Assessing patient safety culture in 15 intensive care units: a mixed-methods study

Tlili, Mohamed Ayoub; Aouicha, Wiem; Sahli, Jihène; Cheikh, Asma Ben; Mtiraoui, Ali; Ajmi, Thouraya; Zedini, Chekib; Chelbi, Souad; Rejeb, M Ben; Mallouli, Manel

doi:10.1186/s12913-022-07665-4

Cited by 8 publications

(9 citation statements)

References 25 publications

(36 reference statements)

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“…In our study, the dimension “Frequency of events reported” (D2) initially had a score of 30.1% and was therefore a dimension to be improved. This score was close to those reported by two other Tunisian studies conducted in intensive care units (ICUs) [ 2 ] and in operating rooms [ 18 ] and which respectively found scores of 20.8% and 25.6%. Also, a study carried out in a maternity hospital in Switzerland in 2022 showed that this dimension was among the least developed ones with a score of 20.8% [ 15 ].…”

Section: Discussionsupporting

confidence: 88%

“…The dimension "Non-punitive response to error" (D7) may confirm this where, before the intervention, it had a score of 21.1%, meaning that the majority of staff feel that mistakes are blamed on them and that when an event is reported, it is the person who is singled out and not the problem. Others point out that the existing reporting system lacks responsiveness and does not go further than reporting, which explains the low rate of AEs reporting [2,18]. This low tendency to report and this limited reactivity will in turn limit learning from errors, since AEs represent opportunities for learning, communication and exchange of experiences between caregivers.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, patient safety has begun to receive particular attention and has become a priority all over the world due to the persistent high and rising incidence of adverse events (AEs), their impact, and the availability of efficient and practical preventative measures [1][2][3]. The incidence of AEs in hospitalized patients ranges from 3 to 17% and up to 50% of AEs are deemed preventable [4].…”

Section: Introductionmentioning

confidence: 99%

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Impact of an educational intervention on patient safety culture among gynecology-obstetrics’ healthcare professionals

Lassoued,

Gharssallah,

Tlili

et al. 2024

BMC Health Serv Res

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Background In recent years, patient safety has begun to receive particular attention and has become a priority all over the world. Patient Safety Culture (PSC) is widely recognized as a key tenet that must be improved in order to enhance patient safety and prevent adverse events. However, in gynecology and obstetrics, despite the criticality of the environment, few studies have focused on improving PSC in these units. This study aimed at assessing the effectiveness of an educational program to improve PSC among health professionals working in the obstetric unit of a Tunisian university hospital. Methods We conducted a quasi-experimental study in the obstetric unit of a university hospital in Sousse (Tunisia). All the obstetric unit’s professionals were invited to take part in the study (n = 95). The intervention consisted of an educational intervention with workshops and self-learning documents on patient safety and quality of care. The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture. Normality of the data was checked using Kolmogorov-Smirnov test. The comparison of dimensions’ scores before and after the intervention was carried out by the chi2 test. The significance level was set at 0.05. Results In total, 73 participants gave survey feedback in pre-test and 68 in post-test (response rates of 76.8% and 71.6, respectively). Eight dimensions improved significantly between pre- and post-tests. These dimensions were D2 “Frequency of adverse events reported” (from 30.1 to 65.6%, p < 0.001), D3 “Supervisor/Manager expectations and actions promoting patient safety” (from 38.0 to 76.8%, p < 0.001), D4 “Continuous improvement and organizational learning” (from 37.5 to 41.0%, p < 0.01), D5 “Teamwork within units” (from 58.2 to 79.7%, p < 0.01), D6 “Communication openness” (from 40.6 to 70.6%, p < 0.001), and D7 “Non-punitive response to error” (from 21.1 to 42.7%, p < 0.01), D9 “Management support for patient safety” (from 26.4 to 72.8%, p < 0.001), and D10 “Teamwork across units” (from 31.4 to 76.2%, p < 0.001). Conclusions Educational intervention, including workshops and self-learning as pedagogical tools can improve PSC. The sustainability of the improvements made depends on the collaboration of all personnel to create and promote a culture of safety. Staff commitment at all levels remains the cornerstone of any continuous improvement in the area of patient safety.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of an educational intervention on patient safety culture among gynecology-obstetrics’ healthcare professionals

Lassoued,

Gharssallah,

Tlili

et al. 2024

BMC Health Serv Res

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“…In Tunisia, reporting systems remain uncommon in hospitals and reporting culture is very little developed. This is demonstrated through the patient safety culture surveys carried out in ICUs and where the dimensions related to frequency of events reported and non-punitive response to error had the lowest scores [ 16 , 17 ]. There is no national reporting system, nor a specific regulation relating to the implementation of reporting systems in hospitals.…”

Section: Introductionmentioning

confidence: 99%

A retrospective analysis of adverse events reported by Tunisian intensive care units’ professionals

Tlili,

Aouicha,

Gambashidze

et al. 2024

BMC Health Serv Res

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Introduction Adverse events (AEs) that occur in hospitals remain a challenge worldwide, and especially in intensive care units (ICUs) where they are more likely to occur. Monitoring of AEs can provide insight into the status and advances of patient safety. This study aimed to examine the AEs reported during the 20 months after the implementation of the AE reporting system. Methods We conducted a retrospective analysis of a voluntary ICU AE reporting system. Incidents were reported by the staff from ten ICUs in the Sahloul University Hospital (Tunisia) between February 2020 and September 2021. Results A total of 265 reports were received, of which 61.9% were deemed preventable. The most frequently reported event was healthcare-associated infection (30.2%, n = 80), followed by pressure ulcers (18.5%, n = 49). At the time of reporting, 25 patients (9.4%) had died as a result of an AE and in 51.3% of cases, the event had resulted in an increased length of stay. Provider-related factors contributed to 64.2% of the events, whilst patient-related factors contributed to 53.6% of the events. As for criticality, 34.3% of the events (n = 91) were unacceptable (c3) and 36.3% of the events (n = 96) were ‘acceptable under control’ (c2). Conclusions The reporting system provided rich information on the characteristics of reported AEs that occur in ICUs and their consequences and may be therefore useful for designing effective and evidence-based interventions to reduce the occurrence of AEs.

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“…In Tunisia, reporting systems remain uncommon in hospitals and reporting culture is very little developed. This is demonstrated through the patient safety culture surveys carried out in ICUs and where the dimensions related to frequency of events reported and non-punitive response to error had the lowest scores [13,14]. There is no national reporting system, nor a speci c regulation relating to the implementation of reporting systems in hospitals.…”

Section: Introductionmentioning

confidence: 99%

A retrospective analysis of adverse events reported by Tunisian intensive care professionals

Tlili

Aouicha

Gambashidze

et al. 2023

Preprint

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Introduction Adverse events (AEs) that occur in hospitals remain a challenge worldwide, and especially in intensive care units (ICUs) where they are more likely to occur. Monitoring of AEs can provide insight into the status and advances of patient safety. This study aimed at examining the AEs reported during 20 months after the implementation of AE reporting system. Methods We conducted a retrospective analysis of a voluntary ICU AE reporting system. Incidents were reported by staff from 10 ICUs in the Sahloul University Hospital (Tunisia) between February 2020 and September 2021. Results A total of 265 reports were received, of which, 61.9% were deemed preventable. The most reported event was healthcare-associated infections (30.2%, n=80), followed by pressure ulcers (18.5%, n=49). At the time of reporting, 25 patients (9.4%) had died as a result of an AE and in 51.3% of cases, the event had resulted in an increased length of stay. Provider-related factors contributed to 64.2% of the events, whilst patient-related factors contributed to 53.6% of the events. As for criticality, 34.3% of the events (n=91) were unacceptable (c3) and 36.3% of the events (n= 96) were ‘acceptable under control’ (c2). Conclusions The reporting system provided rich information on the characteristics of reported AEs that occur in ICUs and their consequences and may be therefore useful for designing effective and evidence-based interventions to reduce the occurrence of AEs.

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Assessing patient safety culture in 15 intensive care units: a mixed-methods study

Cited by 8 publications

References 25 publications

Impact of an educational intervention on patient safety culture among gynecology-obstetrics’ healthcare professionals

Impact of an educational intervention on patient safety culture among gynecology-obstetrics’ healthcare professionals

A retrospective analysis of adverse events reported by Tunisian intensive care units’ professionals

A retrospective analysis of adverse events reported by Tunisian intensive care professionals

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