Hospital staff respondents

Since the first annual comparative database report, published in 2007, which included data voluntarily submitted from 382 US hospitals, the number of hospitals and staff respondents included in the database report has grown each year. The Hospital SOPS 2012 Comparative Database Report displays results from 1,128 hospitals and 567,703 hospital staff respondents (Sorra et al. 2012). This large number of hospitals provides for a much more reliable and comprehensive set of benchmarks. 

Field First Aid Remove victim(s) to an area of safety (away from the Hot Zone). Remember patients may contaminate you and/or other emergency responders if you fail to don proper personal protective equipment. Provide victims with emergency medical care as soon as possible. Unless otherwise recommended, remove victim(s) clothing, shoes, and personnel belongings for later return. If the victim was obviously in contact with infectious substance(s), flush skin and eyes for fifteen to twenty minutes. Route victim(s) to hospital for a physician s professional opinion. Ensure that hospital staff is fully aware of the medical situation and the poison or infectious substance that may be involved. An enzyme-linked immunosorbent assay test (ELISA) is now approved for anthrax use in hospital laboratories. 

Hereafter, we will illustrate application of the above-mentioned method through a case study conducted in Japan. In this study, two other fictitious cases - i.e. mild and near-miss cases, which were also adopted from Andersen et al. (2002) - were also used in addition to the above-mentioned severe outcome example. Hospital staff s self-reported reactions were elicited from about 1,000 doctor and 18,000 nurse responses in 84 hospitals. The results are summarised in Table 4.6 in terms of the percentage of respondents who strongly or slightly agreed with each reaction item. There were significant differences between doctors and nurses and between outcome severities for most reactions. 

The draft smvey was then eognitively tested with over a dozen hospital staff. Cognitive testing involved asking individuals to complete the survey and provide comment about their answers in one-on-one, in-person or telephone interviews. The purpose of cognitive testing was to assess respondent eomprehension and interpretation of items, to determine how they arrived at their answers and to find... 

The principle of benchmarking safety cultrrre perceptions in Belgian hospitals is based on the respondents positive attitude towards patient safety. As such, the comparative report only considers explicitly positive answers of hospital staff towards differerrt safely culture dimensions. This approach has the lirrritation that neutral or negative perceptions are not separately taken into accormt. 

JOB REQUIREMENTS Ability to work independently with minimal direct supervision. Ability to work with hospital and pharmacy staff. Ability to handle frequent interruptions and adapt to changes in workload and work schedule. Ability to set priorities, make critical decisions, and respond quickly to emergency requests. Ability to exercise sound professional judgement. Ability to meet the pharmaceutical care needs of neonatal, pediatric, adolescent, adult, and geriatric patients. 

Children may be separated from their parents and family members if they are deemed to be contagious. If children are quarantined, parents may not be able to visit. Young children may experience separation anxiety and they may not respond to staff members. Nurses and health care professionals must be able to distinguish separation anxiety and fear of abandonment from a worsening neurologic status. Children who are quarantined require extra staff for their care because they cannot care for themselves, and their health condition must be closely monitored. Plans for the care of quarantined children and families must be included in community and hospital disaster planning. 

Over the next several days, the community and the hospital had to endure worsening conditions. Freezing rain continued, the ice coating caused trees to fall, most of the community had disruptions in their electricity, water, and phone service. Many of SOMC staff were not able to report to work because of road conditions, fallen trees, or lack of utilities. The 200-foot tower that held the communication equipment for the county s emergency responders (fire, sheriff, and EMS) fell because of the heaviness of the ice coating, leaving ambulance dispatching out of service. 

Minimally, all hospital personnel (e.g., nurses, physicians, security, and triage) who have a designated role in a HAZMAT response must be trained to the first responder awareness level (Levitin Siegelson, 2002). Staff must be comfortable with knowing how to locate and use personal protective equipment and with the decontamination process (see chapter 26, Mass Casualty Decontamination, for further discussion). 

The pharmacist collaborates with nursing, medical staff, and hospital administration to prepare the ICU for the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) survey and responds to any deficiencies identified. 

In more recent times, the Aum Shinrikyo religious cult used sarin in two terrorist attacks in Japan. At Matsumoto, in 1994, overall 600 individuals reported acute signs and symptoms, 58 were admitted to hospital and seven people died (Morita et al., 1995). Following the release of sarin on the Tokyo underground in 1995, approximately 1000 individuals exhibited signs and symptoms and twelve people died (Nagao et al., 1997 IoM, 2000) (see Chapter 13). Not only were substantial numbers of members of the public directly affected, but in both situations, first responders and medical staff were also exposed to sarin as they attended those exhibiting marked... 

One strategy to respond to the pressure to reduce operational costs is reduction in the level of staffing. Staff reduction is based on a wishful thinking that it would he possible to care for the same number of patients with less staff, without degrading safety and quality of care. This in short term reduces costs and sets cost/reimbursement differential on a favorable path, but in long run it may increase the probabihty of AEs, and may lead to increases in cost in many ways a) Cost of treatment of compUcations because of the AE occurrence, b) Longer stay of patients and associated costs, c) Decreased hospital capacity for new patients, d) No reimbursement from insurance in form of denial due to AE and e) Increased cost because of the decrease in reimbursement as a result of feedback of AEs which impose more challenging reimbursement pohcies on hospital in future. 

Based on the literature review, key dimensions of hospital patient safety culture were identified and items drafted to measure those dimensions. Items were written to obtain a staff-level perspeetive of the extent to which a hospital organisation s culture supports patient safety and event reporting. In addition, most of the items were foeused on the respondent s own work area or unit beeause unit-level eulture is more salient and relevant and has the most immediate influenee on staff attitudes and behaviors. Sinee eulture varies aeross units, it was important to foeus respondents on their own unit s eulture by asking them to identify and seleet their unit first and then answer the questions in the survey about that unit. However, some patient safety eulture issues cut across units, so the last part of the survey foeused specifically on hospital-wide patient safety eulture, ineluding handoffs and transitions, pereeptions of management support and teamwork aeross units. 

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