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基层牙科患者安全氛围研究:系统范围界定审查。

Patient safety climate research in primary care dentistry: A systematic scoping review.

机构信息

Centro de Investigaciones de Ergonomía, University of Guadalajara, Jalisco, Mexico.

School of Dentistry, Universidad Autónoma Metropolitana (UAM-X), Mexico City, Mexico.

出版信息

J Public Health Dent. 2024 Sep;84(3):260-271. doi: 10.1111/jphd.12621. Epub 2024 Apr 28.

Abstract

BACKGROUND

Patient safety climate constitutes an important element for quality improvement. Its current evidence base has been generated in hospital settings in developed countries. Studies in dentistry are limited.

OBJECTIVE

To systematically explore the evidence regarding assessing patient safety climate in dentistry.

METHODS

We developed a search strategy to explore MEDLINE, SCOPUS, and Web of Science databases from January 1st, 2002, to December 31st, 2022, to include observational studies on patient safety culture or patient safety climate assessment. Methodological features and item data concerning the dimensions employed for assessment were extracted and thematically analyzed. Reported scores were also collected.

RESULTS

Nine articles out of 5584 were included in this study. Most studies were generated from high-income economies. Our analysis revealed methodological variations. Non-randomized samples were employed (ranging from 139 to 656 participants), and response rates varied from 28% to 93.7%. Three types of measurement instruments have been adapted to assess patient safety climate. These mainly consisted of replacing words or rewording sentences. Only one study employed an instrument previously validated through psychometric methods. In general, patient safety climate levels were either low or neutral. Only one study reported scores equal to or greater than 75.

DISCUSSION

Despite diverse assessment tools, our two-decade analysis reveals a lag compared with medicine, resulting in methodological variations for assessing patient safety climate. Collaboration is vital to elevate standards, prioritize patient safety across oral healthcare services, and advocate for integrating safety climate into local and national quality and patient safety strategies.

摘要

背景

患者安全氛围是质量改进的重要组成部分。其现有证据基础是在发达国家的医院环境中产生的。牙科领域的研究有限。

目的

系统探索评估牙科患者安全氛围的证据。

方法

我们制定了搜索策略,以探索 2002 年 1 月 1 日至 2022 年 12 月 31 日期间 MEDLINE、SCOPUS 和 Web of Science 数据库,纳入关于患者安全文化或患者安全氛围评估的观察性研究。提取并主题分析了关于评估所采用维度的方法学特征和项目数据。还收集了报告的分数。

结果

在 5584 篇文章中,有 9 篇文章被纳入本研究。大多数研究来自高收入经济体。我们的分析显示出方法学的差异。采用了非随机样本(范围为 139 至 656 名参与者),响应率从 28%到 93.7%不等。三种类型的测量工具已被改编用于评估患者安全氛围。这些主要包括替换词语或重新措辞句子。只有一项研究使用了先前通过心理测量方法验证过的工具。总体而言,患者安全氛围水平要么较低,要么为中性。只有一项研究报告的分数等于或大于 75。

讨论

尽管评估工具多种多样,但我们对过去二十年的分析表明,与医学相比存在滞后,导致评估患者安全氛围的方法学存在差异。合作对于提高标准、优先考虑口腔保健服务中的患者安全以及倡导将安全氛围纳入地方和国家质量和患者安全战略至关重要。

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