Qual Saf Health Care
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Qual Saf Health Care · Oct 2010
Simulation and patient safety: evaluative checklists for central venous catheter insertion.
In the advent of concerns for patient safety, simulation training is emerging as a method to train healthcare providers to perform invasive procedures such as central venous catheter (CVC) insertion while minimising harmful complications to the patient. New technologies in medical simulation have begun to shift research attention to the performance component of clinical competency. Accurate assessment of healthcare provider competence is a major priority in medical education necessitating the development of valid and reliable assessment tools. ⋯ Ease of use, ability to be completed by a non-expert, categorical breakdown of critical actions involved in CVC insertion and the need for a comprehensive stepwise procedural checklist are discussed. The development of an ideal checklist may improve future competency-based training and performance evaluation in the clinical setting. A more thorough understanding of the status of checklists as evaluation tools in assessing performance of invasive procedures will lead to better training protocols and ultimately to improved patient safety.
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Qual Saf Health Care · Oct 2010
A new way of relating: perceptions associated with a team-based error disclosure simulation intervention.
Despite the call for open and team-based approaches to error disclosure, the participation beyond physicians and managers is not a common practice in health care settings. Moreover, within the growing literature base on error disclosure, team-based error disclosure is an emerging concept. To address this knowledge gap, a study was undertaken to explore the perceptions associated with an educational simulation intervention for team-based error disclosure. ⋯ Study findings revealed that a team-based approach to disclosure is not realistic or necessary for all error situations, such as when the error involves a single discipline. However, when the error involves a variety of health care professionals interacting with the patient, a team-based approach is beneficial to them and the patient. Further work is required by researchers and administrators to develop and test out interventions that enable health care professionals to practice team-based error disclosure in a safe and supported environment.
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Qual Saf Health Care · Oct 2010
Clinical simulation in maternity (CSiM): interprofessional learning through simulation team training.
Focusing on interprofessional relations in team performance to improve patient safety is an emerging priority in obstetrics. A review of the literature found little information on roles and teamwork in obstetric emergency training. Qualitative research was undertaken through a Clinical Simulation in Maternity programme which gives interprofessional rural clinicians the opportunity to learn collaboratively through simulated obstetric emergencies. This research aimed to determine how interprofessional simulation team training improved maternity emergency care and team performance. ⋯ This research highlights the significance of interprofessional training, particularly through simulation learning in a team where rural clinicians are able to learn more about each other and gain role clarity, leadership skills and mutuality in a safe environment.
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This paper explores the place of simulation in contemporary healthcare education and training, highlighting the challenges of recreating complex clinical settings which can support the development of competent, rounded and caring practitioners, and address issues around human factors as well as technical skill. It frames the relationship between clinical and simulation-based practice as a mutually dependent, two-way process. ⋯ The paper concludes by considering theoretical and practical implications of these innovations, focussing especially on surgery and other craft specialties.
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Qual Saf Health Care · Aug 2010
Organisational readiness: exploring the preconditions for success in organisation-wide patient safety improvement programmes.
Patient safety has been high on the agenda for more than a decade. Despite many national initiatives aimed at improving patient safety, the challenge remains to find coherent and sustainable organisation-wide safety-improvement programmes. In the UK, the Safer Patients' Initiative (SPI) was established to address this challenge. Important in the success of such an endeavour is understanding 'readiness' at the organisational level, identifying the preconditions for success in this type of programme. This article reports on a case study of the four NHS organisations participating in the first phase of SPI, examining the perceptions of organisational readiness and the relationship of these factors with impact by those actively involved in the initiative. ⋯ This preliminary work would suggest that prior to the start of organisation-wide quality- and safety-improvement programmes, organisations would benefit from an assessment of readiness with time spent in the preparation of the organisational infrastructure, processes and culture. Furthermore, a better understanding of the preconditions that mark an organisation as ready for improvement work would allow policymakers to set realistic expectations about the outcomes of safety campaigns.