scholarly journals The Impact of an Electronic Patient Bedside Observation and Handover System on Clinical Practice: Mixed-Methods Evaluation (Preprint)

2018 ◽  
Author(s):  
Alexandra Lang ◽  
Mark Simmonds ◽  
James Pinchin ◽  
Sarah Sharples ◽  
Lorrayne Dunn ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Large Scale ◽  
Situational Awareness ◽  
Early Recognition ◽  
Care Facility ◽  
Workload Management ◽  
Safety Incident ◽  
The Impact ◽  
Roll Out

BACKGROUND Patient safety literature has long reported the need for early recognition of deteriorating patients. Early warning scores (EWSs) are commonly implemented as “track and trigger,” or rapid response systems for monitoring and early recognition of acute patient deterioration. This study presents a human factors evaluation of a hospital-wide transformation in practice, engendered by the deployment of an innovative electronic observations (eObs) and handover system. This technology enables real-time information processing at the patient’s bedside, improves visibility of patient data, and streamlines communication within clinical teams. OBJECTIVE The aim of this study was to identify improvement and deterioration in workplace efficiency and quality of care resulting from the large-scale imposition of new technology. METHODS A total of 85 hours of direct structured observations of clinical staff were carried out before and after deployment. We conducted 40 interviews with a range of clinicians. A longitudinal analysis of critical care audit and electronically recorded patient safety incident reports was conducted. The study was undertaken in a large secondary-care facility in the United Kingdom. RESULTS Roll-out of eObs was associated with approximately 10% reduction in total unplanned admissions to critical care units from eObs-equipped wards. Over time, staff appropriated the technology as a tool for communication, workload management, and improving awareness of team capacity. A negative factor was perceived as lack of engagement with the system by senior clinicians. Doctors spent less time in the office (68.7% to 25.6%). More time was spent at the nurses’ station (6.6% to 41.7%). Patient contact time was more than doubled (2.9% to 7.3%). CONCLUSIONS Since deployment, clinicians have more time for patient care because of reduced time spent inputting and accessing data. The formation of a specialist clinical team to lead the roll-out was universally lauded as the reason for success. Staff valued the technology as a tool for managing workload and identified improved situational awareness as a key benefit. For future technology deployments, the staff requested more training preroll-out, in addition to engagement and support from senior clinicians.

scholarly journals Data-driven approach to Early Warning Score-based alert management

2018 ◽  
Vol 7 (3) ◽  
pp. e000088 ◽  
Author(s):  
Muge Capan ◽  
Stephen Hoover ◽  
Kristen E Miller ◽  
Carmen Pal ◽  
Justin M Glasgow ◽  
...  
Keyword(s):  
Patient Safety ◽  
Early Warning ◽  
Early Recognition ◽  
Clinical Information ◽  
Patient Characteristics ◽  
The Elderly ◽  
Early Warning Score ◽  
The Right ◽  
The Impact ◽  
Alerting Systems

BackgroundIncreasing adoption of electronic health records (EHRs) with integrated alerting systems is a key initiative for improving patient safety. Considering the variety of dynamically changing clinical information, it remains a challenge to design EHR-driven alerting systems that notify the right providers for the right patient at the right time while managing alert burden. The objective of this study is to proactively develop and evaluate a systematic alert-generating approach as part of the implementation of an Early Warning Score (EWS) at the study hospitals.MethodsWe quantified the impact of an EWS-based clinical alert system on quantity and frequency of alerts using three different alert algorithms consisting of a set of criteria for triggering and muting alerts when certain criteria are satisfied. We used retrospectively collected EHRs data from December 2015 to July 2016 in three units at the study hospitals including general medical, acute care for the elderly and patients with heart failure.ResultsWe compared the alert-generating algorithms by opportunity of early recognition of clinical deterioration while proactively estimating alert burden at a unit and patient level. Results highlighted the dependency of the number and frequency of alerts generated on the care location severity and patient characteristics.ConclusionEWS-based alert algorithms have the potential to facilitate appropriate alert management prior to integration into clinical practice. By comparing different algorithms with regard to the alert frequency and potential early detection of physiological deterioration as key patient safety opportunities, findings from this study highlight the need for alert systems tailored to patient and care location needs, and inform alternative EWS-based alert deployment strategies to enhance patient safety.

New Earth-space infrastructures enable full-scale monitoring capability

2021 ◽  
Author(s):  
Eija Tanskanen ◽  
Tero Raita ◽  
Joni Tammi ◽  
Jouni Pulliainen ◽  
Hannu Koivula ◽  
...  
Keyword(s):  
Large Scale ◽  
Situational Awareness ◽  
Full Scale ◽  
The Arctic ◽  
Environment Change ◽  
Earth Space ◽  
Earth Environment ◽  
Internal Sources ◽  
Space Environments ◽  
The Impact

<p>The near-Earth environment is continuously changing by disturbances from external and internal sources. A combined research ecosystem is needed to be able to monitor short- and long-term changes and mitigate their societal effects. Observatories and large-scale infrastructures are the best way to guarantee continuous 24/7 observations and full-scale monitoring capability. Sodankylä Geophysical Observatory takes care of continuous geoenvironmental monitoring in Finland and together with national infrastructures such as FIN-EPOS and E2S enable extending and expanding the monitoring capability. European Plate Observing System of Finland (FIN-EPOS) and flexible instrument network of FIN-EPOS (FLEX-EPOS) will create a national pool of instruments including geophysical instruments targeted for solving topical questions of solid Earth physics. Scientific and new hardware building by FLEX-EPOS is essential in order to identify and reduce the impact of seismic, magnetic and geodetic hazards and understand the underlying processes.</p><p> </p><p>New national infrastructure Earth-Space Research Ecosystem (E2S) will combine measurements from atmosphere to near-Earth and distant space. This combined infrastructure will enable resolving how the Arctic environment change over the seasons, years, decades and centuries. We target our joint efforts to improve the situational awareness in the near-Earth and space environments, and in the Arctic for enhancing safety on ground and in space. This presentation will give details on the large-scale Earth-space infrastructures and research ecosystems and will give examples on how they can improve the safety of society.</p>

scholarly journals Prolonged mental health sequelae among doctors and nurses involved in patient safety incidents with formal complaints and lawsuits

2019 ◽  
Vol 30 (4) ◽  
pp. 777-779
Author(s):  
Gerda Zeeman ◽  
Loes Schouten ◽  
Deborah Seys ◽  
Ellen Coeckelberghs ◽  
Philomeen Weijenborg ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Safety ◽  
Related Disorder ◽  
Safety Incident ◽  
Patient Safety Incident ◽  
Formal Complaint ◽  
The Impact ◽  
Patient Safety Incidents ◽  
Doctors And Nurses

Abstract We evaluated the presence of prolonged mental health sequelae in the aftermath of a patient safety incident and the impact of a formal complaint or lawsuit on these mental health sequelae in 19 hospitals and 2635 nurses and doctors. Of 2635 respondents, 983 (37.3%) reported a complaint and 190 (7.2%) reported a lawsuit. In both doctors and nurses prolonged mental health sequelae reflecting a stressor-related disorder were highly prevalent, each well over 20% overall. They were consistently more prevalent in case of a formal complaint or lawsuit. Lawsuits showed 2-, 3- and 4-fold increases in prevalence of mental health sequelae.

scholarly journals Duration of second victim symptoms in the aftermath of a patient safety incident and association with the level of patient harm: a cross-sectional study in the Netherlands

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029923 ◽  
Author(s):  
Kris Vanhaecht ◽  
Deborah Seys ◽  
Loes Schouten ◽  
Luk Bruyneel ◽  
Ellen Coeckelberghs ◽  
...  
Keyword(s):  
Patient Safety ◽  
Healthcare Providers ◽  
Direct Patient Care ◽  
Secondary Outcome ◽  
Symptom Duration ◽  
Common Symptom ◽  
Patient Harm ◽  
Cross Sectional ◽  
Safety Incident ◽  
The Impact

ObjectivesTo describe healthcare providers’ symptoms evoked by patient safety incidents (PSIs), the duration of these symptoms and the association with the degree of patient harm caused by the incident.DesignCross-sectional survey.Setting32 Dutch hospitals that participate in the ‘Peer Support Collaborative’.Participants4369 healthcare providers (1619 doctors and 2750 nurses) involved in a PSI at any time during their career.InterventionsAll doctors and nurses working in direct patient care in the 32 participating hospitals were invited via email to participate in an online survey.Primary and secondary outcome measuresPrevalence of symptoms, symptom duration and its relationship with the degree of patient harm.ResultsIn total 4369 respondents were involved in a PSI and completely filled in the questionnaire. Of these, 462 reported having been involved in a PSI with permanent harm or death during the last 6 months. This had a personal, professional impact as well as impact on effective teamwork requirements. The impact of a PSI increased when the degree of patient harm was more severe. The most common symptom was hypervigilance (53.0%). The three most common symptoms related to teamwork were having doubts about knowledge and skill (27.0%), feeling unable to provide quality care (15.6%) and feeling uncomfortable within the team (15.5%). PSI with permanent harm or death was related to eightfold higher likelihood of provider-related symptoms lasting for more than 1 month and ninefold lasting longer than 6 months compared with symptoms reported when the PSI caused no harm.ConclusionThe impact of PSI remains an underestimated problem. The higher the degree of harm, the longer the symptoms last. Future studies should evaluate how these data can be integrated in evidence-based support systems.

scholarly journals Analisis Faktor yang Mempengaruhi Pelaporan Insiden Keselamatan Pasien pada Perawat

2020 ◽  
Vol 3 (1) ◽  
pp. 15
Author(s):  
Maria Yuventa Wanda ◽  
Nursalam Nursalam ◽  
Andri Setiya Wahyudi
Keyword(s):  
Patient Safety ◽  
Work Experience ◽  
Care Facility ◽  
Incident Reporting ◽  
Cross Sectional ◽  
Safety Incident ◽  
Patient Safety Incident ◽  
Experience Education ◽  
Patient Safety Incidents ◽  
Safety Incident Reporting

Introduction: Patient Safety Incident Report hereinafter referred to as incident reporting, is a system of documenting patient safety incident reports, analyzing and obtaining recommendations and solutions from the health care facility patient safety team. This study aims to analyze the factors of work experience, education, perceptions, attitudes, motivation, leadership towards reporting patient safety incidents to nurses in the inpatient room of Prof. Dr. W. Z. Johannes Kupang.Method: The design of this study was cross-sectional. The sample size of the study was 143 respondents who met the inclusion criteria. The dependent variable is the reporting of patient safety incidents, while the independent variables are work experience, education, perception, attitude, motivation,  leadership. Data were collected using a questionnaire and observation on nurses. Data were then analyzed using multiple logistic regression with a significant value < 0.05.Results:  The results show that there is a perception effect on patient safety incident reporting (p = 0.05) and leadership influence on patient safety incident reporting (p = 0.02).Conclusion: The concludes is that there is an influence of perception and leadership on reporting patient safety incidents. Further researchers are advised to research the effect of training on improving patient safety incident reporting.

scholarly journals RAPID DATA COLLECTION FOR THE AUDIT OF MONUMENTS & MEMORIALS IN SOUTH AFRICA

2021 ◽  
Vol XLVI-M-1-2021 ◽  
pp. 313-320
Author(s):  
C. Jackson ◽  
M. Nkhasi-Lesaoana ◽  
L. Mofutsanyana
Keyword(s):  
South Africa ◽  
Public Space ◽  
Large Scale ◽  
National Audit ◽  
The Public ◽  
Funding Mechanism ◽  
History Of ◽  
Monuments And Memorials ◽  
The Impact ◽  
Roll Out

Abstract. The tradition of memorialising people and events through physical constructions such as statues and monuments like in many countries, has shaped the public space of a modern South Africa. Considering the colonial and apartheid history of South Africa, these physical markers, often uncontextualized, continue to maintain positions of prominence within the modern streetscape.Since the turn of the democratic era in South Africa, a pressing need has existed to assess the impact of the markers on the heritage landscape of the country. An endeavour made more difficult by a lack of a comprehensive inventory of these resources across the country.The National Audit of Monuments and Memorials (NAMM) was designed to address this gap through a full national survey of monuments and memorials, conducted under the auspices of a job creation stimulus package designed to create short term employment in the wake of the economic fallout from the Covid-19 pandemic. Undertaking this project under this funding mechanism required that all phases of the project be undertaken within a six-month period.The compressed timeframes associated with this project required an approach that could support a level of fluidity to address the challenges of undertaking a project of this nature, whilst ensuring that the data collected by field surveyors can be monitored and included in the inventory of the national estate in an effective manner.The aim of this paper is to discuss and showcase the tools and workflows used to roll out and manage the large-scale national audit of monuments and memorials across South Africa.

scholarly journals Effect of SBAR situational awareness technique as educational intervention on critical care nurse students' skills of patient safety

2020 ◽  
Vol 10 (5) ◽  
pp. 47
Author(s):  
Asmaa Ahmed Morsy ◽  
Fatma Refaat Ahmed
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Situation Awareness ◽  
Situational Awareness ◽  
Safety Skills ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Safety Standards ◽  
Significant Difference ◽  
Nurse Students

Background: Situation awareness could actively scan for risk across multiple domains. It has been defined as “the perception of elements in the environment within a volume of time and space, the comprehension of their meaning, and the projection of their status in the near future”. Situation awareness includes three levels; perception, comprehension, and projection. Perception is the first step in developing situation awareness as it includes students' perception of status, attributes, and dynamics of relevant elements in the ICU environment. Comprehension of the present situation is based on outputs of the perception. It includes understanding of the significance of the relevant elements. Finally, projection of future status includes the ability of students to predict the future actions of certain elements in the ICU environment. Appropriate situation awareness could increase the probability of a good task performance. In addition, feedback covers state of the ICU environment affected by both decisions and performance of the selected actions. While SBAR is acromion that represents the actual application of situational awareness through situation, background, assessment and recommendation. A representation of SBAR situational awareness has been depicted as an inner factor in the method for giving patient consideration and basic leadership that helps health care professionals to handle and process information about what is occurring. SBAR is a mechanism useful for framing any conversation, especially critical ones, requiring a practitioner's immediate attention and action to foster a culture of patient safety. Critical care nurses play an important role in their workplace related to patient safety. They should be able to recognize and analyze patient safety incidents using protocols, work in a team, learn from errors, and be able to identify actions and recommendations on how to prevent patient safety incidents through the use of SBAR situational awareness technique. Nursing students’ should recognize and understand what is going on around them. Consequently, they can plan ahead with greater knowledge to patient safety which arise the need to integrate SBAR situation awareness in their curricula.Method: A quasi experimental research design was used in this study in which two tools were used for data collection: “Self-Situational Awareness Assessment Questionnaire” and “Critical Care Nurse Students’ Safety Skills Checklist”.Results: There was a statistical significant difference between both groups of students in relation to situation awareness perception, process and skills (p < .001). Moreover, there was a statistical significant difference between the study and control groups in relation to the students' practices score regarding patients’ safety standards in the post-assessment phase (p < .001).Conclusion: In the current study, the SBAR situation awareness technique was used in training critical care nurse students to improve their situation awareness level to patient safety skills. Situation awareness perception, process and skills level were significantly increased for critical care nurse students who are subjected to the training program. Also, the students' skills regarding patients' safety standards practices were significantly improved. 

scholarly journals The impact of accreditation on healthcare quality improvement: a qualitative case study

2016 ◽  
Vol 30 (8) ◽  
pp. 1242-1258 ◽  
Author(s):  
Sara Melo
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Large Scale ◽  
Positive Impact ◽  
Healthcare Quality ◽  
Healthcare Services ◽  
Content Type ◽  
Healthcare Quality Improvement ◽  
The Impact

Purpose Research on accreditation has mostly focused on assessing its impact using large scale quantitative studies, yet little is known on how quality is improved in practice through an accreditation process. Using a case study of an acute teaching hospital in Portugal, the purpose of this paper is to explore the dynamics through which accreditation can lead to an improvement in the quality of healthcare services provided. Design/methodology/approach Data for the case study was collected through 46 in-depth semi-structured interviews with 49 clinical and non-clinical members of staff. Data were analyzed using a framework thematic analysis. Findings Interviewees felt that hospital accreditation contributed to the improvement of healthcare quality in general, and more specifically to patient safety, as it fostered staff reflection, a higher standardization of practices, and a greater focus on quality improvement. However, findings also suggest that the positive impact of accreditation resulted from the approach the hospital adopted in its implementation as well as the fact that several of the procedures and practices required by accreditation were already in place at the hospital, albeit often in an informal way. Research limitations/implications The study was conducted in only one hospital. The design of an accreditation implementation plan tailored to the hospital’s context can significantly contribute to positive outcomes in terms of quality and patient safety improvements. Originality/value This study provides a better understanding of how accreditation can contribute to healthcare quality improvement. It offers important lessons on the factors and processes that potentiate quality improvements through accreditation.

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