Perspectives on Patient and Family Engagement With Reduction in Harm

Schenk, Elizabeth; Bryant, Ruth; Son, Catherine R Van; Odom‐Maryon, Tamara

doi:10.1097/ncq.0000000000000333

Cited by 15 publications

(31 citation statements)

References 13 publications

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“…At the national level, a study on Portuguese hospitals prepared in 2011 by the National School of Public Health obtained similar conclusions, i.e., an incidence rate of adverse events of approximately 11%, with 53% of the situations considered preventable [9, p. 36]. However, it has been verified that, despite continuous efforts to improve safety in hospitals, the harm caused by hospital care persists [10-12].…”

Section: Introductionmentioning

confidence: 91%

The Family and Safety of the Hospitalized Patient: An Integrative Literature Review

Correia¹,

Martins²,

Barroso³

2020

Port J Public Health

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Framework: Considering that the current data on health care safety remain alarming, there is an overwhelming urge for the ongoing study of this topic and for recommendations and differentiated strategies which aim to promote health and which prove effective. Some recommendations have been taken into consideration, such as patient-centered care, and consequently the need for greater involvement of patient and family in this process. However, we have identified arguments for and against the involvement of family in the care process, and consequently a greater or lesser openness towards hospital visits. Objective: What are the implications of the presence of family for the safety of hospitalized patients? What does the science say about these implications? Methods: We conducted an integrative literature review by referring to the Web of Science, CINAHL, Medline, and Scopus databases, according to the recommendations of the Joanna Briggs Institute for scoping review. Results: We found 115 articles. After selection, 13 articles were included in this review. There were 6 qualitative studies, 5 quantitative studies, and 2 literature reviews. Data were grouped according to: the perspective of patients and their families, the health professionals’ perspective, and statistical evidence. Conclusion: Families take efforts to protect the safety of hospitalized patients but feel unprepared; a lack of follow-up was reported. Some health professionals claim that the presence of the family can increase the risks for patient safety and the fear of an increased workload. The evidence of the presence of the family and its link to the safety of the hospitalized patient demonstrated that this relationship is not yet well understood. There were limited findings about this in the current literature. Relevance to Clinical Practice: Structured interventions about family integration in ensuring the safety of hospitalized patients may have the potential to contribute to the safety of health care.

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Section: Introductionmentioning

confidence: 91%

The Family and Safety of the Hospitalized Patient: An Integrative Literature Review

Correia¹,

Martins²,

Barroso³

2020

Port J Public Health

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“…For environment, research reveals that the hospital is usually unknown to patients and may be perceived as harsh, with unknown people and procedures and different sounds, lighting, and routines, all of which aggravate their perception and hinder wellness (15) . This same study also revealed that patients and their families can be apprehensive about requesting care when the health workers are insensitive to their needs.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to paying attention to the issues that involve patient s safety, they tend to the patient's needs and help create an emotionally supportive environment. According to a study, the need to establish a partnership with patients and family members and, consequently, improve patient safety, increased due to the complexity of health care (15) . Moreover, results showed that families know the history of patients, so they are able to provide information that helps the health team understand the patient's perspective, reinforce the treatment plan, notify changes in health status, and offer comfort to the patient.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, results showed that families know the history of patients, so they are able to provide information that helps the health team understand the patient's perspective, reinforce the treatment plan, notify changes in health status, and offer comfort to the patient. In contrast, the same study revealed that when the desires of the family are not the same as the desires of the patient, the health team must skillfully intervene to verify and manage the situation (15) .…”

Section: Discussionmentioning

confidence: 99%

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Satisfaction attributes related to safety and quality perceived in the experience of hospitalized patients

Costa

Moura

Moraes

et al. 2020

Rev. Gaúcha Enferm.

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Objective: To unveil patient satisfaction attributes related to safety and quality of care. Methods: Qualitative study carried out in a public university hospital in the south region of Brazil. Data were collected in November 2018 through 24 interviews with patients/families from 12 clinical and surgical hospitalization units. Thematic analysis was carried out. Results: The satisfaction attributes were categorized in terms of structure, process, and care outcome, and they were related to: access to the service, amount of personnel, environment, interaction with the health team, staff’s technical competence, perception of safety with the presence of a relative, assistance patterns present in the care, and change in the health status of the patients. Conclusions: It was verified that the structural aspects were relevant in the patient’s experience, besides the relationship established with the health team in the care process, and the technical assistance standards perceived in the staff’s work.

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“…Most investigators have focused on a particular dimension of harm prevention, such as patients’ attitudes toward and comfort in asking providers about handwashing (eg four of 13 studies reported in Schwappach 49 review; Davis et al 55 ), or intervention strategies, 56 and made inferences from those results to patient safety overall. Those primary studies with a more purposeful focus on understanding patients’ attitudes and thoughts about whether they have a role in safety at the direct care level were few in number, 24,57‐60 and were sometimes combined with general care activities, 59,61 or focused on parents 62 . The general findings from these investigations included viewing their role in safety “as a right, not an obligation”, 58 to seeing their role as a “shared responsibility” with providers 60 .…”

Section: Overall Themes—patient Attitudes and Behavioursmentioning

confidence: 99%

Scoping review of patients’ attitudes about their role and behaviours to ensure safe care at the direct care level

Duhn

Godfrey

Medves

2020

Health Expectations

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Background To improve harm prevention, patient engagement in safety at the direct care level is advocated. For patient safety to most effectively include patients, it is critical to reflect on existing evidence, to better position future research with implications for education and practice. Methods As part of a multi‐phase study, which included a qualitative descriptive study (Duhn & Medves, 2018), a scoping review about patient engagement in safety was conducted. The objective was to review papers about patients’ attitudes and behaviours concerning their involvement in ensuring their safe care. The databases searched included MEDLINE, CINAHL and EMBASE (year ending 2019). Results This review included 35 papers about “Patient Attitudes” and 125 papers about “Patient Behaviours”—indicative of growing global interest in this field. Several patterns emerged from the review, including that most investigators have focused on a particular dimension of harm prevention, such as asking about provider handwashing, and there is less known about patients’ opinions about their role in safety generally and how to actualize it in a way that is right for them. While patients may indicate favourable attitudes toward safety involvement generally, intention to act or actual behaviours may be quite different. Conclusion This review, given its multi‐focus across the continuum of care, is the first of its kind based on existing literature. It provides an important international “mapping” of the initiatives that are underway to engage patients in different elements of safety and their viewpoints, and identifies the gaps that remain.

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Perspectives on Patient and Family Engagement With Reduction in Harm

Abstract: The rich data suggest a significant opportunity for reducing risk and harm by more actively engaging patients and families in the effort. Increasing patient acuity and complexity of care furthers the need for partnering with patients and families more intentionally for increased safety.

Cited by 15 publications

References 13 publications

The Family and Safety of the Hospitalized Patient: An Integrative Literature Review

The Family and Safety of the Hospitalized Patient: An Integrative Literature Review

Satisfaction attributes related to safety and quality perceived in the experience of hospitalized patients

Scoping review of patients’ attitudes about their role and behaviours to ensure safe care at the direct care level

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