Exploring patient participation in reducing health-care-related safety risks

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Exploring patient participation in reducing health-care-related safety risks 66 Box 4 .4 . Experts’ main suggestions to increase patient involvement • Identity verification » Patients need to be aware (and be informed) that they will be asked to repeat their name several times for safety reasons before and during transfusion. » Patients will need to be made aware of the importance of maiden name (for women), married name and birth date as part of identity checks. » Patients should ask health care professionals if their identity and suitability for the product to be transfused have been checked. » Health care professionals should explain to patients the importance of the blood group card and encourage them to produce this card upon arrival at the hospital. » Extended use of computerized tools is still being debated. • Listening to the patient » It is essential to establish if patients want to get involved in the process of their own care and to understand the reasons (positive and negative) for their choice. » When possible, the fact that patients want (or do not want) to get involved in the process of their own care should be formalized. • Information and risks » Patients could get more involved by asking questions about the risks and benefits of transfusion, particularly about how to identify (post-)transfusion adverse events. • Health education » The development of health education will promote patients’ involvement. » It is necessary to inform the general population about the process of blood transfusion. » It is essential to explain and document the progress made in enhancing the safety of transfusion treatment and clinical procedures to strengthen positive views. • Surveillance » Patients should be encouraged to participate in their own surveillance of undesirable side-effects; efforts should be sustained and scaled up to delay side-effects and post-transfusion adverse effects to minimize incidents. • Patients’ organizations » Health care structures could help patients to identify organizations that bring transfused patients together and through which they can participate and benefit from additional support. » Patient organization members and blood transfusion recipients should promote blood donation among their relatives and friends. • Social epidemiology » Research is needed to better understand the mechanisms of active patient involvement in reducing transfusion safety risks. conclusions are restricted to this case study, and it is to be noted that not all questions were answered by all patients, which is reflected in the analysis. Descriptive analysis The questionnaire was answered by 24 patients (56.5% female and 43.5% male). One individual considered the questionnaire too difficult. The average age was 63.4 years, but only 47% answered the question relating to their age. All answered questions 3 and 4: 82.6% were hospitalized more than 3 times and 91.3% were transfused more than 3 times. Knowledge and blood transfusion process Almost 70% of patients did not know about their rights in the field of blood transfusion (question 5). Half thought that blood transfusion presented severe potential risks (question 6); 27% did not think it presented severe risks, and 23% did not know.
Blood transfusion safety in France: developing tools to support patients Nearly all patients knew why they have been transfused (only 2 missing values), but 4.5% did not know which blood component they had received (Fig. 4.9). Fig . 4 .9 . Patient responses to the question “Do you know with which blood component you have been transfused?” 45.45% Source: authors. 50% 4.54% Red cells Don’t know Platelets Patient information and satisfaction Only 28.6% of respondents had been worried when informed that they would be given a blood transfusion and all of them stated that they trusted physicians to make transfusion decisions (questions 18 and 19). Just over 57% were accompanied by a relative for their hospitalization, but 50% said that the relative had not helped them to understand information given on blood transfusion. Only 33.3% indicated that they received an information sheet before being discharged from hospital. Only 24% (91% response rate) received written information on blood transfusion before being transfused (question 10); of these, all had read the information. Fifty-nine per cent received oral information related to transfusion treatment, of whom 62.5% received it from a physician and 37.5% from a physician and nurse. Just over 69% considered the information to be sufficient. For those who considered the information insufficient, lack of information was related to risks linked to transfusion and to posttransfusion follow up. Twenty-four per cent received information on post-transfusion follow-up tests (question 8). Among those who received information on transfusion, only 28% declared that they had difficulties understanding the information given. Cited difficulties mainly related to the vocabulary used (Fig. 4.10). Respondents’ feedback on information and involvement Fifty-five per cent (78% response rate) highlighted the importance of oral information. Only 5% indicated their preference for both oral and written information. Just under 90% considered it useful to give information on transfusion to a wider public than transfused patients only. 67
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Exploring patient participation in
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ABSTRACT Patients’ rights have be
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iv Patient information: the link be
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vi LIST OF TABLES, FIGURES AND BOXE
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ACKNOWLEDGEMENTS The editors would
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LIST OF ABBREVIATIONS ABHR alcohol-
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FOREWORD Health is a social value a
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ChApTER 1. pATIENTS’ RIGhTS AND p
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Box 1 .1 . contd Reporting and Lear
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The causal mechanisms through which
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» be involved in routine monitorin
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elationships within the complex env
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ChApTER 2. pATIENTS’ RIGhTS AND p
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CoE Recommendation 2006/7 of the Co
Page 29 and 30: The 2005 United States act on patie
Page 31 and 32: The right to participate in policy-
Page 33 and 34: The right to participate in quality
Page 35 and 36: » engaging with patient representa
Page 37 and 38: hampered by the written and spoken
Page 39 and 40: prevents misunderstandings and shap
Page 41 and 42: Health care providers should nevert
Page 43 and 44: Recommendation 7 - Encourage the av
Page 45 and 46: 20. Constitution of the World Healt
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Page 49 and 50: awareness of the sociomedical burde
Page 51 and 52: Patient participation in hand hygie
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Page 65 and 66: Box 4 .1 . Definitions of adverse e
Page 67 and 68: Fig . 4 .4 . Distribution of advers
Page 73 and 74: The heterogeneity of situations and
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Page 83 and 84: Fig . 4 .12 . Patients’ response
Page 91 and 92: Patient safety, rights and medicati
Page 97 and 98: Fig . 5 .3 . Frequency with which d
Page 107 and 108: ChApTER 6. pATIENT pARTICIpATION IN
Page 109 and 110: Patient participation in elective s
Page 111 and 112: e desirable to have a special statu
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Patient participation in elective s
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» being involved in monitoring and
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Other studies on patient attitudes
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Information about patients’ exper
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available evidence suggests that in
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Adverse events Respondents from the
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Feeling safe Five per cent of hospi
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probability proportional to populat
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care professionals’ and patients
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group recommends that patient invol
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13. Hibbard JH et al. Can patients
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52. Triemstra M et al. Measuring cl
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2009 (http://www.bradfordresearch.n
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of a small-scale patient survey add
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Box 8 .2 . Curricula and CME Chapte
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is provided through interaction of
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Box 8 .4 . Patient education Chapte
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ANNEX 1. QUOTATIONS FROM INTERNATIO
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(2) When designing adverse event re
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17) If yes, do you think this was m
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Box A3 .1 . Reporting procedure Pat
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Box A3 .2 . contd Haemosiderosis Ha
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ANNEX 4. pATIENT QUESTIONNAIRE ABOU
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ANNEX 6. WhO pATIENT SAFETY pROGRAM
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especially those in intensive care.
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ANNEX 7. hANDOVER pROjECT Paul Bara
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(a) Provide new insight into the ro
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Johnson J, Barach P. Handovers of p
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Enhancing the patients’ role in p
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Enhancing the patients’ role in p
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