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PATIENT
SAFETY
4 Factors That Empower
Employees to Speak Up About
Safety Culture
By Shannon Barnet
B
y interviewing 158 hospital executives, managers
and staff members across six hospitals, researchers
have identified four factors that encourage hospital
workers to address errors and improve healthcare safety
culture.
Researchers analyzed transcripts of the participants'
interviews to determine how hospital employees can help
prevent central line-associated bloodstream infections
and other safety hazards. They published their results in
the American Journal of Infection Control.
Based on the interviews, the following four elements
help create an environment in which employees feel
comfortable speaking up about infections and safety
culture.
• Evidence-based practices for CLABSI prevention
• Leader behavior and encouragement
• Employee training
• Error reporting systems
"Although the focus of this study was on CLABSI preven-
tion, broader organizational practices to improve pa-
tient safety were salient in creating a nonpunitive, highly
inclusive environment in which employees felt comfort-
able speaking up," according to the researchers. n
Senior Patients Frequently Prescribed Inappropriate
Drugs Upon Discharge
By Shannon Barnet
A
t least one-third of older adults are
given at least one potentially inap-
propriate prescription when they are
discharged from the hospital, according to a
study published in the Journal of Evaluation
in Clinical Practice.
e authors of the study conducted a retro-
spective, cross-sectional analysis of medical
files for more than 300 patients aged 60 years
or older. ey found:
1. e median number of drugs prescribed
was 7.8. Additionally, a significant positive
correlation was found between the total
number of drugs prescribed and the number
of inappropriate prescriptions.
2. e prevalence of potentially inappropri-
ate prescriptions at hospital discharge was
34.5 percent, according to the Beers and
STOPP version 1 prescribing criteria.
3. STOPP version 2 criteria, on the other
hand, placed the prevalence of potentially in-
appropriate prescriptions at discharge closer
to 63 percent.
4. e drugs most frequently prescribed
inappropriately included aspirin, spirono-
lactone, benzodiazepines, digoxin and
methyldopa.
5. e odds of being inappropriately pre-
scribed a medication were higher in patients
discharged from an internal medicine ward
than from a cardiology ward.
e authors of the study concluded by saying
there is an urgent need for interventions to
reduce inappropriate prescriptions. n
BECKER'S
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