This document summarizes the results of a survey assessing patient safety culture in 15 California hospitals. The survey was sent to over 6,000 hospital employees, including physicians, executives, and other staff, with a 47.4% overall response rate. The survey found that on average, 18% of responses suggested an absence of safety culture, while another 18% were neutral. Responses varied significantly between hospitals and job types. Clinicians, especially nurses, and frontline workers generally gave more negative responses than executives and non-clinical staff. The results provide information on how perceptions of safety culture differ within and between hospitals and employee groups. Further research is needed to understand how to improve safety culture across an organization.
Shekelle et. al 2011 advancing the science of patient safetyJoya Smit
Despite efforts over the past decade, patient safety has improved slowly due to the limited evidence base for developing and disseminating successful practices. An international group of experts developed criteria to improve the design, evaluation, and reporting of patient safety research. The criteria include using theory and logic models, providing detailed descriptions of interventions and implementation processes, explaining intended and unintended outcomes, and better describing how context influences interventions. Adopting these criteria would strengthen the science underlying efforts to improve patient safety.
This document describes the development of an evidence-based position statement on medical device-related hospital-acquired pressure ulcers (HAPUs) within a large healthcare system. A task force used the Iowa Model of Evidence-Based Practice to identify device-related HAPUs as an issue, review the literature, and define device-related HAPUs as injuries caused by external medical devices. They developed a position statement to standardize identification and reporting. Implementation involved disseminating the statement to various groups. Initial results showed improved identification and a 33% reduction in overall HAPU rates.
The document discusses a study that found aviation-based crew resource management training improved patient safety behaviors like checklist use and incident reporting in hospital staff over several years. The training led to increased empowerment scores and a sustained culture of safety. While errors still occur, physician-led programs may be more effective than penalties at improving safety.
The panel convened by the National Patient Safety Foundation to discuss the current state of patient safety 15 years after the seminal IOM report To Err Is Human identified several key points:
1) While awareness of patient safety issues has increased, progress has been slower than anticipated and the scale of improvement has been limited.
2) A total systems approach is needed to move beyond reactive, piecemeal interventions to prioritizing safety culture, developing the science of safety, and ensuring coordination across the care continuum and settings.
3) Specific recommendations include establishing safety leadership, centralized oversight, common safety metrics, increased research funding, addressing safety across all care settings, supporting the healthcare workforce, partnering with patients and families, and optim
Improving Medication Administration Safety in the Clinical.pdfstudywriters
Work interruptions during medication administration can lead to errors. A project implemented medication safety vests and signage to improve situation awareness and reduce interruptions on a medical-surgical unit. Nurses received education on the project. Interruptions decreased and adherence to vest use was high. Medication errors decreased 88% during the project period. Nurses reported the vests and signage were effective at reducing distractions. Continued use of these strategies may further improve medication safety.
The document discusses patient safety culture and climate. It defines safety culture as the shared values and behaviors regarding safety in an organization. Safety climate refers to perceptions of safety at a point in time and is measurable. The document outlines tools for assessing safety culture, including the AHRQ Hospital Survey on Patient Safety Culture, which measures 12 dimensions of safety culture. It provides guidance on using the survey results to identify strengths and areas for improvement to enhance patient safety.
Work interruptions during medication administration can lead to errors and safety risks. A project was implemented on a medical-surgical unit to reduce interruptions using medication safety vests and signage. Surveys found interruptions decreased and medication errors reduced by 88% with these interventions. Nurses' perceptions of the vest and education were also positive. While successful, continued research on interruptions is still needed.
This document summarizes the results of a survey assessing patient safety culture in 15 California hospitals. The survey was sent to over 6,000 hospital employees, including physicians, executives, and other staff, with a 47.4% overall response rate. The survey found that on average, 18% of responses suggested an absence of safety culture, while another 18% were neutral. Responses varied significantly between hospitals and job types. Clinicians, especially nurses, and frontline workers generally gave more negative responses than executives and non-clinical staff. The results provide information on how perceptions of safety culture differ within and between hospitals and employee groups. Further research is needed to understand how to improve safety culture across an organization.
Shekelle et. al 2011 advancing the science of patient safetyJoya Smit
Despite efforts over the past decade, patient safety has improved slowly due to the limited evidence base for developing and disseminating successful practices. An international group of experts developed criteria to improve the design, evaluation, and reporting of patient safety research. The criteria include using theory and logic models, providing detailed descriptions of interventions and implementation processes, explaining intended and unintended outcomes, and better describing how context influences interventions. Adopting these criteria would strengthen the science underlying efforts to improve patient safety.
This document describes the development of an evidence-based position statement on medical device-related hospital-acquired pressure ulcers (HAPUs) within a large healthcare system. A task force used the Iowa Model of Evidence-Based Practice to identify device-related HAPUs as an issue, review the literature, and define device-related HAPUs as injuries caused by external medical devices. They developed a position statement to standardize identification and reporting. Implementation involved disseminating the statement to various groups. Initial results showed improved identification and a 33% reduction in overall HAPU rates.
The document discusses a study that found aviation-based crew resource management training improved patient safety behaviors like checklist use and incident reporting in hospital staff over several years. The training led to increased empowerment scores and a sustained culture of safety. While errors still occur, physician-led programs may be more effective than penalties at improving safety.
The panel convened by the National Patient Safety Foundation to discuss the current state of patient safety 15 years after the seminal IOM report To Err Is Human identified several key points:
1) While awareness of patient safety issues has increased, progress has been slower than anticipated and the scale of improvement has been limited.
2) A total systems approach is needed to move beyond reactive, piecemeal interventions to prioritizing safety culture, developing the science of safety, and ensuring coordination across the care continuum and settings.
3) Specific recommendations include establishing safety leadership, centralized oversight, common safety metrics, increased research funding, addressing safety across all care settings, supporting the healthcare workforce, partnering with patients and families, and optim
Improving Medication Administration Safety in the Clinical.pdfstudywriters
Work interruptions during medication administration can lead to errors. A project implemented medication safety vests and signage to improve situation awareness and reduce interruptions on a medical-surgical unit. Nurses received education on the project. Interruptions decreased and adherence to vest use was high. Medication errors decreased 88% during the project period. Nurses reported the vests and signage were effective at reducing distractions. Continued use of these strategies may further improve medication safety.
The document discusses patient safety culture and climate. It defines safety culture as the shared values and behaviors regarding safety in an organization. Safety climate refers to perceptions of safety at a point in time and is measurable. The document outlines tools for assessing safety culture, including the AHRQ Hospital Survey on Patient Safety Culture, which measures 12 dimensions of safety culture. It provides guidance on using the survey results to identify strengths and areas for improvement to enhance patient safety.
Work interruptions during medication administration can lead to errors and safety risks. A project was implemented on a medical-surgical unit to reduce interruptions using medication safety vests and signage. Surveys found interruptions decreased and medication errors reduced by 88% with these interventions. Nurses' perceptions of the vest and education were also positive. While successful, continued research on interruptions is still needed.
Patient Safety in Indian Ambulatory Care settings By.Dr.Mahboob ali khan PhdHealthcare consultant
This document discusses patient safety in ambulatory care settings in India. It outlines three key factors that influence safety: patient and caregiver behaviors, provider-patient interactions, and the role of the community and health system. Common safety issues in ambulatory care include medication errors, diagnostic errors, poor care coordination and transitions. Improving safety will require reforms like using electronic health records more widely and engaging patients to take a more active role in managing their own care and acting as a check on the care they receive.
18Falls in The Long-Term Care SettingsNayaris ReyeAnastaciaShadelb
1
8
Falls in The Long-Term Care Settings
Nayaris Reyes
Florida National University
June 12, 2021
Brief Literature Review
The elderly in the long-term care facilities are typically predisposed to falling and might fall for various reasons. Some predisposing factors might be related to unsteady balance and gait, poor vision, weak muscles, dementia, and medications. In addition, various medical conditions, including stroke, low blood pressure, brain disorders, and poorly managed epilepsy, might increase older people's risk for falls (Golmakani et al., 2014). Therefore, several studies have been conducted to evaluate the efficacy of multi-factorial interventions on the occurrence of falls in long-term care settings, including psycho-geriatric nursing home patients. Based on the clinical study, it was concluded that various multi-factorial interventions used in preventing falls such as a general medical assessment emphasizing falls, specific fall risk evaluation devices, assessing medication intake, fall history, and mobility, using protective and assistive aids play a significant role in reducing the incidence of falls among the elderly (Ungar et al., 2013). Accordingly, it was evident that fall prevention, usually geared towards psycho-geriatric patients in a long-term care facility, is possible and efficient in minimizing falls among older people.
Other researchers carried out a study in developing a fall prevention program for the aged patients in long-term care entities, especially those at risk of falling, by increasing caregiving expertise or skills and motivating staff members. From the analysis, exercise programs encompassing warm-up, muscle reinforcement, especially in the lower extremities, and proprioceptive neuromuscular expedition are used in increasing motivation and caregiving skills (Donath et al., 2016). Another research conducted to evaluate the statistics of falls among the elderly found out that falls are the leading cause of injury-interrelated visits to emergency facilities in the U.S. They are also the primary etiology of accidental deaths in persons aged 60 and above. From the analysis, falls might be markers of diminishing function and poor health and are significantly attributable to morbidity.
To assess the risk factors related with falls among the older people in the long-term care facilities, it was realized that more than 25% of facility-dwelling older individuals and 60% of nursing home residents fall yearly (Pfortmueller et al., 2014). Various risk factors linked to their falls are medication use, increasing age, sensory deficits, and cognitive impairment. Studies depict that older persons who have fallen must undergo a thorough clinical evaluation (within the facilities) to analyze the preventive strategies further. This will aid in determining and treating the underlying cause of their falls, return them to baseline function, and minimize the likelihood of recurrent falls (Karlsson et al., 20 ...
This study investigated the influence of hospital safety climate on patient satisfaction and nursing care quality. Data was collected from nurses and patients at an Egyptian emergency hospital using questionnaires on safety climate, patient satisfaction, and quality of nursing care. The results found that 50% of respondents reported a low safety climate score and only 29.5% of patients were highly satisfied. Nurses reported that the quality of care was low for 69% of patients. A significant relationship was found between safety climate and both patient satisfaction and nursing care quality. The study concluded that improving the hospital safety climate can positively influence patient outcomes like satisfaction and quality of care.
The best way to enhance patient safety is to build a culture of safety at the hospital. The Johns Hopkins Hospital Comprehensive Unit-based Safety Program (CUSP)
Scheduling Of Nursing Staff in Hospitals - A Case Studyinventionjournals
This document summarizes a study that developed a goal programming algorithm to schedule 11 nurses across a two-week period at a hospital. The goals were to satisfy each nurse's contracted time, ensure minimum nurse requirements by role each day, give full-time nurses a weekend off while avoiding more than two consecutive days off, and honor nurses' weekend preference when possible. The algorithm solved the 154-variable, 120-constraint scheduling problem in under 30 seconds. The results showed schedules that met goals for minimum nurse levels each day and individual nurses' two-week schedules.
By administering assessments and analyzing the results, targeted aTawnaDelatorrejs
By administering assessments and analyzing the results, targeted and individualized interventions can be determined to best serve the needs of students with disabilities. The actual implementation of the interventions provides teachers opportunities to collect data and gauge the effectiveness of the interventions in addressing documented student needs. Teachers can also gain important skills and knowledge on how to best advocate for practical classroom interventions. Teachers will also be able to collaborate with colleagues and families in mentoring students to take ownership of learning strategies.
Allocate at least 2 hours in the field to support this field experience,
Part 1: Assessment and Interventions
Select at least one student to whom you will administer the informal RTI assessment created in Clinical Field Experience A. Score the assessment and share the results with the student to increase understanding of his or her strengths and areas for improvement.
Collaborate with the certified special education teacher and the student to develop 2-3 interventions based on the student assessment data to support the student’s progress in the classroom. In addition, detail one intervention that can be incorporated at home with family support.
Use any remaining field experience hours to assist the teacher in providing instruction and support to the class.
Part 2: Reflection
In 250-500 words, summarize and reflect upon the following:
· Describe each intervention, including teacher, student, and family roles, where applicable.
· Your experiences administering the assessment, analyzing the results, and providing the student feedback on his or her performance.
· Explain how you expect the interventions you developed to meet the needs of the student, incorporating his or her assessment results in your response.
· Explain how you will use your findings in your future professional practice.
APA format is not required, but solid academic writing is expected.
This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
6
Annotated Bibliography
Student’s Name
Course
Instructor’s name.
Institutional Affiliation
October 7, 2021.
Annotated Bibliography
Ali, H., Ibrahem, S. Z., Al Mudaf, B., Al Fadalah, T., Jamal, D., & El-Jardali, F. (2018). Baseline assessment of patient safety culture in public hospitals in Kuwait. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-2960-x
The researchers conducted a cross-sectional study in 16 public hospitals in Kuwait using the Hospital Survey on Patient Safety Culture (HSOPSC). The study aimed to assess patient safety culture in public hospitals as perceived by hospital staff and relate the findings similar to regional and international ...
This document summarizes a presentation given at a patient safety conference about implementing a "just culture" approach at Tawam Hospital in the United Arab Emirates. It discusses adopting the Comprehensive Unit-based Safety Program (CUSP) to assess safety culture, educate staff, and improve communication and teamwork. Initial surveys found room for improvement in safety attitudes. CUSP was expanded to more units over time and subsequent surveys showed increases in positive safety culture scores. Infection rates like CLABSI declined as well. The presentation highlights challenges faced and lessons learned from the culture change journey.
Barriers to Health Care Access for Low Income Families.docxwrite31
Patient safety issues in healthcare can arise from errors such as misdiagnosis, poor communication between providers, and an overburdened healthcare system. The most common causes of safety lapses are preventable adverse events stemming from diagnostic errors, failures to consider patient context, and miscommunication. Implementing electronic health records and improving communication standards and leadership can help create a culture of safety to reduce errors and protect patients.
This document reviews the literature on patient safety culture in hospitals. It identifies 7 key subcultures that define safety culture: leadership, teamwork, evidence-based practice, communication, learning, justice, and patient-centered care. Leadership is seen as essential for establishing a culture of safety. The review develops a conceptual model and typology that categorizes properties of each subculture identified in the literature. The model and typology are intended to help hospital leaders understand and develop an organizational culture of safety.
This document provides resources and instructions for conducting a root cause analysis of a medical error or safety issue related to medication administration. Students are asked to choose a safety concern from a previous assessment or personal experience and analyze the root cause. They then develop a safety improvement plan using best practices and existing organizational resources. The goal is to demonstrate understanding of root cause analysis and developing plans to improve patient safety regarding medication administration.
This document discusses patient safety in a hospital setting. It defines key terms, identifies common patient safety issues like medication errors and falls. It emphasizes the importance of patient safety in preventing deaths and injuries. It also provides tips to improve safety such as educating patients, using standard precautions, and encouraging teamwork among healthcare providers. The goals are to enhance accuracy in patient identification and medication management, reduce infections, and minimize risks of falls.
NUR 4325 Central Video System versus Using Staff to Sit.pdfbkbk37
This document describes a quality improvement project to implement a central video monitoring system instead of using staff to sit at the bedside of high fall risk patients. The project aims to analyze costs and benefits to develop a budget proposal. Available evidence suggests video monitoring can reduce falls, injuries, and sitter costs while improving staffing. The document outlines collecting facility fall and cost data, estimating potential savings of $201,864 per year from fewer falls and injuries with video monitoring. A financial narrative was developed to obtain approval for the estimated $150,000 system.
Delirium in intensive_care_units__perceptions_of.6 (1)Ahmad Ayed
1) Delirium is common in ICU patients and is associated with negative outcomes like longer hospital stays and higher costs, but it often goes underdiagnosed.
2) The study assessed the knowledge, attitudes, and practices of Palestinian healthcare professionals regarding delirium in ICU patients. It found delirium appears to be underrecognized or misdiagnosed in Palestinian ICUs.
3) Educating medical and nursing teams on delirium assessment tools could help reduce the length and costs of hospital stays by improving early diagnosis and management of delirium.
This study investigated the quality and safety of discharge prescriptions from mental health hospitals in the UK. The researchers found that:
1) 20.8% of discharge prescriptions contained at least one prescribing error, with an overall error rate of 5.08% of prescribed items. Nearly three-quarters of errors were considered clinically relevant.
2) Increasing numbers of medications prescribed (polypharmacy) and prescriptions written by GP Trainees and Core/Specialist Trainees were associated with higher rates of prescribing errors.
3) Over 70% of prescriptions contained clerical errors, most commonly related to specifying who should continue prescribing medications. Over 67% of prescriptions requiring communication
Part 6 Disseminating Results Create a 5-minute, 5- to 6-sli.docxsmile790243
Part 6: Disseminating Results
Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project:
· Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
Points Range: 81 (81%) - 90 (90%)
The narrated presentation accurately and completely summarizes the evidence-based project. The narrated presentation is professional in nature and thoroughly addresses all components of the evidence-based project.
The narrated presentation accurately and clearly explains in detail how to disseminate the results of the project to an audience, citing specific and relevant examples.
The narrated presentation accurately and clearly provides a justification that details the selection of this dissemination strategy that is fully supported by specific and relevant examples.
The narrated presentation provides a complete, detailed, and specific synthesis of two outside resources related to the dissemination strategy explained. The narrated presentation fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.
Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Points Range: 5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.
Points Range: 5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Evidenced Based Change
Leslie Hill
Walden University
Introduction/PurposeChange is inevitable.Health care organizations need change to improve.There are challenges that need to be addressed(Baraka-Johnson et al. 2019).Challenges should be addressed using evidence-based research.These changes enhance professionalism therefore improving quality of care and quality of life.The purpose of this paper is to identify an existing problem in health care and suggest a change idea that would be effective in addressing the problem. The paper also articulates risks associated with the change process, how to distribute the change information and how to implement change successfully.
Organizational CultureThe Organization is a hospice facilityOffers end of life care for pain and symptom managementThe health care providers cu.
Adverse Event from My Professional Nursing Experience.docxwrite22
1) A nurse experienced an adverse event during their professional nursing career where a patient's medical management led to an unintended outcome rather than their underlying condition.
2) The event was caused by missed steps and protocol deviations by the interprofessional team. It impacted stakeholders in both short-term and long-term ways.
3) To prevent similar events, the nurse proposes a quality improvement initiative for their organization that incorporates lessons learned from other institutions and utilizes relevant metrics and technologies to enhance patient safety.
Delivering Value Through Evidence-Based PracticeMacias, Charles .docxcuddietheresa
Delivering Value Through Evidence-Based Practice
Macias, Charles G; Loveless, Jennifer N; Jackson, Andrea N; Srinivasan, Suresh. Clinical Pediatric Emergency Medicine; Maryland Heights Vol. 18, Iss. 2, (2017): 89-97. DOI:10.1016/j.cpem.2017.05.002
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Unwanted variation in care is a challenge to high-quality care delivery in any healthcare system. Across the Emergency Medical Services for Children (EMSC) continuum, there is wide variation in care delivery for which best practices have demonstrated opportunities to minimize that variation through clinical standards (evidence-based pathways, protocols, and guidelines for care). A model of development of clinical standards is delineated and tools used in that process are described. Implementation strategies for improving utilization are also described with clinical decision support tools being a promising strategy for accelerating uptake of guidelines. Critical to implementing guidelines through improvement science strategies is the ability to make iterative improvements directed by data and analytics. The progression of sophistication in a system's informatics and analytics capabilities is driven by a maturity of data reporting to analytics that drives decision support for implementing clinical standards. Integration of financial data into the clinical standards processes and analytics platforms is necessary to determine value of the work. Within the EMSC continuum, a number of initiatives will drive national clinical standards activities and are fueled by current pockets of successful development and implementation activities within organizations and systems.
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Longer documents ...
Variables in a Research Study and Data CollectionIn this assignmen.docxdaniahendric
Variables in a Research Study and Data Collection
In this assignment, you will explore the variables involved in a research study.
Complete the following tasks:
Read the following articles from the Cumulative Index to Nursing and Allied Health Literature (CINAHL) Database in the South University Online Library.
Lee, A., Craft-Rosenberg, M. (2010). Ineffective family participation in
professional care: A concept analysis of a proposed nursing
diagnosis.
Nurs Diagn
. 2002 Jan-Mar;
13
(1), 5–14.
Witt, C. M., Lüdtke, R., Willich, S. N. (2010). Homeopathic treatment
of patients with migraine: A prospective observational study with
a 2-year follow-up period.
J Altern Complement Med
. 2010 Apr;
16
(4), 347–55. doi: 10.1089/acm.2009.0376.
Read the process for data collection employed in both these studies. Compare the method used in each of them.
Provide a bulleted list of the five tasks performed as part of data collection in each of them. Click
here
to enter your responses in the organizer.
.
Variation exists in virtually all parts of our lives. We often see v.docxdaniahendric
Variation exists in virtually all parts of our lives. We often see variation in results in what we spend (utility costs each month, food costs, business supplies, etc.). Consider the measures and data you use (in either your personal or job activities). When are differences (between one time period and another, between different production lines, etc.) between average or actual results important? How can you or your department decide whether or not the observed differences over time are important? How could using a mean difference test help?
.
Patient Safety in Indian Ambulatory Care settings By.Dr.Mahboob ali khan PhdHealthcare consultant
This document discusses patient safety in ambulatory care settings in India. It outlines three key factors that influence safety: patient and caregiver behaviors, provider-patient interactions, and the role of the community and health system. Common safety issues in ambulatory care include medication errors, diagnostic errors, poor care coordination and transitions. Improving safety will require reforms like using electronic health records more widely and engaging patients to take a more active role in managing their own care and acting as a check on the care they receive.
18Falls in The Long-Term Care SettingsNayaris ReyeAnastaciaShadelb
1
8
Falls in The Long-Term Care Settings
Nayaris Reyes
Florida National University
June 12, 2021
Brief Literature Review
The elderly in the long-term care facilities are typically predisposed to falling and might fall for various reasons. Some predisposing factors might be related to unsteady balance and gait, poor vision, weak muscles, dementia, and medications. In addition, various medical conditions, including stroke, low blood pressure, brain disorders, and poorly managed epilepsy, might increase older people's risk for falls (Golmakani et al., 2014). Therefore, several studies have been conducted to evaluate the efficacy of multi-factorial interventions on the occurrence of falls in long-term care settings, including psycho-geriatric nursing home patients. Based on the clinical study, it was concluded that various multi-factorial interventions used in preventing falls such as a general medical assessment emphasizing falls, specific fall risk evaluation devices, assessing medication intake, fall history, and mobility, using protective and assistive aids play a significant role in reducing the incidence of falls among the elderly (Ungar et al., 2013). Accordingly, it was evident that fall prevention, usually geared towards psycho-geriatric patients in a long-term care facility, is possible and efficient in minimizing falls among older people.
Other researchers carried out a study in developing a fall prevention program for the aged patients in long-term care entities, especially those at risk of falling, by increasing caregiving expertise or skills and motivating staff members. From the analysis, exercise programs encompassing warm-up, muscle reinforcement, especially in the lower extremities, and proprioceptive neuromuscular expedition are used in increasing motivation and caregiving skills (Donath et al., 2016). Another research conducted to evaluate the statistics of falls among the elderly found out that falls are the leading cause of injury-interrelated visits to emergency facilities in the U.S. They are also the primary etiology of accidental deaths in persons aged 60 and above. From the analysis, falls might be markers of diminishing function and poor health and are significantly attributable to morbidity.
To assess the risk factors related with falls among the older people in the long-term care facilities, it was realized that more than 25% of facility-dwelling older individuals and 60% of nursing home residents fall yearly (Pfortmueller et al., 2014). Various risk factors linked to their falls are medication use, increasing age, sensory deficits, and cognitive impairment. Studies depict that older persons who have fallen must undergo a thorough clinical evaluation (within the facilities) to analyze the preventive strategies further. This will aid in determining and treating the underlying cause of their falls, return them to baseline function, and minimize the likelihood of recurrent falls (Karlsson et al., 20 ...
This study investigated the influence of hospital safety climate on patient satisfaction and nursing care quality. Data was collected from nurses and patients at an Egyptian emergency hospital using questionnaires on safety climate, patient satisfaction, and quality of nursing care. The results found that 50% of respondents reported a low safety climate score and only 29.5% of patients were highly satisfied. Nurses reported that the quality of care was low for 69% of patients. A significant relationship was found between safety climate and both patient satisfaction and nursing care quality. The study concluded that improving the hospital safety climate can positively influence patient outcomes like satisfaction and quality of care.
The best way to enhance patient safety is to build a culture of safety at the hospital. The Johns Hopkins Hospital Comprehensive Unit-based Safety Program (CUSP)
Scheduling Of Nursing Staff in Hospitals - A Case Studyinventionjournals
This document summarizes a study that developed a goal programming algorithm to schedule 11 nurses across a two-week period at a hospital. The goals were to satisfy each nurse's contracted time, ensure minimum nurse requirements by role each day, give full-time nurses a weekend off while avoiding more than two consecutive days off, and honor nurses' weekend preference when possible. The algorithm solved the 154-variable, 120-constraint scheduling problem in under 30 seconds. The results showed schedules that met goals for minimum nurse levels each day and individual nurses' two-week schedules.
By administering assessments and analyzing the results, targeted aTawnaDelatorrejs
By administering assessments and analyzing the results, targeted and individualized interventions can be determined to best serve the needs of students with disabilities. The actual implementation of the interventions provides teachers opportunities to collect data and gauge the effectiveness of the interventions in addressing documented student needs. Teachers can also gain important skills and knowledge on how to best advocate for practical classroom interventions. Teachers will also be able to collaborate with colleagues and families in mentoring students to take ownership of learning strategies.
Allocate at least 2 hours in the field to support this field experience,
Part 1: Assessment and Interventions
Select at least one student to whom you will administer the informal RTI assessment created in Clinical Field Experience A. Score the assessment and share the results with the student to increase understanding of his or her strengths and areas for improvement.
Collaborate with the certified special education teacher and the student to develop 2-3 interventions based on the student assessment data to support the student’s progress in the classroom. In addition, detail one intervention that can be incorporated at home with family support.
Use any remaining field experience hours to assist the teacher in providing instruction and support to the class.
Part 2: Reflection
In 250-500 words, summarize and reflect upon the following:
· Describe each intervention, including teacher, student, and family roles, where applicable.
· Your experiences administering the assessment, analyzing the results, and providing the student feedback on his or her performance.
· Explain how you expect the interventions you developed to meet the needs of the student, incorporating his or her assessment results in your response.
· Explain how you will use your findings in your future professional practice.
APA format is not required, but solid academic writing is expected.
This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
6
Annotated Bibliography
Student’s Name
Course
Instructor’s name.
Institutional Affiliation
October 7, 2021.
Annotated Bibliography
Ali, H., Ibrahem, S. Z., Al Mudaf, B., Al Fadalah, T., Jamal, D., & El-Jardali, F. (2018). Baseline assessment of patient safety culture in public hospitals in Kuwait. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-2960-x
The researchers conducted a cross-sectional study in 16 public hospitals in Kuwait using the Hospital Survey on Patient Safety Culture (HSOPSC). The study aimed to assess patient safety culture in public hospitals as perceived by hospital staff and relate the findings similar to regional and international ...
This document summarizes a presentation given at a patient safety conference about implementing a "just culture" approach at Tawam Hospital in the United Arab Emirates. It discusses adopting the Comprehensive Unit-based Safety Program (CUSP) to assess safety culture, educate staff, and improve communication and teamwork. Initial surveys found room for improvement in safety attitudes. CUSP was expanded to more units over time and subsequent surveys showed increases in positive safety culture scores. Infection rates like CLABSI declined as well. The presentation highlights challenges faced and lessons learned from the culture change journey.
Barriers to Health Care Access for Low Income Families.docxwrite31
Patient safety issues in healthcare can arise from errors such as misdiagnosis, poor communication between providers, and an overburdened healthcare system. The most common causes of safety lapses are preventable adverse events stemming from diagnostic errors, failures to consider patient context, and miscommunication. Implementing electronic health records and improving communication standards and leadership can help create a culture of safety to reduce errors and protect patients.
This document reviews the literature on patient safety culture in hospitals. It identifies 7 key subcultures that define safety culture: leadership, teamwork, evidence-based practice, communication, learning, justice, and patient-centered care. Leadership is seen as essential for establishing a culture of safety. The review develops a conceptual model and typology that categorizes properties of each subculture identified in the literature. The model and typology are intended to help hospital leaders understand and develop an organizational culture of safety.
This document provides resources and instructions for conducting a root cause analysis of a medical error or safety issue related to medication administration. Students are asked to choose a safety concern from a previous assessment or personal experience and analyze the root cause. They then develop a safety improvement plan using best practices and existing organizational resources. The goal is to demonstrate understanding of root cause analysis and developing plans to improve patient safety regarding medication administration.
This document discusses patient safety in a hospital setting. It defines key terms, identifies common patient safety issues like medication errors and falls. It emphasizes the importance of patient safety in preventing deaths and injuries. It also provides tips to improve safety such as educating patients, using standard precautions, and encouraging teamwork among healthcare providers. The goals are to enhance accuracy in patient identification and medication management, reduce infections, and minimize risks of falls.
NUR 4325 Central Video System versus Using Staff to Sit.pdfbkbk37
This document describes a quality improvement project to implement a central video monitoring system instead of using staff to sit at the bedside of high fall risk patients. The project aims to analyze costs and benefits to develop a budget proposal. Available evidence suggests video monitoring can reduce falls, injuries, and sitter costs while improving staffing. The document outlines collecting facility fall and cost data, estimating potential savings of $201,864 per year from fewer falls and injuries with video monitoring. A financial narrative was developed to obtain approval for the estimated $150,000 system.
Delirium in intensive_care_units__perceptions_of.6 (1)Ahmad Ayed
1) Delirium is common in ICU patients and is associated with negative outcomes like longer hospital stays and higher costs, but it often goes underdiagnosed.
2) The study assessed the knowledge, attitudes, and practices of Palestinian healthcare professionals regarding delirium in ICU patients. It found delirium appears to be underrecognized or misdiagnosed in Palestinian ICUs.
3) Educating medical and nursing teams on delirium assessment tools could help reduce the length and costs of hospital stays by improving early diagnosis and management of delirium.
This study investigated the quality and safety of discharge prescriptions from mental health hospitals in the UK. The researchers found that:
1) 20.8% of discharge prescriptions contained at least one prescribing error, with an overall error rate of 5.08% of prescribed items. Nearly three-quarters of errors were considered clinically relevant.
2) Increasing numbers of medications prescribed (polypharmacy) and prescriptions written by GP Trainees and Core/Specialist Trainees were associated with higher rates of prescribing errors.
3) Over 70% of prescriptions contained clerical errors, most commonly related to specifying who should continue prescribing medications. Over 67% of prescriptions requiring communication
Part 6 Disseminating Results Create a 5-minute, 5- to 6-sli.docxsmile790243
Part 6: Disseminating Results
Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project:
· Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
Points Range: 81 (81%) - 90 (90%)
The narrated presentation accurately and completely summarizes the evidence-based project. The narrated presentation is professional in nature and thoroughly addresses all components of the evidence-based project.
The narrated presentation accurately and clearly explains in detail how to disseminate the results of the project to an audience, citing specific and relevant examples.
The narrated presentation accurately and clearly provides a justification that details the selection of this dissemination strategy that is fully supported by specific and relevant examples.
The narrated presentation provides a complete, detailed, and specific synthesis of two outside resources related to the dissemination strategy explained. The narrated presentation fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.
Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Points Range: 5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.
Points Range: 5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Evidenced Based Change
Leslie Hill
Walden University
Introduction/PurposeChange is inevitable.Health care organizations need change to improve.There are challenges that need to be addressed(Baraka-Johnson et al. 2019).Challenges should be addressed using evidence-based research.These changes enhance professionalism therefore improving quality of care and quality of life.The purpose of this paper is to identify an existing problem in health care and suggest a change idea that would be effective in addressing the problem. The paper also articulates risks associated with the change process, how to distribute the change information and how to implement change successfully.
Organizational CultureThe Organization is a hospice facilityOffers end of life care for pain and symptom managementThe health care providers cu.
Adverse Event from My Professional Nursing Experience.docxwrite22
1) A nurse experienced an adverse event during their professional nursing career where a patient's medical management led to an unintended outcome rather than their underlying condition.
2) The event was caused by missed steps and protocol deviations by the interprofessional team. It impacted stakeholders in both short-term and long-term ways.
3) To prevent similar events, the nurse proposes a quality improvement initiative for their organization that incorporates lessons learned from other institutions and utilizes relevant metrics and technologies to enhance patient safety.
Delivering Value Through Evidence-Based PracticeMacias, Charles .docxcuddietheresa
Delivering Value Through Evidence-Based Practice
Macias, Charles G; Loveless, Jennifer N; Jackson, Andrea N; Srinivasan, Suresh. Clinical Pediatric Emergency Medicine; Maryland Heights Vol. 18, Iss. 2, (2017): 89-97. DOI:10.1016/j.cpem.2017.05.002
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Unwanted variation in care is a challenge to high-quality care delivery in any healthcare system. Across the Emergency Medical Services for Children (EMSC) continuum, there is wide variation in care delivery for which best practices have demonstrated opportunities to minimize that variation through clinical standards (evidence-based pathways, protocols, and guidelines for care). A model of development of clinical standards is delineated and tools used in that process are described. Implementation strategies for improving utilization are also described with clinical decision support tools being a promising strategy for accelerating uptake of guidelines. Critical to implementing guidelines through improvement science strategies is the ability to make iterative improvements directed by data and analytics. The progression of sophistication in a system's informatics and analytics capabilities is driven by a maturity of data reporting to analytics that drives decision support for implementing clinical standards. Integration of financial data into the clinical standards processes and analytics platforms is necessary to determine value of the work. Within the EMSC continuum, a number of initiatives will drive national clinical standards activities and are fueled by current pockets of successful development and implementation activities within organizations and systems.
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Longer documents ...
Variables in a Research Study and Data CollectionIn this assignmen.docxdaniahendric
Variables in a Research Study and Data Collection
In this assignment, you will explore the variables involved in a research study.
Complete the following tasks:
Read the following articles from the Cumulative Index to Nursing and Allied Health Literature (CINAHL) Database in the South University Online Library.
Lee, A., Craft-Rosenberg, M. (2010). Ineffective family participation in
professional care: A concept analysis of a proposed nursing
diagnosis.
Nurs Diagn
. 2002 Jan-Mar;
13
(1), 5–14.
Witt, C. M., Lüdtke, R., Willich, S. N. (2010). Homeopathic treatment
of patients with migraine: A prospective observational study with
a 2-year follow-up period.
J Altern Complement Med
. 2010 Apr;
16
(4), 347–55. doi: 10.1089/acm.2009.0376.
Read the process for data collection employed in both these studies. Compare the method used in each of them.
Provide a bulleted list of the five tasks performed as part of data collection in each of them. Click
here
to enter your responses in the organizer.
.
Variation exists in virtually all parts of our lives. We often see v.docxdaniahendric
Variation exists in virtually all parts of our lives. We often see variation in results in what we spend (utility costs each month, food costs, business supplies, etc.). Consider the measures and data you use (in either your personal or job activities). When are differences (between one time period and another, between different production lines, etc.) between average or actual results important? How can you or your department decide whether or not the observed differences over time are important? How could using a mean difference test help?
.
Valerie Matsumoto's "Desperately Seeking "Deirde": Gender Roles, Multicultural Relations, and Nisei Women Writers of the 1930s," focuses on the writings of Deirde, a second generation Japanese American advice columnist. But as the abstract of this piece suggests, Matsumoto was not so much interested in the advice Deirde was giving her readers as much as she was interested in the questions her readers were asking the "Dear Abby"of their community in the mid-1930s to early 1940s. What were they asking about? From Deidre's columns, what were some of the concerns of the Japanese-American community during 1935-1941? While it is of extreme importance to study the experience of the Japanese-Americans during World War II , Matsumoto argues that it is also of importance to study the pre-war lives of Japanese-Americans. Why? What did these concerns reveal about the Japanese-American experience in the United States during this time period?
.
valerie is a 15 year old girl who has recently had signs of a high f.docxdaniahendric
valerie is a 15 year old girl who has recently had signs of a high fever, her parents took her to the ER and the test results say she has a bacterial infection and her white blood cells are trapping bacteria it is not binding with the vacuole and releasing necessarg enzymes to break the cell wall. What disease does valerie have?
.
Utilizing the Statement of Financial Position on page 196 of the Acc.docxdaniahendric
Utilizing the Statement of Financial Position on page 196 of the Accounting Fundamentals for Health Care Management text book (see attachement), compare the figures for 2013 and 2012. Compose a narrative of possible explanations for the documented charges in the year-end figures for the organization. Your response should be a minimum of 200 words in length and submitted in a Word document, utilizing APA format.
See attachment referencing Statement of Financial Position
.
Utech Company has income before irregular items of $307,500 for the .docxdaniahendric
Utech Company has income before irregular items of $307,500 for the year ended December 31, 2014. It also has the following items (before considering income taxes): (1) an extraordinary fire loss of $53,000 and (2) a gain of $27,100 from the disposal of a division. Assume all items are subject to income taxes at a 39% tax rate.
Prepare Utech Company’s income statement for 2014, beginning with “Income before irregular items.”
.
Using your work experience in the public and nonprofit sector, and t.docxdaniahendric
Using your work experience in the public and nonprofit sector, and the knowledge you have gained in this MPA program as a guide, address the following question in a detailed fashion:
What methods, specifically, have citizens utilized to influence and become involved in the budgeting and financial management arenas in the public sphere? Which movements or strategies have been most successful from a citizen perspective? To what degree do budgeting professionals and public administrators seek and consider this citizen involvement? What will be the trend for the future with regard to citizen participation in the process?
.
Using your textbook, provide a detailed and specific definition to.docxdaniahendric
Using your textbook, provide a detailed and specific definition to the following terms:
Transformation Leadership
Transactional Leadership
Laissez-Faire Leadership
Idealized Influence
Inspirational Motivation
Intellectual Stimulation
Idealized Consideration
Contingent Reward
Management by Exception
Kouzes and Posner wrote a book entitled the
Leadership Challenge
in which they identified five practices of exemplary leaders. Using your textbook and Internet sources, discuss the five practices and give examples of leadership behaviors that would illustrate the practice. (1 page minimum)
.
Using your text and at least one scholarly source, prepare a two to .docxdaniahendric
Using your text and at least one scholarly source, prepare a two to three page paper (excluding title and reference page), in APA format, on the following:
Explain the difference between Charity Care and Bad Debt in a healthcare environment.
Explain how the patient financial services personnel assist in determining which category the uncollectible account should be placed.
Discuss the financial implications of gross uncollectibles on the bottom line of the healthcare institution, and explain how these are recorded on the financial statements.
This is the textbook that we are on:
Epstein, L. & Schneider, A. (2014).
Accounting for Health Care Professionals
. San Diego, CA: Bridgepoint Education, Inc.
.
Using Walgreen Company as the target organization complete the.docxdaniahendric
Using
Walgreen Company
as the target organization complete the following three-step process:
First, conduct an external assessment and complete either an EFE or CPM. Use the following five websites in conducting your assessment:
http://marketwatch.com
www.hoovers.com
http://moneycentral.msn.com
http://us.etrade.com/e/t/invest/markets
http://globaledge.msu.edu/industries
Second, conduct an internal assessment and complete an IFE. Use the following documents, which may be found in the target organization’s corporate website:
Most current Form10K document
Most current Annual Report
Then develop a well-written paper describing the findings that you discovered by
analyzing the data
from the external assessment and from the internal assessment.
Present facts.
Consider putting some of the data into a graphical display (chart, figure, table) to present information in a clear way. Use citations to substantiate your ideas. Insert the completed matrixes as appendixes and reference them within the body of the paper according to APA standards.
Your paper should meet the following requirements:
Be 2-3 pages in length
Be formatted according to
APA GUIDELINES
Cite a minimum of three outside sources.
Include all required elements, including a reference page and required appendixes.
.
Using the text book and power point on Interest Groups, please ans.docxdaniahendric
Interest groups use various tactics to influence political parties and policymakers, including lobbying. There are different types of interest groups, with some being more powerful in certain states than others. Lobbyists represent interest groups and try to sway legislators through various approved methods outlined in the attached powerpoint presentation.
Using the template provided in attachment create your own layout.R.docxdaniahendric
Using the template provided in attachment create your own layout.
Review the Goals
Who is the Persona you are trying to reach?
Use the "How to Change Consumer Behavior" file
Integrate social media
A Twitter feed needs to be on the Home Page
Use a Site Architecture Excel File to let the IT Developer know sub menus
Simplify wherever you can. What is the 1 message you want the viewer to remember?
.
Using the simplified OOD methodologyWrite down a detailed descrip.docxdaniahendric
The document provides instructions for using the simplified Object-Oriented Design (OOD) methodology to design software for a police department. The methodology involves writing a description of the problem, identifying relevant nouns and verbs, selecting objects from the nouns and their data components, selecting operations from the verbs, and writing a paper proposing classes with data members and methods for tracking people, property, and criminal activity.
Using the text, Cognitive Psychology 5 edition (Galotti, 2014), .docxdaniahendric
Using the text,
Cognitive Psychology 5 edition
(Galotti, 2014), the University Library, the Internet, and/or other resources, answer the following questions. Your response to each question should be at least 150 words in length.
1.
What is primary memory? What are the characteristics of primary memory?
2.
What is the process of memory from perception to retrieval? What happens when the process is compromised?
3.Is it possible for memory retrieval to be unreliable? Why or why not? What factors may affect the reliability of one’s memory?
.
Using the Tana Basin in Kenya,1.Discuss the water sources and .docxdaniahendric
Using the Tana Basin in Kenya,
1.
Discuss the water sources and their quality - ( 5 marks)
2.
Outline the factors that influence their potential uses - (5 marks)
3.
Identify and map the current users of water in the catchment - (15 marks)
4.
Map the potential source of pollution in the catchment - (5 marks)
Need three pages APA format.
.
Using the template provided in a separate file, create your own la.docxdaniahendric
Using the template provided in a separate file, create your own layout.
Review the Goals
Who is the Persona you are trying to reach?
Use the "How to Change Consumer Behavior" file
Integrate social media
A Twitter feed needs to be on the Home Page
Use a Site Architecture Excel File to let the IT Developer know sub menus
Simplify wherever you can. What is the 1 message you want the viewer to remember?
.
Using the template provided in attachment create your own layo.docxdaniahendric
The document provides instructions for creating a website layout using the provided template, reviewing goals, identifying the target persona, integrating information from an attached file on changing consumer behavior, including a Twitter feed on the home page, using an Excel file to communicate the site architecture and submenus to developers, and simplifying the design to focus on one key message for viewers.
Using the Sex(abled) video, the sexuality section in the Falvo text.docxdaniahendric
Using the "Sex(abled) video, the sexuality section in the Falvo text (Chapter 12), and your own thoughts and experiences as context, describe prominent issues related to forming intimate relationships by people with intellectual disabilities. You may consider the viewpoints from caregivers and family members, educators, societal attitudes, counselors or support personnel, and viewpoints from people with disabilities. You may include disabilities outside of intellectual disabilities if you wish.
Watch Video: Sexuality and Relationships
.
Using the required and recommended resources from this week and last.docxdaniahendric
Using the required and recommended resources from this week and last, as well as ‘found’ resources, identify at least one specific example of groups or individuals in your community, state, or at the national level that exemplify the following themes and include a brief description of why you feel this example meets the concept. Add a link for any ‘found’ resources.
Works “with” young people rather than conducting activities “for” them.
Creates an atmosphere that sparks young people’s aspirations.
Digs deep and incorporates key elements of authentic youth involvement by making sure that:
Youth are valued and heard
Youth shape the action agenda
Youth build assets for and with each other
Why is it important for programs and or organizations to work “with” young people rather than “for” them?
.
Using the Internet, textbook or related resources, research the crea.docxdaniahendric
Using the Internet, textbook or related resources, research the creation and role of the Federal Reserve. Then in a 1-2 page paper, address the following:
When was the Federal Reserve created and for what purpose?
How does the Federal Reserve manipulate our economy to foster economic growth?
Research at
least three
specific policies instituted by the Federal Reserve.
Finally give an analysis as to why or why not you feel these policies were successful. Remember to support your position with cited sources
Due Sunday 11/30/14 at 11am CST, in APA format with APA bibliography
.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
2. leadership and frontline clinicians about patient safety
concepts and lead to cultural changes such as increased
transparency in discussions of adverse events and an
improved rate of safety-based changes.5
One year following WR implementation in a 1000-bed
tertiary care facility in Canada, there was a 64% to 80%
increase in the number of identified patient safety issues
that had been resolved or had active improvement work
in progress.6 Nine out of 10 clinicians reported that they
felt comfortable when openly and honestly discussing
patient safety issues, and they had enhanced awareness of
patient safety. In another study at a 711-bed tertiary care
473635AJMXXX10.1177/1062860612473635Ameri
can Journal of Medical QualitySchwendimann et al
1University of Basel, Institute of Nursing Science, Basel,
Switzerland
2Patient Safety Training and Research Center, Duke University
Health
System, Durham, NC
3Duke University School of Nursing, Durham, NC
4Duke University Hospital, Durham, NC
5Duke University School of Medicine, Durham, NC
6Pascal Metrics Inc, Washington, DC
7Duke University Department of Psychiatry, Durham, NC
The authors declared no potential conflicts of interest with
respect to
the research, authorship, and/or publication of this article. The
authors
received no financial support for the research, authorship,
and/or
publication of this article.
3. Corresponding Author:
René Schwendimann, PhD, RN, University of Basel, Institute of
Nursing Science, Bernoullistrasse 28, 4056 Basel, Switzerland.
Email: [email protected]
A Closer Look at Associations Between
Hospital Leadership Walkrounds
and Patient Safety Climate and Risk
Reduction: A Cross-Sectional Study
René Schwendimann, PhD, RN,1,2,3 Judy Milne, MSN, RN,2,4
Karen Frush, MD, BSN,2,3,5 Dietmar Ausserhofer, PhD, RN,1
Allan Frankel, MD,6 and J. Bryan Sexton, PhD2,7
Abstract
Leadership walkrounds (WRs) are widely used in health care
organizations to improve patient safety. This retrospective,
cross-sectional study evaluated the association between WRs
and caregiver assessments of patient safety climate and
patient safety risk reduction across 49 hospitals in a nonprofit
health care system. Linear regression analyses using
units’ participation in WRs were conducted. Survey results from
706 hospital units revealed that units with ≥60% of
caregivers reporting exposure to at least 1 WR had a
significantly higher safety climate, greater patient safety risk
reduction, and a higher proportion of feedback on actions taken
as a result of WRs compared with those units with
<60% of caregivers reporting exposure to WRs. WR
participation at the unit level reflects a frequency effect as a
function of units with none/low, medium, and high leadership
WR exposure.
Keywords
leadership walkrounds, safety climate, leadership, patient
safety, hospital
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Schwendimann et al 415
hospital, nurses participating in WRs scored significantly
higher in safety climate attitudes (73% positive) com-
pared with controls (53% positive).7 The authors con-
cluded that safety climate scores likely will increase in
clinical areas in which caregivers are engaged in rigor-
ously implemented WRs. However, such implementation
requires significant organizational will in a given hospi-
tal.8 In 2002, the University of Michigan Medical Center
implemented hospital-wide Patient Safety Rounds (PSRs)
as a modified approach of WRs. In a follow-up study,
researchers conducted a retrospective study of more than
900 staff members who had participated in a total of 70
PSRs over the last 4 years. Overall, patient safety was
enhanced as demonstrated by the resolution of a series
of local safety problems (eg, repair of equipment), the
development of safety policies to address safety concerns
at the regional level (eg, intravenous medication policy),
and the initiation of systemwide changes (eg, simulation-
based training on central line catheter insertion). In addi-
tion, clinical staff who participated in PSRs were more
likely to report errors and near misses and were more
likely to perceive that their managers promote patient
safety as compared with those who did not participate in
PSRs. However, it remains unclear to what extent these
differences are attributable to the PSRs.9
Although the concept of WRs is popular and widely
used in North American hospitals,9-12 the broad impact of
5. WRs on specific patient safety attitudes of clinical staff as
well as clinical patient outcomes is less well known. One
of the barriers to rigorous scientific scrutiny of WRs is
that their format varies widely between the institutions
and the leaders facilitating the discussions. For example,
the authors’ experiences with conducting and investigat-
ing WRs have included formats as varied as hallway
conversations, breakroom discussions over snacks, audi-
torium presentations, and “Safe-Tea Time,” during which
general questions were asked over tea. Other variations
range from collecting rigorous minutes, to refusing to let
names or details be written down at all.13,14 To date, little
is known about the frequency of WRs and their associa-
tion with safety culture, although reported WR frequen-
cies range from weekly WRs across the hospital8 to
monthly visits in the same hospital units or clinical areas,
to random visits to random units once a month.6,7
The aim of this study was to evaluate the association
between leadership WRs and caregiver assessments of
patient safety climate, patient safety risk reduction, and
feedback on leadership WR-related actions. The authors
hypothesized that frequency of caregivers’ participation
in WRs (ie, exposure) at the unit level was positively
associated with favorable assessments of patient safety
climate, patient risk reduction, and actions taken as a
result of WRs. More specifically, it was hypothesized
that higher rates of participation in WRs would be associ-
ated with better safety climate, more feedback received
on actions taken as a result of WRs, and patient safety
risk reduction at the unit level.
Methods
Survey data from 49 hospitals of a nonprofit US health
system were used for this cross-sectional study. The
6. study setting consisted of a mix of clinical areas (eg,
medical-surgical units, pharmacy, intensive care units,
radiology) and included caregivers such as nurses, phy-
sicians, technicians, support staff, and others directly or
indirectly involved in patient care. All participating
hospitals had implemented WRs between 2002 and
2005 as part of their quality improvement strategies
related to enhancing patient safety culture, which was
initiated in 2001 and 2003 with leadership WRs train-
ing workshops from the Institute for Healthcare
Improvement15 and annual patient safety, quality, and
risk management conferences, respectively. Thus, all
units within hospitals were included in the overall
health system’s quality improvement strategy that
focused on assessing the individual hospital’s safety
culture, including features such as leadership WR expo-
sure, teamwork climate, and safety climate, in its vari-
ous clinical areas.
Leadership WRs
The WR approach used in this study is based on the
model developed by Allan Frankel3 and consisted of
regular monthly visits by hospital executives (eg, depart-
ment chiefs, chairs, risk managers) to clinical areas to
discuss patient safety issues with caregivers. The execu-
tives were instructed on how to conduct and schedule
their rounds and use rounds to address concerns related
to patient safety. The leaders were given scripted, open-
ended questions that should be asked during each round.
These might include questions about staff members’
specific concerns, such as “What keeps you up at night?”
or “What aspects of the environment are likely to lead to
the next harmful event?” The questions raised in the WR
sessions are intended to initiate group discussion and
stimulate safety problem resolution. It was important for
leaders to explain that their desire was to talk openly and
7. honestly with staff about “what is the next thing that
could harm a patient,” and to reassure staff that any infor-
mation discussed during the WR would be kept confiden-
tial. Safety issues raised during the sessions were
documented and led to actions, which were followed up
by leaders providing feedback to participating staff (eg,
at team meetings).
For study purposes, 2 questions from a version of the
Safety Attitudes Questionnaire (SAQ) were used; these
questions were modified to include specific WR-related
items: (a) “Does your clinical area use Patient Safety
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416 American Journal of Medical Quality 28(5)
Leadership WalkRounds to discuss with senior leaders
any issues that could harm patients or undermine the safe
delivery of care? (Yes; No; Not Sure)” and (b) “How
often did you participate? (0, 1, 2, 3-4, 5-7, 8 or more, Not
Sure).” The other WR items on the survey were the fol-
lowing: “Did you receive feedback about actions taken as
a result of the WalkRounds? (Yes, No, Not Sure)” and
“Do you think that 1 or more patient safety risks were
reduced as a result of the WalkRounds? (Yes, No,
Not Sure).”
Patient Safety Climate
Patient safety climate, defined as “the perceived level of
commitment to and focus on patient safety within a given
unit,” is a consensus assessment about patient safety-
related norms and behaviors. Thus, patient safety atti-
8. tudes of caregivers were measured with the 7-item
patient safety climate subscale from the SAQ. Each item
is rated on a 5-point Likert-type scale ranging from dis-
agree strongly to agree strongly. Examples of questions
included statements such as “I would feel safe being
treated here as a patient” or “In this clinical area, it is
difficult to discuss mistakes.” There is growing evidence
that the SAQ elicits attitudes that are responsive to
interventions associated with caregivers’ behaviors, such
as communication and teamwork to improve patient
safety.14,16
Patient Safety Risk Reduction
The WR item “Do you think that 1 or more patient safety
risks were reduced as a result of the WalkRounds? (Yes,
No, Not Sure)” was the self-reported caregiver assess-
ment of the extent to which patient safety issues were
elicited and acted on to reduce risk. Anecdotal examples
include double-checking medication before administer-
ing, supported ambulation from bed to wheelchairs, and
unit staff briefings before morning shifts, among others.
Feedback on WR-Related Actions
The nature of leadership WRs is to discuss patient safety
issues and concerns at the unit level and include appro-
priate follow-up actions using the leader’s position to
make things happen at hierarchical levels above indi-
vidual units. Accordingly, providing feedback to the
involved unit caregivers about actions taken as a result of
these WRs is essential to keep momentum and build trust
in management’s ability to solve patient safety problems.
For instance, unit managers and safety officers track
planned measures at the unit or departmental level fol-
lowing WRs for updates and communicate this follow-up
information to caregivers and senior leadership with the
9. aim of supplying accurate feedback to ensure completion
of improvement tasks.3
Therefore, the modified SAQ included the item “Did
you receive feedback about actions taken as a result of the
WalkRounds? (Yes/No/Not Sure)” to capture the care-
giver’s experience.
Data Collection
After the patient safety survey was initiated by the health
system, in each hospital, the questionnaire was adminis-
tered (paper and pencil) in all clinical patient care areas
to caregivers who had a working commitment of at least
50% in a specific care area and who had been working
full-time or part-time for at least 4 weeks. Participation
was voluntary. Completing the questionnaire implied
consent and took approximately 10 minutes. Data collec-
tion took place between May and September 2006 as a
partial evaluation of the hospital’s strategies to enhance
patient safety. Data from returned questionnaires were
scanned, exported to statistical software, and checked for
consistency.
Statistical Analysis
Descriptive analyses such as frequencies, percentages,
means (±standard deviation [SD]), and graphs were used
to describe demographics and the 3 variables: safety cli-
mate, exposure to leadership WRs, and patient safety risk
reduction.
Units were included in the analyses if at least 60% of
the respective caregivers completed the questionnaire
and there were at least 5 respondents per unit.
Leadership WR exposure was aggregated at the unit
level by calculating the percentage of respondents within
10. a unit who reported participating in leadership WRs at
least once. Safety climate was calculated for individual
respondents by taking the average of the scaled items and
then calculating the percentage of respondents within a
unit who reported positive safety climate (ie, proportion
of those who agreed slightly or strongly).17,18
Patient safety risk reduction and received feedback
about actions taken as a result of WRs were both calcu-
lated as the proportion of respondents within a unit who
answered “Yes,” that 1 or more patient risks were reduced
as a result of WRs or that they received feedback about
actions taken as a result of WRs, respectively (ie, respon-
dents who answered “No” or “Not Sure” to these items
were excluded).
Linear regression analyses were used to test the
assumption that the rate of caregiver participation in WRs
at the unit level was positively associated with safety
climate, patient risk reduction, and feedback about WR
actions. The predictor variable, unit exposure to WRs,
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Schwendimann et al 417
was categorized as follows: (a) 0% to 19% of caregivers
reported participating in WRs = no or low exposure; (b)
20% to 59% = medium exposure; and (c) ≥60% = high
exposure. The thresholds for this categorization came
from earlier studies using the SAQ.8,14,19 Because the data
aggregated at the unit level were hierarchically structured
(units within hospitals), the authors considered multilevel
11. modeling to be appropriate and included hospitals as a
random effect.
All analyses were performed using IBM SPSS Statistics,
version 19.0.1 (IBM Inc, Armonk, NY) and STATA
11.2 (StataCorp LP, College Station, TX).
Results
A total of 19,053 SAQ surveys were received from
49 hospitals and included 706 clinical and nonclinical
units (4-38 per hospital); the units included medical and
surgical patient units, critical care units, hospital pharma-
cies, and med tech laboratories (overall response rate =
80.2%; range = 64% to 100% per hospital). Mean and
median number of respondents per unit were 27 (SD 19)
and 22, respectively. Respondent characteristics are
shown in Table 1.
Leadership WRs
Based on the item “Does your clinical area use Patient
Safety Leadership WalkRounds to discuss with senior
leaders any issues that could harm patients or undermine
the safe delivery of care,” the percentage of people
within units who answered “Yes” ranged from 0% (49
units) to ≥80% (16 units). More specifically, using the
item “How often did you participate?” 100 units (14.2%)
had 0 respondents who self-reported participating at
least once in WRs, whereas the proportion of respon-
dents who reported that they themselves had participated
at least once ranged from 4% to 100% in the remaining
606 units (85.8%).
Only 52 (7.4%) of the 706 hospital units in this study
reported WR exposure above the 60% threshold (60% of
respondents participating in WRs at least once).
12. Safety Climate
In 419 (59.3%) of the total 706 units, ≥60% of the respon-
dents reported a positive safety climate. Overall, the propor-
tion of respondents per unit reporting a “good safety climate”
ranged from 0% (1 unit) to 100% (35 units; Figure 1).
Patient Safety Risk Reduction
Of the total 706 units, the percentages of respondents per
unit reporting safety risk reduction following WR expo-
sure ranged from 0% (62 units) to 100% (1 unit; Figure 2).
More specifically, ≥60% of the respondents reported
patient safety risk reduction as a result of WR exposure
in only 41 (5.8%) of the units.
Table 1. Respondent Characteristics (N = 19 053).
Female sex, n (%)a 15 337 (82.8)
Professional categories, n (%)a
Nurses (registered nurse, nurse manager,
LVN/LPN)
8463 (46.3)
Support staff (eg, unit assistant, clerk,
secretary)
2960 (16.2)
Technicians (eg, EKG, laboratory, radiology) 2253 (12.3)
Physicians (attending/staff/resident
physician)
1267 (7.0)
13. Therapists (eg, respiratory, PT, OT, speech,
dietician)
1280 (7.0)
Pharmacist 331 (1.8)
Nurse practitioner/physician assistant 105 (0.6)
Medical administrator 30 (0.2)
Others (eg, maintenance personnel) 1594 (8.7)
Years in organization, n (%)a
<1 year 2324 (12.8)
1-2 years 2640 (14.6)
3-4 years 5432 (28.5)
5-10 years 2301 (12.1)
11-20 years 2798 (14.7)
>20 years 2633 (13.8)
Abbreviations: LVN, licensed vocational nurse; LPN, licensed
practical nurse; EKG, electrocardiogram; PT, physical therapist;
OT,
occupational therapist.
aMissing data: sex = 541; professional categories = 770; years
in
organization = 925.
Figure 1. Safety climate, percentage of respondents reporting
“good safety climate” (n = 706 units).
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418 American Journal of Medical Quality 28(5)
14. Actions Taken as a Result of WRs
Percentages of respondents per unit reporting feedback
about actions taken as a result of WRs ranged from 0%
(79 units) to 100% (1 unit; Figure 3). More specifically,
≥60% of the respondents reported feedback about actions
taken as a result of WR in only 34 (4.8%) of the 706 units.
Association Between Leadership WR
Exposure, Safety Climate, Patient Safety
Risk Reduction, and Feedback About WR
Actions Taken
Units with ≥60% of caregivers reporting at least 1 WR
exposure had a significantly higher safety climate com-
pared with those units in either of the other categories
(Figure 4). In the multilevel regression analysis testing
for associations between unit WR exposure and unit
safety climate, significant variability between hospitals
was observed (variance = 55.02; 95% confidence interval
[CI] = 29.14-103.91). In addition, units in which ≥60% of
caregivers reported at least 1 WR exposure reported sig-
nificantly higher patient safety risk reduction compared
with units in either of the other categories (Figure 4). The
regression analysis for unit WR and unit patient safety
risk reduction, considering hospital level as random
effects, revealed significant variability between hospitals
(variance = 38.58; 95% CI = 21.36-69.67). Furthermore,
units in which ≥60% of caregivers reported at least 1 WR
exposure reported significantly higher feedback about
WR actions compared with those units in either of the
other categories (Figure 4). The regression analysis for
unit WR and received feedback about actions taken as
a result of WR, considering hospital level as random
effects, revealed significant variability between hospitals
(variance = 24.26; 95% CI = 12.21-48.18).
15. Discussion
This retrospective multicenter study on the relationship
between WRs and patient safety climate, patient safety
risk reduction, and WR feedback included more than
19 000 caregivers from 706 clinical areas in 49 hospitals
of a large nonprofit health system in the United States. A
strong association was observed between exposure of
caregivers to WRs and all 3 outcome variables at the
hospital unit level. These associations may reflect a
frequency effect as a function of units with none/low,
medium, and high leadership WR exposure, whereby
these effects varied significantly between participating
hospitals.
Differences in safety climate scores of caregivers in
units with a higher WR exposure compared with units
with a relatively low WR exposure might indicate an
effect of this widely applied intervention on team perfor-
mance and perceptions. It appears that WRs elicited
patient safety issues and potential solutions within these
caregiver teams, allowing them not only to express their
concerns to WR leaders but also to openly discuss identi-
fied aspects of what may harm patients and how the care
teams may eliminate those risks.
Figure 2. Patient safety risk reduction, percentage of
respondents reporting patient safety risk reduction following
walkround (n = 706).
Figure 3. Actions taken as a result of the walkround (WR),
percentage of respondents reporting received feedback about
actions taken as a result of the WR (n = 706).
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16. Schwendimann et al 419
Caregivers’ notions of patient safety risk reduction
and feedback about actions taken as a result of the WRs
also revealed significant differences between units with
relatively high WR exposure compared with those units
with relatively low WR exposure. This indicates that
WRs likely impact caregiver behavior toward patient
safety. Although the characteristics of patient safety risk
reduction and actions taken as a result of the WRs were
not explored in detail, findings indicate that greater num-
bers of caregivers being exposed to WRs was associated
with greater risk reduction and more feedback on
WR-related actions at the unit level. From anecdotal evi-
dence, caregiver teams used a variety of teamwork
behaviors such as structured information delivery, criti-
cal language, and debriefing20 to resolve patient safety
defects and provide safe care.
Units with relatively high WR exposure showed favor-
able results in terms of safety climate scores when com-
pared with units having a relatively low WR exposure.
One could argue that WRs lead to proactively identifying
safety risks, facilitating open discussion of solutions, and
providing feedback on actions taken as a result of the dis-
cussion. These activities likely positively influence safety
climate, because units with more exposure to these expe-
riences reported a significantly higher safety climate.
These findings are in line with another study in which
WRs were associated with increased caregivers safety
climate perceptions.8 That study relied on a pre–post
design comparing 21 clinical areas in 2 hospitals over
time, whereas the current study findings are based on a
17. 1-time observation of a multicentre sample of more than
700 hospital units showing strong associations between
safety climate and the rate of WR exposure. Although
examples of patient safety risk reduction activities were
not explored in detail and rely solely on caregiver self-
report, these results are clearly in line with another study
showing that risk reduction related to specific actions
resulting from WRs is a common strategy to provide safe
care.9 WR data from the current study suggest that WRs
encouraged teams to speak up about errors and potential
safety risks, as well as to adopt practices shared through
“lessons learned.” In another study, improvements in
safety culture and facilitated reporting led to substantial
improvements in safety practices such as equipment
replacement, process changes, and effective communica-
tion.10 Such safety practices also were employed in many
of the clinical units in the current study, according to
anecdotal evidence. Each may have influenced caregivers’
perceptions of patient safety climate. However, the fact
remains that more than 3 times the number of units with
>60% participation in WRs had positive patient safety
climate scores compared with units with participation
below the 60% threshold. Therefore, the authors attribute
the positive safety climate to WR exposure, especially
in those units with high WR exposure rates compared
with those with relatively low exposure.
This study reinforces the argument that “leaders must
see patient safety problems as problems of their system
(eg, different units within hospitals) not of their employ-
ees,”1 supported by the use of WRs that allow leaders to
tap into questions such as “How did this incident occur?”
or “What in our treatment chain could harm a patient?”
rather than “Who did it?” or “Who was at fault?” In this
study, hospital units that participated in WRs with senior
19. 90
100
0%-19% exposed to WR
(n=259 units)
20%-59% exposed to WR
(n=395 units)
≥60% exposed to WR
(n=52 units)
(p=0.149)
(p=0.000)
(p=0.000)
(p=0.000)
(p=0.000)
(p=0.000)
Pa�ent safety risk reduc�on
Feedback about WR ac�ons
Figure 4. Association between low, medium, and high
walkround (WR) exposure, safety climate, risk reduction, and
feedback
about WR actions taken (n = 706 units).
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20. 420 American Journal of Medical Quality 28(5)
leaders demonstrated enhanced patient safety perfor-
mance, as evidenced by improved safety culture scores
and increased risk reduction efforts. Indeed, units with
high WR exposure reported some of the highest safety
climate scores and most robust risk reduction strategies.
Study Limitations
Several study limitations must be recognized. First, the
reliance on cross-sectional surveys allows for observa-
tions and associations to be made, whereas causal rela-
tionships between WR frequency and improvements in
safety climate could not be established. Second, patient
safety “risk reduction” was noted on the questionnaire as
“Do you think one or more patient safety risks were
reduced as a result of WalkRounds? (Yes, No, Not
Sure),” such that exploring the specific patient safety risk
reduction strategies or the format and content of WRs
was beyond the scope of the current study. Nevertheless,
the results suggest that higher WR frequency was associ-
ated with larger proportions of respondents reporting that
they thought one or more patient safety risks were
reduced as a result. Third, the science of assessing and
improving safety culture is not yet mature, and the use of
a 60% positive threshold is based on previous experience
and a priori thresholds used in previous safety culture
studies. Fourth, other activities and safety practices (eg,
risk reduction practices such as error reporting and dis-
cussion or safety debriefing) that have been used in the
study units in addition to the WRs may have contributed
to the positive patient safety climate (above the 60%
threshold) in many units. Nevertheless, the 60% thresh-
21. old is quite conservative relative to other standards,21 the
response rates for this study were relatively high, and the
sample was large. Moreover, the focus on rates of WR
exposure rather than format or content, while a limita-
tion, is also a methodological option that others may
choose to explore, as it allows for systematic compari-
sons between units, over time, regardless of the type of
unit, background of the senior leader, length of the WR,
location of the WR, and dynamics between the caregivers
and the senior leaders.
Conclusion
These findings from a large retrospective study indicate
that WR participation is associated with a positive safety
climate, safety risk reduction, and feedback about WR
actions. This study substantiates preliminary findings on
the positive effects of WRs on caregivers’ safety behav-
iors and supports the conceptual approach of the necessity
of leaders’ direct engagement with caregivers at the unit
level in the endeavor of safety creation and their commit-
ment to multidisciplinary teamwork across hierarchical
ladders. However, the effect of leadership WRs on vari-
ous patient safety outcomes in hospitals requires further
evaluation. Given the international magnitude of patient
safety issues, the authors recommend cross-cultural stud-
ies with contextual adapted intervention protocols includ-
ing WRs, teamwork training, and specific communication
tools such as briefing/debriefing.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
22. Funding
The authors received no financial support for the research,
authorship, and/or publication of this article.
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