María Victoria Navarta-Sánchez

Objectives: To analyse the association between organisational patient safety practices, including training in patient safety and clinical simulation, and safety culture and adverse event (AE) reporting in paediatric emergency departments. Design: Observational analytical multicentre cross-sectional study. Setting: 19 paediatric emergency departments at different levels of healthcare. Participants: Healthcare professionals working in paediatric emergency departments. Interventions: Not applicable Primary and secondary outcomes: Safety culture was analysed using the Hospital Survey on Patient Safety Culture, following the Agency for Healthcare Research and Quality methodology. Logistic regression analyses were performed. Organisational patient safety practices included the presence of patient safety specialists, leadership walkarounds, additional reporting systems and training in patient safety and clinical simulation. Results: A total of 1176 professionals participated (response rate 63.8%). The presence of patient safety specialists was associated with more favourable scores in ‘supervisor/manager expectations and actions’, ‘organisational learning’ and ‘teamwork’ (p‘ frequency of events reported ’ and ‘ feedback ’ (p<0.001). Leadership walkarounds were associated with higher response rates in ‘supervisor/manager expectations and actions’ (p=0.013) and ‘organisational learning’ (p=0.048). Training in patient safety and clinical simulation were associated with higher positive response rates across most questionnaire dimensions. Higher AE reporting was observed in centres with clinical simulation training, presence of patient safety specialists, leadership walkarounds and additional reporting systems in bivariate analyses. However, in the multivariable model, only other reporting systems (OR 2.690; 95% CI 1.565 to 4.662) and annual emergency department visit volume (OR 1.023; 95% CI 1.1013 to 1.033) were independently associated with AE reporting. The presence of more than two patient safety specialists was associated with lower reporting (OR 0.553; 95% CI 0.306 to 0.998). Paediatricians were more likely to report AEs. Conclusions: Organisational patient safety practices were associated with favourable safety culture dimensions. However, after the adjustment, AE reporting was primarily associated with reporting infrastructure and organisational characteristics. The implementation of these practices varied across centres, highlighting differences in the availability of organisational safety practices. Further research is needed to better understand these associations in paediatric emergency departments.

This study aimed to explore the interests and expectations of people living with Parkinson’s disease (PD), family carers, health and social care professionals, and key stakeholders regarding relevant systems of support and community resources for PD management. As part of the OPTIM-PARK project (Optimisation of Community Resources and Systems of Support to Enhance the Process of Living with PD), an exploratory qualitative study was conducted in Spain. Forty-one participants completed a GENIE concentric circles mapping exercise to identify existing support systems and community resources. These maps informed subsequent semi-structured interviews. All interviews were digitally recorded and transcribed verbatim for thematic analysis. Participants identified several barriers to effective collaboration across healthcare and social care systems, including poor understanding of PD, limited financial resources, and insufficient communication among professionals and sectors. Facilitators for improved community-based PD management included personalised care pathways, shared decision-making, improved access to professional services and local resources, and the strategic use of Information and Communication Technologies (ICTs). Participants emphasised the need for long-term investment and strong institutional commitment to reinforce community-based support networks for individuals living with PD.

Objectives Safety culture is essential to improving healthcare quality. Paediatric emergency departments are high-risk environments where evaluating safety culture helps identify areas for improvement. This study aimed to analyse the safety culture among professionals in paediatric emergency departments, according to job category and gender. Design Multicentre cross-sectional study using the Hospital Survey on Patient Safety Culture (HSOPSC). Setting 19 paediatric emergency departments, covering all levels of care. Participants 1843 healthcare professionals were invited to participate; the response rate was 63.8%, and 33% of respondents were nurses. All clinical staff in paediatric emergency departments were eligible. Professionals from other specialties and non-clinical staff were excluded. Outcome measures The primary outcome was the assessment of patient safety culture using the HSOPSC, following the methodology of the Agency for Healthcare Research and Quality. Secondary outcomes included comparisons by job category and gender, and an exploratory cluster analysis. Results In terms of patient safety, the main strength was ‘teamwork within units’ (83.65% positive), while the main weakness was ‘staffing’ (61.92% negative). Patient safety was rated with an average score of 7.21 by the participants. Paediatricians rated ‘manager expectations’ significantly higher than nurses (p=0.023) and residents (p=0.026). Paediatricians gave more positive responses overall, with significant differences in ‘communication openness’, ‘feedback and communication’, ‘non-punitive response’ and ‘teamwork across units’, though none were classified as strengths. Cluster analysis showed that the group with more paediatricians identified more strengths and no weaknesses, while the group with more nurses and nursing assistants showed no strengths and significant weaknesses in ‘overall safety perception’, ‘staffing’ and ‘management support’. Conclusions Safety culture in paediatric emergency departments is acceptable, but still far from excellent, indicating ample room for improvement. Differences between professional categories, especially between paediatricians and nurses, highlight the need for targeted safety strategies and leadership involvement.

Patient safety is fundamental to healthcare. Adverse events, particularly medication errors, cause harm to patients, especially the paediatric population in the emergency department. Aim: To explore paediatric emergency nurses’ perceptions of medication administration errors. Method: A qualitative, ethnomethodological, descriptive study. The participants were nurses working in the paediatric emergency department. Data were collected through in-depth individual interviews with paediatric emergency nurses. The study excluded nurses employed for less than six months. Ten individual interviews were carried out. All interviews were face-to-face and audio-recorded with the participant’s consent. Interviews took between 52 min and 1 h 25 min. A questions guide was followed during the interviews. The analysis of the data was carried out according to the scheme proposed by Taylor and Bogdan. Results: The participants’ discourse revealed three main categories: Safety culture, transmitted by supervisors and safety groups. Teamwork, with good communication and a positive relationship. Error management, the lack of formal support and negative feelings despite an understanding of the multifactorial nature of errors. The study identifies several challenges in the healthcare system. Emphasis was placed on the perception of errors in terms of patient harm, while near misses or dose delays or omissions are not treated as errors. Conclusions: Although institutions have implemented safety culture strategies, nurses have not fully embraced them. There is a need to promote a positive safety culture and a safe working environment that encourages communication within the team. The hospital should provide training in safe management and patient safety and develop effective protocols. This study was not registered.

Patient safety is fundamental to healthcare. Adverse events particulary medication errors, cause harm to patients specially paediatric population in the emergency departament. Aim: To explore paediatric emergency nurses' perceptions of medication administration errors. Method: A qualitative, ethnomethodological, descriptive study. Data were collected through in-depth individual interviews with paediatric emergency nurses and analysed using Taylor and Bogdan's proposal. Results: Main categories extracted: 1) Safety culture transmitted by supervisors and safety groups. 2) Teamwork with good communication and a positive relationship. 3) Error management, the lack of formal support and negative feelings despite an understanding of the multifactorial nature of errors. The study identifies several challenges in the healthcare system. Emphasis on the per-ception of errors in terms of patient harm, while near misses or dose delays or omissions are not treated as errors. Conclusions: Although institutions have implemented safety culture strategies, nurses have not fully embraced them. Negative emotions and coping strategies are reported. There is a need to promote a positive safety culture and a safe working environment that encourages communica-tion within the team. Protocols could be adapted according to feasibility and perceived risk. The hospital should provide training in safe management and patient safety. This study was not reg-istered.

Introduction: Workplace Mental health promotion in healthcare sector, is a global priority due to the stress associated with caregiving environments and the increase of mental health problems among health professionals and students. The role of emotional intelligence (EI) and sense of coherence (SOC) have been identified as critical health protectors. However, the relationship between them as well as the underlying mechanisms of these relationships on health benefits in this population is still unclear.Aim: To synthetize the existing literature on the relationship between emotional intelligence and sense of coherence, as well as their mutual impact on healthcare workers’ and student’s well-being.Method: A scoping review was conducted following the Joanna Briggs Institute guidelines. A systematic search was conducted in PsyCINFO, CINHAL, SCOPUS and PUBMED databases, using key-terms such as students, health professionals, emotional intelligence, and sense of coherence.Results: A total of 11 articles were included, with a range of years from 2014 to 2022. Evidence was found to support the positive relationship between sense of coherence and emotional intelligence. The use of EI as a training pathway to improve SOC and health promoting behaviors is suggested. The benefits of intervening on these factors contribute to improved health professionals’ and students’ general well-being and motivation for a better performance, either in their studies or clinical work.Conclusion: The positive relationship between emotional intelligence and a sense of coherence has direct and indirect benefits on students’ and healthcare professionals’ well-being. Future studies should address longitudinal and experimental analysis to confirm these findings.

Objectives This study explores the impact of the COVID-19 pandemic on the Spanish primary care structure and services and the mechanisms implemented by the primary care workforce to restore and reinforce their reference care model. Design An exploratory, qualitative study with semistructured interviews and a focus group discussion conducted during the fall semester of 2020. Setting Primary health centres in Madrid (Spain), chosen based on factors such as infection rates during the earliest stages of the pandemic and demographic and socioeconomic aspects. Participants A total of 19 primary health and social care professionals were purposively selected. Criteria for inclusion were gender (male/female), at least 5 years of experience in their current position, category (health/social/administrative worker), and whether they worked in a rural or urban healthcare setting. Results Two main themes were identified: (1) reflecting on a model in crisis—particularly the reopening of centres to users and the proactive, participative strategies implemented by primary care professionals to reach their community; and (2) regaining a sense of purpose—how healthcare professionals implemented strategies to sustain their vision of their reference model. The COVID-19 pandemic exposed leadership deficiencies that, together with the initial unavailability of resources and difficulties maintaining face-to-face contact with users, triggered a sense of loss of professional identity. On the other hand, the analysis revealed potential strategies to restore and reinforce the traditional model, such as the adoption of digital technologies and reliance on community networks. Conclusion This study highlights the importance of a solid reference framework and enhances the strengths and skills of the workforce to reinforce the community-based service provision model.

Objectives: The purpose of this study was to explore the expectations of and experiences with the public healthcare system of domestic partners of people with Parkinson`s disease (PD) in Denmark and Norway. Methods: A qualitative exploratory design was applied. The sample consisted of 14 people from Denmark ( n = 9) and Norway ( n = 5) living with a partner with PD. Semi-structured individual interviews were conducted between June and September 2020, digitally recorded, transcribed verbatim and analysed using a reflexive thematic analysis approach combining inductive and deductive approaches. Results: The main themes were ‘negotiating systems of support’ and ‘balancing being both a partner and a family carer’. Partners take responsibility for the people with whom they live and attempt to fill gaps in the public healthcare system. The most frequently described needs were more information, service coordination as the illness progressed and acknowledgement of the complex role. Discussion: A recommendation for practice is recognition of the complex roles of partners to people with PD and reaching out to both regularly to determine needs. This may enhance the collaboration between partner carers, people with PD and healthcare providers, ensure sustainability of the system and optimise living with PD in the family.