Exploring patient participation in reducing health-care-related safety risks
Exploring patient participation in reducing health-care-related safety risks
Exploring patient participation in reducing health-care-related safety risks
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<strong>Explor<strong>in</strong>g</strong> <strong>patient</strong> <strong>participation</strong> <strong>in</strong> reduc<strong>in</strong>g <strong>health</strong>-<strong>care</strong>-<strong>related</strong> <strong>safety</strong> <strong>risks</strong><br />
66<br />
Box 4 .4 . Experts’ ma<strong>in</strong> suggestions to <strong>in</strong>crease <strong>patient</strong> <strong>in</strong>volvement<br />
• Identity verification<br />
» Patients need to be aware (and be <strong>in</strong>formed) that they will be asked to repeat their name several times for<br />
<strong>safety</strong> reasons before and dur<strong>in</strong>g transfusion.<br />
» Patients will need to be made aware of the importance of maiden name (for women), married name and<br />
birth date as part of identity checks.<br />
» Patients should ask <strong>health</strong> <strong>care</strong> professionals if their identity and suitability for the product to be transfused<br />
have been checked.<br />
» Health <strong>care</strong> professionals should expla<strong>in</strong> to <strong>patient</strong>s the importance of the blood group card and encourage<br />
them to produce this card upon arrival at the hospital.<br />
» Extended use of computerized tools is still be<strong>in</strong>g debated.<br />
• Listen<strong>in</strong>g to the <strong>patient</strong><br />
» It is essential to establish if <strong>patient</strong>s want to get <strong>in</strong>volved <strong>in</strong> the process of their own <strong>care</strong> and to<br />
understand the reasons (positive and negative) for their choice.<br />
» When possible, the fact that <strong>patient</strong>s want (or do not want) to get <strong>in</strong>volved <strong>in</strong> the process of their own <strong>care</strong><br />
should be formalized.<br />
• Information and <strong>risks</strong><br />
» Patients could get more <strong>in</strong>volved by ask<strong>in</strong>g questions about the <strong>risks</strong> and benefits of transfusion,<br />
particularly about how to identify (post-)transfusion adverse events.<br />
• Health education<br />
» The development of <strong>health</strong> education will promote <strong>patient</strong>s’ <strong>in</strong>volvement.<br />
» It is necessary to <strong>in</strong>form the general population about the process of blood transfusion.<br />
» It is essential to expla<strong>in</strong> and document the progress made <strong>in</strong> enhanc<strong>in</strong>g the <strong>safety</strong> of transfusion treatment<br />
and cl<strong>in</strong>ical procedures to strengthen positive views.<br />
• Surveillance<br />
» Patients should be encouraged to participate <strong>in</strong> their own surveillance of undesirable side-effects; efforts<br />
should be susta<strong>in</strong>ed and scaled up to delay side-effects and post-transfusion adverse effects to m<strong>in</strong>imize<br />
<strong>in</strong>cidents.<br />
• Patients’ organizations<br />
» Health <strong>care</strong> structures could help <strong>patient</strong>s to identify organizations that br<strong>in</strong>g transfused <strong>patient</strong>s together<br />
and through which they can participate and benefit from additional support.<br />
» Patient organization members and blood transfusion recipients should promote blood donation among<br />
their relatives and friends.<br />
• Social epidemiology<br />
» Research is needed to better understand the mechanisms of active <strong>patient</strong> <strong>in</strong>volvement <strong>in</strong> reduc<strong>in</strong>g<br />
transfusion <strong>safety</strong> <strong>risks</strong>.<br />
conclusions are restricted to this case study, and it is to be noted that not all questions<br />
were answered by all <strong>patient</strong>s, which is reflected <strong>in</strong> the analysis.<br />
Descriptive analysis<br />
The questionnaire was answered by 24 <strong>patient</strong>s (56.5% female and 43.5% male). One<br />
<strong>in</strong>dividual considered the questionnaire too difficult. The average age was 63.4 years,<br />
but only 47% answered the question relat<strong>in</strong>g to their age. All answered questions 3<br />
and 4: 82.6% were hospitalized more than 3 times and 91.3% were transfused more than<br />
3 times.<br />
Knowledge and blood transfusion process<br />
Almost 70% of <strong>patient</strong>s did not know about their rights <strong>in</strong> the field of blood transfusion<br />
(question 5). Half thought that blood transfusion presented severe potential <strong>risks</strong><br />
(question 6); 27% did not th<strong>in</strong>k it presented severe <strong>risks</strong>, and 23% did not know.