Belorus A. I., Fedosiuк R. M., Kovaliova O. M., Lysak V. P.

THE LEVEL OF PATIENTS’ SAFETY CULTURE AT NEONATAL DEPARTMENTS OF UKRAINE (RESULTS OF SOCIOLOGICAL RESEARCH OF NEONATOLOGISTS)


About the author:

Belorus A. I., Fedosiuк R. M., Kovaliova O. M., Lysak V. P.

Heading:

SOCIAL MEDICINE AND ORGANIZATION OF HEALTHCARE PROTECTION

Type of article:

Scentific article

Annotation:

In modern medicine, ensuring patients’ safety is considered one of the main priorities. An important primer for patients’ safety is the so-called culture of safety. The awareness of the need to create a patient-centered culture in hospitals is increasing. The aim of the research is to evaluate the level of safety culture of patients at health care facilities of Ukraine that provide medical care to newborns and to study the attitude of healthcare providers towards the implementation of patients’ safety tools and the system for monitoring medical errors and critical incidents. Research methods. The questionnaire survey of neonatologists and children’s anaesthesiologists was conducted based on the modified questionnaire “Research of patients’ safety culture at hospitals” of the Agency for Research and Quality in Public Health (USA). The questionnaire included 8 modules and 51 statements/questions, which were divided into 2 categories. Positive responses to the questions of the first category indicated a sufficient level of safety culture for patients at the department, and positive responses to the second category – its insufficient level. Results. In total, 200 questionnaires were distributed, of which 161 were valid (80.5% response rate). Among the surveyed medical staff, 35 (21.7%) work at the perinatal center, 32 (19.9%) – at the maternity hospital, 54 (33.5%) – at the children’s regional hospital, 27 (16.8%) – at the children’s city hospital and 7 (4.3%) – at other institutions. Among respondents, 33.8% had the professional experience at the current hospital department for more than 15 years, 29.3% of respondents – from 5 to 15 years and 36.0% of respondents – up to 5 years. The average value of positive responses provided by physicians in the first category ranged from 55.3% in the module “Communication” to 88.5% in the module “Your administrative manager”, and in the second category – from 39.1% of the module “Your hospital” to 10.6% of the module “Your administrative manager”. The low percentage of positive responses in the modules “Communication” and “Medical Errors & Feedback” indicates a lack of implementation of patients’ safety culture in the neonatology service of Ukraine. Thus, 60 respondents (37.3%) indicated that their hospital often or always allowed mistakes but did not reach the patient, that is, the error was corrected in a timely manner and did not affect the patient. Fifty one respondents (31.7%) indicated that their hospital often or always allowed mistakes that had reached patients but did not harm them. Almost a third of respondents indicated that their hospital often or always have errors that reach the patients and caused harm. At the same time, 32.9% of respondents indicated that they themselves had made mistakes that could potentially harm the patients. In the “Patient Safety Grading” module, respondents express their subjective opinion about the overall level of patient safety in their structural subdivision. According to the results of the survey, 29 (18.0 ± 3.03%) respondents reported that the level of patient safety at their department was excellent, 71 (44.1 ± 3.91%) of respondents – that the level of patients’ safety was very good and 49 (30, 4 ± 3.63%) of the respondents – that the level of patient safety was acceptable. The results of the study revealed that trained personnel are crucial for ensuring patients’ safety. The highest percentage of positive responses in the second category, “Unit Personal&Team» means that the distribution of staff, according to respondents, is not sufficient to guarantee the patients’ safety. That is, the culture of safety should become a new paradigm of medical relationships if we want to succeed in such sensitive areas as elimination of human mistakes. However, the vast majority of doctors (94.4%) would like to receive more information about patients’ safety and are ready to report their unintended mistakes and adverse events (88.8% of doctors). Conclusions. Research among neonatologists and children’s anaesthesiologists in Ukraine has demonstrated a rather high level of readiness for introduction and maintenance of a new, tolerant culture of patients’ safety.

Tags:

patients’ safety culture, questionnaires, neonatologists, children’s anaesthesiologists, medical errors

Bibliography:

  • Kontseptualni pidkhody do zabezpechennia yakosti ta bezpeky medychnoi dopomohy novonarodzhenym / O.M. Kovalova, T.K. Znamenska, V.I. Pokhylko [ta in.] // Perynatolohiia ta pediatriia. – 2013. – № 4 (56). – S. 6-10.
  • Agency for Healthcare Research and Quality (AHRQ). International Use of the Surveys on Patient Safety Culture [Electronic resource] // Agency for Healthcare Research and Quality(AHRQ). – 2012. – Mode of access: http://www.ahrq.gov/legacy/qual/ patientsafetyculture/pscintusers.htm.
  • Aspden P. Patient Safety: Achieving a New Standard for Care / P. Aspden, J. Corrigan, J. Wolcott. – Washington, D.C.: The National Academies Press, 2004.
  • Bodur S. Validity and reliability of Turkish version of “hospital survey on patient safety culture” and perception of patient safety in public hospitals in turkey / S. Bodur, E. Filiz // BMC Health Serv. Res. – 2010. – № 10. – Р. 28.
  • Building a Better Delivery System: A New Engineering / Health Care Partnership / P.R. Reid, W.D. Compton, J.H. Grossman, G. Fanjiang. – 2005. – 262 p. – (Washington, D.C.: National Academies Press).
  • Challenging patient safety culture: survey results / J. Hellings, W. Schrooten, N. Klazinga [et al.] // Int. J. Health. Care Qual. Assur. – 2007. – Vol. 20, № 7. – P. 620-632.
  • Chen I.C. Measuring patient safety culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC) / I.C. Chen, H.H. Li // Health Serv. Res. – 2010. – № 10. – Р. 152-162.
  • Effect of a Systems Intervention on the Quality and Safety of Patient Handoffs in an Internal Medicine Residency Program / K.L. Graham, E.R. Marcantonio, G.C. Huang [et al.] // J. Gen. Intern. Med. – 2013. – Vol. 28, № 8. – P. 986-993.
  • Evaluation of postoperative handover using a tool to assess information transfer and teamwork / K. Nagpal, M. Abboudi, L. Fischler [et al.] // Ann. Surg. – 2011. – № 253. – P. 831-837.
  • Hospital safety culture in Taiwan: a nationwide survey using Chinese version safety attitude questionnaire / W.C. Lee, H.Y. Wung, H.H. Liao [et al.] // BMC Health Serv. Res. – 2010. – № 10. – P. 234.
  • Hospital survey on patient safety culture in China / Y. Nie, X. Mao, H. Cui // BMC Health Serv. Res. – 2013. – № 13. – P. 228.
  • Hospital Survey on Patient Safety Culture: 2012 User Comparative Database Report [Electronic resource] / J. Sorra, T. Famolaro, N. Dyer [et al.] // Rockville, MD: Agency for Healthcare Research and Quality. – 2012. – Mode of access: http://www.ahrq.gov/ professionals/quality-patient-safety/patientsafetyculture/hospita /2012/index.html.
  • Hughes R.G. Working conditions that support patient safety / R.G. Hughes, C.M. Clancy // J. Nurs. Care Qual. – 2005. – Vol. 20, № 4. – P. 289-292.
  • Matsubara S. Development of a patient safety climate scale in Japan / S. Matsubara, A. Hagihara, K. Nobutomo // Int. J. Quality in Health Care. – 2008. – Vol. 20, № 3. – P. 211-220.
  • Panagos P.G. Creating a Highly Reliable Neonatal Intensive Care Unit Through Safer Systems of Care / P.G. Panagos, S.A. Pearlman // Clin. Perinatol. – 2017. – Vol. 44, № 3. – Р. 645-662.
  • Perception of nursing and medical professionals on patient safety in neonatal intensive care units / A. Tomazoni, P.K. Rocha, M.B. Ribeiro [et al.] // Rev. Gaucha Enferm. – 2017. – Vol. 38, № 1. – P. 64996.
  • The psychometric properties of the ‘hospital survey on patient safety Culture’ in Dutch hospitals / M. Smits, I. Christiaans-Dingelhoff, C. Wagner [et al.] // BMC Health Serv. Res. – 2008. – № 8. – Р. 1-9.
  • What constitutes patient safety culture in Chinese hospitals? / J. Zhu, L.P. Li, M.Y. Shi [et al.] // Int. J. Qual. Health Care. – 2012. – Vol. 24, № 3. – Р. 250-257.
  • Zohar D. A group-level model of safety climate: testing the effect of group climate on microaccidents in manufacturing jobs / D. Zohar // J Appl Psychol. – 2000. – Vol. 85, № 4. – P. 587-596.

Publication of the article:

«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 332-338 pages, index UDK 616-053.3:674.8(477)

DOI: