Assessing the Safety Level of Hospitalized Patients: Analyzing Patient Activities
-
Sayedeh Somayyeh Mousavipour
,
Mousa Jabbari
,
Mahnaz Saremi
,
Abbas Ebadi
,
Ehsan Shariat Bahadori
,
Davoud Khorasani Zavareh
Abstract
One of the important issues in health care systems that affect safety-related behaviors and reduce medical errors is to improve the safety level of the hospitalized patients. The aim of this study was to evaluate the level of safety of the hospitalized patients by analyzing the patient's activities. In the present study, all activities of the hospitalized patients were considered as one job, and the occupational safety analysis technique was used. For this purpose, all the activities of hospitalized patients from the time of entering the hospital to the time of leaving the hospital were identified and by forming a team of specialists in the field of patient care, a list of all possible risks in different stages of patient activities was determined. To assess the risk, the risk matrix model, which is one of the risk assessment models, was used. Experts' opinions were used to rank the risk, and finally the risk level of the identified hazards was determined before and after the control measures. The results showed that the risks in 6 stages for the patient include the patient entering the hospital, patient admission in the ward, patient entry into the room, hospitalization in the room, patient transfer for medical and diagnostic purposes and patient discharge from the hospital. There are a total of 79 potential hazards. The results showed that by managing the four types of risks "Struck against", "Fall to below", "Fall same level", "Struck by", which are among the most important risks that threaten the hospitalized patients, more than 50% of potential risks is reduced. The findings showed that the recurrence and severity of risk and, consequently, the level of risk identified in different stages of hospitalization are different. Therefore, improving the level of management and prioritization and providing the controlling and the suggested solutions, which are the main management tasks in a hospital, can improve the safety of the hospitalized patients.
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34. Zhu J, Li L, Zhou Z, Lou Q, Wu AW. Variations in patient safety climate in Chinese hospitals. J Patient Saf 2021;17:e214-e21.
35. Zakerian S, Mohammadian F, Fathi A, Rahmani A, Ahmadnezhad I. The relationship between workload and quality of life among hospital staffs. J Ergonomic 2013;1:43-56.
36. Carayon P, Hundt AS, Karsh B, Gurses AP, Alvarado C, Smith M, et al. Work system design for patient safety: the SEIPS model. Qual Saf Health Care 2006;15 Suppl:i50-8.
37. Morse JM. Enhancing the safety of hospitalization by reducing patient falls. Am J Infect Control 2002;30:376-80.
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39. Mohammadi M, Rahi F, Javadi M, Atighechian G, Jabbari A. The Potential Failure Modes and Effects Analysis (FMEA) of the Nursing Care Processes in One of the Sub Specialty Hospitals in Isfahan. payavard 2017;11:161-72.
40. Tourani S, Hassani M, Ayoubian A, Habibi M, Zaboli R. Analyzing and prioritizing the dimensions of patient safety culture in emergency wards using the TOPSIS technique. Glob J Health Sci 2015;7:143-50.
41. Abdel-Sattar S, Abdelhamid Z. Work Environment Perception as a Predictor of Patient Safety Culture among Nurses at Al-Ahrar Teaching Hospital. J Nurs Health Sci 2018;7:73-83.
42. Toghian Chaharsoughi N, Emadi F. Application Root Cause Analysis Technique in Investigating the Causes of a Fatal Sentinel Event: Case Report. Iran J Nurs 2017;30:53-61.
43. Fracica PJ, Fracica EA. Patient safety. Medical Quality Management: Springer; 2021:53-90.
44. Colman N, Stone K, Arnold J, Doughty C, Reid J, Younker S, et al. Prevent safety threats in new construction through integration of simulation and FMEA. Pediatr Qual Saf 2019;4:e189.
45. Rezaei T. Analysis of medication errors by RCA method and implementation of reducing strategies to improve patient safety in Hujjat Kuh-Kamari Hospital in Marand-2017. J Inj Violence Res 2019;11.
46. Jannati A, Saadati M, Valizadeh S, Gholamzadeh R, Ataiee H, Salehi V. Risk management in the hospital medical sterilization Shams of Tabriz city states of risk analysis methods and effects. J Picture Health 2012;3:1-10.
47. College PA, Bass EJ. Enhancing Safety in the Security and Alarm Monitoring Industry: A Case Study in the Development of Job Hazard Analyses. Proceedings of the Human Factors and Ergonomics Society Annual Meeting. Los Angeles, CA: SAGE Publications Sage CA; 2020.
48. Halvani G, Ehrampoush MH, Ghaneian MT, Dehghani A, Arani MH. Applying job hazard analysis and William Fine methods on risks identification and assessment of jobs in hot rolling steel, Iran. J Mazandaran Univ Med Sci 2017;26:293-303.
2. Park M, Giap TTT. Patient and family engagement as a potential approach for improving patient safety: a systematic review. J Adv Nurs 2020;76:62-80.
3. Hemmati Maslakpak M SM, Baghaie R. Relationship between the communication skill of nurse - patient with patient safety in the critical care units. Clin Nurs Midwifery 2014;3:84-77.
4. Patient safety solutions preamble. WHO Collaborating Centre for Patient Safety Solutions, 2007.
5. Moppett I, Moppett S. Surgical caseload and the risk of surgical Never Events in England. Anaesthesia 2016;71:17-30.
6. World alliance for patient safety: forward programme. World Health Organization, 2008.
7. Spath P. Patient safety improvement guidebook: Brown-Spath & Associates; 2000.
8. Department of Health and Human Service Office of Inspector General. Adverse events in hospitals: national incidence among Medicarebeneficiaries [Internet]. (Accessed 23 July; 2024, at https://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf.)
9. Classen DC, Munier W, Verzier N, Eldridge N, Hunt D, Metersky M, et al. Measuring patient safety: the Medicare patient safety monitoring system (past, present, and future). J Patient Saf 2021;17:e234-e40.
10. Nakai A, Akeda M, Kawabata I. Incidence and risk factors for inpatient falls in an academic acute-care hospital. J Nippon Med Sch 2006;73:265-70.
11. Victor C, Dickinson A, Narayanan V, Simpson CM, Griffiths C, Humphrey D. Falling in acute mental health settings for older people: who falls, where, when and why? J Gerontol Geriatr Res 2014;3:173.
12. Rahimi E, Safaeian AR, Abbasgholizadeh N. An Investigation of Patient Safety Culture: The Beginning for Quality and Safety Improvement Plans in Patient Care Services. J Health 2020;11:235-47.
13. Zegers M, Hanskamp‐Sebregts M, Wollersheim H, Vincent C. Patient Safety Strategies. Improving Patient Care: The Implementation of Change in Health Care. United States: Wiley-Blackwell; 2020:275-98.
14. Hofmann DA, Mark B. An investigation of the relationship between safety climate and medication errors as well as other nurse and patient outcomes. Personnel Psychol 2006;59:847-69.
15. Dean JE, Hutchinson A, Escoto KH, Lawson R. Using a multi-method, user centred, prospective hazard analysis to assess care quality and patient safety in a care pathway. BMC Health Serv Res 2007;7:1-10.
16. Mohebi Far R, Alijan zade M, Safari Variani A, Khoshtarkib H, Ghanati E, Teymouri F, et al. Studying patient safety culture from the viewpoint of staffs in educational hospitals in Tehran City. J Health Saf Work 2015;5:64-57.
17. Shahin Salarvand AMK, Narjes Bahri, Payam Dalvand, Maryam Moghimian, Ghafar Ali Mahmoudi FE. Assessing medical staff's view of patient safety culture. Nurs Manag 2015;4:64-54.
18. Tahan M, Ahangari E. The relationship between teaching patient safety culture with promoting safety culture and self-efficacy of nurses. J Birjand Univ Med Sci 2019;26:226-36.
19. Øvretveit J, Gustafson D. Using research to inform quality programmes. BMJ 2003;326:759-61.
20. Wensing M, Elwyn G. Methods for incorporating patients' views in health care. BMJ 2003;326:877-9.
21. Reason J. Managing the risks of organizational accidents: Routledge; 2016.
22. Vincent C, Taylor-Adams S, Stanhope N. Framework for analysing risk and safety in clinical medicine. BMJ 1998;316:1154-7.
23. Haidarpour p, Dastjerdi R, Rafiei S, Sadat SM, Mostofian F. Familiarity with the basics of clinical governance. Tehran: Ministry of Health and Medical Education; 2011:112.
24. Jabbari M. Safety Management and Engineering: Shahid Beheshti University of Medical Sciences; 2019.
25. Glenn DD. Job safety analysis: Its role today. Prof Saf 2011;56:48-57.
26. Ericson CA. Hazard analysis techniques for system safety. United States of America: John Wiley & Sons; 2005.
27. Pareto Law 2021. Market leaders in growth and transformation. (Accessed at https://www.pareto.co.uk(/.
28. Simsekler MCE, Kaya GK, Ward JR, Clarkson PJ. Evaluating inputs of failure modes and effects analysis in identifying patient safety risks. Int J Health Care Qual Assur 2019;32:191-207.
29. Saranjam B, Rahimi E, Etemad M, Babaei-Pouya A. Assessment of Health and Safety Hazards in Hospitals using five methods and comparing the results with the FMEA method. Health Saf Hazards Hosp 2020;14:813-7.
30. Reiling JG, Knutzen BL, Stoecklein M. FMEA-the cure for medical errors. Qual Prog 2003;36:67-71.
31. Johna S, Tang T, Saidy M. Patient safety in surgical residency: root cause analysis and the surgical morbidity and mortality conference—case series from clinical practice. Perm J 2012;16:67-9.
32. Wu AW, Lipshutz AK, Pronovost PJ. Effectiveness and efficiency of root cause analysis in medicine. JAMA 2008;299:685-7.
33. Tzeng HM. Triangulating the extrinsic risk factors for inpatient falls from the fall incident reports and nurse's and patient's perspectives. Appl Nurs Res 2011;24:161-70.
34. Zhu J, Li L, Zhou Z, Lou Q, Wu AW. Variations in patient safety climate in Chinese hospitals. J Patient Saf 2021;17:e214-e21.
35. Zakerian S, Mohammadian F, Fathi A, Rahmani A, Ahmadnezhad I. The relationship between workload and quality of life among hospital staffs. J Ergonomic 2013;1:43-56.
36. Carayon P, Hundt AS, Karsh B, Gurses AP, Alvarado C, Smith M, et al. Work system design for patient safety: the SEIPS model. Qual Saf Health Care 2006;15 Suppl:i50-8.
37. Morse JM. Enhancing the safety of hospitalization by reducing patient falls. Am J Infect Control 2002;30:376-80.
38. Davis Giardina T, King BJ, Ignaczak AP, Paull DE, Hoeksema L, Mills PD, et al. Root cause analysis reports help identify common factors in delayed diagnosis and treatment of outpatients. Health Aff (Millwood) 2013;32:1368-75.
39. Mohammadi M, Rahi F, Javadi M, Atighechian G, Jabbari A. The Potential Failure Modes and Effects Analysis (FMEA) of the Nursing Care Processes in One of the Sub Specialty Hospitals in Isfahan. payavard 2017;11:161-72.
40. Tourani S, Hassani M, Ayoubian A, Habibi M, Zaboli R. Analyzing and prioritizing the dimensions of patient safety culture in emergency wards using the TOPSIS technique. Glob J Health Sci 2015;7:143-50.
41. Abdel-Sattar S, Abdelhamid Z. Work Environment Perception as a Predictor of Patient Safety Culture among Nurses at Al-Ahrar Teaching Hospital. J Nurs Health Sci 2018;7:73-83.
42. Toghian Chaharsoughi N, Emadi F. Application Root Cause Analysis Technique in Investigating the Causes of a Fatal Sentinel Event: Case Report. Iran J Nurs 2017;30:53-61.
43. Fracica PJ, Fracica EA. Patient safety. Medical Quality Management: Springer; 2021:53-90.
44. Colman N, Stone K, Arnold J, Doughty C, Reid J, Younker S, et al. Prevent safety threats in new construction through integration of simulation and FMEA. Pediatr Qual Saf 2019;4:e189.
45. Rezaei T. Analysis of medication errors by RCA method and implementation of reducing strategies to improve patient safety in Hujjat Kuh-Kamari Hospital in Marand-2017. J Inj Violence Res 2019;11.
46. Jannati A, Saadati M, Valizadeh S, Gholamzadeh R, Ataiee H, Salehi V. Risk management in the hospital medical sterilization Shams of Tabriz city states of risk analysis methods and effects. J Picture Health 2012;3:1-10.
47. College PA, Bass EJ. Enhancing Safety in the Security and Alarm Monitoring Industry: A Case Study in the Development of Job Hazard Analyses. Proceedings of the Human Factors and Ergonomics Society Annual Meeting. Los Angeles, CA: SAGE Publications Sage CA; 2020.
48. Halvani G, Ehrampoush MH, Ghaneian MT, Dehghani A, Arani MH. Applying job hazard analysis and William Fine methods on risks identification and assessment of jobs in hot rolling steel, Iran. J Mazandaran Univ Med Sci 2017;26:293-303.
| Files | ||
| Issue | Vol 62 No 5 (2024) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/acta.v62i5.17771 | |
| Keywords | ||
| Safety Patient Risk Falling | ||
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How to Cite
1.
Mousavipour SS, Jabbari M, Saremi M, Ebadi A, Shariat Bahadori E, Khorasani Zavareh D. Assessing the Safety Level of Hospitalized Patients: Analyzing Patient Activities. Acta Med Iran. 2025;62(5):236-246.
