review of related literature sample

7/27/2019 Review of Related Literature Sample

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Review of Related Literature/Studies

Patient Safety

World Health Organization (WHO, 2010) defined patient safety as the reduction of risk of

unnecessary harm associated with healthcare to an acceptable minimum. An acceptable

minimum refers to the collective idea that care is delivered and weighed based on practice

standards. On the other hand, Gaba (2002) defined patient safety as the extent to which

probability of preventable, unintentional injury or complication that may result to disability,

death or prolongation of hospital stay, caused by health care management rather than the

patient’s disease itself. Her definition implied that many unwanted occurrences during the

hospital stay of the patient can be attributed to human error. This made us realize that the culture

of the organization needs to be in line with activities that will improve patient safety.

According to Institute of Medicine (IOM, 2001) there is an overwhelming evidence that

significant numbers of patients are harmed from their healthcare either resulting in permanent

injury, increased length of stay in hospitals and even death. Kohn, et al (2000) mentioned that the

ill-effects brought by controllable human errors confront the healthcare system in many countries

whether they are privately commissioned or funded by the government. Along with this,

Emmanuel (2008) suggested the application of safety science methods in all activities relating to

healthcare. By doing this he admitted that the likelihood that these unwanted healthcare incidents

that impede recovery of the patient will be minimize, thus, reducing healthcare cost. Considering

this, Affonso and Doran (2002) reiterated that the public had put pressure to patient safety

strategist to discover new and better ways to deliver health care that is safe and effective. This

may be the reason why many leaders in the many organizations had expanded their horizon in

their field by innovating ways and methods to better serve the patient.



According to the National Steering Committee on Patient Safety (NCSPC, 2002) ensuring

patient safety will an ongoing process and has no end. Lilford (2002) abided with the idea of

NCSPC and stated that innovating ways that promote patient safety is a healthful endeavor.

Ensuring patient safety is everyone’s business in any workplace setting. In healthcare

organizations, patient safety means life for the patient, increase trustworthiness of the patient to

the healthcare providers, and reduced healthcare cost for the patient. When patient safety

measures are observed, the sanctity of life is preserved. Life is preserved in such a way that

patient’s health is not compromised by error brought by human who delivers healthcare services.

Providing a safe and effective care to the patient would place a sense of high value for the patient

and in return patient pays a high trust to his healthcare provider. When patient safety is enhanced

it would create fewer complications from healthcare procedures and shorter hospital stay (IOM,

2001). Therefore, it is vital to emphasize and practice patient safety measures at all times.

Australian Commission on Safety and Quality in Healthcare Reference Group (ACSQHC,

2003) found out other factors that hinder patient safety and quality in health.

Barriers to Patient Safety

Patient safety and quality in health care barriers were identified by the

ACSQHC Reference Group. One of these barriers to patient safety is the culture of blame that

prevails to the staff who reports incident of error commission and omission in delivering health

care services. Secondly, the lack of clear governance framework that outlines responsibilities and

accountabilities for managers and clinicians when error incidence was committed. Thirdly, the

limited use of information technology causes delay in delivery of healthcare services. There is



clear evidence that show that clinical support systems and clinical information systems have

enhanced patient safety. However, the healthcare industry is lagged behind other industries in

investing in information technology and cannot therefore take full advantage of the information

revolution. Issues such as competing priorities for limited resources, privacy concerns, high costs

and cultural issues have been identified as barriers. Another barrier to patient safety is the lack of

communication and collaboration between primary health care, community services and hospital

care. Similarly, the health care industry takes low priority in changing system designs when

appropriate. Therefore, it is necessary to have an ongoing evaluation on the system so that

changes in its design can be made when necessary. Other patient safety barriers are the lack of

clear goals in an organization, lack of time and resources to carry out quality care, staff

shortages, skill mix of the workforce numbers and distribution of staff, and recruitment

problems. Thus, having this work scenario causes staff in the healthcare industry to feel

frustrated and limited in their capacity to contribute a continuous safe effective health care. To

add also, individual factors such as stress, fatigue and low morale have strongly influence the

delivery of safe efficient patient care. Lastly, a complex regulatory framework like having

inefficient, punitive, and inconsistent administrative regulations can affect patient safety.

As healthcare provider, it is important to determine the barriers to patient safety because

knowing them will guide us to entertain possible interventions that will direct us until we find the

suitable solution to the problem based on the situation.

Safety Culture

The term safety culture first appeared in 1987 in the International Nuclear Safety Advisory

Group (INSAG) report as a result of the 1986 Chernobyl disaster (INSAG, 1991). Later, Cullen,



et al (1995) later used the term to describe the corporate atmosphere in which safety is

understood to exist. Safety culture is currently proposed by patient safety leaders as a core

element in health organization for improving patient safety (Carmel, et al., 2006).

The definition of safety culture abounds. A number of definitions have been developed. The

most widely used was developed by the Advisory Committee on the Safety of Nuclear

Installations (ACSNI, 1993) that defined safety culture as the product of individual and group

values, attitudes, perception, competencies and patterns of behavior that determine commitment

to, proficiency of an organization’s health and safety management. Pidgeon (1991) believed that

these set of beliefs, norms, attitudes, roles, social and technical practices are concerned to

minimize exposure of workers and customers to conditions considered dangerous or injurious.

Vincent, et al (1998) expressed the idea that an organization’s safety culture is

fundamental factor that influences safety system. This may be the reason why most definition of

safety culture is being directed to a proactive stand toward safety (Lee and Harrison, 2010).

Improvement of patient safety culture has become an important aspect by aiming for high

quality and safe healthcare. The nursing profession has prided itself on being the patient's

advocate and the keeper of quality and safe care. Physicians and nurses play key roles in

providing quality care, which leads to improve patients’ outcomes (Page, 2004). Primarily, it is

the doctors and nurses who are almost in contact with the patient during their hospital stay. The

patient’s health status is being monitored. Periodic assessment evaluations are conducted by

healthcare providers before and after introducing treatment or therapy. It is a challenge to

healthcare providers to promote activities and actions that will sustain safety culture in the

organization.

review of related literature sample

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