BMJ quality & safety
-
BMJ quality & safety · Mar 2014
Staffing and resource adequacy strongly related to RNs' assessment of patient safety: a national study of RNs working in acute-care hospitals in Sweden.
Although registered nurses (RNs) are central in patient care, we have not found prior research that specifically addresses how RNs assess the safety of patient care at their workplace and how factors in RNs' work environment are related to their assessments. This study aims to address these issues. ⋯ While previous research emphasises patient-to-nurse ratios in strengthening patient safety practices, this study complements this by emphasising RNs' own perception of having enough staff and resources to provide quality nursing care, as well as having good collegial nurse-physician relations and the presence of visible and competent nursing leadership-all factors highly related to RNs' assessment of the safety of patient care at their workplace.
-
BMJ quality & safety · Mar 2014
Comparative Study Observational StudyManaging competing demands through task-switching and multitasking: a multi-setting observational study of 200 clinicians over 1000 hours.
To provide a detailed characterisation of clinicians' work management strategies. ⋯ Despite differences in factors associated with work management strategy use among ED doctors, ward doctors and ward nurses, clinicians in all settings appeared to prioritise certain types of tasks over others. Documentation was generally given low priority in all groups, while the arrival of direct care tasks tended to be treated with high priority. These findings suggest that considerations of safety may be implicit in task-switching and multitasking decisions. Although these strategies have been cast in a negative light, future research should consider their role in optimising competing quality and efficiency demands.
-
Venous thromboembolism (VTE) is a common cause of preventable harm for hospitalised patients. Over the past decade, numerous intervention types have been implemented in attempts to improve the prescription of VTE prophylaxis in hospitals, with varying degrees of success. We reviewed key articles to assess the efficacy of different types of interventions to improve prescription of VTE prophylaxis for hospitalised patients. ⋯ Many intervention types have proven effective to different degrees in improving VTE prevention. Provider education is likely a required additional component and should be combined with other intervention types. Active mandatory tools are likely more effective than passive ones. Information technology tools that are well integrated into provider workflow, such as alerts and computerised clinical decision support, can improve best practice prophylaxis use and prevent patient harm resulting from VTE.