Premium
Applying an ecological restoration approach to study patient safety culture in an intensive care unit
Author(s) -
Gimenes Fernanda Raphael Escobar,
Torrieri Mayara Carvalho Godinho Rigobello,
Gabriel Carmen Silvia,
Rocha Fernanda Ludmilla Rossi,
Silva Ana Elisa Bauer de Camargo,
Shasanmi Rebecca O,
Cassiani Silvia Helena De Bortoli
Publication year - 2016
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.13147
Subject(s) - patient safety , safety culture , nursing , organizational culture , focus group , health care , participatory action research , citizen journalism , qualitative research , medicine , quality management , intensive care unit , quality (philosophy) , psychology , public relations , sociology , management system , operations management , psychiatry , management , engineering , social science , philosophy , epistemology , world wide web , political science , anthropology , computer science , economics , economic growth
Aims and objectives To gain an understanding of medication safety culture and other quality issues in a Brazilian intensive care unit using a restorative approach. Background Patient safety should be considered one of the pillars of quality in health care. Thus, patient safety culture is increasingly being explored as a guide for quality improvement efforts. Design A qualitative approach. Methods Participatory photographic research methods from the field of ecological restoration were adapted in this study. This study used focus groups, then subsequent nurse‐led photo‐narrated walkabouts, and photo elicitation with 23 nurses and one physician in interactive phases of data collection and analysis over an eight‐month timeframe. Results The core themes identified were: the ‘medication system shapes patient safety’ and the ‘feeling of helplessness in the face of the prevailing organization culture’. Participants discussed supports exiting in the intensive care unit that shape medication safety, the barriers that impede safe medication management, the solutions to improve medication safety and the creation of a better medication safety culture. Conclusions The methods used allowed participants to visualise sound practices as well as key safety issues, reflect on their day‐to‐day work, re‐think potential improvements, and enact changes to improve medication safety and medication safety culture. However, the patient safety culture is also marked by administrative pressure. The hospital needs to adopt participatory management, where the health professionals can act together with the organisational leaders to promote a just culture. Relevance to clinical practice The participatory photographic research methods from the field of ecological restoration provided participants with a tool to promote patient safety culture and engage policy change dialogue. However, it will be important in future restorative research to track‐specific safety outcomes over time to assess the cost‐benefit of the adoption of participatory management models.