Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, 01-445 Warsaw, Poland.
Department of Health Policy Programs, Department of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00-032 Warsaw, Poland.
Int J Environ Res Public Health. 2022 Nov 21;19(22):15354. doi: 10.3390/ijerph192215354.
Patient safety in long-term care is becoming an increasingly popular subject in the scientific literature. Organizational problems such as shortages of medical staff, insufficient numbers of facilities or underfunding increase the risk of adverse events, and aging populations in many countries suggests that these problems will become more and more serious with each passing year. The objective of the study is to identify interventions that can contribute to increasing patient safety in long-term care facilities.
A systematic review of secondary studies was conducted in accordance with the Cochrane Collaboration guidelines. Searches were conducted in Medline (via PubMed), Embase (via OVID) and Cochrane Library. The quality of the included studies was assessed using AMSTAR2.
Ultimately, 10 studies were included in the analysis. They concerned three main areas: promoting safety culture, reducing the level of occupational stress and burnout, and increasing the safety of medication use. Promising methods that have an impact on increasing patient safety include: preventing occupational burnout of medical staff, e.g., by using mindfulness-based interventions; preventing incidents resulting from improper administration of medications, e.g., by using structured methods of patient transfer; and the use of information technology that is more effective than the classic (paper) method or preventing nosocomial infections, e.g., through programs to improve the quality of care in institutions and the implementation of an effective infection control system.
Taking into account the scientific evidence found and the guidelines of institutions dealing with patient safety, it is necessary for each long-term care facility to individually implement interventions aimed at continuous improvement of the quality of care and patient safety culture at the level of medical staff and management staff.
患者安全在长期护理中变得越来越受到科学文献的关注。组织问题,如医护人员短缺、设施数量不足或资金不足,增加了不良事件的风险,许多国家的人口老龄化意味着这些问题将随着时间的推移变得越来越严重。本研究的目的是确定可以有助于提高长期护理机构患者安全性的干预措施。
根据 Cochrane 协作组织指南进行了二次研究的系统评价。在 Medline(通过 PubMed)、Embase(通过 OVID)和 Cochrane Library 中进行了检索。使用 AMSTAR2 评估纳入研究的质量。
最终,有 10 项研究纳入分析。它们涉及三个主要领域:促进安全文化、降低职业压力和倦怠水平,以及增加用药安全性。有希望的方法包括:预防医护人员职业倦怠,例如使用基于正念的干预措施;预防因用药不当而导致的事件,例如通过结构化的患者转移方法;以及使用比传统(纸质)方法更有效的信息技术,预防医院感染,例如通过改善机构护理质量的计划和实施有效的感染控制系统。
考虑到发现的科学证据和处理患者安全的机构指南,每个长期护理机构都有必要针对医疗保健人员和管理人员的持续改进护理质量和患者安全文化的目标实施干预措施。