1. Perceptions of patient safety culture among triage nurses in the emergency department : a cross-sectional studyZvonka Fekonja, Sergej Kmetec, Nataša Mlinar Reljić, Jožica Černe Kolarič, Majda Pajnkihar, Matej Strnad, 2023, original scientific article Abstract: The patient safety culture is key to ensuring patient safety in healthcare organizations. The triage environment is inherently demanding for patient safety and is characterized by high stress, rapid decision-making, and quick action. In several countries, including Slovenia, there is a lack of studies on the patient safety culture among triage nurses. This study aimed to assess the perceptions of the patient safety culture among triage nurses. A cross-sectional survey design was used. The Emergency Medical Services-Safety Attitudes Questionnaire, distributed to triage nurses, was used to collect data. A total of 201 triage nurses participated in this study. The results revealed that the overall average perception of the patient safety culture was 57.27% (SD = 57.27), indicating that the perception of the patient safety culture among triage nurses in the emergency department was non-positive and requires improvement. “Job Satisfaction” received the highest score (63.18%; SD = 17.19), while “Working Conditions” received the lowest (49.91%; SD = 17.37). The perception of positive and negative safety culture responses was statistically significant for age (χ2 (3) = 17.750, p ≤ 0.001), education (χ2 (2) = 6.957, p = 0.031) and length of working experience (χ2 (3) = 8.875, p = 0.031). The findings emphasize the significance of improving the safety culture in relation to several areas of patient care during the triage process. This research serves as a crucial foundation for enhancing patient safety in triage, providing quality care, and reducing adverse events.
Keywords: triage, patient safety, perception, safety management, emergency medical services
Published in DKUM: 07.04.2025; Views: 0; Downloads: 1
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2. The safety culture of the Ljubljana community health centre's employeesŠpela Tevžič, Tonka Poplas-Susič, Zalika Klemenc-Ketiš, 2021, original scientific article Abstract: Introduction: Patient safety is one of the key aspects of healthcare quality and a serious global public health concern. Patient safety culture is a part of the patient safety concept. In Slovenia, primary care is easily accessible, and for medical care, it serves as a gatekeeper to hospital care. For several years, the quality and safety at the primary healthcare level have been the focus of several studies. The present study aimed to assess patient safety culture among all employees of the Community Health Centre Ljubljana.
Methods: We conducted a cross-sectional study in 2017 using the Slovene version of “Medical Office Survey on Patient Safety Culture” from the Agency for Healthcare Research and Quality. Mean percent positive scores on all items in each composite were calculated according to a user guide.
Results: The final sample contained 1021 participants (67.8% response rate), of which 909 (89.0%) were women. The mean age of the sample was 43.0±11.0 years. The dimensions most highly rated by the respondents were: teamwork and patient care tracking/follow-up. The lowest scores came from leadership support for patients’ safety and work pressure and pace.
Conclusion: Patient safety culture in the Community Health Centre Ljubljana is high, but there are certain areas of patient safety that need to be evaluated further and improved. Our study revealed differences between professions, indicating that a customized approach per profession group might contribute to the successful implementation of safety strategies. Patient safety culture should be studied at national levels.
Keywords: patient safety, safety culture, family medicine, primary healthcare, Slovenia
Published in DKUM: 18.10.2024; Views: 0; Downloads: 5
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3. Safety culture and the positive association of being a primary care training practice during COVID-19 : the results of the multi-country European PRICOV-19 studyBianca Silva, Zlata Ožvačić Adžić, Pierre Vanden Bussche, Esther Van Poel, Bohumil Seifert, Cindy Heaster, Claire Collins, Canan Tuz Yilmaz, Felicity Knights, Zalika Klemenc-Ketiš, 2022, original scientific article Abstract: The day-to-day work of primary care (PC) was substantially changed by the COVID-19 pandemic. Teaching practices needed to adapt both clinical work and teaching in a way that enabled the teaching process to continue, while maintaining safe and high-quality care. Our study aims to investigate the effect of being a training practice on a number of different outcomes related to the safety culture of PC practices. PRICOV-19 is a multi-country cross-sectional study that researches how PC practices were organized in 38 countries during the pandemic. Data was collected from November 2020 to December 2021. We categorized practices into training and non-training and selected outcomes relating to safety culture: safe practice management, community outreach, professional well-being and adherence to protocols. Mixed-effects regression models were built to analyze the effect of being a training practice for each of the outcomes, while controlling for relevant confounders. Of the participating practices, 2886 (56%) were non-training practices and 2272 (44%) were training practices. Being a training practice was significantly associated with a lower risk for adverse mental health events (OR: 0.83; CI: 0.70-0.99), a higher number of safety measures related to patient flow (Beta: 0.17; CI: 0.07-0.28), a higher number of safety incidents reported (RR: 1.12; CI: 1.06-1.19) and more protected time for meetings (Beta: 0.08; CI: 0.01-0.15). No significant associations were found for outreach initiatives, availability of triage information, use of a phone protocol or infection prevention measures and equipment availability. Training practices were found to have a stronger safety culture than non-training practices. These results have important policy implications, since involving more PC practices in education may be an effective way to improve quality and safety in general practice.
Keywords: safety culture, patient safety, quality of care, primary health care, COVID-19, medical education, vocational training, PRICOV-19, infectious disease, multi-country, general practice
Published in DKUM: 04.07.2024; Views: 128; Downloads: 17
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4. The safety of patient management in family medicine in Slovenia during Covid-19 : a crosssectional studyMaja Cvetko Gomezelj, Špela Miroševič, Alina Verdnik Tajki, Ksenija Tušek-Bunc, Esther Van Poel, Sara Willems, Zalika Klemenc-Ketiš, 2023, original scientific article Abstract: Abstract Background During the Covid-19 pandemic, family medicine practices (FMPs) changed to improve safety against new coronavirus infections for both patients and employees. Protocols for treating patients with suspected Sars-Cov-2 infections were established to protect medical staf and other patients from being infected. However, these protocols also led to increased safety risks, such as delays in treating patients with other medical conditions. This exploratory study aimed to investigate safety risks in treating patients in FMPs during the Covid-19 pandemic and to suggest improvements to prevent Covid-19 in FMPs in Slovenia. Methods A cross-sectional study was rolled out in FMPs in Slovenia as part of the international Pricov-19 study. Data collection on safety management during the Covid-19 pandemic in FMPs in Slovenia took place from November 2020 until January 2021 using a self-administered online survey for FP working in Slovenia. A chi-square test, ANOVA, independent samples t-test or bivariate correlation test was performed to explore associations regarding the safety of patients’ management variables. Results From the 191 participating family physicians (FPs) (15.2% response rate), 54.8% reported having treated patients with fever (not Covid-19) late due to the new protocols at least once, and 54.8% reported patients with urgent conditions having been seen late at least once due to not coming. In the suburbs and rural environments FPs more often reported that at least once patient with a fever (not Covid-19) was seen late due to the protocol (p=0.017) and more often reported that at least once patient with an urgent condition was seen late due to not com‑ ing to their FP (p=0.017). The larger the practice, the more they reported that at least once a patient with fever (not Covid-19) was seen late due to the protocol (p=0.012) and the more they reported at least once a patient with an urgent condition was seen late due to not coming to their FP (p=0.012). Conclusion Covid-19 afected the safety of patient management in FMP in Slovenia. The most common prob‑ lem was foregone care. Therefor, protocols for chronic patient management in the event of epidemics need to be established.
Keywords: Covid-19, family medicine, patient safety, patient management, quality of care, PRICOV-19, primary health care, general practice, timeliness
Published in DKUM: 29.03.2024; Views: 249; Downloads: 18
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6. Patient safety in cross-border careEva Turk, Stephen Leyshon, Morten Pytte, 2015, original scientific article Abstract: Patient safety is a right and it raises particular issues in the context of cross-border care. Patients should be able to have trust and confidence in the healthcare structure as a whole; they must be protected from the harm caused by poorly functioning health systems, medical errors and adverse events. This paper addresses the state of cross-border healthcare in the European Union, the state of patient safety, the question of quality assurance and the role of accreditation as a risk based approach.
Keywords: patient safety, cross-border care, accreditation, healthcare, EU
Published in DKUM: 08.10.2018; Views: 1087; Downloads: 134
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7. The safety attitudes questionnaire - ambulatory version : psychometric properties of the Slovenian version for the out-of-hours primary care settingZalika Klemenc-Ketiš, Matjaž Maletič, Vesna Stropnik, Ellen Tveter Deilkås, Dag Hofoss, Gunnar Tschudi Bondevik, 2017, original scientific article Abstract: Background: Several tools have been developed to measure safety attitudes of health care providers, out of which the Safety Attitudes Questionnaire (SAQ) is regarded as one of the most appropriate ones. In 2007, it was adapted to outpatient (primary health care) settings and in 2014 it was tested in out-of-hours health care settings in Norway. The purpose of this study was to translate the English version of the SAQ-Ambulatory Version (SAQ-AV) to Slovenian language; to test its reliability; and to explore its factor structure.
Methods: This was a cross-sectional study that took place in Slovenian out-of-hours primary care clinics in March- May 2015 as a part of an international study entitled Patient Safety Culture in European Out-of-hours services. The questionnaire consisted of the Slovenian version of the SAQ-AV. The link to the questionnaire was emailed to health care workers in the out-of-hours clinics. A total of 438 participants were invited. We performed exploratory factor analysis.
Results: Out of 438 invited participants, 250 answered the questionnaire (response rate 57.1%). Exploratory factor analysis put forward five factors: 1) Perceptions of management, 2) Job satisfaction, 3) Safety climate, 4) Teamwork climate, and 5) Communication. Cronbach's alpha of the whole SAQ-AV was 0.922. Cronbach's alpha of the five factors ranged from 0.587 to 0.791. Mean total score of the SAQ-AV was 56.6 +- 16.0 points. The factor with the highest average score was Teamwork climate and the factor with the lowest average was Job satisfaction.
Conclusions: Based on the results in our study, we cannot state that the SAQ-AV is a reliable tool for measuring safety culture in the Slovenian out-of-hours care setting. Our study also showed that there might be other safety culture factors in out-of-hours care not recognised before. We therefore recommend larger studies aiming to identify an alternative factor structure.
Keywords: patient safety, quality assurance, health care
Published in DKUM: 28.06.2017; Views: 2048; Downloads: 192
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