A survey of patient safety culture in an operating room setting in Abu Dhabi

Chellan, Jamila (Stellenbosch : University of Stellenbosch, 2010-12)

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010.

Thesis

ENGLISH ABSTRACT: Patient safety remains one of the biggest challenges to healthcare organizations. With the escalation in health care costs due to medical errors, many organizations are adopting a number of strategies like the keeping of electronic medical records, the use of medication bar coding, instituting protocol for common procedures and checklists. Although each of these interventions has had a positive impact, problems of preventable medical errors still persist in many health care organizations throughout the world. In order to combat this, a small but increasing number of organizations are trying out basic technology as a low cost solution for patient safety in order to adopt this culture. Approval was given to the researcher to conduct an assessment of the safety culture in a specialized obstetric and gynecology operating room setting in Abu Dhabi. The aim of the study was to explore the patient safety culture and the contributing factors influencing patient safety in the operating room, as part of the preparations for accreditation by the Joint Commission International. A quantitative descriptive survey as research design was implemented for this purpose. In May 2010 the researcher surveyed the entire population of operating room staff, i.e. 250 participants, following a pilot study consisting of 10% of the total sample. The popular hospital wide survey questionnaire of the Agency for Healthcare Research and Quality (AHRQ) was adjusted and used to assess the safety culture among the operating room staff. The survey measured four common dimensions of patient safety, namely an overall perception and grade of patient safety, and the frequency and number of events reported. Further sub-dimensions were also measured in terms of leadership support, team work, and communication. A total of 118 completed questionnaires were received, which represents a 52% response rate. All of the participants had direct interaction or contact with patients. The composite overall score for the perception of safety was 48%. Although findings of the survey indicate that the operating room has patient safety problems, the findings also show much positive strength in the operating room and the organization as a whole. The positive composite scores are reflected in the findings of 74% for hospital management support for patient safety, 70% for teamwork within the units, and 61% for teamwork across hospital units, and 60% for feedback and communication regarding medical errors. The implications of the survey findings were taken into consideration in order for the organization to comply with the requirements for the Joint Commission International’s recertification with the focus on staff education and improving safety standards.

AFRIKAANSE OPSOMMING:Pasiëntbeveiliging bly een van de grootste uitdagings vir gesondheidsorganisasies. Met die toename in onkoste vir gesondheidsorg vanweë mediese misstappe, pas baie organisasies ’n aantal strategieë toe, soos die byhou van elektroniese mediese rekords, die aanbring van strepieskodes op medisyne, die daarstelling van protokolle vir algemene prosedures en kontrolelyste. Alhoewel elkeen van hierdie intervensies ’n positiewe impak gehad het, bestaan probleme vanweë mediese misstappe nog steeds in vele gesondheidsorg organisasies dwarsoor die wêreld. Om dit te voorkom, probeer ’n klein, maar toenemende aantal organisasies om ‚n kultuur van basiese tegnologie as ’n lae-koste oplossing vir pasiëntbeveiliging te kweek. Toestemming is aan die navorser gegee om ’n assessering te doen van die veiligheidskultuur in ’n gespesialiseerde verloskundige en ginekologiese operasiesaal in Abu Dhabi. Die doel van hierdie studie is om die pasiëntveiligheidskultuur te ondersoek, asook die bydraende faktore wat pasiëntbeveiliging in die operasiesaal beïnvloed as deel van die voorbereiding vir akkreditasie deur die Gesamentlike Kommissie Internasionaal (GKI). ’n Kwantitatiewe, beskrywende opname as navorsingsontwerp is toegepas vir hierdie doel. Gedurende Mei 2010 het die navorser ’n opname van die totale populasie van die operasiesaalpersoneel gedoen, naamlik 250 deelnemers, na ’n loodsondersoek wat 10% van die totale steekproef uitgemaak het. Die bekende Agentskap vir Gesondheidsnavorsing en Kwaliteit (AGNK) se hospitaalwye opnamevraelys is aangepas en gebruik om die veiligheidskultuur in die operasiesaal te assesseer. Die opname het vier algemene dimensies van pasiëntveiligheid gemeet, naamlik ’n algemene persepsie en gradering van pasiëntveiligheid, as ook die frekwensie en die aantal ongunstige gebeure wat plaasvind. ’n Totaal van 118 voltooide vraelyste is ontvang wat ’n 52% responskoers verteenwoordig. Al die deelnemers het direkte interaksie of kontak met pasiënte. Die samegestelde algehele telling van persepsie van veiligheid is 48%. Alhoewel bevindinge van die opname aandui dat die operasiesaal pasiëntveiligheidsprobleme het, wys bevindinge ook baie positiewe aspekte in die operasiesaal en die organisasie as ’n geheel uit. Die positiewe samegestelde telling word gereflekteer in die bevindinge van 74% vir ondersteuning vanaf die hospitaalbestuur vir pasiëntbeveiliging, 70% vir spanwerk binne die eenhede, 61% vir spanwerk dwarsoor die hospitaaleenhede en 60% vir terugvoering en kommunikasie ten opsigte van mediese misstappe. Die implikasies van die opname se bevindinge is in ag geneem ten einde die organisasie in staat te stel om te voldoen aan die Gesamentlike Kommissie Internasionaal se hersertifisering met die fokus op personeelopleiding en verbetering van veiligheidstandaarde.

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