Patient Safety Perspectives of Providers and Nurses: The Experience of a Rural Ambulatory Care Practice Using an EHR With E-prescribing

2013 ◽  
Vol 29 (4) ◽  
pp. 383-391 ◽  
Author(s):  
James D. Bramble ◽  
Amy A. Abbott ◽  
Kevin T. Fuji ◽  
Karen A. Paschal ◽  
Mark V. Siracuse ◽  
...  
Keyword(s):  
Patient Safety ◽  
Ambulatory Care ◽  
Care Practice

scholarly journals Patient safety in ambulatory care from the patient's perspective: a retrospective, representative telephone survey

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034617
Author(s):  
Max Geraedts ◽  
Svenja Krause ◽  
Michael Schneider ◽  
Annette Ortwein ◽  
Johannes Leinert ◽  
...  
Keyword(s):  
Patient Safety ◽  
Medical Treatment ◽  
Ambulatory Care ◽  
Outpatient Surgery ◽  
Diagnostic Procedures ◽  
Cross Sectional Study ◽  
Patient Experiences ◽  
Additional Treatment ◽  
Computer Assisted ◽  
Cross Sectional

ObjectivesData on patient safety problems (PSPs) in ambulatory care are scarce. The aim of the study was to record the frequency, type, severity and point of origin of PSPs in ambulatory care in Germany.DesignRetrospective cross-sectional study.SettingComputer-assisted telephone interviews with randomly recruited citizens aged ≥40 years in Germany who were asked about their experiences with PSPs in ambulatory care.Participants10 037 citizens ≥40 years.MeasuresA new questionnaire was developed to record patient experiences with PSPs in ambulatory care. The study reported here targets patient experiences in the last 12 months. The questionnaire focuses on PSPs in seven areas of medical treatment: anamnesis/diagnostic procedures; medication; vaccination, injection, infusion; aftercare; outpatient surgery; office administration; other areas. For each PSP reported, detailed questions were asked about the specialist group concerned, and, on the most serious harm, the severity of the harm and its consequences. The target parameters are presented as proportions with 95% CIs.Results1422 of the respondents (14%) reported 2589 PSPs. The areas most frequently affected by PSPs were anamnesis/diagnostic procedures (61%) and medication (15%). General practitioners accounted for 44% of PSPs, orthopaedists for 15% and internists for 10%. 75% of PSPs were associated with harm, especially unnecessarily prolonged pain or deterioration of health; 35% of PSPs led to permanent harm. 804 PSPs (32%) prompted patients to see another doctor for additional treatment; 255 PSPs (10%) required inpatient treatment.ConclusionPSPs experienced by patients are widespread in ambulatory care in Germany. The study reveals in which areas of medical treatment efforts to prevent PSPs could make the greatest contribution to improving patient safety. It also demonstrates the valuable contribution of patient reports to the analysis of PSPs.

scholarly journals Nurses’ Adherence to Patient Safety Principles: A Systematic Review

2020 ◽  
Vol 17 (6) ◽  
pp. 2028 ◽  
Author(s):  
Mojtaba Vaismoradi ◽  
Susanna Tella ◽  
Patricia A. Logan ◽  
Jayden Khakurel ◽  
Flores Vizcaya-Moreno
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Quantitative Methods ◽  
Healthcare Providers ◽  
Cardiac Monitoring ◽  
Care Process ◽  
Care Practice ◽  
Qualitative And Quantitative Methods ◽  
Systemic Factors ◽  
Care Improvement

Background: Quality-of-care improvement and prevention of practice errors is dependent on nurses’ adherence to the principles of patient safety. Aims: This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses’ adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010–2019. Using the theoretical domains of the Vincent’s framework for analysing risk and safety in clinical practice, we synthesized our findings according to ‘patient’, ‘healthcare provider’, ‘task’, ‘work environment’, and ‘organisation and management’. Findings: Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and surveillance, and care-associated infection precautions. Patients’ participation, healthcare providers’ knowledge and attitudes, collaboration by nurses, appropriate equipment and electronic systems, education and regular feedback, and standardization of the care process influenced nurses’ adherence to patient-safety principles. Conclusions: The revelation of individual and systemic factors has implications for nursing care practice, as both influence adherence to patient-safety principles. More studies using qualitative and quantitative methods are required to enhance our knowledge of measures needed to improve nurse’ adherence to patient-safety principles and their effects on patient-safety outcomes.

Providing feedback to learners in outpatient and ambulatory care practice settings

2015 ◽  
Vol 7 (3) ◽  
pp. 348-356 ◽  
Author(s):  
Anna Hall ◽  
Alexander Miguel ◽  
Kristin Weitzel
Keyword(s):  
Ambulatory Care ◽  
Care Practice

Translating Patient Safety Legislation into Health Care Practice

2006 ◽  
Vol 32 (12) ◽  
pp. 676-681 ◽  
Author(s):  
Alan B.K. Rabinowitz ◽  
John R. Clarke ◽  
William Marella ◽  
Janet Johnston ◽  
Laurie Baker ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Care Practice ◽  
Health Care Practice

scholarly journals A Roadmap to Advance Patient Safety in Ambulatory Care

JAMA ◽  
2020 ◽  
Vol 324 (24) ◽  
pp. 2481
Author(s):  
Hardeep Singh ◽  
Pascale Carayon
Keyword(s):  
Patient Safety ◽  
Ambulatory Care

scholarly journals Sex/gender bias in the management of chest pain in ambulatory care

2018 ◽  
Vol 14 ◽  
pp. 174550651880564 ◽  
Author(s):  
Christelle Clerc Liaudat ◽  
Paul Vaucher ◽  
Tommaso De Francesco ◽  
Nicole Jaunin-Stalder ◽  
Lilli Herzig ◽  
...  
Keyword(s):  
Primary Care ◽  
Sex Differences ◽  
Cohort Study ◽  
Chest Pain ◽  
Confidence Interval ◽  
Ambulatory Care ◽  
Odds Ratio ◽  
Care Practice ◽  
Care Clinic ◽  
Men And Women

Objective: Cardiovascular diseases (CVD) are the main cause of death worldwide and despite a higher prevalence in men, mortality from CVD is higher among women. Few studies have assessed sex differences in chest pain management in ambulatory care. The objective of this post hoc analysis of data from a prospective cohort study was to assess sex differences in the management of chest pain in ambulatory care. Setting: We used data from the Thoracic Pain in Community cohort study that was realized in 58 primary care practices and one university ambulatory clinic in Switzerland. Participants: In total, 672 consecutive patients aged over 16 years attending a primary care practice or ambulatory care clinic with a complaint of chest pain were included between February and June 2001. Their mean age was 55.2 years and 52.5% were women. Main outcome measures: The main outcome was the proportion of patients referred to a cardiologist at 12 months follow-up. A panel of primary care physicians assessed the final diagnosis retained for chest pain at 12 months. Results: The prevalence of chest pain of cardiovascular origin (n = 108, 16.1%) was similar for men and women (17.5% vs 14.8%, respectively, p = 0.4). Men with chest pain were 2.5 times more likely to be referred to a cardiologist than women (16.6% vs 7.4%, odds ratio: 2.49, 95% confidence interval: 1.52–4.09). After adjustment for the patients’ age and cardiovascular disease risk factors, the estimates did not significantly change (odds ratio: 2.30, 95% confidence interval: 1.30–3.78). Conclusion: Although the same proportion of women and men present with a chest pain of cardiovascular origin in ambulatory care, there is a strong sex bias in their management. These data suggest that effort must be made to assure equity between men and women in medical care.

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