Concern for Patient Safety Culture of ECMO Team in Emergency Department: A Cross-Sectional Survey

Abstract

To evaluate the patient safety culture status of the ECMO team in the emergency department of a tertiary care hospital. A cross-sectional survey was conducted in the emergency department of Xiangya Hospital from September 1st to 30th, 2021. The Chinese version of HSOPSC electronic questionnaire was administered to all staff involved in ECMO management and initiation. A total of 152 ECMO team members completed the survey. Among the 12 dimensions of patient safety culture, 4 dimensions recorded relatively high positive response rates (>50%): organizational learning-continuous improvement (87.1%), teamwork within units (86.8%), feedback and communication about errors (58.5%), and supervisor/manager expectations and actions promoting patient safety (55.6%). 8 dimensions recorded relatively low positive response rates (<50%): nonpunitive responses to errors (24.1%), hospital handoffs and transitions (27.1%), staffing (28.6%), the frequency of event reporting (32.4%), teamwork across units (33.2%), communication openness (39.7%), management support for patient safety (48.7%), and overall perceptions of patient safety (49.3%). The overall level of patient safety culture was measured at 47.6%. The ECMO team should immediately address issues of nonpunitive responses to errors, hospital handoffs and transitions, and staffing to improve the safety of ECMO. Going forward, the head of the ECMO team should regard patient safety culture as a top priority, improve staff satisfaction, standardize the transfer and handover process, and create a blame-free environment to facilitate event reporting.

Assessing patient safety implementation and its associate factors in a pediatric inpatient ward

“…The SOP of patient safety culture is to measure the perceptions of nurses in connection with patient safety work standards in their respective work units, the perceptions of managers/supervisors/ heads of units on how to promote patient safety work standards, communications from nurses related to patient safety and medical errors, and reporting of patient safety incidents in work units by the nurse. (16) The measurements demonstrated validity, usability, feasibility, internal consistency, and reliability (Cronbach alpha = 0.94). (17) Patient safety culture in each dimension has several questions with positive and negative statement aspects.…”

“…There were 20 nurses were excluded based on the exclusion criteria. The research sample of 80 nurses was divided equally among 5 hospitals based on hospital clusters (16 nurses in each hospital). A random sample to reduce bias and to estimate the prevalence of unknown parameter(s) from the target population.…”

ICU Nurses’ Perception of Sensitive Indicators of Quality of Care for ECMO Patients in Guizhou Province, China: A Cross-Sectional Study

“…[4][5][6][7] According to the Extracorporeal Life Support Organization (ELSO) statistic, 8,9 as of April 18, 2023, a total of 16,803 cases of ECMO were conducted in the year 2022, with a cumulative total of 196,108 cases, and 54% of the patients survived to hospital discharge or transfer. However, ECMO is technically complex, demanding, and challenging to manage during operation; 10,11 Therefore, it often requires specialized teamwork, and ECMO nurses play a significant role during the treatment or management of ECMO patients. 12 Previous studies have shown that 55% of patients experienced complications such as hemorrhage and cerebral infarction during ECMO support due to inadequate monitoring of their condition, and the cumulative incidence of 90-day in-hospital mortality was 37.4%.…”