The PeaceHealth Ambulatory Medication Safety Culture Survey
نویسندگان
چکیده
Objective: The objective of this project was to construct a measure of medication safety culture in ambulatory settings. Methods: A 16-item survey was created to measure the degree to which a culture of medication safety exists within ambulatory clinics. The instrument was tested with two administrations separated by 12 months in three ambulatory clinics and evaluated with Mplus factor analysis, internal consistency reliability, and discrimination ability. Results: Of 105 staff, 62 (60 percent) returned surveys in the first administration and 80 (77 percent) in the second. The measure had good internal consistency reliability, with a Cronbach alpha of 0.94 and 0.90 for the two administrations and 0.90 to 0.96 across the three clinics. The measure demonstrated good sensitivity and discrimination between clinics. Five subdomains of medication safety culture were identified: (1) leadership, (2) learning culture, (3) quality improvement, (4) physician responsibility, and (5) safety as a priority. Conclusion: The measure is psychometrically strong and capable of assisting in the improvement of medication management safety. Introduction One of the biggest challenges in health care is providing safe, effective care, and one of the most significant areas of opportunity for improvement is medication safety. It is well known that many adverse drug events (ADEs) occur within the hospital setting. However, little is known about the incidence of ADEs in the ambulatory setting. This knowledge gap exists despite the fact that medication prescribing is the most frequently used therapeutic intervention, with nearly twothirds of office visits concluding with a prescription for medication. The risks for medication errors and subsequent ADEs in the outpatient setting can be a result of (or a combination of) physician/provider-related, health system/practice process-related, or patient-related factors. To best understand these factors, it is important to examine the processes involved in each of those three domains. In the health system/practice domain, a key measurable component is “safety culture,” which includes the management behaviors, safety system processes, and staff perceptions of safety that exist within the health care environment. The Institute of Medicine (IOM) has recommended that health care organizations improve patient safety culture. In their report, Preventing Medication Errors, the IOM notes that developing an organizational culture of medication safety in the health care setting is a key component to improving medication safety outcomes and preventing ADEs. A number of safety culture (or climate) surveys have been developed to assess the degree to which a safety culture exists within an organization. Most have measured safety attitudes and perceptions at the
منابع مشابه
Patient Safety and Quality in Ambulatory Care
The majority of patient safety and quality research has focused on the inpatient setting, leaving a lack of intervention-based research in patient safety and quality for the ambulatory setting. There were an estimated 1.1 billion ambulatory visits in the US in 2010 with this number expecting to rise due to the shift from inpatient to outpatient care and the aging population. Given these numbers...
متن کاملPatient Safety Culture in Nephrology Nurse Practice Settings: Initial Findings.
Patient safety culture has been studied in many practice settings, but there is a dearth of information on the culture of safety in nephrology nurse practice settings. This research study employed the use of an online survey to assess patient safety cultures in nephrology nurse practice settings. The survey was created using items from two Agency for Healthcare Research and Quality (AHRQ) surve...
متن کاملAORN guidance statement: safe medication practices in perioperative settings across the life span.
Introduction This guidance statement provides a framework for perioperative registered nurses to develop, implement, and evaluate safe medication management practices specific to the perioperative setting. This evidenced-based framework may be used to facilitate policy development and provide a foundation for the creation of quality improvement (QI)/process improvement (PI) monitors. It is the ...
متن کاملAttitude of Academic Ambulatory Nurses toward Patient Safety Culture in Saudi Arabia
Patient safety issues in Saudi Arabia have received increasing attention. Pressures to improve patient safety within academic healthcare settings are gaining momentum daily. Health care organization providers and policy makers continually strive to promote patient safety culture. The purpose of this study was to examine the nurses’ attitude toward patient safety culture in academic ambulatory h...
متن کاملMeasuring Patient Safety Culture in Iran Using the Hospital Survey on Patient Safety Culture (HSOPS): an Exploration of Survey Reliability and Validity
Background and Objectives: Patient Safety Culture is increasingly recognized as an essential driver of patient safety. To establish patient safety culture, firstly the current status of the construct should be assessed. Valid assessment of patient safety culture is contingent on the availability of appropriate measurement tools. Hospital Survey on Patient Safety Culture (HSOPS) developed by th...
متن کامل