Patient Involvement in Patient Safety: A Qualitative Study of Nursing Staff and Patient Perceptions

Bishop, Alex; Macdonald, Marilyn

doi:10.1097/pts.0000000000000123

Cited by 52 publications

(41 citation statements)

References 14 publications

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“…Much has been written about patient involvement in patient safety (Bishop & Macdonald, 2017;Lawton et al, 2017;Vaismoradi, Jordan, & Kangasniemi, 2015…”

Section: Discussionmentioning

confidence: 99%

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

Bucknall

Fossum

Hutchinson

et al. 2019

Journal of Advanced Nursing

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Aims To describe nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in acute hospital settings. Background Medication errors cause unintended harm to patients. Nurses have a major role in ensuring patient safety in medication administration practices in hospital settings. Investigating nurses’ medication administration decision‐making and practices and their perceptions of patient involvement, may assist in developing interventions by revealing how and when to involve patients during medication administration in hospital. Design A descriptive exploratory study design. Methods Twenty nurses were recruited from two surgical and two medical wards of a major metropolitan hospital in Australia. Each nurse was observed for 4 hr, then interviewed after the observation. Data were collected over six months in 2015. Observations were captured on an electronic case report form; interviews were audio‐recorded and transcribed verbatim. Data were analysed using descriptive statistics and content and thematic analysis. Results Ninety‐five medication administration episodes, of between two and eight episodes per nurse, were observed. A total of 56 interruptions occurred with 26 of the interruptions being medication related. Four major themes emerged from the interviews: dealing with uncertainty; facilitating, framing and filtering information; managing interruptions and knowing and involving patients. Conclusion Nurses work in complex adaptive systems that change moment by moment. Acknowledging and understanding the cognitive workload and complex interactions are necessary to improve patient safety and reduce errors during medication administration. Knowing and involving the patient is an important part of a nurses’ medication administration safety strategies.

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“…Much has been written about patient involvement in patient safety (Bishop & Macdonald, 2017;Lawton et al, 2017;Vaismoradi, Jordan, & Kangasniemi, 2015…”

Section: Discussionmentioning

confidence: 99%

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

Bucknall

Fossum

Hutchinson

et al. 2019

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

“…Research shows that clinicians often feel excluded from the development of patient safety policies [49], avoid incident reporting due to lack of anonymity or time [50] and are frequently victimised when pointing out safety issues [51]. PRIORITIZE allows transparent, easy reproducible and anonymous voicing of concerns, suggestions and ideas from many health care providers.…”

Section: Discussionmentioning

confidence: 99%

Preventing delayed diagnosis of cancer: clinicians’ views on main problems and solutions

Car¹,

Papachristou²,

Urch³

et al. 2016

Journal of Global Health

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BackgroundDelayed diagnosis is a major contributing factor to the UK’s lower cancer survival compared to many European countries. In the UK, there is a significant national variation in early cancer diagnosis. Healthcare providers can offer an insight into local priorities for timely cancer diagnosis. In this study, we aimed to identify the main problems and solutions relating to delay cancer diagnosis according to cancer care clinicians.MethodsWe developed and implemented a new priority–setting approach called PRIORITIZE and invited North West London cancer care clinicians to identify and prioritize main causes for and solutions to delayed diagnosis of cancer care.ResultsClinicians identified a number of concrete problems and solutions relating to delayed diagnosis of cancer. Raising public awareness, patient education as well as better access to specialist care and diagnostic testing were seen as the highest priorities. The identified suggestions focused mostly on the delays during referrals from primary to secondary care.ConclusionsMany identified priorities were feasible, affordable and converged around common themes such as public awareness, care continuity and length of consultation. As a timely, proactive and scalable priority–setting approach, PRIORITZE could be implemented as a routine preventative system for determining patient safety issues by frontline staff.

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“…Clinicians often report feeling marginalised in patient safety policy development as well as hesitant toward incident reporting due to lack of anonymity, time and the risk of victimisation [34–36]. The information produced by the incident reporting system has been found to be inaccurate, incomplete and difficult to analyze, making it hard to spot dangerous trends or problem [37,38].…”

Section: Discussionmentioning

confidence: 99%

Prioritizing medication safety in care of people with cancer: clinicians’ views on main problems and solutions

Car

Papachristou

Urch

et al. 2017

Journal of Global Health

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BackgroundCancer care is liable to medication errors due to the complex nature of cancer treatment, the common presence of comorbidities and the involvement of a number of clinicians in cancer care. While the frequency of medication errors in cancer care has been reported, little is known about their causal factors and effective prevention strategies. With a unique insight into the main safety issues in cancer treatment, frontline staff can help close this gap. In this study, we aimed to identify medication safety priorities in cancer patient care according to clinicians in North West London using PRIORITIZE, a novel priority–setting approach.MethodsThe project steering group determined the scope, the context and the criteria for prioritization. We then invited North West London cancer care clinicians to identify and prioritize main causes for, and solutions to, medication errors in cancer care. Forty cancer care providers submitted their suggestions which were thematically synthesized into a composite list of 20 distinct problems and 22 solutions. A group of 26 clinicians from the initial cohort ranked the composite list of suggestions using predetermined criteria.ResultsThe top ranked problems focused on patients’ poor understanding of treatments due to language or education difficulties, clinicians’ insufficient attention to patients’ psychological distress, and inadequate information sharing among health care providers. The top ranked solutions were provision of guidance to patients and their carers on what to do when unwell, pre–chemotherapy work–up for all patients and better staff training. Overall, clinicians considered improved communication between health care providers, quality assurance procedures (during prescription and monitoring stages) and patient education as key strategies for improving cancer medication safety. Prescribing stage was identified as the most vulnerable to medication safety threats. The highest ranked suggestions received the strongest agreement among the clinicians.ConclusionsClinician–identified priorities for reducing medication errors in cancer care addressed various aspects of cancer treatment. Our findings open up an opportunity to assess the congruence between health care professional suggestions, currently implemented patient safety policies and evidence base.

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Patient Involvement in Patient Safety: A Qualitative Study of Nursing Staff and Patient Perceptions

Cited by 52 publications

References 14 publications

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

Preventing delayed diagnosis of cancer: clinicians’ views on main problems and solutions

Prioritizing medication safety in care of people with cancer: clinicians’ views on main problems and solutions

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