الفهرس 
AIN-SHAMS UNIVERSITY HOSPITALSOnly 14 pages are availabe for public view
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Abstract
Ain Shams University hospital is one of the main university hospitals & one of the main medical training sources in Egypt. Ain Shams University hospitals include 4 hospitals & carry the burden of treating a large number of patients serving about half million patients annually in the outpatient clinics and inpatient departments & containing about 2257 beds.
Patient safety is a serious global public health issue. In recent years, countries have increasingly recognized the importance of improving patient safety. Estimates show that in developed countries as many as one in 10 patients is harmed while receiving hospital care. The harm can be caused by a range of errors or adverse events.
Safety culture is defined as the collective product of individual and group values, attitudes and patterns of behaviors in safety performance. Characteristics of a strong and proactive safety culture include the commitment of the leadership to discuss and learn from errors, to document and improve patient safety, to encourage and practice teamwork, to spot potential hazards, to use systems for reporting and analyzing adverse events, and to celebrate workers as heroes improving safety rather than as villains committing errors.
The aim of this work was to assess the current patient safety culture among health care providers at AinShams university hospitals.
Patient safety culture survey was completed voluntarily by (510) health care providers from studied departments.
In the current study, the majority of the participants’ Job category about half of them were physicians (50%), followed by nurses (32.4%) and paramedical personnel (17.6%), as regard their direct contact/interaction with patients; most of the participants (86.1%) have direct contact with patients.
The majority of the participants were females, less than 34 years old who have job experience in work setting less than 5 years.
Study results revealed areas of strength & areas with potential for improvement at Ain Shams university hospitals
Organizational learning – Continuous improvement is bright area of strength in Ain Shams university hospitals which had gained the highest Composite (average % positive) score = 78.2.
The patient safety culture is one of a penalizing nature with suppressed error reporting, lack of open communication, feedback failure especially between frontline health care providers & senior hospital staff, lack of teamwork across hospital units which leads to fragmentation of different units within the same hospital, increased workload & work hours which leads to health care provider distraction & increase rate of errors, lost important patient care information across hospital units & during shift changes which leads to unnecessary repetition of the same investigations and sometimes direct patient harm. In addition health care providers are frustrated & strongly feel that hospital management doesn’t provide them a work climate that promotes patient safety.
As regard Relationship between Patient Safety culture dimensions composite score & participants’ characteristics at AinShams university hospitals: Participants’ aged 35Years or more & those with job experience 10 years or more in specialty had got the highest patient safety culture composite score for all dimensions; there was a statistically significant difference between different age groups’ & Participants’ years of experience composite score as regard Feedback & Communication about error. No difference was found between male and female participants as regard all patient safety dimensions. The current study found that composite scores for participants’ who have indirect contact with patients was the highest as regard most of patient safety dimensions, in addition There was a statistically significant difference between the composite scores of paramedical (indirect contact with patients) & medical personnel (direct contact with patients) as regard Feedback &Communication about error. The current study revealed that safety culture differs among different units within the same hospital and between types of personnel. No significant relation was found between participants’ work hours & all patient safety dimensions.
As regard adverse event reporting At AinShams university hospitals 82.4% of the respondents agreed that adverse events that happen at their work setting were reported orally. 77.4% of the respondents agreed that they can report adverse events to their direct supervisor.
As regard adverse event recording At AinShams university hospitals, only 45.5% of the respondents agreed that adverse events that happen at their work setting are recorded. 36.9% of the respondents agreed that their direct supervisor is the responsible person for recording adverse events. Other tools for adverse event recording found during the survey were computerized system in the ICU & sampling control unit in the central hospital lab. In addition, 90.2% of respondents stated that they didn’t fill any adverse event reports during the last year.
As regard common adverse events occurring at Ain Shams university hospitals, Medication errors were the most common adverse event as mentioned by 24.7% of the respondents.
As regard punitive response to error, 70.2% of the respondents had experienced different types of punishment in response to their errors reporting during their work setting. 25.7% of the participants refuse to mention type of punishment, Financial punishment in the form of payrolls/bonus deduction was the most common type of punishment as mentioned by 22.3% of the participants, Increasing the work load in the form of increasing work hours or cancelling day offs was the 2nd most common type of punishment as mentioned by 12.8% of participants.
Based upon the study results, the following actions are recommended to improve safety culture at AinShams university hospital:
As regards Supervisors & Policy makers: Management commitment to safety, Rewarding, rather than punishing, those who report near-misses, errors, injuries, Open communication in which all staff members can talk freely about safety problems with their supervisors and policy makers and how to solve them, without fear of blame or punishment, Allow front line staff the opportunity to provide feedback about errors to senior staff & decision makers in a confidential manner, Supervisors must appreciate the role of junior staff even by saying good word, Conduct safety culture surveys every 6 months, Infection control guidelines & procedures should be adequately applied, Repairing & regular maintenance of equipments especially life saving equipments.
As regard education & training unit: Providing Patient safety education & Training, Encourage Activities that initiate & maintain safety culture such as conferences, seminars, and discussions.
As regard health care providers: Implemented Safety Briefings at shift change & when patient is transferred across units, Promote Teamwork within & across hospital units.