acute patient care. It is important that the cognitive aid should be familiar, in a format that has been used in practice and training

    Additional file 1: of The effect of an electronic cognitive aid on the management of ST-elevation myocardial infarction during caesarean section: a prospective randomised simulation study

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    Text of cognitive aid (Translated from German, not original formatting). The layout was adapted from a template available from Ariadne Labs [1]. (DOCX 26 kb
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