Prioritising patient safety

News / Judy Baulch / September 17, 2019

Today is the first ever WHO World Patient Safety Day, highlighting the need for safety and quality care for patients everywhere.


According to the World Health Organisation (WHO), at least five patients around the world die every minute because of unsafe care, and most of these deaths are preventable.

Deakin University’s Institute for Health Transformation’s quality and patient safety research domain focuses on improving patient experience, patient safety and quality in order to reduce the incidence of unsafe patient care and save lives.

“Failures in the safety and quality of care can have serious consequences for care recipients, their families, the staff members involved, organisations and society broadly,” says Professor Alison Hutchinson RN, Head of the quality and patient safety domain.

“We’re aiming to improve the quality and safety of patient care through applied health services research conducted in a well-established, distinctive and internationally renowned integrated health service partnership network.”

Just two examples of the world-leading research conducted by the quality and patient safety domain are reducing harm for people displaying symptoms of delirium or dementia, and prioritising nurses’ responses to deteriorating conditions in patients.

Reducing harm for people displaying symptoms associated with a neurocognitive disorder (delirium or dementia)

People experiencing behavioural and psychological symptoms (BPS) related to a neurocognitive disorder like dementia or delirium are at high risk of experiencing preventable harm during their hospital admission.

Despite strong evidence that individually-tailored, non-pharmacological interventions can reduce symptoms and prevent harm, care delivered in hospitals is frequently inconsistent with best practice.

“We wanted to understand the acceptability and feasibility of a strategy to increase nurses’ uptake of best practice guidelines in relation to people displaying BPS associated with a neurocognitive disorder,” Professor Hutchinson said.

“Our objectives were to co-produce a three-part knowledge translation strategy, comprising facilitation, education, and a decision-support tool, to improve nurses’ understanding of neurocognitive disorders, and to support them in the application of their knowledge in patient care. We then evaluated the acceptability of the strategy to ward staff and the feasibility for its use in acute hospital settings.”

The study, funded by the Dementia Centre for Research Collaboration as part of an Australian Government initiative, found the strategy was acceptable, usable and feasible to assist nurses with clinical decision making to address patients’ BPS in hospital settings.

“Over 170 hours of observations of the care provided to patients with BPS showed that the number of best practice interventions used by nurses increased from a median of 1 pre-intervention, to 4 post-intervention,” Professor Hutchinson said.

“The average number of medication errors and falls per month, measured prior to and during the study period also decreased by 26.8 per cent and 5.8 per cent, respectively.

“The intervention showed it has the potential to improve nurses’ knowledge and use of best-practice interventions when caring for patients displaying BPS related to a neurocognitive disorder and we believe future research is warranted to refine the strategy, and test its impact and sustainability.”

Other members of the research team include Deakin’s Associate Professor Bernice Redley, Professor Tracey Bucknall, Dr Helen Rawson and Dr Emily Tomlinson and colleagues from Cairnmillar Institute, Monash Health, Monash University and University of Manitoba, Canada.

Prioritising responses of nurses to deteriorating patient observations (PRONTO)

Approximately 10 per cent of patients who enter hospitals suffer an adverse event unrelated to their medical condition, which translates to millions of people every day around the world. The PRONTO project, led by Professor Tracey Bucknall focuses on improving nurses’ measurement and response to vital signs in a bid to reduce serious adverse events and improve patient health.

The researchers have found that a gap between knowledge and practice exists in this regard, despite vital signs being the most common assessment technique employed in healthcare.

“Vital signs are fundamental to patient safety and health in hospital. They are the first step in patient rescue,” Professor Bucknall explained. “If physiological signs of deterioration are missed, misinterpreted or mismanaged by nurses in hospitals, then critical illness, cardiac arrest, unplanned intensive care admissions and death may result.”

Extending collaborative work over the past six years, the researchers conducted a randomised trial in four Victorian hospitals, with the goal of improving nurses’ adherence to clinical practice guidelines for identifying and managing deteriorating patients in hospital; and determining the effectiveness and cost of an intervention to improve guideline adherence.

Other members of the research team include Deakin’s Professor Hutchinson, Professor Julie Considine, Dr Mohammadreza Mohebbi, and Ms Jennifer Watts, and colleagues from Bangor University, the University of Adelaide, Australian National University and the University of Ottawa, Canada. Partners in the project are Alfred Health, Bangor University (Wales), Monash Health, Eastern Health – Victoria, The Australian Commission on Safety and Quality in Health Care and SA Health.

Read more about World Patient Safety Day.