Division of Research and Innovation, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, ON, M2H 3J1, Canada; Department of Chiropractic, Université du Québec à Trois-Rivières, 3351, Boulevard des Forges, Trois-Rivières, Quebec, G9A 5H7, Canada.
AECC University College, Parkwood Campus, Parkwood Rd, Bournemouth, BH5 2DF, UK.
Musculoskelet Sci Pract. 2021 Dec;56:102470. doi: 10.1016/j.msksp.2021.102470. Epub 2021 Oct 20.
Patient safety research is expanding from hospitals to community-based healthcare settings. Knowledge gaps persist among manual therapy professions that may impede patient safety initiatives within musculoskeletal care settings.
To describe perceptions of patient safety among chiropractors and physiotherapists who provide spinal manipulation therapy (SMT).
Qualitative descriptive study.
Cross-sectional data were collected using the SafetyNET Survey to Support Quality Improvement. SMT providers (n = 705) in 3 countries completed surveys, with 84 providing written responses to an open-ended question about patient safety. Qualitative thematic analysis described providers' perceptions about patient safety within their practice.
SMT providers' perceptions were influenced by professional, patient, and practice setting factors. Five themes and 10 supporting categories were developed. Doing Our Best for Patient Safety concerned Avoiding Mistakes and Prioritizing Safety.Putting Patients First focused on Developing Relationships and Individualizing Care.Working and Learning Together advocated for Interprofessional Communication and Collaborative Learning. Organizing Practice Processes emphasized Standardizing Procedures and Benchmarking Progress.Considering Practitioner Identity highlighted how Recognizing Difference among SMT providers and Challenging Fears of other healthcare professionals and patients about SMT were important for enhancing patient safety.
Findings align with World Health Organization guiding principles that the nature of healthcare settings influence patient safety strategies. Most responses focused on individual strategies to prevent adverse events. However, this approach may overlook the benefits of identifying and documenting adverse events, setting time to discuss adverse events with clinic members, standardizing clinical practices, and building transparent patient safety cultures across healthcare professions and settings.
患者安全研究的范围已经从医院扩展到社区医疗环境。在提供手动治疗的专业人员中，仍然存在知识差距，这可能会阻碍肌肉骨骼护理环境中的患者安全计划。
描述从事脊柱手法治疗（SMT）的脊椎治疗师和物理治疗师对患者安全的看法。
定性描述性研究。
使用 SafetyNET 调查来支持质量改进收集横断面数据。来自 3 个国家的 705 名 SMT 提供者完成了调查，其中 84 名提供者对关于患者安全的开放式问题做出了书面回答。定性主题分析描述了提供者在实践中对患者安全的看法。
SMT 提供者的看法受到专业、患者和实践环境因素的影响。制定了五个主题和十个支持类别。“为患者安全尽我们最大的努力”涉及避免错误和优先考虑安全。“以患者为中心”侧重于建立关系和个性化护理。“共同工作和学习”提倡跨专业沟通和协作学习。“组织实践流程”强调了标准化程序和基准进展。“考虑从业者身份”突出了在 SMT 提供者之间识别差异以及挑战其他医疗保健专业人员和患者对 SMT 的恐惧对于提高患者安全的重要性。
研究结果与世界卫生组织的指导原则一致，即医疗环境的性质影响患者安全策略。大多数回应都集中在预防不良事件的个别策略上。然而，这种方法可能会忽略识别和记录不良事件、为与诊所成员讨论不良事件留出时间、标准化临床实践以及在医疗保健专业人员和环境中建立透明的患者安全文化的好处。
