BMJ quality & safety
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BMJ quality & safety · Dec 2017
Effects of the I-PASS Nursing Handoff Bundle on communication quality and workflow.
Handoff communication errors are a leading source of sentinel events. We sought to determine the impact of a handoff improvement programme for nurses. ⋯ Implementation of the I-PASS Nursing Handoff Bundle was associated with widespread improvements in the verbal handoff process without a negative impact on nursing workflow. Implementation of I-PASS for nurses may therefore have the potential to significantly reduce medical errors and improve patient safety.
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BMJ quality & safety · Dec 2017
Multicenter Study Observational StudyPatients' and providers' perceptions of the preventability of hospital readmission: a prospective, observational study in four European countries.
Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority consensus to determine contributing factors that could potentially foresee (preventable) readmissions. ⋯ There is no consensus between readmitted patients, their carers and treating professionals about predictability and preventability of readmissions, nor associated risk factors. A readmitted patient reporting not feeling ready for discharge at index admission was strongly associated with preventability/predictability. Therefore, healthcare workers should question patients' readiness to go home timely before discharge.
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BMJ quality & safety · Nov 2017
Multicenter StudySpeaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents.
Open communication between healthcare professionals about care concerns, also known as 'speaking up', is essential to patient safety. ⋯ Interns and residents commonly observed unprofessional behaviour yet were less likely to speak up about it compared with traditional safety threats even when they perceived high potential patient harm. Measuring SUC-Safe, and particularly SUC-Prof, may fill an existing gap in safety culture assessment.
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BMJ quality & safety · Nov 2017
Randomized Controlled TrialRandomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.
A subset of high-risk procedures present significant safety threats due to their (1) infrequent occurrence, (2) execution under time constraints and (3) immediate necessity for patient survival. A Just-in-Time (JIT) intervention could provide real-time bedside guidance to improve high-risk procedural performance and address procedural deficits associated with skill decay. ⋯ A JIT intervention improved procedure perfromance, suggesting a role for JIT interventions in rarely performed procedures.