Konlan Kennedy Diema, Shin Jinhee
Mo- Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Korea.
Department of Public Health Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
PLOS Glob Public Health. 2022 Dec 13;2(12):e0001085. doi: 10.1371/journal.pgph.0001085. eCollection 2022.
Poor patient safety practices may result in disability, injury, poor prognosis, or even death and are primarily associated with a common concern in Africa. This study synthesized the factors influencing the maintenance of patient safety in Africa's healthcare institutions. There was an in-depth search in PubMed Central, CINAHL, Cochrane library, web of science, and Embase using the PICO framework. The search results were filtered for Africa and from 2011 to September 2021 to yield 9,656 titles after duplicates were removed using endnote software, and 211 titles were selected for full-text reading as 16 were selected based on predetermined criteria. The quality appraisal was done using the Mixed Methods Appraisal Tool. A matrix was developed, discussed, accepted, and used as a guide for the data extraction. A convergent synthesis design was adopted for data analysis as the data was transformed into qualitative descriptive statements. Patient safety ratings ranged from 12.4% to 44.8% as being good. Patient safety was identified as an essential structure to improve patient outcomes. The factors associated with patient safety were level of education, professional category, hours worked per week, participation in a patient safety program, reporting of adverse events, openness in communication, organizational learning, teamwork, physical space environment, exchange of feedback about error, and support by hospital management. Poor patient safety environment could lead to the staff being prosecuted or imprisoned, lack of respect and confidence by colleagues, embarrassment, loss of confidence and trust in the health team by patients, documentation errors, drug errors, blood transfusion-related incidences, development of bedsores, and disability. These strategies by health institutions to promote patient safety must focus on reducing punitive culture, creating a culture of open communication, and encouraging incidence reporting and investigations to ensure continuous learning among all health care professionals.
不良的患者安全措施可能导致残疾、伤害、预后不良甚至死亡,并且主要与非洲一个普遍关注的问题相关。本研究综合了影响非洲医疗机构患者安全维护的因素。使用PICO框架在PubMed Central、CINAHL、Cochrane图书馆、科学网和Embase中进行了深入检索。检索结果针对非洲地区且时间范围为2011年至2021年9月进行筛选,使用EndNote软件去除重复项后得到9656个标题,根据预定标准选择了211个标题进行全文阅读,最终选定16篇。使用混合方法评估工具进行质量评估。制定了一个矩阵,经过讨论、认可并用作数据提取的指南。数据分析采用收敛性综合设计,因为数据被转化为定性描述性陈述。患者安全评级中认为良好的比例在12.4%至44.8%之间。患者安全被确定为改善患者结局的重要结构。与患者安全相关的因素包括教育水平、专业类别、每周工作时长、参与患者安全计划、不良事件报告、沟通开放性、组织学习、团队合作、物理空间环境、错误反馈交流以及医院管理层的支持。不良的患者安全环境可能导致工作人员被起诉或监禁、同事缺乏尊重和信任、尴尬、患者对医疗团队失去信心和信任、记录错误、用药错误、输血相关事件、褥疮形成以及残疾。医疗机构促进患者安全的这些策略必须侧重于减少惩罚性文化、营造开放沟通的文化以及鼓励事件报告和调查,以确保所有医护人员不断学习。