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

Abstract

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.

Use of Failure Mode and Effects Analysis (FMEA) for Risk Analysis of Drug Use in Patients with Lung Cancer

“…Existing studies suggest that patients and their families have been regarded as so-called “vigilant partners” in safe cancer care [ 21 ]. Patients generally have a positive attitude toward their participation in the practice of safe drug use [ 32 , 33 ], but their evaluation of their own participation in the process of error prevention is less positive [ 34 ]. Patients’ intention to participate is affected by clinical diseases and related to attitude, willpower, and other factors [ 35 ].…”

How to engage patients in achieving patient safety: A qualitative study from healthcare professionals’ perspective

“…Since Patient engagement (PE) has become essential to be enhanced, WHO placed the “patient for patient safety program” at the core of the latest strategies to achieve PS and higher quality health services, PE has become essential to be enhanced [ 5 , 6 ]. Several studies found that employing patient and family engagement strategies reduced hospital-acquired infections, medical errors, serious safety accidents, and increased patient satisfaction [ [7] , [8] , [9] ]. Although these initiatives are highly beneficial, they are often confined to policy development, administrative procedures, patient education, increasing healthcare professionals' (HCPs') awareness and capacity, as well as technical assistance.…”

Validación del paciente como auditor de prácticas seguras. Factores facilitadores desde una triple perspectiva: pacientes, profesionales y gestores

“…Sin embargo, y tal como refleja la literatura, indicarle a un profesional que no ha realizado una práctica correctamente o que la ha omitido, genera incomodidad, miedo a molestarles, a posibles represalias, etc. 101,102,107,117,120,[135][136][137] Las formas de dirigirse al profesional para indicarle o "recordarle" que no ha llevado a cabo una determinada acción, puede hacerse de forma indirecta mediante preguntas factuales o bien interpelarle directamente al respecto.…”

“…En esta investigación queda reflejado por el grupo de padres y madres, especialmente a través de los grupos focales, en los que manifiestan cuidar y protegen a sus hijos e hijas. De igual forma, aunque no ha surgido desde los participantes en esta investigación, ocurriría en personas dependientes por procesos de salud o en personas más mayores que van delegando funciones en las personas que les cuidan 137 .…”

“…Indicaban que la voluntariedad puede dificultar la participación al no tener ningún tipo de reconocimiento institucional. Por otro lado, como refieren Duhn et al 137 puede que las creencias sobre cómo se va actuar no se materialicen en acciones. Es posible estar de acuerdo, pero esto no quiere decir que vaya a realizar una acción o en este caso piense que sí participaría y finalmente no lo haga.…”