Frequency of and predictors for withholding patient safety concerns among oncology staff: a survey study

Abstract

Speaking up about patient safety is vital to avoid errors reaching the patient and to improve a culture of safety. This study investigated the prevalence of non-speaking up despite concerns for safety and aimed to identify predictors for withholding voice among healthcare professionals (HCPs) in oncology. A self-administered questionnaire assessed safety concerns, speaking up beliefs and behaviours among nurses and doctors from nine oncology departments. Multiple regression analysis was used to identify predictors for withholding safety concerns. A total of 1013 HCPs returned the completed survey (response rate 65%). Safety concerns were common among responders. Fifty-four per cent reported to recognise their colleagues making potentially harmful errors at least sometimes. A majority of responders reported at least some episodes of withholding concerns about patient safety. Thirty-seven per cent said they remained silent at least once when they had information that might have helped prevent an incident. Respondents believed that a high level of interpersonal, communication and coping skills are necessary to speak up about patient safety issues at their workplace. Higher levels of perceived advocacy for patient safety and psychological safety significantly decreased the frequency of withholding voice. Remaining silent about safety concerns is a common phenomenon in oncology. Improved strategies are needed to support staff in effective communication and make cancer care safer.

Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents

“…First, about half of residents reported observing a safety threat during their most recent inpatient month, and about 70% spoke up about it, similar to a prior study of >1000 oncology doctors and nurses, where 54% recognised a colleague making a harmful error and 37% remained silent at least once 16. However, the prevalence of professionalism breaches was higher, with three-quarters of interns and residents reporting that they had observed such behaviour.…”

Medication safety incidents in paediatric oncology after electronic medication management system implementation

“…In reporting the results, we present the quantitative distribution of the incidents as background to the qualitative findings, but note that it is not appropriate to use counts of voluntary incident reports as a measure of incident numbers that have occurred (Schwappach & Gehring, 2015;Westbrook et al, 2015). While we report on all types of medication incidents reported, we focus on TA B L E 1 Coding scheme for classification of medication-related incidents…”

Desafios da seguran�a do paciente e a qualidade em servi�os de oncologia

“…As situações que predispõem a redução da qualidade e aumento do risco de eventos adversos incluem o avanço tecnológico com insuficiente educação em serviço, falha na aplicação do processo de enfermagem, desmotivação, delegação da assistência sem supervisão apropriada e sobrecarga de trabalho (3) .…”

“…apontam que a maioria dos acidentes nos setores de radioterapia está relacionado à documentação incompleta e/ou errada. Para evitá-los, as informações detalhadas necessitam estar descritas no plano de tratamento do paciente, as quais devem ser claramente comunicadas e documentadas por toda equipe (radioterapeutas, físicos, enfermeiros e oncologistas), além do desenvolvimento de software para aumentar a eficiência e eficácia do planejamento do tratamento de radioterápico (3) .…”