Uvod: Klinični mentorji v zdravstveni negi potrebujejo sodobno znanje in veščine za prenos znanj na študente pri kliničnem usposabljanju. Namen raziskave je bil ugotoviti pogled in znanje o varnosti ...pacientov pri kliničnih mentorjih Fakultete za zdravstvo Jesenice (FZJ).
Metode: Uporabljen je bil preveden vprašalnik Svetovne zdravstvene organizacije o razumevanju varnosti in znanju o varnosti pacientov s priložnostnim vzorcem kliničnih mentorjev, ki so se udeležili delavnice o izboljševanju kakovosti v zdravstvu v organizaciji FZJ, odzivnost je bila 52 % (n = 36). Obdelava podatkov je bila narejena s statističnim programom SPSS verzija 20 z uporabo Kruskal-Wallisovega testa in binarne logistične regresije.
Rezultati: V sklopu osebnega odnosa do varnosti pacientov je bilo pozitivnih odgovorov preko 90 %. Rezultati ocene lastnega znanja o varnosti pacientov, varnosti zdravstvenega sistema, vpliva posameznika na varnost pa niso dosegli ravni, ki bi zagotavljala dobro varnost pacientov – odstotek pravilnih odgovorov za vseh enajst tem o znanju varnosti pacientov je bil 25,5 %. Delovna doba v sedanjem poklicu in število ur predhodnega formalnega izobraževanja niso napovedovale verjetnosti dobrega celokupnega znanja o varnosti pacientov (x2 (4, N = 31) = 8,83, p = 0,07).
Diskusija in zaključek: Rezultati raziskave so pokazali pomanjkljivo znanje o varnosti pacientov pri kliničnih mentorjih. Pri kliničnih mentorjih zdravstvene nege je potrebno usposabljanje s področja varnosti pacientov.
Objective. To study the psychometric properties of a translated version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPSC) in the Slovenian setting. ...Design. A cross-sectional psychometric study including principal component and confirmatory factor analysis. The percentage of positive responses for the 12 dimensions (42 items) of patient safety culture and differences at unit and hospital-level were calculated. Setting. Three acute general hospitals. Participants. Census of clinical and non-clinical staff (n = 976). Main Outcome Measures. Modelfit,internal consistency and scale score correlations. Results. Principal component analysis showed a 9-factor model with 39 items would be appropriate for a Slovene sample, but a Satorra-Bentler scaled χ² difference test demonstrated that the 12-factor model fitted Slovene data significantly better. Internal consistency was found to be at an acceptable level. Most of the relationships between patient safety culture dimensions were strong to moderate. The relationship between all 12 dimensions and the patient safety grade was negative. The unit-level dimensions of patient safety were perceived better than the dimensions at the hospital-level. Conclusion. The original 12-factor model for the HSOPSC was a good fit for a translated version of the instrument for use in the Slovene setting.
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BFBNIB, NMLJ, NUK, PNG, UL, UM, UPUK
Background: The goal of this research was to measure patient safety culture in all Slovenian acute general hospitals. Methods: The hospital survey on patient safety culture questionnaire developed by ...researchers at Westat was used. Prior to this study, the questionnaire was psychometrically tested in three pilot hospitals and the results showed no need to modify the original model for the Slovene setting. Responses were scored on the 5-level Likert scale. The questionnaire was distributed to all hospital sta. Aer the exclusion of 159 questionnaires, which did not full the inclusion criteria, 2932 (48.5 %) questionnaires were analysed. Descriptive statistics, conrmatory factor analysis, reliability of the scales, and construct validity were computed. For each item the percentage of positive, neutral and negative responses were calculated. Areas for improvement were dened as those answered positively by 50 % or less of the respondents. With one-way analysis of variance a comparison of the means among dierent sizes of the hospitals was performed. Results: The conrmative factor analysis showed adequate t for the model and the questionnaire reliability was also adequate. The average positive percentage for all 12 composites was 53 %. Composite scores of patient safety culture revealed that none reached the level that would establish safety strengths. Statistically signicant dierences of means for hospital size were found (d.f. 2, 337,006; p < 0,0005) but were practically unimportant. PUBLICATION ABSTRACT
Nursing clinical mentors need current knowledge and skills to successfully train nursing students. Here, Robida evaluates the attitude and knowledge of patient safety among clinical mentors of the ...Faculty for Health Care Jesenice (FHCJ). Opportunity sampling was used among clinical nursing mentors who participated in the workshop on quality in health care in the organization of FHCJ. Results revealed that in the domain of personal attitudes towards patient safety more than 90% of answers were positive. Student attitudes and knowledge about patient safety, safety of the health care system and personal influence over safety did not reach the level of good patient safety practice. In this research nursing clinical mentors demonstrated an insufficient knowledge about patient safety.
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NUK, ODKLJ, UL, UM, UPUK, VSZLJ
Background: The goal of this research was to measure patient safety culture in all Slovenian acute general hospitals.
Methods: The hospital survey on patient safety culture questionnaire developed by ...researchers at Westat was used. Prior to this study, the questionnaire was psychometrically tested in three pilot hospitals and the results showed no need to modify the original model for the Slovene setting. Responses were scored on the 5-level Likert scale. The questionnaire was distributed to all hospital staff. After the exclusion of 159 questionnaires, which did not fulfil the inclusion criteria, 2932 (48.5 %) questionnaires were analysed. Descriptive statistics, confirmatory factor analysis, reliability of the scales, and construct validity were computed. For each item the percentage of positive, neutral and negative responses were calculated. Areas for improvement were defined as those answered positively by 50 % or less of the respondents. With one-way analysis of variance a comparison of the means among different sizes of the hospitals was performed.
Results: The confirmative factor analysis showed adequate fit for the model and the questionnaire reliability was also adequate. The average positive percentage for all 12 composites was 53 %. Composite scores of patient safety culture revealed that none reached the level that would establish safety strengths. Statistically significant differences of means for hospital size were found (d.f. 2, 337,006; p < 0,0005) but were practically unimportant.
Conclusion: The survey showed overall low patient safety culture, however it has provided the first insight into patient safety culture in acute general hospitals in Slovenia with several opportunities for improvement.
Background: For better performance, it is crucial to continuously improve quality and patient safety based on the science of quality and patient safety and the usage of appropriate tools such as ...statistical process control. The aim of this article is to describe statistical process control in the continuous improvement of healthcare processes.Methods: Patient falls and surgical site infections were studied using a run chart, u-chart, and g-chart.Results: In the case of patient falls special causes of variation were depicted.However, these are only statistical conclusions, whereas the content of the causes can be found only by those who work in the process of fall prevention.In the case of surgical site infection, the use of a new wound covering material was abandoned because the g-chart showed failure to improve the process. The g-chart showed that a different type of preparation of the surgical site with hair cutting instead of shaving showed a decrease in infection rates.Conclusion: Statistical process control can differentiate between common and special causes of process variability. The importance of this distinction is in the employment of different strategies for process improvement.
Abstract Background: For better performance, it is crucial to continuously improve quality and patient safety based on the science of quality and patient safety and the usage of appropriate tools ...such as statistical process control. The aim of this article is to describe statistical process control in the continuous improvement of healthcare processes. Methods: Patient falls and surgical site infections were studied using a run chart, u-chart, and g-chart. Results: In the case of patient falls special causes of variation were depicted. However, these are only statistical conclusions, whereas the content of the causes can be found only by those who work in the process of fall prevention. In the case of surgical site infection, the use of a new wound covering material was abandoned because the g-chart showed failure to improve the process. The g-chart showed that a dierent type of preparation of the surgical site with hair cutting instead of shaving showed a decrease in infection rates. Conclusion: Statistical process control can differentiate between common and special causes of process variability. The importance of this distinction is in the employment of dierent strategies for process improvement.
Effective human resources management plays a vital role in the success of health-care sector reform. Leaders are selected for their clinical expertise and not their management skills, which is often ...the case at the middle-management level. The purpose of this study was to examine the situation in some fields that involve working with people in health-care organizations at middle-management level.
The study included eight state-owned hospitals in Slovenia. A cross-sectional study included 119 middle managers and 778 employees. Quota sampling was used for the subgroups. Structured survey questionnaires were administered to leaders and employees, each consisting of 24 statements in four content sets evaluated on a 5-point Likert-type scale. Respondents were also asked about the type and number of training or education programmes they had participated in over the last three years. Descriptive statistics, two-way analysis of variance, Pearson's correlation coefficient and multiple linear regression were used. The study was conducted from March to December 2008.
Statistically significant differences were established between leaders and employees in all content sets; no significant differences were found when comparing health-care providers and health-administration workers. Employment position was found to be a significant predictor for employee development (β = 0.273, P < 0.001), the leader-employee relationship (β = 0.291, P < 0.001) and organizational motivation (β = 0.258, P < 0.001). Area of work (β = 0.113, P = 0.010) and employment position (β = 0.389, P < 0.001) were significant predictors for personal involvement. Level of education correlated negatively with total scores for organizational motivation: respondents with a higher level of education were rated with a lower score (β = -0.117, P = 0.024). Health-care providers participate in management programmes less frequently than do health-administration workers.
Employee participation in change-implementation processes was low, as was awareness of the importance of employee development. Education of employees in Slovenian hospitals for leadership roles is still not perceived as a necessary investment for improving work processes. Hospitals are state owned and a national strategy should be developed on how to improve leadership and management in Slovenian hospitals.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background. The Objective of the article is a two year statistics on sentinel events in hospitals. Results of a survey on sentinel events and the attitude of hospital leaders and staff are also ...included. Some recommendations regarding patient safety and the handling of sentinel events are given.
Methods. In March 2002 the Ministry of Health introduce a voluntary reporting system on sentinel events in Slovenian hospitals. Sentinel events were analyzed according to the place the event, its content, and root causes. To show results of the first year, a conference for hospital directors and medical directors was organized. A survey was conducted among the participants with the purpose of gathering information about their view on sentinel events. One hundred questionnaires were distributed.Results. Sentinel events. There were 14 reports of sentinel events in the first year and 7 in the second. In 4 cases reports were received only after written reminders were sent to the responsible persons, in one case no reports were obtained. There were 14 deaths, 5 of these were in-hospital suicides, 6 were due to an adverse event, 3 were unexplained. Events not leading to death were a suicide attempt, a wrong side surgery, a paraplegia after spinal anaesthesia, a fall with a femoral neck fracture, a damage of the spleen in the event of pleural space drainage, inadvertent embolization with absolute alcohol into a femoral artery and a physical attack on a physician by a patient. Analysis of root causes of sentinel events showed that in most cases processes were inadequate.Survey. One quarter of those surveyed did not know about the sentinel events reporting system. 16% were having actual problems when reporting events and 47% beleived that there was an attempt to blame individuals. Obstacles in reporting events openly were fear of consequences, moral shame, fear of public disclosure of names of participants in the event and exposure in mass media. The majority of the surveyed persons agreed to disclosure of the event to a patient but this was the case in less than half of the occasions.Conclusions. The small number of reports of sentinel events, late or incomplete reporting of conducted analyses of root causes and plans for future prevention of these events and survey data showed the state of culture in the majority of hospitals. Fear of reporting and therefore, hiding of errors or ascribing errors to the »usual« complications of a disease or procedures, the reaction of leadership to quickly find a culprit for the event, disregarding a serious approach to analyze the event and taking measures for their future prevention leads to the culture of silence. Root cause analysis of the events showed that the reason frequently lies in systems and processes and not in individuals. Health care will never be without risks for patients. However, with an open approach without the blaming and shaming of individuals, implementation of reporting the events in hospitals and other health care facilities with clear goals of patient safety, standardization of equipment, materials, and processes and education on patient safety many sentinel events and medical errors could and should be prevented.
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