The association of patient safety climate and nurse-related organizational factors with selected patient outcomes: a cross-sectional survey.

Background. Photovoice is a participatory action research method combining photography and group work to give people an opportunity to record and reflect on their daily lives.Purpose. To review the use of Photovoice in health research and consider the implications for occupational therapy research.Methods. Literature review, guided by a scoping framework, reveals the purposes, rationales and populations with whom Photovoice has been used.Findings. From 351 documents retrieved, 191 original studies were surveyed; 68% were peer-reviewed. The majority of studies (76%) occurred within the public health domain and a smaller percentage (24%) with individuals experiencing a specific illness and/or disability, with very few (2%) documented in the occupational therapy literature.Implications. Photovoice provides a useful framework to apply a participant-centred research approach on occupational participation. It is important to consider and further examine ethical and methodological issues related to stigma, physi...

http://journals.sagepub.com/doi/pdf/10.2182/cjot.2012.79.3.8

A scoping review of the Photovoice method: implications for occupational therapy research.

O cenario moderno e competitivo dos sistemas de prestacao de cuidados de saude contrapoe-se as suas demandas ascendentes e aos recursos nem sempre suficientes. A preocupacao com a seguranca do paciente, importante dimensao da qualidade do cuidado de saude, constitui atualmente tema de relevância crescente entre pesquisadores do todo o mundo. Os eventos adversos ocorrem em qualquer local onde se prestam cuidados de saude e na maioria das situacoes sao passiveis de medidas preventivas. O objetivo deste artigo e apresentar, por meio de uma revisao bibliografica, o discurso sobre a seguranca do paciente a partir do seculo XXI, enfocando sua relevância enquanto problema global de saude publica; discorrer sobre os desafios relacionados as lacunas e perspectivas em termos de pesquisa acerca do tema e sua abordagem na realidade brasileira. Verifica-se que a investigacao sobre a seguranca do paciente ainda nao possui o beneficio de ter suas abordagens bem estabelecidas; e ainda, que multiplas barreiras e desafios precisam ser enfrentados na concepcao de delineamentos de estudos e na utilizacao de tecnicas de pesquisa.

/pdf/a-seguranca-do-paciente-como-dimensao-da-qualidade-do-1z2egyui3s.pdf

A segurança do paciente como dimensão da qualidade do cuidado de saúde: um olhar sobre a literatura

Staff behaviours to optimise patient safety may be influenced by burnout, depression and strength of the safety culture. We evaluated whether burnout, symptoms of depression and safety culture affected the frequency of medical errors and adverse events (selected using Delphi techniques) in ICUs. Prospective, observational, multicentre (31 ICUs) study from August 2009 to December 2011. Burnout, depression symptoms and safety culture were evaluated using the Maslach Burnout Inventory (MBI), CES-Depression scale and Safety Attitudes Questionnaire, respectively. Of 1,988 staff members, 1,534 (77.2 %) participated. Frequencies of medical errors and adverse events were 804.5/1,000 and 167.4/1,000 patient-days, respectively. Burnout prevalence was 3 or 40 % depending on the definition (severe emotional exhaustion, depersonalisation and low personal accomplishment; or MBI score greater than −9). Depression symptoms were identified in 62/330 (18.8 %) physicians and 188/1,204 (15.6 %) nurses/nursing assistants. Median safety culture score was 60.7/100 [56.8–64.7] in physicians and 57.5/100 [52.4–61.9] in nurses/nursing assistants. Depression symptoms were an independent risk factor for medical errors. Burnout was not associated with medical errors. The safety culture score had a limited influence on medical errors. Other independent risk factors for medical errors or adverse events were related to ICU organisation (40 % of ICU staff off work on the previous day), staff (specific safety training) and patients (workload). One-on-one training of junior physicians during duties and existence of a hospital risk-management unit were associated with lower risks. The frequency of selected medical errors in ICUs was high and was increased when staff members had symptoms of depression.

/pdf/the-iatroref-study-medical-errors-are-associated-with-r2qbkl8vcn.pdf

The Iatroref study: medical errors are associated with symptoms of depression in ICU staff but not burnout or safety culture

Purpose To learn the weaknesses and strengths of safety culture as expressed by the dimensions measured by the Hospital Survey on Patient Safety Culture (HSOPSC) at hospitals in the various cultural contexts. The aim of this study was to identify studies that have used the HSOPSC to collect data on safety culture at hospitals; to survey their findings in the safety culture dimensions and possible contributions to improving the quality and safety of hospital care. Data sources Medline (via PubMed), Web of Science and Scopus were searched from 2005 to July 2016 in English, Portuguese and Spanish. Study selection Studies were identified using specific search terms and inclusion criteria. A total of 33 articles, reporting on 21 countries, was included. Data extraction Scores were extracted by patient safety culture dimensions assessed by the HSOPSC. The quality of the studies was evaluated by the STROBE Statement. Results The dimensions that proved strongest were 'Teamwork within units' and 'Organisational learning-continuous improvement'. Particularly weak dimensions were 'Non-punitive response to error', 'Staffing', 'Handoffs and transitions' and 'Teamwork across units'. Conclusion The studies revealed a predominance of hospital organisational cultures that were underdeveloped or weak as regards patient safety. For them to be effective, safety culture evaluation should be tied to strategies designed to develop safety culture hospital-wide.

/pdf/the-patient-safety-culture-a-systematic-review-by-5gkfl8nu4j.pdf

The patient safety culture: a systematic review by characteristics of Hospital Survey on Patient Safety Culture dimensions.

Background: A growing body of peer-reviewed studies demonstrate the importance of safety culture in healthcare safety improvement, but little attention has focused on developing a common set of definitions, dimensions and measures. Objectives: Specific objectives of this literature review include: summarising definitions of safety culture and safety climate, identifying theories, dimensions and measures of safety culture in healthcare, and reviewing progress in improving safety culture. Methods: Peer-reviewed, English-language articles published from 1980 to 2009 pertaining to safety culture in healthcare were reviewed. One hundred and thirty-nine studies were included in this review. Results: Results suggest that there is disagreement among researchers as to how safety culture should be defined, as well as whether or not safety culture is intrinsically diverse from the concept of safety climate. This variance extends into the dimensions and measurement of safety culture, and interventions to influence culture change. Discussion: Most studies utilise quantitative surveys to measure safety culture, and propose improvements in safety by implementing multifaceted interventions targeting several dimensions. Conversely, very few studies made their theoretical underpinnings explicit. Moving forward, a common set of definitions and dimensions will enable researchers to better share information and strategies to improve safety culture in healthcare, building momentum in this rapidly expanding field. Advancing the measurement of safety culture to include both quantitative and qualitative methods should be further explored. Using the expertise of traditional culture experts, anthropologists, more in-depth observational and longitudinal research is needed to move research in this area forward.

/pdf/safety-culture-in-healthcare-a-review-of-concepts-dimensions-3ed002jsuc.pdf

Safety culture in healthcare: a review of concepts, dimensions, measures and progress

Objective The purpose of this study was to assess the facilitators and barriers to implementation of the Systemic Falls Investigative Method (SFIM) on selected hospital units. Design A cross-sectional explanatory mixed methods design was used to converge results from a standardized safety culture survey with themes that emerged from interviews and focus groups. Findings were organized by six elements of the Ottawa Model of Research Use framework. Setting A geriatric rehabilitation unit of an acute care hospital and a neurological unit of a rehabilitation hospital were selected purposefully due to the high frequency of falls. Participants Hospital staff who took part in: surveys (n = 39), interviews (n = 10) and focus groups (n = 12), and 38 people who were interviewed during falls investigations: fallers, family, unit staff and hospital management. Intervention Implementation of the SFIM to investigate fall occurrences. Main outcome measure(s) Percent of positive responses on the Modified Stanford Patient Safety Culture Survey Instrument converged with qualitative themes on facilitators and barriers for intervention implementation. Results Both hospital units had an overall poor safety culture which hindered intervention implementation. Facilitators were hospital accreditation, strong emphasis on patient safety, infrastructure and dedicated champions. Barriers included heavy workloads, lack of time, lack of resources and poor communication. Conclusions Successful implementation of SFIM requires regulatory and organizational support, committed frontline staff and allocation of resources to identify active causes and latent contributing factors to falls. System-wide adjustments show promise for promotion of safety culture in hospitals where falls happen regularly.

Improving safety culture in hospitals: Facilitators and barriers to implementation of Systemic Falls Investigative Method (SFIM).

Background/aim: In this study, we bring attention to the university education of health science students with respect to occupation in later life. Our goal was to provide descriptive data from narratives of a group of undergraduate students and initiate discussion about the place of occupation in the context of ageing to answer the following questions: (i) How young people perceive successful ageing in relation to occupation? and (ii) can spirituality-related activities be considered occupations in later life?



Methods: Based on a thematic selection, the quality of photographs and reflective narratives, 60 Photovoice assignments created by health sciences students were analysed using content analysis.



Results: The findings of this study indicate that students seem to neglect the benefits of ‘being’ through spiritual engagement, and instead emphasise the importance of ‘doing’, and perpetuate pervasive successful ageing discourses in Western societies.



Conclusions: Occupational therapists have potential to take an active role in undergraduate health science education and to inform the development of holistic models that would include spirituality as an avenue to live late life to its fullest potential. Photovoice emerged as a powerful teaching method to increase awareness, empathy and compassion of young adults towards ageing.

Happy and healthy only if occupied? Perceptions of health sciences students on occupation in later life

Objectives This case study aimed to understand safety culture in a high-risk secured unit for cognitively impaired residents in a long-term care (LTC) facility. Specific objectives included the following: diagnosing the present level of safety culture maturity using the Patient Safety Culture Improvement Tool (PSCIT), examining the barriers to a positive safety culture, and identifying actions for improvement. Methods A mixed methods design was used within a secured unit for cognitively impaired residents in a Canadian nonprofit LTC facility. Semistructured interviews, a focus group, and the Modified Stanford Patient Safety Culture Survey Instrument were used to explore this topic. Data were synthesized to situate safety maturity of the unit within the PSCIT adapted for LTC. Results Results indicated a reactive culture, where safety systems were piecemeal and developed only in response to adverse events and/or regulatory requirements. A punitive regulatory environment, inadequate resources, heavy workloads, poor interdisciplinary collaboration, and resident safety training capacity were major barriers to improving safety. Conclusions This study highlights the importance of understanding a unit's safety culture and identifies the PSCIT as a useful framework for planning future improvements to safety culture maturity. Incorporating mixed methods in the study of health care safety culture provided a good model that can be recommended for future use in research and LTC practice.

Understanding safety culture in long-term care: a case study

Smoking cessation after a cancer diagnosis can improve health outcomes, but the Coronavirus disease 2019 (COVID-19) pandemic significantly altered healthcare patterns and strained resources, including for smoking cessation support for cancer patients. A Network that included all 13 provinces and territories (jurisdictions) in Canada received funding and coordinated support from a national organization to implement access to smoking cessation support in cancer care between 2016 and 2021, including throughout the COVID-19 pandemic. Descriptive analyses of meetings between the organization and jurisdictions between March of 2020 and August of 2021 demonstrated that all jurisdictions reported disruptions of existing smoking cessation approaches. Common challenges include staff redeployment, inability to deliver support in person, disruptions in travel, and loss of connections with other clinical resources. Common adaptations included budget and workflow adjustments, transition to virtual approaches, partnering with other community resources, and coupling awareness of the harms of smoking and COVID-19. All jurisdictions reported adaptations that maintained or improved access to smoking cessation services. Collectively, data suggest coordinated national efforts to address smoking cessation in cancer care could be crucial to maintaining access during an international healthcare crisis.

/pdf/challenges-and-adaptations-for-providing-smoking-cessation-1d0nz41k.pdf

Michelle Halligan

Papers

Safety culture in healthcare: a review of concepts, dimensions, measures and progress

Improving safety culture in hospitals: Facilitators and barriers to implementation of Systemic Falls Investigative Method (SFIM).

Happy and healthy only if occupied? Perceptions of health sciences students on occupation in later life

Understanding safety culture in long-term care: a case study

Challenges and Adaptations for Providing Smoking Cessation for Patients with Cancer across Canada during the COVID-19 Pandemic