Analysing the implementation of patient safety incident reporting and learning guidelines in specialised care units, in the selected hospitals in KwaZulu-Natal, South Africa.

Abstract

Background: Despite the implementation of patient safety strategies, patient safety incidents (PSIs) in specialised care units (SCUs) remain high and are of serious concern worldwide, including in South Africa. Implementing Patient Safety Incident Reporting and Learning (PSIRL) Guidelines is critical in guiding clinical practice and improving clinical outcomes in SCUs. There is limited research on evidence of the implemented PSIRL Guidelines in SCUs at the global level. Aim: To analyse the implementation of the PSIRL Guidelines in SCUs and to develop a strategy for the effective implementation of the PSIRL Guidelines in selected hospitals in KwaZulu-Natal, South Africa. Methods: A convergent parallel mixed methods or embedded strategy was used to collect quantitative and qualitative data. A descriptive, non-experimental, cross-sectional survey was used to collect the quantitative data via online questionnaires from March 2021 to May 2021. A purposive sample targeted 237 healthcare professionals. Furthermore, a descriptive, explorative, qualitative approach was used to collect qualitative data from senior healthcare professionals through focus groups and individual interviews, for in-depth information, from August 2021 to October 2021. Content data analysis was performed using Tesch’s method of analysis process. The quantitative and qualitative data were analysed separately and then converged to provide a comprehensive analysis of the research problem. Results: For a quantitative study, a total of 181 questionnaires were returned, yielding a response rate of 76%. Notably, 83% of respondents had high-perceived knowledge of the PSIRL Guidelines, while 98% had low perceptions of the implementation. For the qualitative study, the main themes that emerged during data analysis were ineffective reporting systems affecting the communication of PSI guidelines, inadequate institutional management for the healthcare professionals, insufficient education and training of healthcare professionals and poor human resources affecting the implementation of PSI guidelines. The findings highlighted that there were more major barriers to the implementation of the PSIRL Guidelines. Conclusion: For the quantitative study, the respondents demonstrated good perceptions of knowledge of the PSIRL Guidelines; however, the perception of the implementation was poor. The qualitative study confirmed that the PSIRL Guidelines are still not successfully implemented in the SCUs and the barriers to implementation were highlighted. For rigorous implementation in South Africa, the study recommends revised PSIRL Guidelines, designed in consultation with the frontline healthcare professionals, consisting of standardised, simple -user-friendly reporting processes as well as an implementation strategy to guide the healthcare professionals.