Health Care Professionals' Knowledge and Attitudes Regarding Patient Safety and Skills for Safe ...

108 Pages·2016·2.47 MB·English

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INDRĖ BRASAITĖ
Health Care Professionals’
Knowledge and Attitudes
Regarding Patient Safety
and Skills for Safe
Patient Care
ACADEMIC DISSERTATION
To be presented, with the permission of
the Board of the School of Health Sciences of the University of Tampere,
for public discussion in the Jarmo Visakorpi auditorium
of the Arvo building, Lääkärinkatu 1, Tampere,
on 17 June 2016, at 12 o’clock.
UNIVERSITY OF TAMPERE
INDRĖ BRASAITĖ
Health Care Professionals’
Knowledge and Attitudes
Regarding Patient Safety
and Skills for Safe
Patient Care
Acta Universitatis Tamperensis 2175
Tampere University Press
Tampere 2016
ACADEMIC DISSERTATION
University of Tampere, School of Health Sciences
Finland
Supervised by Reviewed by
Professor Tarja Suominen Docent Kaisa Haatainen
University of Tampere University of Eastern Finland
Finland Finland
Professor Marja Kaunonen Professor Lisette Schoonhoven
University of Tampere University of Southampton
Finland United Kingdom
The originality of this thesis has been checked using the Turnitin OriginalityCheck service
in accordance with the quality management system of the University of Tampere.
Copyright ©2016 Tampere University Press and the author
Cover design by
Mikko Reinikka
Distributor:
[email protected]
https://verkkokauppa.juvenes.fi
Acta Universitatis Tamperensis 2175 Acta Electronica Universitatis Tamperensis 1674
ISBN 978-952-03-0135-4 (print) ISBN 978-952-03-0136-1 (pdf)
ISSN-L 1455-1616 ISSN 1456-954X
ISSN 1455-1616 http://tampub.uta.fi
Suomen Yliopistopaino Oy – Juvenes Print
Tampere 2016
P4a4i1n o t7u2o9te
Contents
1 Introduction ..................................................................................................................... 12
2 Literature review .............................................................................................................. 15
2.1 Patient safety in healthcare.................................................................................. 15
2.1.1 Patient safety definition .................................................................................. 15
2.1.2 Patient safety culture ....................................................................................... 16
2.1.3 Patient safety incidents ................................................................................... 19
2.2 Health care professionals’ knowledge, attitudes and skills regarding
patient safety ......................................................................................................... 20
2.2.1 Health care professionals' knowledge regarding patient safety ................ 20
2.2.2 Health care professionals' attitudes regarding patient safety .................... 22
2.2.3 Health care professionals' skills for safe patient care ................................ 23
3 The purpose, aim, hypothesis and research questions of the study ........................ 26
4 Material and methods ..................................................................................................... 27
4.1 Study Design ......................................................................................................... 27
4.2 Settings, sample, participants .............................................................................. 28
4.3 Instruments ........................................................................................................... 30
4.4 Data collection ...................................................................................................... 32
4.5 Data analysis .......................................................................................................... 33
4.6 Ethical considerations .......................................................................................... 34
5 Results ............................................................................................................................... 36
5.1 Health care professionals’ knowledge regarding patient safety ..................... 36
5.2 Health care professionals’ attitudes regarding patient safety ......................... 37
5.3 Health care professionals’ skills for safe patient care ..................................... 38
5.4 Summary of the results ........................................................................................ 39
6 Discussion ........................................................................................................................ 43
6.1 Validity and reliability of the study .................................................................... 43
6.2 Comparison of the research findings with earlier studies .............................. 45
6.3 Conclusions ........................................................................................................... 48
6.4 Implications for practice, management, education and research .................. 49
7 References ........................................................................................................................ 51
8 Acknowledgements ......................................................................................................... 60
9 Original publications ....................................................................................................... 62
List of Tables
Table 1. Phases, purposes, time and articles.

Table 2. Characteristics of study participants.

Table 3. Instruments for measuring health care professionals’ knowledge,
attitudes and skills regarding patient safety.

Table 4. Correlations between health care professionals’ knowledge,
attitudes and skills regarding patient safety.
List of Abbreviations
AHRQ = Agency for Health Care Research and Quality
ANOVA = Analysis of Variance
CINAHL = Cumulative Index to Nursing and Allied Health Literature
GTT = Global Trigger Tool
HSD = Honest significant difference
HSPSC = Hospital Survey on Patient Safety Culture
ICPS = International Classification for Patient Safety
ICU = Intensive Care Unit
IOM = Institute of Medicine
IQR = Interquartile range
N = Population size
n = Number of cases, sample size
NMC = Nursing and Midwifery Council
p = p-value
PS-ASK = Patient Safety Attitudes, Skills and Knowledge scale
PSC = Patient Safety Climate
SAQ = Safety Attitudes Questionnaire
SD = Standard Deviation
SPSS = Statistical Package for the Social Sciences
WHO = World Health Organization
List of original publications
The dissertation is based on the following articles which are specified in the text by
their Roman numerals from I to IV.

I Brasaite, I., Kaunonen, M., Suominen, T. 2015. Healthcare professionals'
knowledge, attitudes and skills regarding patient safety: a systematic
literature review. Scandinavian Journal of Caring Sciences, 29, 30–50.

II Brasaite, I., Kaunonen, M., Martinkenas, A., Mockiene, V., Suominen, T. 2016.
Healthcare professionals' knowledge regarding patient safety. Clinical
Nursing Research, 1-16. DOI: 10.1177/1054773816628796.

III Brasaite, I., Kaunonen, M., Martinkenas, A., Suominen, T. 2016. Healthcare
professionals' attitudes regarding patient safety: a cross-sectional survey.
BMC Research Notes, 9:177. DOI: 10.1186/s13104-016-1977-7.

IV Brasaite, I., Kaunonen, M., Martinkenas, A., Mockiene, V., Suominen, T.
Healthcare professionals' skills regarding patient safety. Submitted.

The articles are reprinted with the kind permissions of the copyright holders.
Article IV is not included in the electronic version of the summary, as it has not
yet been published. The summary contains some unpublished results.
Abstract
The overall purpose of this study was to describe the knowledge, attitudes and skills
of health care professionals regarding patient safety, and to explain their
relationships. The aim of the study was to uncover knowledge of the present
situation and how knowledge, attitudes and skills are related, in order to have an
advanced basis on which to improve the knowledge, attitudes and skills of health
care professionals regarding patient safety.
The overall study process took place from 2012 to 2015 and was divided into two
phases. In Phase 1, a qualitative systematic literature review of 18 articles concerning
health care professionals’ knowledge, attitudes and skills regarding patient safety was
undertaken. In Phase 2, a quantitative descriptive cross-sectional empirical study was
conducted in three regional hospitals in Lithuania, involving all of the health care
professionals (n=1082) who worked with adult patients.
Overall, it was seen that health care professionals have a low level of safety
knowledge, but positive safety attitudes and they are competent regarding safety
skills. The health care professionals’ safety knowledge, attitudes and skills showed
several positive and negative associations with background factors such as their
education, length of experience in their primary speciality or work experience in
general, and the information they had received about patient safety during their
vocational or continuing education. Also, significant differences were found in
health care professionals’ knowledge, attitudes and skills regarding patient safety
when comparing their profession, the results between hospitals and working units,
and the incidents which were reported during the last year.
Based on this empirical study, health care professionals’ safety knowledge had
significant positive associations with all of the safety attitudes and safety skills scales
used in the evaluation, thus supporting the offered hypothesis.
This study offers implications for practice, management, education and research.
Based on results, it can be seen that some improvements are needed, and that
researchers, hospital managers, physicians, nurses and nurse assistants should be
involved in developing this important area. Especially, safety skills and knowledge
should be improved by way of vocational education, including an evaluation of
current curriculums and the incorporation of patient safety issues in education