Abstract of Dissertation

Keyword : Safe care, Patient Safety Solutions, Training Interventions

Objective : The objective of the study was to identify the gaps in implementation of World Health Organization International Patient Safety Solutions in 525 bedded tertiary care hospitals and devise & implement necessary training interventions.

Background : All patients have a right to effective, safe care at all time. Increasing evidences from various hospitals show unacceptable number of patients being harmed mentally as well as physically in some or the other way during hospital stay worldwide. Therefore more knowledge and analytical approach is needed to define and measure the risks and underlying causes of various forms of harm. In 2005, the World Health Organization (WHO) launched the world alliance for patient safety and identified six action areas. One of these action areas is the development of "Solutions for Patient Safety”.

Methodology : Area of the study: Jaypee Hospital Noida Study Design: Cross-sectional Descriptive study Sample Size: Total 90 (Ward Nurses =75 & Resident medical officers=15). It was based on the IPD wards (5th and 6th floor) being allotted for training purposes. Sampling Technique: Convenience sampling Data collection: 1. Primary data: • Checklist and questionnaires based on WHO IPSS • Direct observation • Discussions with hospital IPD staff 2. Secondary data: Reports, forms and registers of various departments and other relevant records

Findings : Results: Patient identification gaps was found to be 65.33% (n=75) which was significantly reduced to 28% after training programs were conducted for them. The efficacy of formal training was found to be 25.33%. Unawareness for hand hygiene to prevent hospital acquired infections was found to be 62.67% (N=75) which after hand hygiene awareness session was reduced to 45.33%. After analyzing checklists filled by respondents, only 42.86% of doctors were communicating thorough patient handing taking over during resumption or relieving of duties before training sessions whereas an improvement of 14.29 % was observed post training. Only 30.33 % of nurses were following proper communication during patient hand over before such refresher training was given to them whereas after training nurses knowledge raised to 53.33 %. RMO knowledge about medication error during each transition in patient care was 72% before any formal training which raised to 84% afterwards.

Recommendations : Healthcare industry is presently developing at excellent pace to meet health demands of populace, and as quality of life indices are rising, so are the expectations. Even a minor health care error stands out evident in front of patients. The improvement in scores of post training assessment shows that unintentional harm or errors can be reduced down by giving regular trainings on regular hand wash with soap and water, use of ID band in every patient, follow read back and repeat back policy while doing patient hand over and conducting medication reconciliation programs in the educational curricula, orientation, and continuing professional development for health-care professionals.