Egyptian Neonatal Safety Training Network: a dream to improve patient safety culture in Egyptian neonatal intensive care units

Abstract

Background: Patient safety is fundamental to upholding the quality of health care. Health-care workers in neonatal intensive care units (NICUs) face daily challenges to sustain safe care for their patients and to counteract medical errors. Aims: The objectives were to develop the Egyptian Neonatal Safety Training Network (ENSTN) to promote safe health care practices in NICUs through training of Health-care workers on PtS and dissemination of a culture for patient safety. Methods: The ENSTN project accomplishments were completed through 8 work packages. The first package activities were intended to establish standards of knowledge and skills for safe practices in the NICU, develop the course specifications for PtS and develop standards. The remaining packages included: a professional patient safety reporting system and database; cohesive shared education and training in patient safety leadership and research; development of protocols and guidelines to enhance and ensure sustainability of safe practice; dissemination of ENSTN messages; confirmation of quality measures and adequate performance; sustainability of patient safety practices in the NICU; and structuring the management plan and facilitating project activities. Results: Project outputs included: patient safety standards for NICUs in Arabic and English; 3 patient safety courses for physicians, nurses and other health-care workers the ENSTN electronic reporting system for medical errors and guidelines; and a parent's booklet. Conclusions: Continuous organized training for health-care workers on patient safety and implementation of ENSTN standards to reduce medical errors in the NICU are needed. We implemented the first confidential patient safety reporting system for NICU.

Mechanical Ventilation Trigger Tool Identify Errors Associated with Mechanical Ventilation in Newborn Infant

“…Medical errors are potentially harmful eight times more in the neonatal intensive care unit when compared to adult settings in the hospital [7], [8]. Newborn infants are more vulnerable and even minor errors lead to devastating short-and long-term consequences [9].…”

Impact of Safety Guidelines on Nurses’ Knowledge regarding Incidents and Nurses’ Safety Attitude at Neonatal Intensive Care Unit

“…The researchers think that, these incidents may be due to that, neonates receive an excess number of medications and expose to many invasive procedures for diagnosis and treatment over a prolonged time, as well as, incidents can due to less equipment, devices failure, poor team communication, lack of nurses' education and training. In this regards El-Meneza et al, (2019) (24) mentioned that, the most adverse event types were due to equipment/device failure and added, the most errors contributing factors were due to poor education/training, and communication problems.…”

Developing patient safety standards for health-care quality promotion in neonatal intensive care units

“…Following the RAM guidelines, the components will be classified and agreed to as valid based on the median rating of appropriateness and the degree of panel agreement (dispersion). Accordingly, the classification of components with a median panel score in the top tertile[ 7 8 9 ] without disagreement is “appropriate,” median ratings in the bottom tertile[ 1 2 3 ] without disagreement are “inappropriate,” and median scores between 4 and 6 or any median with disagreement are neither “appropriate” nor “appropriate,” rather they are “uncertain.” The second round is face to face for allowing the members to discuss their judgments and reaching a consensus on the components in the “uncertain” category among panelists. [ 34 ]…”

“…Poorly designed care processes and environments, lack of facilities, and human resources can endanger patient safety. [ 4 9 ] Furthermore, stressors such as light and noise, infection, unplanned removal of the endotracheal tube, and implementing invasive procedures can increase the risk of infant injury and affect the growth and neurodevelopmental outcomes. [ 10 11 12 13 14 15 ] Conversely, improving the work environment,[ 16 17 ] teamwork, safety climate,[ 6 ] and quality promotion efforts[ 18 ] may be a promising strategy to achieve safer settings for at-risk newborns.…”