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Saraç, Çakıl. "Safety climate in acute hospitals." Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165841.
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Abstract This thesis measures safety climate in a sample of Scottish acute hospitals. It demonstrates how staff perceptions related to safety issues are linked to their safety behaviours and also to the consequences, both for the workers and the patients. Following a review of the industrial and healthcare safety climate literatures, a theoretical model was proposed to investigate the underlying mechanisms between safety climate and safety outcomes. Based on this review, the Hospital Survey on Patient Safety Culture (HSOPSC) was selected as part of a questionnaire to measure safety climate, safety behaviours and safety outcomes. A total of 1969 clinical staff from seven Scottish acute NHS hospitals were surveyed. The psychometric analysis, using EFA and CFA, showed that the original 12 factor structure of the HSOPSC scale was replicated. A focus group study (n = 25) was conducted in two of the hospitals to extend the survey findings. The qualitative data supported the theoretical model proposed based on the literature review by demonstrating the role of managerial practices on safety-related issues. The group discussions further contributed to a wider conceptualization of safety culture by illustrating the multi-level perspective of staff on safety-related issues, including both the external influences and the individual factors. Using structural equation modelling on the same quantitative data set, managerial aspects of safety climate were examined in relation to safety outcomes (safety behaviours, worker and patient outcomes). Results demonstrated the effects of managerial commitment to safety at hospital and unit level on safety outcomes. It also showed the intervening role of safety compliance and safety participation between supervisory practices and self-reported injuries, both for workers and patients. Overall, this thesis provided a psychometrically robust safety climate measurement tool tested in Scottish acute hospitals, and showed the influence of safety-related managerial activities at different levels of the organization on safety outcomes for workers and patients separately.
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Solomita, Joy B. "An analysis of variance in nursing-sensitive patient safety indicators related to magnet status, nurse staffing, and other hospital characteristics." Fairfax, VA : George Mason University, 2009. http://hdl.handle.net/1920/4531.
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Thesis (Ph.D.)--George Mason University, 2009.<br>Vita: p. 231. Thesis director: Chien-yun Wu. Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Nursing. Title from PDF t.p. (viewed June 10, 2009). Includes bibliographical references (p. 213-230). Also issued in print.
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Al, Salem Gheed F. "An assessment of safety climate in Kuwaiti public hospitals." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/30685/.
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Background: Patient safety in healthcare organisations received global attention following the Institute of Medicine’s release of its hallmark report “To Err Is Human: Building a Safer Health System”, where it was estimated that 44,000–98,000 patients die annually in US hospitals as a result of errors in care. Similar rates of error and avoidable harm have been reported in different research studies in many modern health systems across the world. “Safety Culture” has been identified as a key element of healthcare organisations’ ability to learn from errors and reduce preventable harm to patients resulting from health care. The perceived importance of safety culture in improving patient safety and its impact on patient outcomes has led to a growing interest in the assessment of safety culture in healthcare organisations. The use of safety climate questionnaires is one of the most popular methods for assessing safety culture. These questionnaires are thought to help in measuring healthcare workers' perceptions of the prevailing safety culture or “safety climate” in their organisations. Since no surveys of safety climate have been conducted at public hospitals in the state of Kuwait, nor are valid or reliable survey instruments available, this thesis aimed to investigate patient safety climate in public hospitals in Kuwait. The main objectives of the study were: 1. To identify an existing safety climate tools to be employed in my PhD thesis. 2. To test the psychometric properties of the identified tool in a sample of Kuwaiti public hospitals. 3. To provide a measure of the prevailing safety climate in Kuwaiti public hospitals. 4. To explore with key stakeholders the main findings of the safety climate survey and identify the potential barriers and facilitators to safety improvement initiatives in Kuwaiti public hospitals. Based on the overall findings, a series of recommendations are made for clinical leaders, policy makers and others to consider and a conceptual model informing a systems’ based approach to safety culture theory and practice is proposed for future research. Methods: A multi-method, triangulated approach including both quantitative and qualitative methods was adopted for the study. There were four phases of the research: A systematic review of published literature on safety climate tools used in acute hospital settings was carried out using seven electronic databases, with manual searches of bibliographies of included papers and key journals. A suitable tool was identified. A cross-sectional survey of 1,511 healthcare staff in three public hospitals was conducted for two purposes: Firstly, to assess the psychometric properties of the identified tool and develop an optimum model for assessing safety climate in Kuwaiti hospitals. Secondly, to provide an assessment of the current state of safety climate in Kuwaiti hospitals. Finally, interviews with key personnel were conducted to extend the examination of the survey findings and provide a rounded picture of the current state of safety climate in Kuwaiti public hospitals. Results: The search strategy identified 3,576 potential papers. Of these, eighty-eight papers were reviewed, with five studies meeting the inclusion criteria. Three out of five studies, covering three tools, were rated as ‘good’ quality papers and reported more robust psychometric properties. The Hospital Survey on Patient Safety Culture (HSOPSC) was selected as the most appropriate for my PhD thesis (in terms of usability, applicability and psychometric properties), and was pilot tested with minor modifications. A modified version of the HSOPSC was used to conduct the survey using a sample of healthcare staff with an 87% (n=1,310) response rate. Results of psychometric evaluation, including exploratory factor analysis, confirmatory factor analysis, reliability and correlation analysis, showed an optimal model of eight factors and 22 safety climate items. General evaluation of the prevailing safety climate amongst the workforce in acute hospital settings was conducted. The dimensions “Teamwork within units” (84%), “organisational learning-continuous improvement” (82%), “supervisor/manager expectations and actions promoting safety” (77%) and “management support for patient safety” (74%) were identified as strongly positive areas for the three hospitals. The dimensions “Non-punitive response to error” (34%), “communication openness” (47%) and “frequency of event reporting” (50%) were identified as areas in need of improvement. Building on the survey findings, interviews with key stakeholders added rich insight into hospital employees' perceptions on safety and allowed exploration of emerging issues in more detail. The research findings of my PhD thesis, and of the literature informed the design of a preliminary framework that aims to extend the examination of the construct of safety climate beyond the domains and items that typically inform safety climate theory to include system wide factors which potentially influence the prevailing safety culture/climate. Conclusions: This is the first validation study of a Standardised safety climate measure in a Kuwaiti healthcare setting. The study assessed the psychometric properties of the HSOPSC questionnaire and constructed an optimal model for assessing patient safety climate in Kuwaiti hospitals. It highlighted important patient safety and staff wellbeing concerns to inform organisational and national learning, and provided a baseline for measuring patient safety climate in Kuwaiti hospitals. As such, my PhD thesis raises and emphasizes the critical importance of appropriate validation of safety climate questionnaires before extending their usage in different countries or healthcare contexts. It provided new knowledge about areas of strength and weakness in safety climate with the potential to drive local improvements in Kuwaiti public hospitals. It is recommended that future investigations of patient safety culture and climate combine both quantitative and qualitative approaches and adopt a system wide approach to inform safety climate theory and questionnaire development, leading to stronger frameworks guiding safety culture research and practice.
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Kaya, Gulsum Kubra. "Good risk assessment practice in hospitals." Thesis, University of Cambridge, 2018. https://www.repository.cam.ac.uk/handle/1810/273747.
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Risk assessment is essential to ensure safety in hospitals. However, hospitals have paid little attention to risk assessment. Several problems have already been identified in the literature about current risk assessment practice, such as inadequate risk assessment guidance and bias in risk scoring. This research aimed to improve current risk assessment practice in hospitals in the National Health Service (NHS) in England. To address this aim, the research investigated current risk assessment practice and designed a new risk assessment approach by the use of mixed methods. One hundred hospitals’ risk assessment documents were reviewed to examine the current recommended risk assessment practice. Seventeen interviews and sixty-one questionnaires were conducted, a risk management system from a single hospital was reviewed, and strategic risks from thirty-four hospitals were reviewed, in order to examine how risks are assessed in actual practice. Following that, the proposed approach was designed by conducting requirements analysis and then evaluated by interviews and questionnaires with ten healthcare staff. The findings of this research reveal that hospitals conduct risk assessments in different ways (i.e. with a focus on individual patient-based, operational and strategic risks). There are also many problems involved in current risk assessment practice regarding both the foundations and use of risk assessment. For example, organisation-wide risk assessments predominantly rely on risk matrices which might lead to wrong risk prioritisation and resource allocation; and risks tend to reflect existing or past problems rather than being proactive. All these reveal a need to improve current risk assessment practice. This research makes an important contribution to the current understanding of risk assessment practice in hospitals by providing extensive evidence on both recommended and actual practice, and proposes a new risk assessment framework. The framework guides healthcare staff on how to conduct risk assessment in a more comprehensive way by encouraging its potential users to consider good risk assessment practice.
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Afroze, Tonima, and Palmqvist Mia Isaksson. "Patient Safety Regarding Medical Devices at ICUs in Bangladesh." Thesis, KTH, Skolan för teknik och hälsa (STH), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-132245.
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Accidents related to medical devices are a worldwide problem and result in many deaths each year. It affects patients, relatives, health care workers and society. Due to the complexity of intensive care units (ICUs), such accidents lead to particularly serious consequences. The aim of this thesis was to identify patient safety aspects at ICUs in public and private hospitals in Bangladesh, in order to provide a basis for improving the quality of performance of devices as well as personnel, care and cost effectiveness. The objectives were to a) compare the conditions of medical devices at ICUs in private and public hospitals, b) increase understanding of errors, risks and accidents related to medical devices, c) study reporting systems and communication between staff at ICUs and d) find ways to minimize hazards related to medical equipment to ensure effective and safe use of devices. Data was collected through interviews during field visits to six hospitals in Dhaka, Bangladesh. Interviews were held with the chiefs of the ICUs, physicians, nurses and technicians. It was noticed that the admission fees to the public hospitals were lower and had more limited resources. Differences between public and private hospitals could be seen in the aspects of finance, the existence of a Biomedical Engineering Department, maintenance and calibration of medical equipment, further education of staff, working environment and infection control. The reporting systems for adverse events and communication about patients’ conditions between coworkers were weak at all hospitals. The procurement process was lengthy at all hospitals. Access to disposable items was limited at several hospitals. The lower admission fee at the government hospitals results in the patients of these hospitals often having a lower income and status, thus less inclined to be critical of the received care. A number of suggestions have been proposed in order to improve the work in the ICU. These include a) following up rules made by the authorities to ensure they are implemented at each hospital, b) increasing documentation of malfunctioning devices and adverse events, c) nurses and physicians taking part in the procurement process, d) establishing a Biomedical Engineering Department at all hospitals, e) organizing workshops for health care workers, f) developing biomedical products adapted for multiple time use and with less need for calibration, g) providing more education for health care workers in infection control, management of specific devices, solutions to common technical problems, patient safety and user safety, for example using Information and Communication Technology tools (audio and audiovisual material) and discussion platforms as well as h) constructing an internet forum for consultation on the abovementioned subjects for technicians.<br>Olyckor relaterade till medicinteknisk utrustning är ett globalt problem som leder till många dödsfall varje år. Det påverkar patienter, anhöriga, sjukvårdspersonal och samhället. Den komplexa miljön på intensivvårdsavdelningar gör att olyckorna leder till allvarliga konsekvenser. Uppsatsen syftade till att identifiera patientsäkerhetsaspekter på intensivvårdsavdelningar i Bangladesh för att skapa en grund för prestandaförbättring, både gällande utrustning och gällande personal. Det ska också öka vård- och konstandseffektiviteten. Målet uppnåddes genom att a) jämföra användandemiljön för medicinteknisk utrustning på intensivvårdsavdelningar på statliga och privata sjukhus, b) öka förståelsen för fel, risker och olyckor relaterade till medicinteknisk utrustning, c) studera rapporteringssystem samt kommunikation mellan personal på intensivvårdsavdelningar och d) hitta sätt att minimera faror relaterade till medicinteknisk utrustning för att försäkra en effektiv och säker användning av utrustningen. Data samlades in genom intervjuer under en fältstudie på sex sjukhus i Dhaka, Bangladesh. Intervjuer hölls med cheferna på intensivvårdsavdelningarna, läkare, sjuksköterskor och tekniker. Det upptäcktes att patientavgiften på de statliga sjukhusen var lägre och resurserna var mer begränsade. Skillnader mellan statliga och privata sjukhus kunde ses inom ekonomiska resurser, förekomsten av medicintekniskavdelning, underhåll och kalibrering av medicinteknisk utrustning, vidareutbildning av personal, arbetsmiljö och infektionskontroll. Rapporteringssystemen för olyckor samt kommunikationen om patienters tillstånd mellan medarbetare var bristfällig på alla sjukhus. Upphandlingsprocesserna av ny medicintekniskutrustning var lång på alla sjukhus. Tillgången på engångsartiklar var begränsad på flera utav sjukhusen. Den lägre avgiften på de statliga sjukhusen resulterar i att patienterna på dessa sjukhus ofta har lägre inkomst samt status i samhället och är därför mindre benägna att vara kritiska till den mottagna vården. Ett antal ändringar föreslogs för att förbättra arbetet på intensivvårdsavdelningarna. Dessa inkluderar att a) följa upp de av myndigheterna satta reglerna för att försäkra att de är implementerade på varje sjukhus, b) öka dokumentationen av icke fungerande utrustning tillika olyckor, c) sjuksköterskor och läkare skall delta i upphandlingsprocesserna, d) starta medicintekniska avdelningar på alla sjukhus, e) organisera workshops för vårdpersonal, f) utveckla medicintekniska produkter som är anpassade för att användas flera gånger och som behöver kalibreras mer sällan, g) ge mer utbildning till sjukvårdspersonal om infektionskontroll, hantering av specifika maskiner, lösningar till vanligt förekommande tekniska problem, patientsäkerhet och användarsäkerhet till exempel genom att använda information- och kommunikationsteknik-verktyg (audio och audiovisuellt material) och diskussionsplattformar samt h) konstruera ett internetforum där tekniker kan få konsultation angående ovannämnda ämnen.<br>To develop patient safety system to improve the safety and quality of patient care at the Intensive Care Units
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Kobewka, Daniel. "Preventable Deaths at Acute Care Hospitals." Thesis, Université d'Ottawa / University of Ottawa, 2016. http://hdl.handle.net/10393/34346.
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Background
Previous measurements of preventable death in hospital do not account for the uncertainty of preventability ratings.
Objective
To determine the proportion of deaths in hospital that a have high probability of being prevented with high quality care.
Methods
We created summaries for every death at a tertiary care hospital over 4-months. Four reviewers assigned preventability ratings to each death and latent class analysis was used to classify deaths into high and low preventability categories.
Results
There were 480 decedents with mean age of 73.9. Inter-rater reliability was poor with an intra-class correlation of 0.14. The best latent class model found that 6.2% (95% CI 0.00 – 15.2%) of deaths had a 31.0% probability of being rated more likely preventable than not by each reviewer. In contrast, 93.8% (95% CI 84.8 - 100.0%) of deaths had a 0.8% probability of being rated more likely preventable than not by each reviewer. The incidence of truly preventable deaths is less than the 6.2% that are deemed possibly preventable.
xi
Conclusion
Very few deaths in hospital are preventable. The low incidence of preventable deaths and low inter-rater reliability means that peer review methodology is only sensitive to large differences in preventable death rate.
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Bardach, David R. "Evidence-Based Hospitals." UKnowledge, 2015. http://uknowledge.uky.edu/epb_etds/5.
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In 2011 the University of Kentucky opened the first two inpatient floors of its new hospital. With an estimated cost of over $872 million, the new facility represents a major investment in the future of healthcare in Kentucky. This facility is outfitted with many features that were not present in the old hospital, with the expectation that they would improve the quality and efficiency of patient care. After one year of occupancy, hospital administration questioned the effectiveness of some features. Through focus groups of key stakeholders, surveys of frontline staff, and direct observational data, this dissertation evaluates the effectiveness of two such features, namely the ceiling-based patient lifts and the placement of large team meeting spaces on every unit, while also describing methods that can improve the overall state of quality improvement research in healthcare.
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Shika, Matsepane Rebecca. "Radiation safety standards at public hospitals in Limpopo Province, South Africa." Thesis, University of Limpopo (Turfloop Campus), 2012. http://hdl.handle.net/10386/859.
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Brajshori, Naime [Verfasser]. "Patient safety culture in Kosovo hospitals : multicenter study / Naime Brajshori." Halle, 2017. http://d-nb.info/1147758085/34.
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Gauthereau, Vincent. "Work practice, safety and heedfulness : studies of organizational reliability in hospitals and nuclear power plants /." Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/tek842s.pdf.
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Hyatt, Rick D. "Nurse Perceptions: The Relationship Between Patient Safety Culture, Error Reporting and Patient Safety in U.S. Hospitals." Franklin University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=frank1607988520967849.
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Woods, Bernadette M. "Assessment of staff attitudes to patient safety." View thesis, 2004. http://handle.uws.edu.au:8081/1959.7/46693.
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Thesis (M.N. (Hons))--University of Western Sydney, 2004.<br>A thesis presented to the University of Western Sydney, College of Social and Health Sciences, School of Nursing, Family and Community Health, in fulfilment of the requirements for the degree of Masters of Nursing (Honours). Includes bibliographical references and appendices.
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Braun, Lesley Anne, and lgbraun@bigpond net au. "Complementary Medicines in Hospitals - a Focus on Surgical Patients and Safety." RMIT University. Health Sciences, 2007. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20080414.115624.
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This study aimed to determine how CMs used by surgical patients are managed in the hospital system by doctors and pharmacists and what patient and practitioner influences affect this management. Research design and method Five systematic reviews were conducted to investigate the peer-reviewed literature for information about Australians use of CM; overseas and Australian doctors and CM; surgical patients use of CM and safety information about CMs in surgery as a basis to design and conduct three surveys. Surveys of hospital doctors, pharmacists and surgical patients were used to obtain measurement of people's attitudes, perceptions, behaviours and usage of CMs. For healthcare practitioners, knowledge of complementary medicines (CMs), past training, current practice and interest in future practice of complementary therapies (CTs) and education was also investigated. Approximately 50% of surgical patients reported taking CMs in the 2 weeks prior to surgery and approximately 50% of these patients intended to continue use in hospital. The most commonly used CMs were: fish oil supplements, multivitamins, vitamin C and glucosamine supplements as well as some CMs considered to potentially increase bleeding risk or induce drug interactions. It was not uncommon for CMs to be used at the same time as prescription medicines. Most surgical patients in general self-prescribe their CMs or have them recommended by family and friends whereas medical practitioners were the main prescribers to cardiac surgery patients. Nearly 60% of patients using CMs in the 2 weeks prior to admission did not tell hospital staff about use. The main reason for non-disclosure was not being asked about use whereas fear of a negative response was rarely a concern. The most common sources of information surgery patients refer to were GPs, pharmacists and health food stores. Hospital doctors and pharmacists did not routinely refer to information sources about CMs safety. The majority of doctors and pharmacists did not routinely ask patients about CMs, or record usage information. They had little training and knowledge of the evidence of commonly used CMs and lacked confidence in dealing with CMs-related issues. Their attitude to CMs is moderately negative and many are wary of safety, efficacy and cost-effectiveness issues. The majority of practitioners considered some CTs as potentially useful, particularly acupuncture, massage and meditation whereas the medicinal CTs and chiropractic were considered potentially harmful. Most practitioners were interested in future education about CMs and CTs and some would consider practising CTs. Personal usage of CTs was low although there was substantial interest in receiving future treatment. Despite many strategically orientated initiatives developed in Australia to promote evidence based medicine (EBM) and quality use of medicines (QUM), it appears that CMs have been largely ignored and overlooked in the practice of Medicine and Pharmacy within the hospital system. Furthermore, it appears that in regards to CMs a 'don't ask, don't tell, don't know' culture exists within hospitals and that evidence based patient-centred care and concordance is not being achieved and potentially patient safety and wellbeing is being compromised.
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Morgan, David Reginald. "Infection control in clinical environments with particular reference to Human Immunodeficiency Virus (HIV) and viral hepatitis." Thesis, Open University, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387238.
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Clark, Olga L. "COMPLIANCE WITH SAFETY PRACTICES AMONG NURSES: EXPLORING THE LINK BETWEEN ORGANIZATIONAL SAFETY CLIMATE, ROLE DEFINITIONS, AND SAFE WORK PRACTICES." Connect to this title online, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1143231038.
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Suliman, Mohammad Mahmoud. "NURSES’ PERCEPTIONS OF PATIENT SAFETY CULTURE IN PUBLIC HOSPITALS IN JORDAN." Case Western Reserve University School of Graduate Studies / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=case1415739033.
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Latha, Sampath Shakti. "Comprehensive Understanding of Injuries in Hospitals through Nursing Staff Interviews and Hospital Injury Records." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1544101088645945.
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RinaldiFuller, Julie. "Patient to nurse ratios and safety outcomes for patients." [Denver, Colo.] : Regis University, 2008. http://165.236.235.140/lib/JRinaldiFuller2008.pdf.
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Brown, Carl. "Exploring Leadership Strategy Influence on Nursing Personnel Retention Within Safety-net Hospitals." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3142.
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Frequent turnover among a hospital's nursing staff can profoundly impact organizational operating costs. With a national turnover rate of 17% in 2015, understanding the impact of management approaches on nurse attrition is vital to business success. Guided by Homan's social exchange theory, the purpose of this single case study was to explore leadership strategies used by safety-net hospital leaders to increase nursing personnel retention. Data collection consisted of semistructured interviews from a purposive snowball sampling of 8 senior directors working at a safety-net hospital in southern Maryland. Additional information collected involved documents and artifacts related to human resources management policies and guidelines. Constant comparative method enabled the analysis and identification of latent patterns in words used by respondents. Through methodological triangulation, several themes emerged. These themes included engagement and management support, education and career development, teamwork and work atmosphere, recognition, relationship building and communication, and health reform and innovation. According to the study results, increasing employee engagement, offering training and career development, performing technological upgrades, and developing sustainable relationships are appropriate approaches for gaining nursing personnel commitment. The findings of this study are important to senior leaders and middle managers in healthcare and other industries as they seek to attract talented staff members to sustain their organizations. The conclusions in this study may contribute to positive social change through improved nursing staff retention, leading to better patient experiences, healthier communities, and more satisfied customers.
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Scott, Gordon Livingstone Stanley. "An assessment of health and safety management in selected rural hospitals / Gordon Livingstone Stanley Scott." Thesis, North-West University, 2011. http://hdl.handle.net/10394/8437.
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Health and safety is of the utmost importance for any company or institution to be
successful. There is quite a negative perception regarding the health and safety
of rural hospitals and clinics.
Rural hospitals are most of the time overcrowded due the large amount of
patients that has no medical aid, thus increases the risk for health and safety
issues. Patients sit in long queues for hours to receive medical attention and their
medication and are therefore exposed to all kinds of diseases, which is a high
risk for these patients’s health.
The employees working in these rural areas are also exposed to life-threatening
diseases on a daily basis and have a good chance of being infected. Employees
leave the public sector because of these unsafe working conditions and find
themselves either working in the private sector or may even immigrate to foreign
countries for better and safer working conditions.
During this research done, there were a few shortcomings identified for the
management to improvement on and to ensure a safe working environment.
There are quite a lot of negativities surrounding the patients and employees in
these rural hospitals, because patients get raped by nurses, babies get stolen
from maternity wards, doctors are attacked by patients and much more horrific
incidents happening in these hospitals.
Cultural differences are also a main concern for management, because there are
a lot of different races working together in the same department and not
everyone has the same beliefs and ways in doing tasks. These cultural
differences may lead to clashes amongst employees and result in a negative
working environment. This quantitative research was done in selected rural hospitals, due to cost and
time consumption. Only 80 employees (doctors, nurses and pharmacists)
participated in the research done and the research was not an in-depth research,
but enough evidence was compiled to make the necessary assumptions that all
is not well in the public sector.
With the new National Health Insurance (NHI) to be implemented from 2012,
there may a lot of changes in the rural hospitals for the better. Hospitals all over
the country are being upgraded and the working conditions are being attended to
by the government which may attract more health professional to rural hospitals
and clinics.<br>Thesis (MBA)--North-West University, Potchefstroom Campus, 2012
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Cancino-Rey, Marlenne. "Nurses and health and safety : interpretation and application of health and safety legislation among the nursing workforce within hospitals /." Title page, table of contents and abstract only, 1992. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmc215.pdf.
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Williams, Michael Dermot Andrew. "Developing a system resilience approach to the improvement of patient safety in NHS hospitals." Thesis, University of Exeter, 2011. http://hdl.handle.net/10036/3256.
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The objective of this thesis is to explore how a systems approach can be used to provide an insight into patient safety in NHS hospitals in England. Healthcare delivers considerable benefits yet there remains a relatively high rate of harm and death for patients through adverse events occurring during the process of treatment. The extant patient safety literature acknowledges the influence of organisational or system factors on patient safety. However, the literature is weak in explaining how system factors affect patient safety. To provide an insight into the interactions within healthcare systems, this research explores the characteristics of NHS hospitals, regarded as complex socio-technical systems, using concepts from resilience, systems, accident and social theory. A theoretical Safe Working Envelope (SWE) model (Rasmussen, 1997) is developed and contextualised for use in the NHS. The case study field work was carried out in two NHS hospitals during consecutive winter months at times of high demand for inpatient services. A third case study uses secondary data about patient safety failures in the Mid Staffordshire NHS Foundation Trust. The original SWE model has three failure boundaries. The model is developed by introducing an additional boundary to take account of Government targets. Social theory and system dynamics are used to include the dialectic feedback of social actors and the dynamics of workload. The model depicts the competing pressures, constraints and the workload associated with the need to meet the financial, target, staff workload and patient safety requirements. Three interacting construct sets are explored. These are the constraints within which the system operates, the pressures from the context, and the system dynamics of demand, capacity and decision making. Insights into system behaviours of the hospitals are derived from examining the construct set interactions. The proposition is made that there are five system behaviour archetypes which create the conditions that influence patient safety. The archetypes are derived from the system dynamics and in particular the relationship between reinforcing and balancing feedback loops. The five archetypes are safe practice, drift, tip, collapse and transition towards failure. As hospitals become overcrowded the complexity increases and the reinforcing feedback loops dominate the system and potentially increase the risk to patients. An element of risk arises from staff normalising to the drift in standards of care.
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Al-Mohaithef, Mohammed. "Food hygiene in hospitals : evaluating food safety knowledge, attitudes and practices of foodservice staff and prerequisite programs in Riyadh's hospitals, Saudi Arabia." Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/5194/.
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In global terms, Saudi Arabia is a rapidly developing country. As such, its food industries have yet to fully implement the food safety management systems common in the EU. In the hospitals sector, the Ministry of Health intends to implement Hazard Analysis Critical Control Points (HACCP) system to provide safe meals for patients, staff and hospital visitors. The aim of this study was to evaluate the readiness of the Saudi Arabian hospitals to implement HACCP by assessing the pre-requisites programmes in their foodservices departments. An audit form was used in four hospitals in Riyadh. Questionnaires were also used to assess self-reported behaviour, knowledge and attitudes of 300 foodservices staff. Lack of training was known to be a major omission in the pre-requisite programs (PRP’s) of all hospitals. Therefore a bespoke food safety training program was developed and delivered to food handlers in the participating hospitals. An assessment was then made to determine whether this intervention had any effect on their knowledge, attitude to food safety and self-reported behaviour. The results show that, the prerequisite programs were not implemented properly in the participating hospitals. Also, foodservices staff had a poor knowledge with regard to food safety. However, staff knowledge was significantly improved following the training (p. value < 0.05) and their level of knowledge remained stable after six months. Participants’ behaviours and attitudes also improved after the training. This indicates that, training has a positive impact on food handlers knowledge, practices and attitude.
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Samaranayake, Nithushi Rajitha. "Medication safety in hospitals : medication errors and interventions to improve the medication use process." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193507.
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Medication errors are an unnecessary threat to patient safety. The aim of this study was to assess the epidemiology of medication errors and to assess the effectiveness of interventions intended to avoid medication errors in a tertiary-care hospital in Hong Kong.
The epidemiology of medication errors included the study of the pattern of interception of medication errors and the study of technology-related medication errors using medication incidents reported during years 2006–2010. 34.1% of all medication errors that were reported in the study hospital were not intercepted and 92.4% of all drug administration errors reached the patient. 17.1% of all reported medication errors were technology-related and, most were due to human interaction with technology.
The effects of a bar-code assisted medication administration (BCMA) system when used without the support of computerised prescribing (stand-alone), on its users and the dispensing process was studied using direct observations, questionnaires (Likert scale) and interviews. It was found that this system increased the number of dispensing steps from 5 to 8 and dispensing time by 1.9 times. Potential dispensing errors also increased (P<0.001). The perceived usefulness of the technology decreased among pharmacy staff (P=0.008) after implementation and they (N=16) felt that the system offered less benefit to the dispensing process (8/16) without the support of computerised prescribing. Nurses (N=10) felt that the stand-alone BCMA system was useful in improving the accuracy of drug administration (8/10).
Avoiding the use of inappropriate abbreviations in prescriptions will help to reduce medication errors. Therefore the effectiveness of a ‘Do Not Use’ list (a list of error-prone abbreviations used in the study hospital) and attitudes of health care professionals on using abbreviations in prescriptions was studied using prescription review and questionnaires respectively. The use of abbreviations included in the ‘Do Not Use’ list decreased significantly (P<0.001) after its introduction but other unapproved abbreviations to denote drug names and instructions were commonly used. 96% of doctors, and all pharmacists and nurses, believed that avoiding inappropriate abbreviations will help to reduce medication errors.
The use of abbreviations in prescriptions and attitudes of pharmacists in the study hospital was compared with a different medical system to determine the appropriateness of developing a universal error-prone abbreviation list. It was found that the types and frequencies of using inappropriate abbreviations vary among different medical systems.
In conclusion, additional interventions such as technological interventions are needed to minimise drug administration errors, but proper planning and careful monitoring are needed to avoid unintended errors when using technologies. Implementing a stand-alone BCMA system aimed at reducing drug administration errors may affect the dispensing process. Therefore effects of a technology on all related processes need to be considered before implementation, and monitored after implementation. The introduction of a ‘Do Not Use’ list is effective in reducing inappropriate abbreviations in prescriptions and most health care professionals agree that avoiding inappropriate abbreviations may help to reduce medication errors. However, formulating in-house error-prone and standard abbreviation lists in hospitals, continuous updating of the lists and frequent reminders to prescribers are recommended.<br>published_or_final_version<br>Medicine<br>Doctoral<br>Doctor of Philosophy
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Khuspe, Shaila. "Effects of staffing and expenditure variables on after surgery patient safety in Forida hospitals." [Tampa, Fla.] : University of South Florida, 2004. http://purl.fcla.edu/fcla/etd/SFE0000245.
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Khuspe, Shaila. "Effects of Staffing and Expenditure Variables on After Surgery Patient Safety in Florida Hospitals." Scholar Commons, 2004. https://scholarcommons.usf.edu/etd/1113.
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Objective: To investigate the association between hospital investment in human resources variables and patient safety, specifically after surgery adverse events in Florida hospitals. We performed the analysis to identify the association of after surgery complication rates with full time equivalent employees (FTEs) per admission and per patient day, expenses per admission and per patient day and, the percent of total operating expense accounted for by payroll expenses.
Design: A cross sectional analysis using inpatient hospital discharge data and financial data from seventy short-term general hospitals, both for-profit and not-for-profit.
Methods: Discharge data from year 2000 was obtained from Agency for Health Care Administration (AHCA). This data was used to calculate Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs) related to after surgery complications in 840,945 hospital discharge records from 70 short-term general hospitals across the state of Florida. The predictor variables include: payroll expenditures per admission, payroll expenditures per patient day, personnel (FTE) per admission, personnel (FTE) per patient day and payroll expense as a percent of total operating expenses.
Main outcome measures: Nine patient safety indicators defined by AHQR and specific to after surgery complications: complications of anesthesia, foreign body left during procedure, postoperative hemorrhage or hematoma, postoperative physiologic and metabolic derangement, postoperative pulmonary embolism or deep vein thrombosis, postoperative respiratory failure, postoperative sepsis, postoperative wound dehiscence.
Results: Patient safety indicator rate showed an inverse relationship with the percent of total operating expense represented by payroll, Personnel per patient day and personnel per admission. The patient safety indicators showing significant relationship with hospital human resource characteristics are postoperative hemorrhage or hematoma (p=0.0002), postoperative hip fracture (p<0.0001), and postoperative sepsis (p=0.0371).
Conclusion: Human resource investment is positively related to favorable outcomes, although the effect varies across the type of outcomes.
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Eiu-Seeyok, Busarin. "Quality and safety of inter-hospital transfers care of critically ill patients from rural community hospitals to the Tertiary Regional Hospital in Thailand : a focused ethnographic study." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/33222.
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Background: The safety of critically ill patients during inter-hospital transfer is recognised as a globally important issue. However, little evidence exists pertaining to the care provided by transfer nurses throughout the processes of inter-hospital transfer in rural community hospitals where there is a high risk of adverse clinical events occurring during transportation. Aim: The overall aim of the study was to explore transfer nurses' understanding of the delivery of quality of care during the transfer of critically ill patients from rural community hospitals to a tertiary regional hospital in Thailand. Design and Methods: The theory of symbolic interactionism (Blumer, 1986) and focused ethnography methodology were used. Data were collected using multiple qualitative methods including sixteen semi-structured interviews with transfer nurses, fourteen observations of critically ill patients' transfers from three rural community hospitals to a tertiary centre and twenty-three subsequent handover events and the analysis of transfer documents from four hospital settings (e.g. one regional hospital and three rural community hospitals) in Thailand. Translation from Thai into English and back translation into vernacular language was required. Inductive, thematic analysis was conducted to identify major themes by using qualitative data analysis software, NVivo 10 to assist data management during the analysis. Results: Five major themes emerged including (i) protective factors influencing safe transfer care, (ii) barrier factors influencing safe transfer care, (iii) behavioural patterns in transfer care processes, (iv) maintaining the health condition of the patients, and (v) overcoming adverse events. These particular themes elaborate the meaning of the quality and patient safety of transfer care, the provision of care for safe transfer care, and significant contextual factors that influence the quality of inter-hospital transfer care for critically ill patients. In addition, Donabedian's model (Donabedian, 1966, 1988) incorporated within the concept of context and culture was utilised to assist in conceptualising the framework for the quality of inter-hospital transfer care of critically ill patients in Thailand. Conclusion: The Donabedian model is useful as it is simple, but it does not include detail of the organisational context and culture as determinants of care quality. A conceptual framework for the quality of inter-hospital transfer care of critically ill patients in Thailand was therefore proposed. This study has expanded on current theoretical knowledge of the quality of inter-hospital transfer care by elaborating the patterns of thought and the behaviour of transfer nurses during provision of care throughout the processes of the inter-hospital transfer. It also highlights the limitations of organisational structure and the environment in which transfer work takes place, including issues on handover processes in hospital transfer care. The results can be useful to transfer nurses in that they facilitate greater understanding of the provision of better quality of care. They also help to inform hospital policy makers how to ensure safety of critically ill patients being transferred from community hospital settings.
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Rages, Salem. "Perceptions of patient safety culture amongst health care workers in the hospitals of Northeast Libya." Thesis, Liverpool John Moores University, 2014. http://researchonline.ljmu.ac.uk/4334/.
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Objective: To examine the perception of patient safety culture amongst health care workers in Libyan Hospitals. Study Design: The study adopted a mixed methods approach with 2 phases. Phase 1 was conducted prior to the Libyan revolution. This was a quantitative research study, which used the Survey of Hospital Patient Safety Culture (HSOPSC) that was developed by the US Agency for Health Care Research and Quality (AHRQ, 2004). Phase 2 was conducted post revolution and it was a qualitative research study, which used semi-structured interviews. Setting: The three largest hospitals which were located in the Northeast of Libya were involved in the study. Participants and sampling: Phase 1 of the study included a stratified sample of 346 health care workers who were working as Doctors, Nurses, Technicians, Pharmacists and Managers. Phase 2 of the study used a purposeful sample which involved 27 health care workers from those took part in the survey study. Main Outcome Measures: The survey measured twelve Patient Safety Culture dimensions. It indicated that ten of the twelve dimensions were weak and need to be improved. The interview findings also showed that the 12 patient safety culture dimensions were very weak and shed light on some of the reasons for this sub-optimal practice. Findings: The respondents who took part in the study were from different departments in the three hospitals. The survey showed the dimensions with acceptable positive ratings were teamwork within hospitals and organizational learning and continuous improvement, while those with lowest ratings included frequency of reporting errors, non-punitive response to error and communication and openness. Approximately 60% of health care workers perceived patient safety culture practice in Libya negatively. Twenty respondents (5.8%) who gave an excellent grade for patient safety in their hospitals. Furthermore, the interviews results revealed that patient safety culture dimensions were very weak. The interview explored further factors and issues of poor safety culture in the 3 hospitals; which had not been identified in the survey. These were related to results of the political changes, administrative factors, environmental issues, organisational system issues, and health care workers matters. Conclusions: The study identified that the current state of patient safety culture in Libyan hospitals is very weak and there is a need for improvement to safety practice and for promotion of this important issue amongst those health care workers and health managers working at the frontline of health care delivery. Furthermore, the study found that the level of patient safety in the 3 hospitals was below an unacceptable level according to the perceptions of the health care staff. It was noted that there was no effective patient safety system in any of the 3 hospitals to deal with patient safety issues and there were no proactive patient safety measures in place to reduce the level of risk to patients. Furthermore, the study revealed other significant aspects that represent a serious threat to patient safety in the 3 hospitals, which were mainly due to poor hospital management, ineffective emergency services and a lack of training programmes. Moreover, poor organisation of monitoring systems for the licensing of medical practice of health care workers was shown to have a significant impact on patient safety culture. Lastly, the study showed the political change in Libya had affected patients’ safety sharply as result of the military conflict and the lack of hospitals’ preparedness to cope with such emergency events.
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Xu, Jing, and 许晶. "Examining long patient waiting time in two outpatient departments in mainland China : causes, bottlenecks in patient flow, and impact on patients' perceptions of medical care." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2014. http://hdl.handle.net/10722/197529.
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Background: Long outpatient waiting time is a significant problem in Mainland China’s healthcare system. Long patient waiting time negatively affects actual care quality as well as patients’ perceptions of medical care.
Aim: This study aims to understand the causes of long patient wait times in China’s outpatient care departments, and how those waits influence patients’ attitudes towards medical care. The rhythm of hospital patient flow will be explored in order to posit modest suggestions to resolve these issues.
Objectives: The objectives of this study are to identify the causes of long waiting times in China’s outpatient care departments, to distinguish the specific bottleneck points in patient flow, and to characterize the relationship between waiting time length and the patients’ perceptions of medical care.
Method: Two tertiary care hospitals in Mainland China were included as study sites. Macroergonomic methodologies were adopted to guide the data collection and analysis. The Systems Engineering Initiative for Patient Safety (SEIPS) model was specifically adopted to guide the study design and data analysis procedures. First, audio records were made of interviews with care providers from the two hospitals in order to document and discern the causes of long outpatient care waiting times. Second, a time study was carried out with patients visiting two outpatient departments at the two study sites in order to identify inefficiencies and bottleneck points in the patient flow. Third, a questionnaire survey was provided to the patients in order to understand the impact of lengthy wait times on their overall perceptions of medical care. The interview data was analyzed using content analysis methods, time study data was used to generate a patient flow model, and the questionnaire feedback was analyzed in tandem with the time study data using a linear regression analysis.
Results: Sixty-three factors contributing to lengthy patient wait time were discerned from the interview data, concerning each of the five dimensions of the SEIPS model work system. Two patient flow diagrams were designed based on identified patient flow inefficiencies and bottlenecks. A majority (four-fifths and three-quarters, respectively, at the two study sites) of total patient visit time was spent on waiting for physician services and ancillary, non-medical activities. Serious bottlenecks in patient flow occurred while waiting for physician consultation, ultrasound examinations, and medical test result feedback. Patients’ evaluations of medical care quality dropped 0.04 points for each minute of consultation wait time, and 0.02 points for each minute of total visit duration and total waiting time.
Conclusions: The causes of long patient wait times concern the physicians’ and patients’ characteristics, the organization and management of the hospital, the tasks, technology, and tools involved, and the hospital environment. Waiting for physician consultation, ultrasound examinations, and medical test result feedback cause the most patient flow problems. Long wait times have an adverse impact upon patients’ perceptions of medical care. The macroergonomic methodologies prove feasible and effective in evaluating health care systems.<br>published_or_final_version<br>Industrial and Manufacturing Systems Engineering<br>Master<br>Master of Philosophy
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Al, Nadabi Waleed K. A. "Towards a multidimensional approach to measure quality and safety of care in maternity units in Oman." Thesis, University of Bradford, 2019. http://hdl.handle.net/10454/18500.
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Improving the quality and safety of maternity services is an international top agenda item. This
thesis describes the progress towards the development of a multidimensional approach to measure
the quality and safety of care in ten maternity units in Oman based on three of the five
dimensional Patient Safety Measurement and Monitoring Framework (PSMMF) which include
measuring "past harm" and "anticipation and preparedness”.
The three monitoring approaches used in this research are: (1) measuring the patient safety culture
(2) measuring patient satisfaction (3) and monitoring caesarean section rates.
The specific objectives of the research are to (1) measure patient safety culture level, (2) examine
the association between nurse’s nationality and patient safety culture, (3) validate an Arabic
language survey to measure maternal satisfaction about the childbearing experience, (4) measure
patient satisfaction about the childbearing experience, and (5) to examine caesarean section rates
across maternity units using statistical process control charts.
This thesis started with four systematic reviews that focused on (1) the use of patient safety culture
for monitoring maternity units (2) the available interventions to improve patient safety culture (3)
Arabic surveys available for measuring maternal satisfaction and (4) the use of statistical process
control charts for monitoring performance indicators. The overall conclusion from these reviews that these approaches are being increasingly used in maternity, found feasible and useful, and
there are areas that need attention for future work. Five field studies were conducted to address the
research aim and objectives.
Patient safety culture was measured by a cross-sectional survey of all staff in the ten maternity
units. It was found that safety culture in Oman is below the target level and that there is wide
variation in the safety scores across hospitals and across different categories of staff.
Non-Omani nurses have a more positive perception of patient safety culture than Omani nurses in
all domains except in respect of stress recognition and this difference need further investigation
and needs to be considered by designers of interventions to enhance patient safety culture.
Using two existing validated English surveys, an Arabic survey was developed, validated, and
used to measure maternal satisfaction with childbirth services. It was found that the new survey
has good psychometric properties and that in all the ten hospitals, mothers were satisfied with the
care provided during child delivery but satisfaction score varied across hospitals and groups of
participants.
Caesarean section rate in the last 17 years was examined using statistical process control charts to
understand the variation across the ten hospitals. It was found that caesarean section rate is above
the rate recommended by the World Health Organisation. Special cause variations were detected
that warrant further investigation.
In conclusion, the field studies demonstrated that it is feasible to use the three approaches to
monitor quality and safety in maternity units. However, further work is required to use these data
to enhance the quality and safety of care. Additionally, future work is needed to cover the other
three dimensions of the PSMMF.<br>Ministry of Health in Oman,
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Saginur, Michael David. "Technologies to improve medication safety in hospitals: A study of their effectiveness and use in Canada." Thesis, University of Ottawa (Canada), 2005. http://hdl.handle.net/10393/27028.
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Introduction. Adverse drug events (ADEs) caused by medication errors occur regularly in hospitals. Research questions. (1) How effective are in-hospital drug-distribution technologies at improving medication safety? (2) How prevalent are such technologies in Canada's acute-care hospitals?
Methods. A systematic review synthesized publications from 1985 to 2002 about the effectiveness of inpatient drug-distribution technologies. A cross-sectional survey of pharmacy directors at Canada's 100 largest acute-care hospitals described technology use, plans for change, and pharmacy-directors' attitudes to technology use and medication error.
Results. The systematic review categorized 154 technology comparisons into 23 technology groupings. The evidence consistently favoured the new technologies but its strength was limited. The survey response rate was 78%. Clinical pharmacy services, computerized decision support for pharmacists, and unit-dose system were common; bar-coding and computerized physician order entry were not.
Conclusion. This thesis offers a unique compilation of evidence to guide decision-makers in their uptake of technologies intended to improve medication safety.
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Baratto, Mari Angela Meneghetti. "CULTURA DE SEGURANÇA DO PACIENTE: PERCEPÇÕES E ATITUDES DOS TRABALHADORES NAS INSTITUIÇÕES HOSPITALARES DE SANTA MARIA." Universidade Federal de Santa Maria, 2015. http://repositorio.ufsm.br/handle/1/7443.
Full textAbstract:
Patient safety culture is a key component to the quality of health services. This study aims to analyze the attitudes and perceptions of professionals working directly or indirectly in the care of the hospitalized patient regarding the patient safety culture. This is a cross-sectional study, conducted in 2014, with professionals in the field of health and support services in seven hospitals in Santa Maria, Rio Grande do Sul, Brazil. As a research tool, used the Brazilian version of the Safety Attitudes Questionnaire (SAQ) and sociodemographic and labor issues of workers. Data were organized in Epiinfo 6.04® program, and doubled entered independently. After the correction of errors and inconsistencies, conducted the analysis in PASW Statistic® program, using descriptive and analytical statistics. The cutoff for positive assessment of safety culture was ≥ 75 points. The SAQ was measured by the total score and its six areas. As a result, participated in the study 2,634 professionals, having female predominance (72.6%), aged between 19 and 38 years (50.9%), working in mixed shifts (45.1%), contact the patients (71.6%), which did not have another job (79.9%) and have no overtime work (66.2%). The internal consistency of the SAQ was 0.90. The total score SAQ ranged from 13.9 to 97.9, with an average of 70.1 and a mean of 68.4 (± 13.4). Positive evaluation is evidenced in the fields working as a team and Climate Job satisfaction, with an average of 75 and 90 respectively, indicating that, as much as there are difficulties in the workplace, professionals expressed happiness for what they do, valued colleagues and the place in which they worked. The other areas negatively rated for safety culture (<75). The Hospital Management Perception domain had the lowest score (average 60). When the two professional groups being compared (health and support), we identified little variability in the assessment of areas, although the support of professionals tend to lower scores. The results presented should not be analyzed in isolation, but as backings for the enactment of improvement initiatives in order to improve the quality of patient care and professionals.<br>A cultura de segurança do paciente é um componente fundamental para a qualidade dos serviços de saúde. Este estudo objetiva analisar as atitudes e percepções dos profissionais que atuam direta ou indiretamente no cuidado ao paciente hospitalizado, acerca da cultura de segurança do paciente. Trata-se de um estudo transversal, realizado em 2014, com profissionais da área da saúde e dos serviços de apoio de sete instituições hospitalares de Santa Maria, Rio Grande do Sul, Brasil. Como instrumento de pesquisa, utilizou-se a versão brasileira do Questionário de Atitudes de Segurança (SAQ) e questões sóciodemogáficas e laborais dos trabalhadores. Os dados foram organizados no programa Epiinfo 6.04®, com dupla digitação independente. Após a correção de erros e inconsistências, realizou-se a análise no programa PASW Statistic®, utilizando-se da estatística descritiva e analítica. O ponto de corte para avaliação positiva da cultura de segurança foi ≥ 75 pontos. O SAQ foi mensurado pela pontuação total e pelos seus seis domínios. Como resultados, participaram do estudo 2.634 profissionais, com predomínio do gênero feminino (72,6%), com idade entre 19 e 38 anos (50,9%), atuantes em turnos mistos (45,1%), em contato com os pacientes (71,6%), que não possuíam outro emprego (79,9%) e não faziam horas extras (66,2%). A consistência interna do SAQ foi 0,90. O escore total do SAQ variou entre 13,9 e 97,9, com mediana de 70,1 e média de 68,4 (±13,4). Evidenciou-se avaliação positiva nos domínios Clima de trabalho em equipe e Satisfação no trabalho, com mediana de 75 e 90 respectivamente, indicando que, por mais que existam dificuldades nos ambientes de trabalho, os profissionais manifestaram o gosto pelo que fazem, valorizaram os colegas e o setor em que trabalhavam. Os demais domínios apresentaram avaliação negativa para a cultura de segurança (<75). O domínio Percepção de Gerência do Hospital obteve o resultado mais baixo (mediana 60). Ao serem comparadas as duas categorias profissionais (saúde e apoio), identificou-se pouca variabilidade na avaliação dos domínios, embora os profissionais do apoio tendam a escores mais baixos. Os resultados apresentados não devem ser analisados isoladamente, mas como subsídios para a implementação de iniciativas de melhorias, a fim de aprimorar a qualidade da atenção ao paciente e aos profissionais.
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Chukmaitov, Askar S. "Variations in Quality Outcomes Among Hospitals in Different Types of Health Systems." VCU Scholars Compass, 2005. https://scholarscompass.vcu.edu/etd/1414.
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Although prior research has found differences in costs and financial performance across different types of hospital systems, there has been no systematic study of variations in patient quality of care or safety indicators across different systems. Our study examines whether five main types of health systems - centralized (CHS), centralized physician/insurance (CPIHS), moderately centralized (MCHS), decentralized (DHS), and independent (IHS) - as well as other hospital characteristics are associated with differences in quality of patient care. Data were assembled for 6 years (1995 - 2000) from multiple sources. We used 4 AHRQ risk adjusted inpatient quality indicators (IQIs) and 5 risk-adjusted patient safety indicators (PSIs) as dependent variables. Random effects models were used in the analysis.It was found that the IQI and PSI models have different patterns. In the IQI models, CHS hospitals have lower AMI, CHF, Stroke, and Pneumonia mortality rates than hospitals in other system types. The PSI models did not indicate any systems' effects on adverse event rates. It was also found that system hospitals' compliance with the JCAHO performance area indicator for availability of patient specific information was associated with lower rates of CHF, Stroke, Pneumonia, and Infection due to medical care.The findings suggest that centralization of hospital structures may improve internal clinical processes by enhancing coordination of activities, communication between providers, timely adjustments of processes of care delivery and structures to external pressures. A lack of systems' effect on adverse events may be explained by a newness of the patient safety issues for hospitals and possible changes in reporting patterns of medical errors after the Institute of Medicine report of 1999. A system hospitals' compliance with the JCAHO performance area indicator may indicate improvements in information and clinical record systems.Hospital systems hold much potential for hospitals in improving patient quality of care and safety because they provide a laboratory for studying the health care process and sharing lessons across multiple institutions. Based on our findings, we recommend that future studies use a combination of IQIs and PSIs when examining institutional quality of care because both provide different and complementary information.
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Wood, Benjamin R. "Workplace violence in the emergency healthcare setting balancing the needs of behavioral patients-in-crisis with the personal safety of hospital staff /." Online version, 2009. http://www.uwstout.edu/lib/thesis/2009/2009woodb.pdf.
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Rapoula, Miguel Pereira e. Simão. "Influência da cultura de segurança do paciente na implementação de inovações nas rotinas organizacionais hospitalares : Hospitais Distritais de Leiria e Figueira da Foz." Master's thesis, Instituto Superior de Economia e Gestão, 2014. http://hdl.handle.net/10400.5/7849.
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Mestrado em Gestão e Estratégia Industrial<br>Com os serviços e a inovação a contribuírem para o desenvolvimento da economia portuguesa, criar vantagens competitivas, hoje, numa sociedade do conhecimento, exige ofertas mais ajustadas às exigências dos consumidores. Tal não é exceção no setor da saúde que recorre à inovação para o seu desenvolvimento, sendo a Patient Safety (PS) uma das áreas prioritárias nesta atuação.
Neste sentido, o presente estudo analisou a influência da perceção de segurança do paciente na inovação, percebendo como são efetuadas alterações às rotinas e, simultaneamente, como é que a inovação tem em conta a PS, nos serviços de ortopedia do Hospital Distrital da Figueira da Foz, E.P.E. (HDFF) e do Hospital Santo André, E.P.E. - Centro Hospitalar Leiria - Pombal (HSA). Suplementarmente, devido à qualidade da informação recolhida, incluiu-se a entrevista realizada ao chefe de serviço de ortopedia do Centro Hospitalar e Universitário de Coimbra, E.P.E. (CHUC).
Para a recolha de informação foram usadas as entrevistas semiestruturadas, realizadas aos chefes de serviço, e a tradução do questionário hospitalar Hospital Survey on Patient Safety, elaborada por Eiras e Escoval (2014), aplicado ao HDFF e ao HSA.
Da análise concluiu-se que a origem e a tendência seguida por cada serviço no desenvolvimento de novas práticas e a atitude na promoção da PS no processo de inovação, influenciam a forma como a inovação nos serviços hospitalares integra a preocupação com a PS. Também o uso crescente de abordagens sistémicas para a resolução de eventos adversos é cada vez mais uma opção para a melhoria da PS.<br>With the services and innovation to contribute to the development of the Portuguese economy, create competitive advantage, today, in knowledge society requires more offers adjusted to the demands of consumers. This is no exception in the health sector that has used innovation to their development, being the Patient Safety (PS) one of the priority areas in this action.
In this sense, the present study analyzed the influence of patient safety perception in innovation, realizing how changes are made in routines and simultaneously how innovation takes into account the PS, involving the orthopedic services of Hospital Distrital da Figueira da Foz, E.P.E. (HDFF) and the Hospital Santo André, E.P.E. - Hospital Leiria - Pombal (HSA). Furthermore, due to the quality was included the information collected at the interview conducted to the head of orthopedic service at Centro Hospitalar e Universitário de Coimbra, E.P.E. (CHUC).
As elements for the collection of information were used the semi-structured interviews, conducted to heads of service, and the translation of the hospital questionnaire Hospital Survey on Patient Safety, drawn up by Eiras and Escoval (2014)), applied to HDFF and HSA.
The analysis concluded that the origin and the trend followed by each service in the development of new practices and the attitude in the promotion of PS in the innovation process influence how innovation in hospital services integrates the concern for PS. Similarly, the increased use of system approaches to the resolution of adverse events is becoming an option for improving the PS.
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Lyon, Julie Stella. "The missing link an examination of safety climate and clinical outcomes in a national sample of hospitals /." College Park, Md. : University of Maryland, 2007. http://hdl.handle.net/1903/6834.
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Thesis (Ph. D.) -- University of Maryland, College Park, 2007.<br>Thesis research directed by: Psychology. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.
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Seblega, Binyam. "EFFECTS OF HEALTH INFORMATION TECHNOLOGY ADOPTION ON QUALITY OF CARE AND PATIENT SAFETY IN US ACUTE CARE HOSPITALS." Doctoral diss., University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/2957.
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The adoption of healthcare information technology (HIT) has been advocated by various groups as critical in addressing the growing crisis in the healthcare industry. Despite the plethora of evidence on the benefits of HIT, however, the healthcare industry lags behind many other economic sectors in the adoption of information technology. A significant number of healthcare providers still keep patient information on paper. With the recent trends of reimbursement reduction and rapid technological advances, therefore, it would be critical to understand differences in structural characteristics and healthcare performance between providers that do and that do not adopt HIT. This is accomplished in this research, first by identifying organizational and contextual factors associated with the adoption of HIT in US acute care hospitals and second by examining the relationships between the adoption of HIT and two important healthcare outcomes: patient safety and quality of care. After conducting literature a review, the structure-process-outcome model and diffusion of innovations theory were used to develop a conceptual framework. Hypotheses were developed and variables were selected based on the conceptual framework. Publicly available secondary data were obtained from the American Hospital Association (AHA), the Health Information and Management Systems Society (HIMSS), and the Healthcare Cost and Utilization Project (HCUP) databases. The information technologies were grouped into three clusters: clinical, administrative, and strategic decision making ITs. After the data from the three sources were cleaned and merged, regression models were built to identify organizational and contextual factors that affect HIT adoption and to determine the effects of HIT adoption on patient safety and quality of care. Most prior studies on HIT were restricted in scope as they primarily focused on a limited number of technologies, single healthcare outcomes, individual healthcare institutions, limited geographic locations, and/or small market segments. This limits the generalizability of the findings and makes it difficult to draw definitive conclusions. The new contribution of the present study lies in the fact that it uses nationally representative latest available data and it incorporates a large number of technologies and two risk adjusted healthcare outcomes. Large size and urban location were found to be the most influential hospital characteristics that positively affect information technology adoption. However, the adoption of HIT was not found to significantly affect hospitals performance in terms of patient safety and quality of care measures. Perhaps a remarkable finding of this study is the better quality of care performance of hospitals in the Midwest, South, and West compared to hospitals in the Northeast despite the fact that the latter reported higher HIT adoption rates. In terms of theoretical implications, this study confirms that organizational and contextual factors (structure) affect adoption of information technology (process) which in turn affects healthcare outcomes (outcome), though not consistently, validating Avedis Donabedian s structure-process-outcome model. In addition, diffusion of innovations theory links factors associated with resource abundance, access to information, and prestige with adoption of information technology. The present findings also confirm that hospitals with these attributes adopted more technologies. The methodological implication of this study is that the lack of a single common variable and uniformity of data among the data sources imply the need for standardization in data collection and preparation. In terms of policy implication, the findings in this study indicate that a significant number of hospitals are still reluctant to use clinical HIT. Thus, even though the passage of the American Recovery and Reinvestment Act (ARRA) of 2009 was a good stimulus, a more aggressive policy intervention from the government is warranted in order to direct the healthcare industry towards a better adoption of clinical HIT.<br>Ph.D.<br>Other<br>Health and Public Affairs<br>Public Affairs PhD
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Al-Awa, Bahjat. "Impact of hospital accreditation on patients' safety and quality indicators." Doctoral thesis, Universite Libre de Bruxelles, 2011. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209917.
Full textAbstract:
Ecole de Santé Publique <p>Université Libre de Bruxelles <p>Academic Year 2010-2011<p><p>Al-Awa, Bahjat<p><p>Impact of Hospital Accreditation on Patients' Safety and Quality Indicators<p><p>Dissertation Summary <p><p>I.\<br>Doctorat en Sciences<br>info:eu-repo/semantics/nonPublished
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Amadi, Obumneke A. "Association Between Physician Characteristics and Surgical Errors in U.S. Hospitals." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3272.
Full textAbstract:
The high incidence of medical and surgical errors in U.S. hospitals and clinics affects patients' safety. Not enough is known about the relationship between physician characteristics and medical error rates. The purpose of this quantitative correlational study was to examine the relationship between selected physician characteristics and surgical errors in U.S. hospitals. The ecological model was used to understand personal and systemic factors that might be related to the incidence of surgical errors. Archived data from the National Practitioner Data Bank database of physician surgical errors were analyzed using bivariate and multivariate logistic regression analyses. Independent variables included physicians' home state, state of license, field of license, age group, and graduation year group. The dependent variable was surgical medical errors. Physicians' field of license and state of license were significantly associated with surgical error. Findings contribute to the knowledge base regarding the relationship between physician characteristics and surgical medical errors, and findings may be used to improve patient safety and medical care.
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Alanazi, Mahdi. "Prescribing errors with High Risk Medicines (HRMs) in hospitals." Thesis, University of Manchester, 2018. https://www.research.manchester.ac.uk/portal/en/theses/prescribing-errors-with-high-risk-medicines-hrms-in-hospitals(b9a525f4-fcf0-4d11-bacf-d266d3b241c7).html.
Full textAbstract:
Background: Prescribing errors are the most frequent type of error in the medication use process. High risk medicines (HRMs) are a sub-class of medications that if used erroneously have potentially devastating consequences which defined by Institute for Safe Medication Practices (ISMP) as the drugs that bear a heightened risk of causing significant patient harm when they are used in error. Therefore, prescribing errors with HRMs are of concern to healthcare professionals that are responsible for ensuring mitigating patient safety. This thesis examines to what extent prescribing errors with HRMs in hospital occur, the causes of prescribing errors with HRMs and the differences to non-HRMs and the prescribing errors with HRMs during the on-call period. Method: The research adopted a mixed methods approach to explore prescribing errors with HRMs in hospitals and three studies were undertaken. The first study was a systematic review of the literature to explore the prevalence and incidence of prescribing errors with HRMs in hospitals. The second study was a secondary analysis of 59 existing interviews with foundation year doctors to explore the causes of prescribing errors with HRMs and compare them to those for non-HRMs reported in the same interviews. The third study was a qualitative study of the challenges of prescribing HRMs safely during the on-call period. This final study involved six focus groups with foundation year doctors (total participants number was 42). Results: Overall, findings demonstrated that there is paucity of studies that explored the prevalence of prescribing errors with HRMs and this literature showed inconsistency in definitions of prescribing errors, HRMs lists, severity scales and study methods (Study One). This resulted in a very wide range of prevalence of prescribing errors with HRMs. In terms of causes of prescribing errors with HRMs (Study Two), prescribing HRMs was considered a complex task for participants, especially those requiring dosage calculations, errors in the legal prescription requirements for controlled medications occurred with HRMs only and the on-call period was a particularly challenging period to prescribe safely especially with HRMs. In Study Three, the reasons found for this include the nature of the on-call period as a fast-paced environment, the methods of communication such as the bleep system, lack of accessibility to patient information and lack of plan from the primary team. Conclusions: HRMs form part of general medications, meaning they share similar traits, but the potentially devastating consequences of HRMs and the complicated task posed by prescribing them makes errors in their prescription profound. Therefore, HRMs need closer attention and more concern from healthcare professionals, researchers and policymakers. Such attention could result in a significant reduction in adverse outcomes and improved patient safety.
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Lawrence, Louann W. Delclos George L. "The effectiveness of a needleless intravenous system in prevention of percutaneous injury in two hospitals /." See options below, 1994. http://proquest.umi.com/pqdweb?did=741832391&sid=1&Fmt=2&clientId=68716&RQT=309&VName=PQD.
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Swart, Reecë Pearl. "The relationship between nurses educational background and the safety and quality of patient care in surgical units in private hospitals in Gauteng / Reecë Pearl Swart." Thesis, North-West University, 2012. http://hdl.handle.net/10394/9215.
Full textAbstract:
Background: International literature seems to agree that nurses are the backbone of quality patient care and safety. Moreover, the appropriate training of nurses is vital to providing high quality and safe patient care. South Africa has a dual healthcare system and different categories of nurses. The perceptions of the safety and quality of care of the different categories of nurses are not known in the South African context.
Objective: To determine the relationship between the educational background of nurses and their perceptions on the safety and quality of patient care in private surgical units in South Africa.
Methods: This study followed a comparative descriptive design. Data was collected by means of a questionnaire as part of an international collaborative study, Nurse Forecasting in Europe (RN4CAST). Hierarchical linear modelling was used to examine the relationships among the variables in the 304 completed and returned questionnaires.
Results: Overall, both registered- and enrolled nurses seemed satisfied with the safety and quality of care delivered in their units. Registered nurses (RNs) scored higher in the occurrence of incidents in surgical wards, whilst enrolled nurses (ENs) were of the opinion that current efforts to prevent errors are adequate.
Conclusions: This study provides information that RN’s and EN’s have different perceptions in some areas on the quality and safety of patient care. A statistically significant difference was found between RN’s and EN’s perceptions on the prevention of errors in the unit, namely, losing patient information between shifts and patient incidents related to medication errors, pressure ulcers and falls with injury.<br>Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.
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Cunningham, Thomas R. "A Behavioral Evaluation of the Transition to Electronic Prescribing in a Hospital Setting." Thesis, Virginia Tech, 2006. http://hdl.handle.net/10919/31873.
Full textAbstract:
The impact of Computerized Physician Order Entry (CPOE) on the dependent variables of medication-order compliance and time to first dose of antibiotic was investigated in this quasi-experimental study of a naturally-occurring CPOE intervention. The impact of CPOE on compliance and time to first dose was assessed by comparing measures of these variables from the intervention site and a non-equivalent control before and during intervention phases. Medication orders placed using CPOE were significantly more compliant than paper-based medication orders (p<.001), and first doses of antibiotic ordered using CPOE were delivered significantly faster than antibiotic orders placed using the paper-based system (p<.001). Findings support previous research indicating the positive impact of CPOE on patient safety as well as justify and enable future interventions to increase CPOE adoption and use among physicians. Additionally, data collected in this study will be used to provide behavior-based feedback to physicians as part of CPOE adoption and use intervention strategies to be explored in the forthcoming research.<br>Master of Science
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Gambashidze, Nikoloz [Verfasser]. "Measuring Patient Safety Culture in Hospitals : Psychometric performance issues of translated and adapted instruments in different healthcare systems / Nikoloz Gambashidze." Bonn : Universitäts- und Landesbibliothek Bonn, 2020. http://d-nb.info/1221669451/34.
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Eaton, Michelle C. "An Analysis of Slip, Trip, and Fall Incidents among Workers at a Veterans Hospital." [Tampa, Fla. : s.n.], 2003. http://purl.fcla.edu/fcla/etd/SFE0000095.
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Haripersad, Vasanthee. "Factors preventing the successful implementation of a Fall Prevention Programme (FPP) in an acute care hospital setting in Abu Dhabi, United Arab Emirates." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/6494.
Full textAbstract:
Thesis (MCur)--University of Stellenbosch, 2011.<br>ENGLISH ABSTRACT: The Joint Commission International Accreditation (JCIA) has included a patient safety goal as
part of the standards for the accreditation of hospitals. Goal number six states the need to
“reduce the risk of patient harm resulting from falls”. An acute care hospital setting in Abu
Dhabi, United Arab Emirates had implemented a multifaceted, multidisciplinary fall
prevention programme (FPP) in preparation for accreditation by the JCIA. The achievement
of the above goal is dependent on compliance with JCIA standard requirements and the
hospital’s FPP. This study was undertaken to identify the factors preventing the successful
implementation of the existing FPP in an acute care setting. The FPP is recognised to be in its
development stages and therefore has opportunities for improvement for better patient safety
outcomes, more so by reducing the incidence of falls and the severity of injuries from falls.
Literature studies by Gowdy and Godfrey (2003:365) and Hathaway, Walsh, Lacey and
Saenger (2001:172) suggests that the most successful approach to reducing falls and the
severity of injuries from falls among patients in an acute care setting is that of a multifaceted,
multidisciplinary approach. The nurses, who were primarily responsible for completing the
initial fall risk assessment, expressed feelings of being overwhelmed by more safety standards
being required for the JCIA. Patients with a high risk for falls were not referred to the
physicians and physical therapists, nor were they referred to the clinical pharmacists for the
review of high-risk medications. In addition, fall risk assessments were sometimes not done in
the afternoon and during the night shift. The existing programme also did not consider bedbound,
long-term patients, who require less frequent assessment. There furthermore was
observer evidence to suggest that the existing FPP was not being implemented correctly.
The aim of this study was to describe factors preventing the successful implementation of the
existing FPP. The objectives were to identify areas being implemented successfully, to
identify any barriers to successful implementation and to identify aspects of the existing FPP
that may need revision.
A quantitative descriptive approach was applied. The population was healthcare providers
(HCPs), including both registered and practical nurses, physicians, physical therapists and
pharmacists, working in an acute care setting in the United Arab Emirates. The respondents
were 118 (86%) from a stratified sample of n = 137 (20%) from 684 HCPs. A specifically
developed structured questionnaire was used for data collection. Reliability and validity were assured through the use of experts in questionnaire design and statistical consulting, in
addition to pre-testing of the questionnaire. Ethical approval was obtained from the University
of Stellenbosch Committee for Human Research and the Ethics Committee of the hospital
where the study was undertaken. The respondents’ completion of the questionnaire served as
voluntary consent to participate.
The data were analysed and are presented in frequency tables. The mean and standard
deviation were used for the statistical analysis. Correlational analyses were not done because
of the descriptive approach to the study. It was considered most practical to focus on the
professional groups and not on the variables, as the initial analysis indicated weak
correlations.
The results show those aspects of the FPP that were successfully implemented and those areas
that need improvement if the JCIA requirements are to be met. Policy revision to include a
clearly defined referral process for the high-risk patients, in addition to consistency of the
environmental safety rounds and greater involvement and support of the unit
managers/supervisors, will contribute to the greater success of the FPP.
The hallmark of a successful FPP is staff education, which should be the key step in
addressing the identified barriers. The human need for safety and the patient’s right to safe
care and a safe environment must be integrated into staff orientation, and education and safety
training programmes for all HCPs. Increased compliance may occur when HCPs are more
aware of the hospital’s commitment to the patient’s right to safety. Compliance with JCIA
standards and the FPP will contribute in the achievement of the accreditation.<br>AFRIKAANSE OPSOMMING: Die Joint Commission International Accreditation (JCIA) het ’n pasiëntveiligheidsdoelwit as
deel van die standaarde vir die akkreditasie van hospitale ingesluit. Doelwit nommer ses lui:
“verminder die risiko vir leed aan die pasiënt as gevolg van val”. ’n Akute sorg hospitaal in
die Verenigde Arabiese Emirate het ’n veelvuldig gefasetteerde, multidissiplinêre program vir
die voorkoming van val (fall prevention programme (FPP)) geïmplementeer ter voorbereiding
vir akkreditasie deur die JCIA. Die bereiking van bogenoemde doelwit is afhanklik van
nakoming van die standaardvereistes van die JCIA en die hospitaal se FPP. Hierdie studie is
onderneem om die faktore wat die suksesvolle implementering van die bestaande FPP in die
akute sorg omgewing verhinder, te identifiseer. Daar word erken dat die FPP nog in die
ontwikkelingstadium is en dat daar dus geleenthede vir beter pasiëntveiligheidsuitkomstes is,
veral deur die aantal valvoorvalle en die erns van beserings as gevolg van val te verminder.
Literatuurstudies deur Gowdy en Godfrey (2003:365) en Hathaway, Walsh, Lacey en Saenger
(2001:172) stel voor dat die suksesvolste benadering tot die vermindering van val en die erns
van die gevolglike beserings onder pasiënte in ’n akute sorg omgewing ’n veelvuldig
gefasetteerde, multidissiplinêre benadering behels. Verpleërs, wat die primêre
verantwoordelikheid vir die voltooiing van die aanvanklike assessering van die risiko vir val
het, het daarop gewys dat hulle oorweldig voel deur bykomende veiligheidstandaarde wat vir
die JCIA vereis word. Pasiënte met ’n hoë risiko vir val is nie na die geneeshere en fisiese
terapeute verwys nie, en ook nie na die kliniese aptekers vir die beoordeling van hoë-risiko
medikasie nie. Assessering van die risiko vir val is soms ook nie in die middag en tydens die
nagskof gedoen nie. Die bestaande program het ook nie bedlêende, langtermyn pasiënte wat
minder gereelde assessering benodig, oorweeg nie. Daar is verder ook waargeneem dat die
bestaande FPP nie korrek geïmplementeer word nie.
Die doel van hierdie studie was om die faktore te beskryf wat die suksesvolle implementering
van die bestaande FPP verhoed. Die doelwitte was om areas wat suksesvol geïmplementeer
word, te identifiseer, sowel as hindernisse tot suksesvolle implementering en aspekte van die
bestaande FPP wat hersiening benodig.
’n Kwantitatiewe beskrywende benadering is gebruik. Die populasie was
gesondheidsorgverskaffers, insluitend beide geregistreerde en praktiese verpleërs, geneeshere,
fisiese terapeute en aptekers wat in ’n akute sorg omgewing in die Verenigde Arabiese Emirate werk. Daar war 118 (86%) respondente uit ’n gestratifiseerde steekproef van n = 137
(20%) uit 684 gesondheidsorgverskaffers. ’n Spesiaal ontwikkelde, gestruktureerde vraelys is
vir dataversameling gebruik. Betroubaarheid en geldigheid is verseker deur die gebruik van
kundiges in vraelysontwerp en statistiese raadgewing, sowel as die vooraftoetsing van die
vraelys. Etiese goedkeuring is van die Universiteit Stellenbosch se Komitee vir Menslike
Navorsing, en die Etiekkomitee van die hospitaal waar die studie onderneem is, verkry. Die
voltooiing van die vraelys deur die respondente het gedien as vrywillige toestemming om deel
te neem.
Die data is geanaliseer en in frekwensietabelle voorgesit. Die gemiddelde en
standaardafwyking is vir die statistiese analises gebruik. Korrelasie-analises is as gevolg van
die beskrywende benadering nie onderneem nie. Daar is besluit dat die mees praktiese
benadering sou wees om op die professionele groeperinge te fokus en nie op die veranderlikes
nie, aangesien die aanvanklike analise swak korrelasies aangedui het.
Die resultate identifiseer daardie aspekte van die FPP wat die suksesvolste geïmplementeer is,
sowel as dié gebiede wat verbetering benodig om aan die JCIA-vereistes te voldoen. Faktore
wat sal bydra tot die groter sukses van die FPP is beleidshersiening wat ’n duidelik bepaalde
verwysingsproses vir hoë-risiko pasiënte insluit, sowel as konsekwentheid in die
omgewingsveiligheidsrondtes, en meer betrokkenheid en ondersteuning deur die
eenheidsbestuurders/toesighouers
Die waarmerk van ’n suksesvolle FPP is personeelopvoeding, wat die belangrikste stap in die
aanspreek van die geïdentifiseerde hindernisse moet wees. Die menslike behoefte aan
veiligheid en die pasiënt se reg op veilige sorg en ’n veilige omgewing moet in
personeeloriëntering, personeelopvoeding- en veiligheidsopleidingsprogramme vir alle
gesondheidsorgverskaffers ingesluit word. Verhoogde nakoming sou moontlik plaasvind
indien gesondheidsorgverskaffers meer bewus was van die hospitaal se verbintenis tot die
pasiënt se reg op veiligheid. Nakoming van JCIA-standaarde en die FPP sal bydra tot die
verkryging van die akkreditasie.
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Keorekile, Opelo. "Occupational health hazards encountered by nurses at Letsholathebe II memorial hospital in Maun, Botswana." Thesis, University of Limpopo, 2015. http://hdl.handle.net/10386/1613.
Full textAbstract:
Thesis (MPH.) -- University of Limpopo, 2015<br>Nurses are an integral component of the health care delivery system and they encounter occupational health problems classified as biological, chemical, physical, and psychosocial hazards. Nurses also face health hazards such as Hepatitis B, Acquired Immune Deficiency Syndrome, tuberculosis, cytotoxic drugs, anesthetic agents, needle stick injury, back pain, and stress. At Letsholathebe II Memorial Hospital in Maun, nurses and other health professionals face occupational health and safety risks at the workplace.
Aim and Objectives
The aim of the study was to identify the occupational health hazards encountered by nurses at Letsholathebe II Memorial Hospital in Maun, Botswana. The objectives were to identify occupational health hazards at Letsholathebe II Memorial Hospital; determine organic and inorganic disorders caused by occupational health hazards; determine coping mechanisms of nurses towards occupational health hazards and the compliance of nurses to written protocols that address occupational health hazards.
Research Method and Design
A quantitative descriptive cross-sectional method was adopted. The population comprised 200 nurses employed at Letsholathebe II Memorial Hospital. Simple random sampling was used to select 132 nurses who participated in the study. A self-administered questionnaire was used for data collection. Descriptive and inferential statistics were used for data analysis.
Results
The study revealed health hazards namely; back aches, frequent headaches, and persistent tiredness; mercury, solvents and anaesthetic gases; HIV, streptococcus,
staphylococcus, Hepatitis B and measles. Nurses also reported fatigue, loss of sleep due to stress, anxiety and persistent tiredness.
Conclusion
The study concluded that nurses at Letsholathebe ll Memorial hospital experienced physical, chemical, biological and psychological health hazards.
Recommendations
The study recommends that nurses should have access to OHS information, that OHS awareness should be created at Letsholathebe II Memorial Hospital.
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O'Connor, Patricia. "Looking for harm in healthcare : can Patient Safety Leadership Walk Rounds help to detect and prevent harm in NHS hospitals? : a case study of NHS Tayside." Thesis, University of St Andrews, 2012. http://hdl.handle.net/10023/2804.
Full textAbstract:
Today, in 21st century healthcare at least 10% of hospitalised patients are subjected to some degree of unintended harm as a result of the treatment they receive. Despite the growing patient safety agenda there is little empirical evidence to demonstrate that patient safety is improving. Patient Safety Leadership Walk Rounds (PSLWR) were introduced to the UK, in March 2005, as a component of the Safer Patients Initiative (SPI), the first dedicated, hospital wide programme to reduce harm in hospital care. PSLWR are designed, to create a dedicated ‘conversation’ about patient safety, between frontline staff, middle level managers and senior executives. This thesis, explored the use of PSLWR, as a proactive mechanism to engage staff in patient safety discussion and detect patient harm within a Scottish healthcare system- NHS Tayside. From May 2005 to June 2006, PSLWR were held on a weekly basis within the hospital departments. A purposive sample, (n=38) of PSLWR discussions were analysed to determine: staff engagement in the process, patient safety issues disclosed; recognition of unsafe systems (latent conditions) and actions agreed for improvement. As a follow-up, 42 semi-structured interviews were undertaken to determine staff perceptions of the PSLWR system. A wide range of clinical and non-clinical staff took part (n=218) including medical staff, staff in training, porters and cleaners, nurses, ward assistants and pharmacists. Participants shared new information, not formally recorded within the hospital incident system. From the participants perspectives, PSLWR, were non threatening; were easy to take part in; demonstrated a team commitment, from the Board to the ward for patient safety and action was taken quickly as a result of the ‘conversations’. Although detecting all patient harm remains a challenge, this study demonstrates PSLWR can be a useful tool in the patient safety arsenal for NHS healthcare organisations.
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Hamd, Dina H. "The risk of low back pain in health care providers who work in the homes of patients compared to nursing aides who work in the long term care hospitals /." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=36020.
Full textAbstract:
A cohort study was conducted in Montreal (1988--1992) to test whether working in home care as a home maker entails a higher risk of developing low back pain than working in long term care hospitals as a nursing aide; and to investigate which risk factors may contribute to low back pain. Data from 978 self-administered questionnaires were analysed. Home makers suffered more than nursing aides from low back pain attributed to work. The adjusted odds ratios for home makers were: 1.63 (95% CI = 1.03--2.58) for a first episode of low back pain during 1998--1992, 2.43 (95% CI = 1.05--5.60) for disabling low back pain in 1992, 1.51 (95% CI = 1.13--2.02) for ever having low back pain as of 1992. The study subjects were divided into two cohorts, incident (newly hired persons during 1988--1992) and prevalent (at work in 1988 and in 1992). There was an excess risk of low back pain in the incident cohort; none in the prevalent cohort. The risk of low back pain was shown to decrease with increasing age, help to move patients, adequate equipment in the bedrooms, sufficient space in the bathrooms of patients. The risk increased with convalescent post-op patients, transfers of patients, seniority greater than 5 years, delivery of children, need of a patient-lift. Disabling low back pain could be reduced by introducing the following preventive measures: adequate bedroom equipment, help to move patients, training, sufficient space in the bathrooms, less transfers of patients.
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Solti, Imre. "Influence of Organizational, Operational, Financial AndEnvironmental Factors on Hospitals' Adoption of Computerized Physician Order Entry Systems for Improving Patient Safety: A Resource Dependence Approach." VCU Scholars Compass, 2006. https://scholarscompass.vcu.edu/etd/1283.
Full textAbstract:
This study examines specific organizational, operational, financial and environmental characteristics to identify factors that are associated with increased likelihood of hospitals' CPOE adoption decision in six rollout regions of the Leapfrog initiatives.Resource dependence theory provides theoretical basis for the study. The study is retrospective observational in design. Individual hospitals are the unit of analysis. The Leapfrog Group's 2002-survey collection serves the primary data source. Univariate statistical methods along with bivariate and ordinal logistic regression models are used to analyze the data. The models provided support for multiple hypotheses for both the adoption and early adoption decisions of study hospitals. The operational characteristics of ownership, in-house physician staff, case mix index and the environmental characteristic of HMO penetration rate had a positive effect on management's adoption decisions. The operational characteristic excess capacity, the organizational characteristic community orientation, the financial characteristic of operating income per admission, and the environmental characteristic of number of HMO contracts had a significant negative effect on CPOE adoption decisions.