Essentials of Patient Safety in Physical Therapy Practice
Original Editor - Sivapriya Ramakrishnan.
Top Contributors - Sivapriya Ramakrishnan, Shaimaa Eldib and Kim Jackson
Introduction[edit | edit source]
Patient safety is defined as a commitment from the healthcare team member in providing the patient with safe techniques and procedures that reduces the risks and errors and maximize the recovery of the patient[1]. The patient safety curriculum guide given by WHO- multidisciplinary edition lacks information from the perspectives of Physiotherapy curriculum principles[2]. Physiotherapists as a healthcare team member must be aware about patient safety protocols and must be able to document and communicate them in a more appropriate way, which lacks until date.[3]
Domains of patient safety practices[edit | edit source]
- Knowledge about the adverse events and the system involved in patient safety[4]: The physical therapist must have knowledge on factors like near misses, errors, risk mitigation strategies.
- Communication[5][6]: Communicating with the patient is one of the essential competencies across the globe. Communication with the patient, family members and team members will begin from history taking, providing knowledge to the patient about the condition and action taken plan, giving instructions while treatment, explaining the home exercise program to the patient and caregivers and it may extend up to negotiation of in terms of long-term care requirement for the patient. Collaboration with the team members[7][8].[9]
- Managing and acting at the moment[10]: According to Endsley's theory situational awareness, the therapist must be aware of how to tackle the situation. It involves three phases perception, understanding and prediction.
- Perception[10]: The therapist is being aware of the situation around, which includes people, environment, modalities, team members action, patient details, medical records, family members etc.
- Understanding[10]: Once the stage of perception has completed, the therapist must now act in a way to integrate these details to practice and understand how one factor can affect all other factors.
- Prediction[10]: As the phase of perception and understanding shall pass, now the therapist must be in a scenario to anticipate that may happen and act ahead of time to create incident management plan. This requires meticulous practice and training with the organization considering the legislative and socio-cultural norms involved within.
- Effective utilization of resources including information technology to reduce risks: Checklist[11] is considered as one of the important resources to be used in critical situations, to reduce human errors. Physical therapist in collaboration with the healthcare team members shall create a checklist to be used to address the patient safety concerns across different situations eg- safety considerations while transferring the patient, pulling up the bed rails after treatment to prevent patient falls, crutch height considerations to prevent axillary nerve injury etc. This can be utilized either in the form of physical checklist or using technology an automated one to be chosen according to the case.
- Being a life-long learner
- Infection control procedures. [2]
Curricular Requirements[edit | edit source]
Though patient safety is recommended to be part of the healthcare curriculum including physiotherapy, there is limited evidence to showcase the same and research are less in this area, which questions the actual implementation of the patient safety curriculum in physiotherapy education and the limited knowledge about patient safety for physiotherapists.[12] The patient safety framework provided by the Australian Patient Safety Education Framework (APSEF) and Canadian safety competency framework emphasizes various domains and in a programmatic method to be introduced in the curriculum. [2]
Methods to inculcate Patient Safety in the physiotherapy education[edit | edit source]
Simulation- Simulated environment and standardized patient is one of the methods to expose the students in an unfamiliar environment, which let the students to gain confidence before approaching a real working situations[13].
Project Based Learning- Assigning the final year students to prepare the project considering the real-world working systems quality in mind to promote patient safety[14].
Interprofessional Problem Based Learning & Team Based Learning- Providing the students with the problem pertaining to the errors and risk mitigation and facilitate the process of learning through inquiry has an impact on the retention of the concept applied [15]and it is enhanced more if the students are working in groups of various health care professionals[16].
References[edit | edit source]
- ↑ Henriksen K, Battles JB, Keyes MA, Grady ML. Advances in patient safety: new directions and alternative approaches. AHRQ Publication. 2008 Aug(08-0034).[1]
- ↑ 2.0 2.1 2.2 Safety WP, World Health Organization. Patient safety curriculum guide: multi-professional edition.[2]
- ↑ Gonzalez-Caminal, G. , Gomez, A. C. , Gomar-Sancho, C. . Patient Safety in Physiotherapy: Are Errors that Cause or Could Cause Harm Preventable?. In: Salen, P. , Stawicki, S. P. , editors. Contemporary Topics in Patient Safety - Volume 2 [Working Title] [Internet]. London: IntechOpen; 2022 [cited 2022 Nov 27]. Available from: https://www.intechopen.com/online-first/83873 doi: 10.5772/intechopen.107847
- ↑ Lawati MH, Dennis S, Short SD, Abdulhadi NN. Patient safety and safety culture in primary health care: a systematic review. BMC family practice. 2018 Dec;19(1):1-2.
- ↑ World Confederation of Physical Therapy, European Region. Euro-pean physiotherapy benchmark statement. Barcelona: WCPT; 2003. Available at: http://www.physio-europe.org/pdf/Benchmark.pdf (last accessed 11/09/2008)
- ↑ King J, Anderson CM. Patient safety and physiotherapy: what does it mean for your clinical practice?. Physiotherapy Canada. 2010 Jul;62(3):172-5.
- ↑ Ajjawi R. Learning to communicate clinical reasoning in physiotherapy practice.
- ↑ Aggarwal D, Ploderer B, Vetere F, Bradford M, Hoang T. Doctor, can you see my squats? Understanding bodily communication in video consultations for physiotherapy. InProceedings of the 2016 ACM conference on designing interactive systems 2016 Jun 4 (pp. 1197-1208).
- ↑ Wloszczak-Szubzda A, Jarosz MJ. Professional communication competences of physiotherapists–practice and educational perspectives. Annals of Agricultural and Environmental Medicine. 2013;20(1).
- ↑ 10.0 10.1 10.2 10.3 Endsley MR, Garland DJ, editors. Situation awareness analysis and measurement. CRC Press; 2000 Jul 1.
- ↑ Hales BM, Pronovost PJ. The checklist—a tool for error management and performance improvement. Journal of critical care. 2006 Sep 1;21(3):231-5.
- ↑ Howarth SD, Fielden SA, O’Hara JK. How do we educate medical students interprofessionally about patient safety? A scoping review. Journal of Interprofessional Care. 2022 Mar 4;36(2):259-67.
- ↑ Phillips AC, Mackintosh SF, Bell A, Johnston KN. Developing physiotherapy student safety skills in readiness for clinical placement using standardised patients compared with peer-role play: a pilot non-randomised controlled trial. BMC medical education. 2017 Dec;17(1):1-0.
- ↑ Gleason KT, VanGraafeiland B, Commodore-Mensah Y, Walrath J, Immelt S, Ray E, Dennison Himmelfarb CR. The impact of an innovative curriculum to introduce patient safety and quality improvement content. BMC medical education. 2019 Dec;19(1):1-8.
- ↑ Madigosky WS, Headrick LA, Nelson K, Cox KR, Anderson T. Changing and sustaining medical students' knowledge, skills, and attitudes about patient safety and medical fallibility. Academic Medicine. 2006 Jan 1;81(1):94-101.
- ↑ Leotsakos A, Ardolino A, Cheung R, Zheng H, Barraclough B, Walton M. Educating future leaders in patient safety. Journal of multidisciplinary healthcare. 2014;7:381.
