Proposed introduction of the SBAR method in rehabilitation

This project aims to implement within the Rehabilitation Operative Unit of the Ausl of Bologna the standardised SBAR (Situation-Background-Assessment-Recommendation) method for the transfer of information between physiotherapists, in order to improve the safety of the care pathway. This project, promoted by the DATeR Direction of the Ausl of Bologna (Technical and Rehabilitation Assistance Direction), is characterised by the insertion of the SBAR form within some of the company's care units. Professional physiotherapists from some of the Care Units under the Rehabilitation Operational Unit were involved. The rehabilitation SBAR card was introduced in the Care Units involved in the following 6 months. The implementation phase was characterised both by the use of the tool and by periodic peer-to-peer meetings which animated discussions and comparisons on the specific contents concerning the card. Monthly sample checks were carried out on some completed SBAR forms to monitor their correct filling in. Finally, the opinion of all the physiotherapists of the 4 Care Units was surveyed through the administration of a semi-structured questionnaire. The SBAR rehabilitation form was therefore officially implemented from January 2020 in the 4 Care Units involved in the project. A further improvement project is planned to implement the use of the rehabilitation SBAR card in the entire Rehabilitation Unit.

Este proyecto tiene como objetivo implementar, dentro de la Unidad Operativa de Rehabilitación del Ausl de Bolonia, el método estandarizado Situación Antecedentes Evaluación Recomendación (SBAR, por sus siglas en inglés) para la transferencia de información entre fisioterapeutas, con el fin de mejorar la seguridad de la vía asistencial. Este proyecto, promovido por la Dirección de Asistencia Técnica y Rehabilitación (Dirección DATeR) de la Ausl de Bolonia, se caracteriza por la inserción del formulario SBAR en algunas de las unidades asistenciales de la empresa. Participaron fisioterapeutas profesionales de algunas de las unidades asistenciales dependientes de la Unidad Operativa de Rehabilitación. Se implantó la tarjeta de rehabilitación SBAR en las unidades asistenciales implicadas en los subsiguientes 6 meses. La fase de implementación se caracterizó tanto por el uso de la herramienta como por reuniones periódicas entre pares que animaron discusiones y comparaciones sobre los contenidos específicos relacionados con la tarjeta. Mensualmente se realizaron controles por muestreo de algunos formularios SBAR completados para controlar que fueran completados correctamente. Finalmente, se indagó la opinión de todos los fisioterapeutas de las 4 unidades asistenciales mediante la administración de un cuestionario semiestructurado. Por lo tanto, el formulario de rehabilitación SBAR se implementó oficialmente a partir de enero de 2020 en las cuatro unidades de atención involucradas en el proyecto. Está previsto otro proyecto de mejora para implantar el uso de la tarjeta SBAR de rehabilitación en toda la unidad de Rehabilitación.

Safety attitudes, burnout and well-being among healthcare workers during the COVID-19 pandemic: an Indo-Pacific regional cross-sectional study

INTRODUCTION@#The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact in Asia and has placed significant burden on already stretched healthcare systems. We examined the impact of COVID-19 on the safety attitudes among healthcare workers (HCWs), as well as their associated demographic and occupational factors, and measures of burnout, depression and anxiety.@*METHODS@#A cross-sectional survey study utilising snowball sampling was performed involving doctors, nurses and allied health professions from 23 hospitals in Singapore, Malaysia, India and Indonesia between 29 May 2020 and 13 July 2020. This survey collated demographic data and workplace conditions and included three validated questionnaires: the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory and Hospital Anxiety and Depression Scale. We performed multivariate mixed-model regression to assess independent associations with the SAQ total percentage agree rate (PAR).@*RESULTS@#We obtained 3,163 responses. The SAQ total PARs were found to be 35.7%, 15.0%, 51.0% and 3.3% among the respondents from Singapore, Malaysia, India and Indonesia, respectively. Burnout scores were highest among respondents from Indonesia and lowest among respondents from India (70.9%-85.4% vs. 56.3%-63.6%, respectively). Multivariate analyses revealed that meeting burnout and depression thresholds and shifts lasting ≥12 h were significantly associated with lower SAQ total PAR.@*CONCLUSION@#Addressing the factors contributing to high burnout and depression and placing strict limits on work hours per shift may contribute significantly towards improving safety culture among HCWs and should remain priorities during the pandemic.

Reliability and validity of the Chinese version of Safety Attitudes Questionnaire / 中国实用护理杂志

Objective To translate the English version of Safety Attitudes Questionnaire (SAQ) into Chinese,and to test the reliability and validity of the Chinese version of SAQ. Methods The SAQ was developed into Chinese version through translation, back-translation and cross-culture adaption. The reliability and validity of the Chinese version of SAQ were tested in 823 first-line nurse managers in Henan. Results The scale content validity index was 0.90 of the Chinese SAQ, and the item content validity index ranged from 0.83 to 0.96. The correlations between the items and the full scale, the dimensions and the full scale separately ranged from 0.32 to 0.64 and 0.50 to 0.81 (P<0.01). The confirmatory factor analysis resulted in a good model fit for the six dimensions and the full construct, the goodness-of-fit index was 0.96, Tucker-Lewis index was 0.93, comparative fit index was 0.95, and root mean square error of approximation was 0.06. The Cronbach alpha coefficient for the scale was 0.913 and for the six dimensions were 0.565, 0.655, 0.825, 0.804, 0.880, 0.725 separately, the test-retest reliability coefficient was 0.934. Conclusions The Chinese version of SAQ is a valid and reliable tool to assess the safety culture of first-line nurse managers in Chinese hospitals.

Safety culture and safety attitudes of nurses in the National University Hospital

Purpose@#Patient safety issues pose a great burden worldwide. However, there is still inadequate data on the burden of Patient Safety issues in the Philippines to specifically address institutional and national concerns through directed programs, policies, and interventions. This current study aims to describe the safety culture and attitudes of nurses of the National University Hospital in Manila, Philippines.@*Design@#This study used a non-experimental design that assessed the safety culture and safety attitudes of nurses from the general units of the National University Hospital (NUH) using two assessment tools: the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (AHRQ-HSOPS) and the Safety Attitudes Questionnaire- Short Form (SAQ). Ethical approval was granted from both the university and the hospital ethics review boards.@*Methods@#Stratified random sampling was used to ensure representation of staff nurses and nurse administrators. A self-administered survey that included the two tools was translated to Filipino and administered to 200 nurses. Percent of positive responses were obtained to describe the safety culture and attitudes as prescribed by toolkits of AHRQ-HSOPS and SAQ.@*Findings@#The overall survey response rate yielded 86.77%. Nurses from the National University Hospital displayed both positive Safety Culture and Safety Attitudes based on AHRQ-HSOPS and SAQ. Dimensions that garnered the highest positive perceptions in Safety Culture were Organizational Learning and Teamwork while the lowest were Hospital Handoffs and Non-Punitive Response to Error. On the other hand, dimensions on Safety Awareness that received the highest positive perceptions were Teamwork and Safety Climate while the lowest was Stress Recognition. Perceptions of nurses also varied significantly across ranks in position titles and work settings.@*Conclusions@#There are identifiable dimensions that can be improved in both Safety Culture and Safety Attitude that can have a positive impact on nurses and potentially impact nurse-patient and hospital-sensitive outcomes through hospital-wide improvement programs.

The perceived incidence rate and patient safety attitudes of health care professionals at Davao Medical School Foundation Hospital

Safety culture is term used to determine the commitment, style and proficiency of an organization's health safety management. Medical errors increase morbidity, causes significant complications, increase hospital costs and prolongs hospital stays for the patient.OBJECTIVE: The aim of this study was to determine the perceived incidence rate and the patient safety attitudes of health care professionals at the Davao Medical School Foundation Hospital (DMSFH)METHODOLOGY: The study involved the health care professionals of DMSFH. The safety Attitudes Questionnaire (SAQ)was used and measured on a 5-point Likert scale for the following domains, Teamwork, Safety Climate, Job Satisfaction, Stress Recognition, Perceptions of Management, Working Conditions, Collaboration and Communication. The last part of the survey questionnaire determines the perceived incidence rate. It is composed of three items: accidents, near-misses and errors and were rated on a 6-point Likert scale.RESULTS: Among the 145 respondents, 88.96% were nurses, 1.38% doctors and 9.66% pharmacists. The overall patient safety climate at the DMSFH was good with a mean rate of 3.5 ± 0.42. Perception of management has the lowest perceived rates with a mean of only 3.06 ±  0.21. In terms of mean perceived incident rates, errors had the highest mean rates of 3.27 ± 1.09. Overall, perceived incidence rates are negatively, albeit weakly, correlated with the DMSFH safety climate.CONCLUSION: The perceived incidence rates are significantly affected by the patient safety measures that are practiced by the health care professionals.

Safety culture and safety attitudes of nurses in the National University Hospital

PURPOSE: Patient safety issues pose a great burden worldwide. However, there is still inadequate data on the burden of Patient Safety issues in the Philippines to specifically address institutional and national concerns through directed program, policies, and interventions. This current study aims to describe the safety culture and attitudes of nurses of the National University Hospital in Manila, Philippines.DESIGN: This study used non-experimental design that assessed the safety culture and safety attitudes of nurses from the general units of the National University Hospital (NUH) using two assessment tools: the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (AHRQ-HSOPS) and the Safety Attitudes Questionnaire- Short Form (SAQ). Ethical approval was granted from both the university and the hospital ethics review boards. METHODS: Stratified random sampling was used to ensure representation of staff nurses and nurse administrators. A self-administered survey that included the two tools was translated to Filipino and administered to 200 nurses. Percent of positive responses were obtained to describe the safety culture and attitudes as prescribed by toolkits of AHRQ-HSOPS and SAQ.FINDINGS: The overall survey response rate yielded 86.77%. Nurses from the National University Hospital displayed both positive Safety Culture and Safety Attitudes based on AHRQ-HSOPS and SAQ. Dimensions that garnered the highest positive perceptions in Safety Culture were Organizational Learning and Teamwork while the lowest were Hospital Handoffs and Non-Punitive Response to Error. On the other hand, dimensions on safety Awareness that received the highest positive perceptions were Teamwork and Safety Climate while the lowest was Stress Recognition. Perceptions of nurses also varied significantly across ranks in position titles and work settings. CONCLUSIONS: There are identifiable dimensions that can be improved in both Safety Culture and Safety Attitude that can have a positive impact on nurses and potentially impact nurse-patient and hospital-sensitive outcomes through hospital-wide improvement programs.

The Correlation between Occupational Safety Attitudes and Occupational Exposure among Nursing Students in Kunming Medical University / 昆明医科大学学报

Objective To understand the current situation of occupational exposure and occupational safety attitudes among nursing students in Kunming Medical University, and to find effective interventions to improve nurses' occupational safety,and to reduce occupational exposure.Methods 854 students in Kunming Medical University were investigated by a questionnaire survey, including Demographic characteristics, Occupational exposure conditions, Occupational safety attitude and Gathers, quit intention . The correlations between occupational safety attitudes and occupational exposure were analyzed with Simple Linear Correlation.Results There were 94.30%female respondents,and only 5.70%male respondents.The average age of respondents was 22.52±2.90 years. The Simple Linear Correlation analysis showed that correlation between Negative attitude and occupational exposure was positive correlated, the occupational exposure and Support from managers, and Optimistic were negative correlation ( <0.05) .Conclusions Occupational safety and attitude are related to occupational exposure. Nursing students should apply standardized operation to improve the professional quality and ability. Schools should strengthen the education of occupational protection for nursing students. Hospital management should regularly organize nurses to study occupational exposure protection knowledge,give full affirmation of the nurse's achievements in the work, and offer certain reward appropriately.

Assessing Safety Attitudes among Healthcare Providers after a Hospital-Wide High-Risk Patient Care Program

PURPOSE: Cardiopulmonary resuscitation (CPR) is commonly performed in high-risk, high intensity situations and is therefore a good procedure around which to develop and implement safety culture strategies in the hospital. The purpose of this study was to evaluate the impact of a hospital-wide quality improvement program on the management of sudden cardiac arrests by assessing healthcare providers' attitudes towards patient safety. MATERIALS AND METHODS: This study was designed as a prospective cohort study at a single academic medical center. The comprehensive hospital-based safety program included steps to identify areas of hazard, partner units with the Resuscitation Committee, and to conduct a Safety Attitudes Questionnaire (SAQ). The SAQ evaluated 35 questions in seven domains to assess changes in patient safety culture by comparing the results before and after the hospital-wide high risk patient care improvement program. RESULTS: The response rates of the pre- and post-SAQ survey were 489 out of 1121 (43.6%) and 575 out of 1270 (45.3%), respectively. SAQ survey responses revealed significant improvement in all seven domains of the questionnaire (p-values of 0.006 and lower). In a subgroup analysis, doctors and nurses showed improvement in five domains. Both doctors and nurses did not show improvement in the "sharing information" domain. CONCLUSION: A hospital-wide quality improvement program for high-risk, high reliability patient care involving CPR care was shown to be associated with a change in healthcare providers' attitudes towards patient safety. Through an immersive and active program on CPR care, change in healthcare providers' attitudes towards patient safety was initiated.