Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Clinical Psychology, Medical School, Center for the Study of Religion and Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
PLoS One. 2023 Aug 15;18(8):e0289511. doi: 10.1371/journal.pone.0289511. eCollection 2023.
Patient safety is a global concern. Safe and effective care can shorten hospital stays and prevent or minimize unintentional harm to patients. Therefore, it is necessary to continuously monitor and improve patient safety in all medical environments. This study is aimed at improving patient safety in gastroenterology departments.
The study was carried out as action research. The participants were patients, nurses and doctors of the gastroenterology department of Ayatollah Taleghani Hospital in Tehran in 2021-2022. Data were collected using questionnaires (medication adherence tool, patient education effectiveness evaluation checklist, and medication evidence-based checklist), individual interviews and focus groups. The quantitative data analysis was done using SPSS (v.20) and qualitative data analysis was done through content analysis method using MAXQDA analytic pro 2022 software.
The majority of errors were related to medication and the patient's fault due to their lack of education and prevention strategy were active supervision, modification of clinical processes, improvement of patient education, and promotion of error reporting culture. The findings of the research showed that the presence of an active supervisor led to the identification and prevention of more errors (P<0.01). Regarding the improvement of clinical processes, elimination of reworks can increase satisfaction in nurses (P<0.01). In terms of patient education, the difference was not statistically significant (P>0.01); however, the mean medication adherence score was significantly different (P<0.01).
The improvement strategies of patient safety in Gastroenterology department included the modification of ward monitoring processes, improving/modification clinical processes, improvement of patient education, and development of error reporting culture. Identifying inappropriate processes and adjusting them based on the opinion of the stakeholders, proper patient education regarding self-care, careful monitoring using appropriate checklists, and presence of a supervisor in the departments can be effective in reducing the incidence rate. A comprehensive error reporting program provides an opportunity for employees to report errors.
患者安全是全球关注的问题。安全有效的护理可以缩短住院时间，并防止或最大限度地减少对患者的非故意伤害。因此，有必要在所有医疗环境中不断监测和改善患者安全。本研究旨在改善胃肠病学部门的患者安全。
本研究采用行动研究方法进行。研究对象为 2021-2022 年德黑兰阿亚图拉·塔莱加尼医院胃肠病科的患者、护士和医生。使用问卷（药物依从性工具、患者教育效果评估检查表和药物循证检查表）、个人访谈和焦点小组收集数据。使用 SPSS（v.20）进行定量数据分析，使用 MAXQDA 分析 pro 2022 软件进行定性数据分析。
大多数错误与药物有关，由于患者缺乏教育和预防策略，患者也有过错，积极监督、修改临床流程、改进患者教育以及促进错误报告文化是主要的预防策略。研究结果表明，积极监督的存在可以识别和预防更多的错误（P<0.01）。关于临床流程的改进，消除返工可以提高护士的满意度（P<0.01）。在患者教育方面，差异无统计学意义（P>0.01）；然而，药物依从性评分的平均值差异有统计学意义（P<0.01）。
改善胃肠病科患者安全的策略包括修改病房监测流程、改进/修改临床流程、改进患者教育和发展错误报告文化。确定不适当的流程，并根据利益相关者的意见进行调整，对自我护理进行适当的患者教育，使用适当的检查表进行仔细监测，以及在部门内设置主管，这些都可以有效降低发生率。全面的错误报告计划为员工提供了报告错误的机会。
