Patient safety incident prevention and management among Finnish dentists

Hiivala, Nora; Mussalo‐Rauhamaa, Helena; Murtomaa, Heikki

doi:10.3109/00016357.2013.797103

Cited by 17 publications

(15 citation statements)

References 22 publications

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“…After further analysis and meetings with the author team, only nine of the studies were found to fit the inclusion criteria. The 31 excluded studies [ 17 , 25 – 54 ], along with justifications for exclusion, are presented in Additional file 3 . The nine included studies were [ 51 , 55 – 62 ].…”

Section: Resultsmentioning

confidence: 99%

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Systematic review of patient safety interventions in dentistry

et al. 2015

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BackgroundThe concept of patient safety in dentistry is in its infancy, with little knowledge about the effectiveness of tools or interventions developed to improve patient safety or to minimise the occurrence of adverse events.MethodsThe aim of this qualitative systematic review was to search the academic and grey literature to identify and assess tools or interventions used in dental care settings to maintain or improve patient safety. All study designs were included from all dental care settings. Outcome measures were: patient safety, harm prevention, risk minimization, patient satisfaction and patient acceptability, professional acceptability, efficacy, cost-effectiveness and efficiency. Quality assessments were performed on the included studies based on CASP tools. Further analysis was undertaken to discover whether any of the tools had been trialled or verified by the authors, or by subsequent authors.ResultsFollowing abstract screening, and initial qualitative synthesis, nine studies were found to meet the inclusion criteria with 31 being excluded following initial analysis. Tools identified included: checklists (4 studies), reporting systems (3), the use of electronic notes (1) and trigger tools (1). Grey literature searching did not identify any further appropriate studies. In terms of study design, there were observational studies including audit cycles (5 studies), epidemiological studies (3) and prospective cluster randomised clinical trials (1). The quality of the studies varied and none of their outcomes were verified by other researchers. The tools identified have the potential to be used for measuring and improving patient safety in dentistry, with two surgical safety checklists demonstrating a reduction in erroneous dental extractions to nil following their introduction. Reporting systems provide epidemiological data, however, it is not known whether they lead to any improvement in patient safety. The one study on trigger tools demonstrates a 50 % positive predictive value for safety incidents. It is not clear as to what impact the introduction of electronic guidelines has on patient safety outcomes.ConclusionsThis systematic review finds that the only interventions in dentistry that reduce or minimise adverse events are surgical safety checklists. We believe this to be the first systematic review in this field; it demonstrates the need for further research into patient safety in dentistry across several domains: epidemiological, conceptual understanding and patient and practitioner involvement.Electronic supplementary materialThe online version of this article (doi:10.1186/s12903-015-0136-1) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…Further research is necessary to provide clarity in the primary medical care field [ 16 ]. Similarly, patient safety in primary care dentistry is an area where the evidence base is lacking at present [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Systematic review of patient safety interventions in dentistry

et al. 2015

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“…There was suspicion of under reporting of incidents and a lack of education in patient safety was noted. The same authors assessed patient safety incident prevention measures utilised by Finnish dentists; 39 a questionnaire was sent out to all dental registrants in Finland. Only 31% of dentists were using an incident reporting system, with 7% planning to introduce one; 71% of dentists reported having some social support after patient safety incidents occurred, with approximately half of these respondents discussing incidents at team meetings.…”

Section: Previous Studies and Findingsmentioning

confidence: 99%

Patient safety in primary care dentistry: where are we now?

2014

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In contemporary healthcare settings, ensuring patient safety must be an underlying principal through which systems, teams, individuals and environments work in tandem to strive for. The adoption of a culture in the NHS where patient safety is given greater priority is key to improvement. Recent events at Mid-Staffordshire hospitals among others have brought patient safety into the minds of the public and it increasingly demands attention from clinicians, the press and governments. However, much of the work into patient safety has been completed in the secondary care field with very little work completed in primary care settings. In primary care dentistry, improving patient safety is a relatively new concept with a distinct lack of evidence base. In this article, we discuss what patient safety is and debate its relevance to primary care dentistry. We also look at previous work completed in this field and make recommendations for future work to address the current lack of research.

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“…[5][6][7] The Institute of Medicine (IOM) defines patient safety as "the prevention of harm to patients." [5][6][7] The Institute of Medicine (IOM) defines patient safety as "the prevention of harm to patients."…”

mentioning

confidence: 99%

“…D espite advances in oral health care, some patients suffer harm in the dental chair, 1-4 so it is in our patients' and our profession's best interest to improve the safety culture in dentistry. [5][6][7] The Institute of Medicine (IOM) defines patient safety as "the prevention of harm to patients." 8 Harm or an adverse event in turn is defined as "an injury caused by medical management rather than by the underlying disease or condition of the patient."…”

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confidence: 99%

Clinical Dental Faculty Members’ Perceptions of Diagnostic Errors and How to Avoid Them

Nikdel¹,

Nikdel²,

Ibarra-Noriega³

et al. 2018

Journal of Dental Education

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Diagnostic errors are increasingly recognized as a source of preventable harm in medicine, yet little is known about their occurrence in dentistry. The aim of this study was to gain a deeper understanding of clinical dental faculty members' perceptions of diagnostic errors, types of errors that may occur, and possible contributing factors. The authors conducted semi-structured interviews with ten domain experts at one U.S. dental school in May-August 2016 about their perceptions of diagnostic errors and their causes. The interviews were analyzed using an inductive process to identify themes and key findings. The results showed that the participants varied in their definitions of diagnostic errors. While all identified missed diagnosis and wrong diagnosis, only four participants perceived that a delay in diagnosis was a diagnostic error. Some participants perceived that an error occurs only when the choice of treatment leads to harm. Contributing factors associated with diagnostic errors included the knowledge and skills of the dentist, not taking adequate time, lack of communication among colleagues, and cognitive biases such as premature closure based on previous experience. Strategies suggested by the participants to prevent these errors were taking adequate time when investigating a case, forming study groups, increasing communication, and putting more emphasis on differential diagnosis. These interviews revealed differing perceptions of dental diagnostic errors among clinical dental faculty members. To address the variations, the authors recommend adopting shared language developed by the medical profession to increase understanding.

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Patient safety incident prevention and management among Finnish dentists

Cited by 17 publications

References 22 publications

Systematic review of patient safety interventions in dentistry

Systematic review of patient safety interventions in dentistry

Patient safety in primary care dentistry: where are we now?

Clinical Dental Faculty Members’ Perceptions of Diagnostic Errors and How to Avoid Them

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