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Patient safety incidents during healthcare cause a high burden and mortality, but many go unreported. Involving patients and caregivers in the identification and reporting of safety incidents would add value to the current incident reporting systems used by health professionals. Identifying and analysing patient safety incidents is essential to prevent future events, allowing organisations to apply a learning-from-error approach and to implement improvement plans. Patient-Reported Incident Measures are tools for patients and caregivers to report safety issues related to their healthcare. In accordance with WHO’s patient safety taxonomy, the term patient safety incidents is used throughout this protocol to encompass events that do and do not reach the patient, including what are commonly referred to as near misses and adverse events. We aim to identify and describe the published literature about tools for patients or caregivers to report patient safety incidents in healthcare.
We will conduct a scoping review. We have developed inclusion criteria using the PCC (population, concept and context) format, where population includes adult patients or caregivers; concept refers to documents describing formal tools used to report patient safety incidents; and context includes any healthcare setting, such as hospitals or mental health centres, during or immediately after care. The scoping review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Evidence sources include primary research, systematic reviews, meta-analyses, conference abstracts, letters, guidelines, as well as policy documents, reports, blogs and websites, without language restriction. An initial database search in Medline, Embase, CINAHL, and Cochrane Library from database inception up to June 2023 identified 4500 initial citations, of which 4103 were selected for evaluation after duplicates were removed. We will supplement the search by checking the reference lists of included studies for additional sources of evidence and an additional search in Google to identify non-peer-reviewed documents. This initial search will be updated before completing the review. We will use a self-created data collection form for data extraction and perform a narrative synthesis to integrate and summarise the review findings. We will describe the general characteristics of the tool: setting, scope, format, content, type of patient safety incident and severity, the moment of notification, relation to patient safety incident reporting and learning systems, development process, testing, validation, or piloting, among other characteristics. As a result of this scoping review, we intend to provide an index of patient/caregiver-reported safety notification tools and a list of descriptive or evaluation studies.
We will only use published data. Approval from the human research ethics committee is not required. The results of this scoping review will be submitted for publication in an international peer-reviewed journal and scientific meetings. Findings will also be disseminated through digital science platforms and academic social media.
To offer a practical proposal regarding the implications of integrating intersectional theory into nursing practice, drawing from the experiences and narratives of nurses across diverse professional contexts.
Qualitative Grounded theory, following the constructivist approach offered by Kathy Charmaz.
Data collection was conducted between 2022 and 2023 with nursing professionals from Catalonia, Spain. Following Charmaz's approach, thematic analysis was performed after theoretical sampling was saturated through 17 in-depth interviews and 2 focus groups.
A total of 26 individuals participated in the study. The analysis identified five dimensions related to considerations for incorporating intersectionality into nursing practice. These dimensions are presented as a conceptual framework, organised from elements most closely related to reflexivity and professional positionality, to those more distally connected to a critique of the structural system within which nursing activities are situated.
Although the findings reveal widespread agreement regarding the necessity of adopting a new perspective that challenges the dominance of biomedical knowledge and facilitates alternative approaches to the social and health complexities in our environments, there exists divergence in the methods for achieving this paradigm shift. Intersectional theory provides a theoretical framework conducive to this reassessment.
The findings outlined in this study hold significant implications for both professional practice and the structuring of nursing education at the university level. Concerning professional practice, we advocate for a theoretical framework that offers lucidity and precision regarding the strategies and skill sets necessary for the integration of an intersectional perspective into nursing practice. This framework may prove beneficial not only to individual practitioners but also to managerial entities seeking to reshape institutional care paradigms. In terms of nursing education, this research provides a foundation for a critical revaluation of curricular structures and their practical execution.
Since health and illness are influenced by social and cultural factors, nursing theories are evolving to address social determinants of health. Strategies are needed to integrate intersectional theory into nursing practice and education.
Findings underscore the importance of aligning nursing values with principles of equality, respect, and social justice to address social health inequalities effectively.
This study provides insights into the ambivalence surrounding the incorporation of intersectional theory in nursing practice, shedding light on its perceived value and feasibility among practitioners.
A practical framework is developed which emphasises the significance of understanding power dynamics in healthcare settings and their implications for perpetuating or challenging social inequalities in health.
The manuscript is based on the Consolidated Criteria for Reporting Qualitative Research (COREQ).
No Patient or Public Contribution.
Introducción. Las heridas crónicas suponen un grave problema de salud con gran impacto socioeconómico debido a su morbimortalidad y a la afectación de la calidad de vida. Desde hace tiempo se conocen las propiedades de los lípidos en el sistema inmunitario. Un sistema inmunológico débil podría conducir a una infección o cronificación de las heridas. El colesterol es un lípido con importancia cuantitativa en las membranas de las células donde contribuye al mantenimiento de la fluidez de membrana. Unos niveles bajos de colesterol se relacionan con mayor riesgo de padecer infecciones. El objetivo del estudio fue analizar los niveles de lípidos en pacientes con úlceras por presión infectadas. Metodología. Se estudiaron 77 pacientes del Departamento de Salud de Elche Hospital General con úlceras por presión infectadas en un periodo de un año. Resultados. Se ponen de manifiesto diferencias estadísticamente significativas entre pacientes con niveles de C-LDL por debajo de 70mg/dL y pacientes con niveles por encima de 70mg/dL que presentan un CT por debajo de 140mg/dL. Discusión. La investigación futura sobre estos aspectos ayudará a aclarar los mecanismos de transporte del colesterol hacia los tejidos para así protegerlos de las agresiones de los microorganismos.
ABSTRACT
Introduction. Chronic wounds are a serious health problem with great socioeconomic impact due to their morbidity and mortality and the affectation of quality of life. The properties of lipids in the immune system have been known for a long time. A weak immune system could lead to infection or chronic wounds. Cholesterol is a quantitatively important lipid in cell membranes where it contributes to maintaining membrane fluidity. Low levels of cholesterol are associated with an increased risk of infections. The objective of the study was to analyze the levels of lipids in patients with pressure ulcers infected. Methodology. 77 patients with infections in pressure ulcers from the Health Department of Elche-General Hospital were studied for one year. Results. Statistically significant differences are revealed between patients with LDL-C levels below 70mg/dL and patients with levels above 70mg/dL. Levels of TC were below 140mg/dL in both groups. Discussion. Future research on these aspects will help clarify the mechanisms of cholesterol transport to the tissues and therefore protect them from microorganism aggressions.
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