Doctoral defence: Ere Uibu "Utilisation and outcomes of patient safety incident reporting and learning in hospitals from a nursing perspective: a multi-method study"

On 25 August at 14:00 Ere Uibu will defend her thesis "Utilisation and outcomes of patient safety incident reporting and learning in hospitals from a nursing perspective: a multi-method study".

Supervisors:
Visiting professor Mari Katariina Kangasniemi, University of Tartu
Associate professor Kaja Põlluste, University of Tartu
Professor Margus Lember, University of Tartu

Opponent:
Associate professor Marja Härkänen, Faculty of Health Sciences, University of Eastern Finland (UEF, Finland)

Summary
Contemporary healthcare is a high-tech and complex system with the most crucial task of ensuring high-quality and safe healthcare services. People getting healthcare have the right to be protected from accidental harm, and current professional knowledge and adherence to quality requirements should secure it. The Estonian healthcare system stipulates that the quality of healthcare services is a healthcare provider's responsibility. Healthcare providers must implement systems and technologies to identify potential risks of injury and health damage on time and reduce the likelihood of patient harm. Healthcare providers must also create a positive safety culture, promote a non-blaming attitude, and raise employee awareness of patient safety. However, patient harm remains unacceptably high nearly everywhere globally.
This doctoral thesis describes the utilisation and outcomes of patient safety incident reporting and learning in hospitals from a nursing perspective. It explains the use of incident reporting systems and how the information reported serves for learning from incidents and patient safety improvements.
The doctoral thesis results show that incidents most reported are those with clearly identifiable causes or immediately visible consequences. However, most planned improvement actions target changes in people's behaviour rather than changes in the system. Action plans and evaluation of the results of the implemented improvement actions are not established as a standard; therefore, it is unclear whether the expected changes have occurred. Nurses and nursing managers, as the most active users of incident reporting systems, see its value primarily in the increased awareness of staff, in competencies development and specific developments implemented. However, they recognise the lack of changes made at the organisational level and insufficient interprofessional cooperation to ensure patient safety. Providing immediate feedback to the incident reporter and systematically sharing information to learn from incidents are rare in organisations, and clearly, patient safety requires multi-level and all healthcare system-wide change, as well as more support and input from leaders at different management levels. Effective use of incident reporting systems requires developments in all aspects of the reporting and learning process to achieve the desired outcome – safer healthcare.

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