Assessing patient safety implementation and its associate factors in a pediatric inpatient ward

Main Article Content

Rukmini Rukmini
Siti Nur Qomariah
Eileen Savage

Abstract

Background
Patient safety is an emerging healthcare discipline with the ultimate goal of reducing errors and harm to patients by implementing quality health services. The provision of patient safety is complex and difficult to achieve. The purpose of this research was to assess patient safety in hospital pediatric inpatient care and factors affecting nurses implementing pediatric patient safety.


Methods
This cross-sectional study involved 80 nurses (male and female) at several private and public hospitals in Surabaya City. The research instruments used were secondary data on patient safety in hospital pediatric inpatient wards, hospital medical records, as well as questionnaires, and observations of the implementation of pediatric patient safety goals. Data were analyzed using multiple logistic regression.


Results
Most participants were female (71.3%), were over 45 years old (18%), and had more than 5 years of work experience in pediatric wards (76%). There were reportedly 145 patient safety incidents, consisting of 46% unexpected events (Kejadian Tidak Diharapkan), 48% nearly injurious events (Kejadian Nyaris Cedera), 6% potential injurious events (Kejadian Potensial Cedera), and 0% sentinel events. Multiple logistic regression analysis showed that nurses who work in less positive working settings are at higher risk of negative implementation of pediatric patient safety than those who work in positive working settings [AOR= 1.85 (95% CI 1.62-4.92)].


Conclusion
This study demonstrated that work setting and frequency of reported events were significantly associated with negative implementation of pediatric patient safety. Therefore, intervention is recommended to minimize unnecessary pediatric patient harm.

Article Details

How to Cite
Rukmini, R., Qomariah, S. N., & Savage, E. (2024). Assessing patient safety implementation and its associate factors in a pediatric inpatient ward. Universa Medicina, 43(1), 4–12. https://doi.org/10.18051/UnivMed.2024.v43.4-12
Section
Original Articles

References

Retnaningsih D, Fatmawati DF. Beban kerja perawat terhadap implementasi patient safety di ruang rawat inap. J Keperawatan Soedirman 2018; 11:44-52. Indonesian. DOI: https://doi.org/ 10.20884/1.jks.2016.11.1.637

Despotou G, Her J, Arvanitis TN. Nurses’ perceptions of Joint Commission International Accreditation on patient safety in tertiary care in South Korea: a pilot study. J Nurs Regul 2020;10:33-6. DOI: https://doi.org/10.1016/S2155-8256(20)30011-9.

Kobayashi K, Ando K, Nakashima H, et al. Challenges for Joint Commission International accreditation: performance of orthopedic surgeons based on International Patient Safety Goals. Nagoya J Med Sci 2021;83:87-92. DOI: https://doi.org/ 10.18999/nagjms.83.1.87.

Larasati A, Dhamanti I. Literature review: implementation of patient safety goals in hospitals in Indonesia. Media Gizi Kesmas 2021;10:138-48. DOI:https://doi.org/10.20473/mgk.v10i1.2021.138-148.

Centers for Disease Control and Prevention. National Healthcare Safety Network (NHSN) Patient Safety Component Manual. Atlanta: Centers for Disease Control and Prevention;2023.

Simamora VS, Zulfendri Z, Simamora RH, Asyura Nasution PCC. Implementasi patient safety di Pelayanan Anak Rumah Sakit Umum Haji Medan Tahun 2019. J Manaj Kesehat Indones 2020;8:188-96. Indonesian. DOI: https://doi.org/10.14710/jmki. 8.3.2020.188-196.

Biresaw H, Asfaw N, Zewdu F. Knowledge and attitude of nurses towards patient safety and its associated factors. Int J Africa Nurs Sci 2020;13: 10229. DOI: https://doi.org/10.1016/j.ijans.2020. 100229.

Syarianingsih Syam N, Kurnia Widi Hastuti S. Relationship between knowledge and attitude with implementation of patient safety targets in RSUD Yogyakarta. JMMR 2018;7:2015-11. DOI: https://doi.org/10.18196/jmmr.7374.

Schwendimann R, Blatter C, Dhaini S, Simon M, Ausserhofer D. The occurrence, types, consequences and preventability of in-hospital adverse events - a scoping review. BMC Health Serv Res 2018;18:521. doi: 10.1186/s12913-018-3335-z.

Wilson RM, Michel P, Olsen S, et al. Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital. BMJ 2012;344:e832. DOI: https://doi.org/10.1136/ bmj.e832.

World Health Organization. Global patient safety action plan 2021–2030: towards eliminating avoidable harm in health care. Geneva: World Health Organization; 2021.

Joseph MM, Mahajan P, Snow SK, Ku BC, Saidinejad M. Optimizing pediatric patient safety in the emergency care setting. J Emerg Nurs 2022;48:652-65. DOI:https://doi.org/10.1016/j.jen.2022.08.010

Offen E. Safeguarding: doing the difficult thing. Prim Dent J 2021;10:112-5. DOI: https://doi.org/ 10.1177/2050168420980981.

Nittari G, Scuri S, Petrelli F, Pirillo I, Di Luca NM, Grappasonni I. Fighting obesity in children from European World Health Organization member states. Epidemiological data, medical-social aspects, and prevention programs. Clin Ter 2019;170:e223-30. DOI:https://doi.org/10.7417/CT.2019.2137.

Albolino S, De Luca M, Morabito A. Patient safety in pediatrics. In: Donaldson L, Ricciardi W, Sheridan S, et al., editors.Textbook of patient safety and clinical risk management. Cham (CH): Springer; 2021. p.299-308. DOI: https://doi.org/ 10.1007/978-3-030-59403-9_21

Zhou L, Li L, Xiao S, Yang N. Concern for patient safety culture of ECMO team in Emergency Department: a cross-sectional survey. Inquiry 2022;59:469580221129168. DOI:https://doi.org/10.1177/00469580221129168.

Hessels AJ, Agarwal M, Saiman L, Larson EL. Measuring patient safety culture in pediatric long-term care. J Pediatr Rehabil Med 2017;10:81-7. DOI:https://doi.org/10.3233/PRM-170432.

Brás CPC, Ferreira MMC, Figueiredo MCAB, Duarte JC. Patient safety culture in nurses’ clinical practice. Rev Latino-Am. Enfermagem 2023;31: e3837. DOI: 10.1590/1518-8345.6231. 3837.

Kaware MS, Ibrahim MI, Shafei MN, Mohd Hairon S, Abdullahi AU. Patient safety culture and its associated factors: a situational analysis among nurses in Katsina Public Hospitals, Northwest Nigeria. Int J Environ Res Public Health 2022;19: 3305. DOI: https://doi.org/10.3390/ ijerph19063305.

Hoffmann LM, Wegner W, Biasibetti C, Peres MÁ, Gerhardt LM, Breigeiron MK. Patient safety incidents identified by the caregivers of hospitalized children. Rev Bras Enferm 2019;72: 707-14. DOI: https://doi.org/10.1590/0034 -7167-2018-0484.

Wildani AA, Wulandari CI. Analysis of head nurse’s leadership style in pediatric’s care ward, Jakarta General Hospital. J Keperawatan Respati Yogyakarta 2020;7:16-20.. DOI: https://doi.org/ 10.35842/jkry.v7i1.436

Qomariah SN, Lidiyah UA. Hubungan faktor komunikasi dengan insiden keselamatan pasien. (Correlation of communication factor with patient safety incident). Journals Ners Community 2015;6: 166-74.

Oktafien S, Roespinedji D, Saudi MHM. Creating conducive work environments that affects employee performance improvement. Int J Innov Creat Chang 2019;6:271-7.

Park E, Choi JS. Attributes associated with person-centered care competence among undergraduate nursing students. Res Nurs Heal 2020;43:511-9. DOI: https://doi.org/10.1002/nur.22062.

Tønnessen S, Scott A, Nortvedt P. Safe and competent nursing care: An argument for a minimum standard? Nurs Ethics 2020;27:1396-407. DOI:https://doi.org/10.1177/0969733020919137.

Kim HW, Kim MG. The relationship among academic achievement, clinical competence, and confidence in clinical performance of nursing students. J Korean Acad Soc Nurs Educ 2021;27: 49-58. DOI:https://doi.org/10.5977/jkasne.2021.27.1.49.

Sonğur C, Özer Ö, Gün Ç, Top M. Patient safety culture, evidence-based practice and performance in nursing. Syst Pract Action Res 2018;31:359-74. DOI:https://doi.org/10.1007/s11213-017-9430-y.

Musgrove E, Gasparini L, McBain K, et al. Synthesizing core outcome sets for outcomes research in cohort studies: a systematic review. Pediatr Res 2022;92:936-45. DOI: https://doi.org/ 10.1038/s41390-021-01801-2.