Patient participation in patient safety and nursing input – a systematic review

Abstract

Aims and objectives. This systematic review aims to synthesise the existing research on how patients participate in patient safety initiatives.

Parents' Perspectives on “Keeping Their Children Safe” in the Hospital

“…This supports further efforts to promote "safety culture" and an environment that is consistently emotionally and physically comfortable for parent participation. 25,26 These parent perspectives on safety suggest that current models on patient engagement and participation 19,20 have not adequately addressed the complicated interpersonal issues that characterize the social role of a parent of hospitalized children. A "social role" consists of a set of connected behaviors, rights, obligations, beliefs, and norms as conceptualized by people in a social situation.…”

“…Parents often experience child hospitalization as loss of control including loss of capacity to protect their child, compromising their role and "right" as parents resulting in a universal admission of "watching over" their child and their care. 24,26 The degree of this vigilance and associated behaviors in parent participation varies on the basis of degree of parent autonomy, self-efficacy, and technical knowledge required. 13,20,25,27,28 Our study adds to the emerging recognition that there is spectrum of parent participation in interdependent safety behaviors that involve assertive behaviors, such as double-checking or questioning professional practice.…”

“…Emphasis and invitation to participate in formal processes, such as bedside handoff and participation in patient-/family-centered rounds, have reduced errors in several settings, possibly by creating a comfortable environment for participation. 26,34,35 Parental capacity and participation in safety-related practices for their hospitalized child reflect the interpersonal complexity of navigating parenthood in the hospital. By exploring the experiences of a diverse group of parents who vary along a spectrum of psychosocial and empowerment/activation characterizations, we identified some potential modifiable factors that affect parent engagement at any given time in a child's illness and admission.…”

“…26,36 By design, promoting high reliability or consistent health care worker practices necessitates standardization of tasks and care around specific practices (safe medication ordering, central line care). However, our study suggests that parents and families perceive this risk-focused approach may not translate for "safety" from a patient and family perspective but instead involves as a challenge to the holistic notion of safety culture that includes staff and families.…”

“…The rich, frequent, and universal descriptions about this quandary from every participant suggest a larger issue around culture and social roles even outside of intensive care. 26,[30][31][32][33] Several reviews have attempted to identify effective tools or materials for promoting patient and family engagement specifically on safety. 5 However, our study found that in the moment of care, parents repeatedly emphasized the importance of comfort around each personal interaction with providers: Individual, specific articulation of safety concerns and precautions could raise awareness and promote openness and trust.…”