Action research for patient safety improvement in pediatric emergency department

Abstract

Background

Patient safety is defined as the absence of preventable patient harm. Despite significant advances, enhancing the safety of pediatric patients is of particular importance. Thus, this study aimed to diagnose the current situation of patient safety and plan, implement, and evaluate patient safety initiatives in the emergency department (ED) of Ali Asghar Pediatrics Hospital.

Methods

Two action research cycles were conducted during 2023–2024 in the ED of Ali Asghar Hospital. Participants were nurses, physicians, and medical residents. In the first cycle, actions such as providing equipment and training in patient safety were carried out. In the second cycle, handoff standardization by I-PASS and continuing staff training were implemented. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC), semi-structured interviews, and incident reports. Quantitative data were analyzed using the T-Test, and the Wilcoxon signed-rank test. Qualitative data were analyzed using content analysis.

Results

In the first cycle, the patient safety culture score was 48.1%. After training sessions, the patient safety test score significantly increased from 65.5% to 87.83% (P < .001). In the second cycle, according to interviewees’ opinion, handoffs and in-service training were improved. The patient safety culture score increased to 62.6%, and overall patient safety perception, communication openness, staffing, handoff, and nonpunitive responses to errors significantly improved (P < .05).

Conclusion

During this study, patient safety knowledge and culture among ED staff improved. Moreover, the standardization of handoff using the I-PASS tool improved the process by comprehensive information transfer, prioritizing critical patients, and reducing information loss.