Development of the perceptions of preventable adverse events assessment tool (PPAEAT): measurement properties and patients’ mental health status

Abstract

Background Patient-centered care and patient involvement have been increasingly recognized as crucial elements of patient safety. However, patient safety has rarely been evaluated from the patient perspective with a quantitative approach aiming at making patient safety and preventable adverse events measurable. Therefore, this study aimed to develop and evaluate the psychometric properties of a questionnaire assessing patient safety by perceived triggers of preventable adverse events among patients in primary healthcare settings while considering mental health. Methods 210 participants were recruited through various digital and print channels and asked to complete an online survey between November 2019 and April 2020. Exploratory factor analysis was performed to identify domains of triggers of preventable adverse events affecting patient safety. Furthermore, a multi-trait scaling analysis was performed to evaluate internal reliability as well as item-scale convergent-discriminant validity. A multivariate analysis of covariance evaluated whether individuals below and above the symptom threshold for depression and generalized anxiety perceive triggers of preventable adverse events differently. Results The five factors were information and communication with patients, time constraints of healthcare professionals, diagnosis and treatment, hygiene and communication among healthcare professionals and knowledge and operational procedures. The questionnaire demonstrated a good total and subscale internal consistency (α = 0.91; α = 0.75 to α = 0.88); good item-scale convergent validity with significant correlations between 0.57 and 0.78 (p<0.05; p<0.01) of all items with their associated subscales and satisfactory item-scale discriminant validity between 0.14 and 0.55 (p>0.05) with no significant correlations between the items and their competing subscales. The questionnaire further revealed to be a generic measure irrespective of patients’ mental health status. Patients older than 50 years of age perceived a significantly greater threat to their own safety compared to patients below that age. Conclusion The developed Perceptions of Preventable Adverse Events Assessment Tool exhibits good psychometric properties, which supports its use in future research and primary healthcare practice. Further validation of this questionnaire in different settings, languages and larger samples is needed. The results of this study need to be considered when assessing patient safety in the context of health care research.

Comparing the Effectiveness of a Web-Based Application With a Digital Live Seminar to Improve Safe Communication for Pregnant Women: 3-Group Partially Randomized Controlled Trial

“…Perceived patient safety was measured as perceived patient safety risks with 9 items that were adapted to the pregnant women’s perspective from a self-constructed and previously validated scale [ 37 ], “Before, during and after birth, I observed at least once that not enough healthcare workers were present.” The answer categories ranged from 1 (does not apply at all) to 6 (applies fully and completely) at baseline and 1 to 4 in the questionnaire after birth, with a Cronbach α of .82 at T1 and .85 at T2. Baseline values were recorded using the formula “Y = (B − A)*(x − a)/(b−a) + A,” with the old minimum (a), new minimum (A), old maximum (b), and new maximum (B) [ 38 ].…”

Psychosocial Processes in Healthcare Workers: How Individuals’ Perceptions of Interpersonal Communication Is Related to Patient Safety Threats and Higher-Quality Care

“…We assessed safety performance indicators regarding threats, such as the perceived preventable adverse trigger scale. We adapted a patient-centric trigger-for-adverse-events scale from Keller et al [59] to the group of HCWs. We measured how often team members noticed possible patient safety threats using a 15-item scale with the sample item "Colleagues or I had insufficient knowledge of technical equipment" Cronbach's alpha was 0.93 [59].…”

“…We assessed safety performance indicators with a trigger scale for threats and a care scale, as in Study 1. Cronbach's alpha for the threats scale was 0.91 [59]. We adapted a short seven-item scale measure of care from Study 1 for practicality.…”

Psychological Intervention to Improve Communication and Patient Safety in Obstetrics: Examination of the Health Action Process Approach

“…Finally, short scales were included regarding communication behavior (seven items, Cronbach's α = 0.80), outcome expectancies (three items, Cronbach's α = 0.76), action self-efficacy (two items, Spearman-Brown coefficient = 0.77) and coping self-efficacy (eight items, Cronbach's α = 0.82), intention to communicate safely (four items, Cronbach's α = 0.88), action planning (three items, Cronbach's α = 0.93) and coping planning (two items, Spearman-Brown coefficient = 0.81) as well as perceived barriers toward safe communication (six items, Cronbach's α = 0.75). To capture perceptions of patient safety, a trigger for adverse events scales (Keller et al, 2021) was adapted to the perspective of HCW. Participants were asked to rate how often they noticed possible triggers for patient safety incidents on a 30-item scale (Cronbach's α = 0.96).…”