Qual Saf Health Care
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Qual Saf Health Care · Oct 2006
Patterns of diffusion of evidence-based clinical programmes: a case study of the Hospital Elder Life Program.
The effective translation of scientific evidence into clinical practice is paramount to improving the quality and safety of patient care. However, little is known about the patterns of diffusion of evidence-based programmes in healthcare. ⋯ Diffusion and take-up rates for this evidence-based programme were substantial; however, programme fidelity was not complete and some hospitals did not adopt the programme at all. Clinicians, researchers and funding agents seeking to promote effective translation of research should be realistic about diffusion rates and recognise the critical ingredient of senior management support to propel adoption of evidence-based programmes to improve quality and safety.
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Qual Saf Health Care · Oct 2006
Comparative StudyUse of a safety climate questionnaire in UK health care: factor structure, reliability and usability.
To explore the factor structure, reliability, and potential usefulness of a patient safety climate questionnaire in UK health care. ⋯ This is one of the few studies to undertake a detailed evaluation of a patient safety climate questionnaire in UK health care and possibly the first to do so in primary as well as secondary care. The results indicate that a 22 item version of this safety climate questionnaire is useable as a research instrument in both settings, but also demonstrates a more general need for thorough validation of safety climate questionnaires before widespread usage.
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Qual Saf Health Care · Oct 2006
Experience of wrong site surgery and surgical marking practices among clinicians in the UK.
Little is known about the incidence of "wrong site surgery", but the consequences of this type of medical error can be severe. Guidance from both the USA and more recently the UK has highlighted the importance of preventing error by marking patients before surgery. ⋯ Marking practices are variable and marking is not always used. Introducing standard guidance on marking may reduce the overall risk of wrong site surgery, especially as clinicians work at different hospital sites. However, the more specific needs of people and specialties must also be considered.
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Qual Saf Health Care · Oct 2006
Effect of the introduction of a lumbar-puncture sticker and teaching manikin on junior staff documentation and performance of paediatric lumbar punctures.
Performing a lumbar puncture in an unwell child can cause anxiety in both the parent and the junior doctor. There is increasing evidence of post-lumbar-puncture complications in this age group. ⋯ The introduction of a lumbar-puncture proforma and formal teaching sessions using a paediatric manikin led to a marked improvement in the documentation of paediatric lumbar-punctures. Lumbar-punctures can be performed only by accredited medical officers who have achieved competency on the lumbar-puncture teaching manikin.
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Medication administration errors (MAEs) occur in 3-8% of all non-intravenous drug doses given in UK hospitals; higher rates have been reported for intravenous drugs. Educational interventions are often advocated as one way of reducing these rates. However, group education sessions are often not practical. We developed internet-based educational modules on drug safety, and evaluated their effect on MAEs. ⋯ An interactive educational package focusing on patient safety was developed, with a high rate of uptake among nursing staff on the study ward. A reduction in non-intravenous MAEs was observed after the use of the package, but no significant change was seen in the overall error rate.