“I just have to take it” – patient safety in acute care: perspectives and experiences of patients with chronic kidney disease

Abstract

Background Frequent hospitalizations and dependency on technology and providers place individuals with chronic kidney disease (CKD) at high risk for multiple safety events. Threats to their safety may be physical, emotional, or psychological. This study sought to explore patient safety from the perspectives and experiences of patients with CKD in acute care settings, and to describe willingness to report incidents utilizing an existing safety reporting system. Methods This study was conducted using a qualitative interpretive descriptive approach. Face to face interviews were conducted with 30 participants at their bedside during their current hospital admission. The majority of the participants were 50 years or older, of which 75% had a confirmed diagnosis of end stage renal disease with the remainder at stages 3 or 4 of CKD. Eighty percent of the participants were either on hemo- or peritoneal dialysis. Results Participants expected to receive safe care, to be taken care of, and to be cared for. Safety threats included: sharing a room with patients who were on precautions; lack of cleanliness; and roommates perceived to be threatening. The concepts of being taken care of and being cared for constituted the safety threats identified within the interpersonal environment. Participants felt taken care of when their physical needs are met and cared for when their psychological and emotional needs are met. There was a general lack of awareness of the presence of a safety reporting system that was to be accessible to patients and families by telephone. There was also an overall unwillingness to report perceived safety incidents, although participants did distinguish between speaking up and reporting. Conclusions A key finding was the unwillingness to report incidents using the safety reporting system. Fear of reprisals was the most significant reporting impediment expressed. Actively inviting patients to speak up may be more effective when combined with a psychologically safe environment in order to encourage the involvement of patients in patient safety. System-wide organizational changes may be necessary to mitigate emotional and physical harm for this client population. Electronic supplementary material The online version of this article (10.1186/s12913-019-4014-4) contains supplementary material, which is available to authorized users.

Improving hospital safety for patients with chronic kidney disease: a mixed methods study

“…Participant narratives were obtained using a semistructured interview guide [21]. To set the context for patient safety, each interview opened by asking participants to recall personal experiences with safety incidents or whether family and friends had incurred harm while in hospital.…”

“…There was a general sense of hesitancy with reporting for reasons of disbelief that any significant change would occur and apprehension regarding the impact on care. A more detailed report was previously published [21].…”

“…The safety of patients remains a top priority for healthcare organizations as evidenced by safety practices that are currently implemented in various healthcare settings, focusing on incidents related to medication errors, hospital acquired infections (HAI), and medical/clinical procedures [13][14][15][16]. In contrast, safety concerns perceived by patients tend to be non-clinical in nature and associated with emotional and psychological impact [17], including communication amongst health care providers, information shared by providers, and relational aspects of care [18][19][20][21][22][23] Integrating the patient lens into safety improvement strategies allows for care processes and issues that are important to patients to be addressed [24], helping to inform safety strategies for addressing psychological and emotional as well as physical harms.…”

Persepsi Pasien dan Perawat tentang Patient Safety di Pelayanan Hemodialisa

“…Selain itu pasien dan keluarga juga merasa dengan adanya kegiatan IKADIA membantu pasien dan keluarga untuk tetap percaya diri, termotivasi, serta mendapatkan ilmu dan teman yang memiliki nasib dan perjuangan yang sama, serta menjalin ikatan hubungan kekeluargaan yang erat antar sesama pasien dan keluarga pasien, sehingga diharapkan dapat saling menguatkan, dan saling memotivasi antar sesama pasien gagal ginjal. Pasien akan sering terlibat dalam perilaku tertentu jika mereka didorong oleh tenaga medis dan jika mereka merasa interaksi antara pasien dengan tenaga medis dilakukan dengan tidak mengancam identitas dengan tenaga medis (New et al, 2019).…”

Clima E Cultura De Segurança Do Paciente Em Unidades De Hemodiálise:

“…2 No cenário dos serviços de hemodiálise, sua ocorrência está relacionada aos processos assistenciais e à cultura de segurança organizacional, 3 bem como à infraestrutura dessas unidades. 4 Uma revisão de literatura apontou que os EAs são pouco explorados nesse contexto assistencial, entretanto, revelou que os casos de origem cardiovascular e de lesões musculoesqueléticas são prevalentes em pacientes em cuidado dialítico. 5 O tratamento hemodialítico, por sua natureza complexa, associado ao uso de tecnologia dura e às condições clínicas do doente renal crônico, elevam o potencial para a ocorrência dos erros.…”