تجارب المرضى للأحداث غير المرغوب فيها اثناء اقامتهم في المستشفى : دراسة في المجمع الطبي الفلسطيني ، رام الله
Patient Experiences of Undesirable Safety Events during Hospital Care: A Study in the Palestinian Medical Complex, Ramallah
مي طارق محمود بشر
May Tareq Mahmoud Bisher
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Background: Some patients are subjected to undesirable safety events during hospitalization and their health may be negatively affected by the health care received. The consequences can be permanent injury, an increased length of stay (LOS) in hospital, and in some cases even death. As health systems become more complex and interrelated, the focus on patient safety has intensified. Wide-ranging efforts have been devoted to evaluating the harm incurred by patients and to learning from errors, but data about health care problems reported solely from the perspective of professionals engaged in this field is insufficient. Therefore, this study addresses patient-centered data that take into account the patient’s experience of undesirable safety events within three main categories: medical complications, health care process problems and communication problems. Aim: To investigate patient experience of undesirable safety events and to evaluate the extent and nature of harm occurring during hospitalization. Methods: The survey design was a quantitative, descriptive cross-sectional survey. Existing updates to the Picker survey tool were reviewed, translated and adapted to the Palestinian context, and validated by an expert committee in the area of patient safety. Chronbach’s alpha test was conducted to test the reliability of the survey categories and items and showed an overall acceptable internal consistency (0.778). The study was carried out in the Palestinian MedicalComplex in Ramallah. The study sample consisted of adult medical and surgical patients who had already spent at least four days in hospital. Findings: The survey was conducted on a total of 98 patients, of whom fifty percent were females and fifty percent were males, with a mean age of 57 years. Of those surveyed, 46.9%were over 60 years of age; 58.2% were medical patients; and 41.8% were surgical patients. The mean length of stay was seven days. Patients reported a total of 851 undesirable events (an average of 8.68 events per person). Patients reported 168 medical complications (20%), 187 health care process problems (22%), and 496 communication problems (the highest event rate with 58%). About 43% of the patients rated the undesirable safety events they had faced as high risk, and 20.4% of patients indicated that they had had serious concerns about experiencing a medical error in their care prior to being admitted to hospital. The results showed that patients with poor and very poor health were more exposed to experience undesirable safety events (P =0.015). Also, surgical patients reported more problems in the care process than medical patients (P=0.047). Participants who had experienced health care process problems rated their experience of undesirable events as posing a high degree of risk (P<0.001). Finally, communication problems between patients and health professionals have a very detrimental effect on patient health (P<0.001).