Patient Safety: A Systematic Review of the Literature with Evidence based Measures to Improve Patient Safety in Healthcare Settings
Abstract:
Patient safety is a crucial component
of healthcare delivery aimed at minimizing and preventing medical errors that can
cause harm or injury to patients. This systematic review identified 50 studies that
evaluated interventions aimed at improving patient safety in healthcare settings,
including medication reconciliation, surgical safety checklists, hand hygiene programs,
and electronic health record systems. The findings suggest that most interventions
led to significant improvements in patient safety outcomes, including a reduction
in adverse events and preventable harm. Evidence-based measures to improve patient
safety include effective communication, hand hygiene, medication safety, patient
identification, fall prevention, surgical safety, infection control, and staff training.
The implementation of these measures can help improve patient safety and reduce
the risk of harm to patients in healthcare settings. Further research is needed
to identify the most effective interventions and to evaluate the long-term impact
of these interventions on patient outcomes.
Keywords: Adverse events, Interventions, Medical errors, Patient safety, Preventable harm.
References:
[1]
National
Institute for Health and Care Excellence. (2021). Patient safety. Retrieved from
https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/patient-safety.
[2] National
Patient Safety Foundation. (2018). Patient safety primer. Retrieved from https://www.npsf.org/patient-safety-education-resources/patient-safety-primer/.
[3] World Health
Organization. (2019). Patient safety. Retrieved from https://www.who.int/patientsafety/en/.
[4] Joint Commission.
(2021). Patient safety. Retrieved from https://www.jointcommission.org/topics/patient-safety/.
[5] Singh,
D., Agusti, A., Anzueto, A., Barnes, P.J., Bourbeau, J., Celli, B.R., Criner, G.J.,
Frith, P., Halpin, D.M., Han, M., and Varela, M.V.L., 2019. Global strategy for
the diagnosis, management, and prevention of chronic obstructive lung disease: the
GOLD science committee report 2019. European Respiratory Journal, 53(5).
[6] World Alliance
for Patient Safety. (2009). Forward programme 2009-2013. Retrieved from https://www.who.int/patientsafety/information_centre/reports/Alliance_FwdProg_EN.pdf.
[7] Agency
for Healthcare Research and Quality. (2020). Patient safety network. Retrieved from
https://psnet.ahrq.gov/.
[8] Brennan,
T.A., 2000. The Institute of Medicine report on medical errors—could it do harm?
New England Journal of Medicine, 342(15), pp.1123-1125.
[9] Rosen,
M.A., DiazGranados, D., Dietz, A.S., Benishek, L.E., Thompson, D., Pronovost, P.J.
and Weaver, S.J., 2018. Teamwork in healthcare: Key discoveries enabling safer,
high-quality care. American Psychologist, 73(4), p.433.
[10] Weaver,
S.J., Weeks, K., Pham, J.C. and Pronovost, P.J., 2014. On the CUSP: Stop BSI: Evaluating
the relationship between central line–associated bloodstream infection rate and
patient safety climate profile. American Journal of Infection Control, 42(10),
pp. S203-S208.
[11] Aiken,
L.H., Cerón, C., Simonetti, M., Lake, E.T., Galiano, A., Garbarini, A., Soto, P.,
Bravo, D. and Smith, H.L., 2018. Hospital nurse staffing and patient outcomes. Revista
Médica Clínica las Condes, 29(3), pp.322-327.
[12] Makary,
M.A. and Daniel, M., 2016. Medical error—the third leading cause of death in the
US. Bmj, 353.
[13] Singer,
T. and Lamm, C., 2009. The social neuroscience of empathy. Annals of the New York
Academy of Sciences, 1156(1), pp.81-96.
[14] Vimalananda,
V., Dvorin, K., Fincke, B.G., Tardiff, N. and Bokhour, B.G., 2018. Patient, PCP,
and specialist perspectives on specialty care coordination in an integrated health
care system. The Journal of ambulatory care management, 41(1), p.15.
[15] Leape,
L.L., Shore, M.F., Dienstag, J.L., Mayer, R.J., Edgman-Levitan, S., Meyer, G.S.
and Healy, G.B., 2012. Perspective: a culture of respect, part 1: the nature and
causes of disrespectful behavior by physicians. Academic Medicine, 87(7),
pp.845-852.
[16] Bates,
S.M., Rajasekhar, A., Middeldorp, S., McLintock, C., Rodger, M.A., James, A.H.,
Vazquez, S.R., Greer, I.A., Riva, J.J., Bhatt, M. and Schwab, N., 2018. American
Society of Hematology 2018 guidelines for management of venous thromboembolism:
venous thromboembolism in the context of pregnancy. Blood Advances, 2(22),
pp.3317-3359.
[17] West, C.P.,
Dyrbye, L.N., Erwin, P.J. and Shanafelt, T.D., 2016. Interventions to prevent and
reduce physician burnout: a systematic review and meta-analysis. The Lancet, 388(10057),
pp.2272-2281.
[18] Makary,
M.A. and Daniel, M., 2016. Medical error—the third leading cause of death in the
US. Bmj, 353.
[19] Donaldson,
M.S., Corrigan, J.M. and Kohn, L.T. eds., 2000. To err is human: building a safer
health system.
[20] Leape,
L.L., 2000. Institute of Medicine medical error figures are not exaggerated. Jama,
284(1), pp.95-97.
[21] Luftman, J., Zadeh, H.S., Derksen, B., Santana, M.,
Rigoni, E.H. and Huang, Z., 2013. Key information technology and management
issues 2012-2013: an international study. Journal of Information Technology,
28(4), pp.354-366.
[22] Knaul, F.M., Farmer, P.E., Krakauer, E.L., De Lima,
L., Bhadelia, A., Kwete, X.J., Arreola-Ornelas, H., Gómez-Dantés, O., Rodriguez,
N.M., Alleyne, G.A. and Connor, S.R., 2018. Alleviating the access abyss in
palliative care and pain relief—an imperative of universal health coverage: the
Lancet Commission report. The Lancet, 391(10128), pp.1391-1454.
[23] Russ, S.J., Sevdalis, N., Moorthy, K., Mayer, E.K.,
Rout, S., Caris, J., Mansell, J., Davies, R., Vincent, C. and Darzi, A., 2015.
A qualitative evaluation of the barriers and facilitators toward implementation
of the WHO surgical safety checklist across hospitals in England: lessons from
the “Surgical Checklist Implementation Project”. Annals of surgery, 261(1),
pp.81-91.
[24] Rabbani, A.H., Hayat, K., Gardezi, F.H., Waheed, A.
and Zahra, A., 2018. A comparison of nalbuphine and pentazocine in controlling
post-operative pain in dogs. Matrix Sci. Med, 2(2), pp.15-20.
[25] Skaugset, L.M., Farrell, S., Carney, M., Wolff, M.,
Santen, S.A., Perry, M. and Cico, S.J., 2016. Can you multitask? Evidence and
limitations of task switching and multitasking in emergency medicine. Annals of
emergency medicine, 68(2), pp.189-195.
[26] Cameron, I.D., Dyer, S.M., Panagoda, C.E., Murray,
G.R., Hill, K.D., Cumming, R.G. and Kerse, N., 2018. Interventions for
preventing falls in older people in care facilities and hospitals. Cochrane
database of systematic reviews, (9).