Objective To provide information for the establishment of a medical risk monitoring and precaution system in China, by reviewing and analyzing the current status of medical risk management system and preventative measures in New Zealand, Methods We searched EI (1969-2006), SCI and SSCI (1975-2006), EMBASE (1966-2006), SCOPUS (included 100% MEDLINE) (1960-2006), VIP (1989-2006), CNKI (1979-2006) and relevant official and governmental websites. This search was conducted in January 2006 and articles about medical risk management and prevention were collected. Results We included 10 articles involving medical adverse events, patient safety and medical litigation. New Zealand took many measures in order to prevent medical error and improve medical quality, including strengthening medical practice standards, doctor-patient communication, safety awareness and promoting informationization of hospitals. New Zealand also revised “The Health Practitioners Competence Assurance Act” and improved medical litigation to form an appropriate law environment. Conclusions New Zealand has taken many measures and established a medical risk management system to prevent medical risk. Some issues of particular relevance to China include building corresponding medical litigation and relevant laws and regulations.
ObjectiveTo investigate and analyze the knowledge, skills and attitudes of nursing students to patient safety before and after internship so as to provide evidence for implementation of patient safety curriculum in nursing students. MethodsUndergraduate nursing students before and after internship in nursing school of Wannan Medical College were recruited. The questionnaire method was performed to investigate the knowledge, attitudes and skills of patient safety before and after the internship. The data were input using EpiData 3.0 software and were analyzed by SPSS 13.0. ResultsA total of 451 questionnaires were distributed before the internship and of which 435 nursing students completed the survey (96.45%), 418 questionnaires were distributed after the internship, of which 412 (98.56%) nursing students completed the survey. There were significant higher scores in female nursing students after the internship in the items of 'Knowledge about medical errors' and 'What am I supposed to do when medical errors occur' (P=0.000 and 0.000, respectively), while lower scores of the items of 'Feelings about making errors' and 'Your intentions regarding patient safety' (P=0.002 and 0.006, respectively). Only the score of the item 'What am I supposed to do when medical errors occur' was significantly higher in male nursing students after the internship (P=0.046). ConclusionThe internship is useful for improving experiencing practice, knowledge on patient safety, reduce the negative feelings about making errors.
ObjectiveTo investigate and analyze the knowledge, skills and attitudes of clinical medical students and nursing students to patient safety before internship so as to provide evidence for implementation of patient safety curriculum in medical and nursing students. MethodsFive-year clinical medical undergraduates and nursing students before internship in the Wannan Medical College were recruited. The questionnaire method was performed to investigate the knowledge, attitudes and skills of patient safety. The data were input using EpiData 3.0 software and were analyzed by SPSS 13.0. ResultsA total of 771 questionnaires were distributed, of which 320 clinical medical students and 435 nursing students completed the survey. The results showed that, the totals of both kinds of students were low concerning the knowledge, attitudes and skills of patient safety; scores were significantly higher in nursing students than in clinical medical students concerning the items of "Knowledge about medical errors" (P=0.012), "Feelings about making errors" (P=0.000), "Feelings about making errors" (P=0.001), and "Personal attitudes to patient safety" (P=0.001). Scores of "Feelings about making errors" were significantly higher in female students than in male students. ConclusionBoth nursing students and clinical medical students lack the knowledge of patient safety before internship, and the latter lack more. More attention should be paid to the knowledge of patient safety for both clinical medical and nursing students.
Nursing staff is one kind of health care professionals who have the most contact with patients and plays an important role in improving patient safety. Patients safety education is a considerable way to raising nurses’ consciousness related to the patient safety. And this paper describes the current status, analyzes the current problems and proposes some suggestions in order to promote the standardization, systematization and scientificization of patient safety education for nursing staff in China.
Objective To learn and analyse the current clinicians’ knowledge and attitudes towards patient safety, and to provide relevant evidence for future medical education. Method We conducted a survey on clinicians mainly in West China Hospital of Sichuan University with group random sampling method. We analysed the data on the clinicians’ knowledge and attitudes with SPSS softerware. Result Totally 300 questionnaires were distributed, of which 258 were completed adequately. The results showed the clinicians’ knowledge on patient safety was poor, however, the respcnse from the clinicians in Outpatient Department were better than those in Inpatient Department. The majority of the clinicians (above 95.00%) were willing to learn the knowledge of patient safety. Conclusion As the clinicians are willing to learn the knowledge of patient safety positively, it is necessary to integrate patient safety education into the current medical education curriculum.
Objective To provide evidence for establishing a medical risk precaution and monitoring system in China by evidence-based evaluation of the medical risk monitoring and precaution system in Canada, including the current situation and corresponding prevention measures. Method According to the unified search strategy made by our research group, we searched relevant databases and official or government websites. We included articles about medical risk management, medical error and patient safety in Canada. The included articles were classified and the quality was ranked. Results A total of 15 articles were included, among which 10 were official documents (about 2/3) and 5 described research methods (about 1/3), mainly involving medical risk management or evaluation, medical error and patient safety. In 2002, Canada established its National Steering Committee on Patient Safety (NSCPS) and proposed the suggestions to integrate health care resources accross the country, build a patient safety system, and established the Canada Patient Safety Institution (CPSI) to improve patient safety. Canada revised the patient safety management system, collected and issued related information, strengthened doctor-patient communication, developed continuous education for medical staff, practiced the best medical behavior and model and improved lawsuit procedures. These activities have achieved great progress in practice. Conclusions What have been done in Canada will provide a guide for us to establish scientific patient safety system and promote public awareness of patient safety.
Objective Interpretation of the growing body of global literature on health care risk is compromised by a lack of common understanding and language. This series of articles aims to comprehensively compare laws and regulations, institutional management, and administration of incidence reporting systems on medical risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China. Methods?We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents. Results?A total of 146 documents were included in this study, including 2 laws (1.4%), 17 policy documents (11.6%), 41 guidance documents (28.1%), 37 reviews (25.3%), and 49 documents giving general information (33.6%). The United States government implemented one law and one rule of patient safety management, while the United Kingdom and Australia each issued professional guidances on patient safety improvement. The four countries implemented patient safety management policy on four different levels: national, state/province/district, hospital, and non-governmental organization. Conclusion?The four countries and one district adopted four levels of patient safety management, and the administration modes can be divided into an “NGO-led mode” represented by the United States and Canada and a “government-led mode” represented by the United Kingdom, Australia, and Taiwan.
Objective To analyze experiences of medical risk management in the United Kingdom so as to explore the possible application for the construction of a Chinese medical risk monitoring and early warning system. Methods We searched Engineering Information, SCI and SSCI, EMBASE, SCOPUS with 100% MEDLINE, VIP, CNKI, and government or official websites. This search was conducted in Jan. 2006. We included articles about medical risk, patient safety and medical errors in the UK. Languages of articles were limited either in English or in Chinese. Results Eleven articles were included, of which 9 article are evidence of level B (about 80%) and the other 2 are evidence of level C (about 20%). The report of “An Organization with a Memory” revealed the severity of medical errors and adverse events in the UK in 2000, and subsequently Minister Blair announced a five-year reform program for NHS. Within 7 years of reform, NHS budget has been increased from ￡33 billion to ￡674 billion,(check numbers-doesn’t sound correct) the National Patient Safety Agency (NPSA) and the New National System for learning from adverse events and near misses have been established, a series of practicable measures aimed at ensuring patient safety, preventing medical risk and improving healthcare quality have been implemented, all of which have effectively resolved many problems that perplexed the government and public, such as patients waiting time, range of NHS service, the availability of medical facility and mortality induced by high-risk diseases. Conclusion There are both advantages and disadvantages in the present status of the UK medical risk management. Both of them will provide a guide to prevent medical risk, improve healthcare quality and to realize the ultimate goal that everybody could share healthcare sources fairly and safely in our country.
Patient safety culture is an extension of the concept of safety culture in medical institutions and is a hot spot of current patient safety research. In recent years, patient safety culture research has developed rapidly, and new assessment tools and related research have emerged. There is a correlation between cultural factors and safety outcomes, and changing the patient safety culture can improve patient outcomes. This paper focuses on the literature review of patient safety and outpatient safety assessment tools published in China and abroad, analyzes and compares the performance characteristics of domestic and foreign assessment tools, and provides reference for the future patient safety culture research.