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Objective: To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC).

Design: In-depth interviews were conducted and analysed using qualitative content analysis.

Setting: Governmental referral teaching hospital in Eastern DRC.

Participants: We purposively selected 2-4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed.

Results: Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs' reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance.

Conclusions: The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all.

(Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Titel:	Qualitative study exploring surgical team members' perception of patient safety in conflict-ridden Eastern Democratic Republic of Congo.
Autor/in / Beteiligte Person:	Labat, F ; Sharma, A
Link:	Zum Volltext
Zeitschrift:	BMJ open, Jg. 6 (2016-04-25), Heft 4, S. e009379
Veröffentlichung:	[London] : BMJ Publishing Group Ltd, 2011-, 2016
Medientyp:	academicJournal
ISSN:	2044-6055 (electronic)
DOI:	10.1136/bmjopen-2015-009379
Schlagwort:	Adult Aged Democratic Republic of the Congo Female Humans Interviews as Topic Male Middle Aged Qualitative Research Warfare Young Adult Delivery of Health Care standards Health Personnel psychology Health Services Accessibility standards Patient Safety economics Patient Safety standards
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [BMJ Open] 2016 Apr 25; Vol. 6 (4), pp. e009379. <i>Date of Electronic Publication: </i>2016 Apr 25. MeSH Terms: Delivery of Health Care / standards ; Health Personnel / psychology ; Health Services Accessibility / standards ; Patient Safety / economics ; Patient Safety / *standards ; Adult ; Aged ; Democratic Republic of the Congo ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Qualitative Research ; Warfare ; Young Adult References: Int J Qual Health Care. 2009 Feb;21(1):18-26. (PMID: 19147597) ; Qual Saf Health Care. 2005 Aug;14(4):290-4. (PMID: 16076795) ; Paediatr Anaesth. 2012 Oct;22(10):962-8. (PMID: 22967153) ; CMAJ. 2009 Sep 15;181(6-7):367-8. (PMID: 19752141) ; Health Care Manage Rev. 2009 Oct-Dec;34(4):312-22. (PMID: 19858916) ; Nurs Philos. 2004 Apr;5(1):4-11. (PMID: 15043693) ; Transcult Psychiatry. 2007 Sep;44(3):459-81. (PMID: 17938156) ; BMJ Open. 2013 Aug 15;3(8):e003039. (PMID: 23950205) ; Best Pract Res Clin Obstet Gynaecol. 2013 Aug;27(4):497-508. (PMID: 23642352) ; Can J Afr Stud. 1985;19(3):627-33. (PMID: 11616767) ; Nurs Inq. 2004 Mar;11(1):14-24. (PMID: 14962343) ; Psychol Health Med. 2012;17(1):1-16. (PMID: 22191491) ; Int J Public Health. 2013 Jun;58(3):377-83. (PMID: 22945841) ; J Med Ethics. 2006 Dec;32(12):739-42. (PMID: 17145917) ; BMC Health Serv Res. 2011;11:45. (PMID: 21349179) ; Soc Sci Med. 2009 Dec;69(12):1767-76. (PMID: 19854551) ; JAMA. 2010 Aug 4;304(5):553-62. (PMID: 20682935) ; Biologicals. 2012 May;40(3):205-8. (PMID: 22316645) ; Anaesthesia. 2003 Oct;58(10):962-84. (PMID: 12969038) ; Int J Infect Dis. 2001;5(2):70-3. (PMID: 11468100) ; Int J Hyg Environ Health. 2010 Jul;213(4):302-7. (PMID: 20471316) ; Soc Sci Med. 2002 Jun;54(11):1685-90. (PMID: 12113450) ; Lancet. 2008 Jul 12;372(9633):139-44. (PMID: 18582931) ; Trop Med Int Health. 2005 Aug;10(8):799-811. (PMID: 16045467) ; Lancet. 2012 Sep 22;380(9847):1075-81. (PMID: 22998717) ; Arch Pediatr Adolesc Med. 2009 Jun;163(6):525-30. (PMID: 19487608) ; Health Policy Plan. 2008 Mar;23(2):83-94. (PMID: 18281310) ; Patient Educ Couns. 2011 Feb;82(2):201-6. (PMID: 20580183) ; Soc Sci Med. 2010 Jan;70(1):1-6. (PMID: 19931960) ; Confl Health. 2011 Nov 02;5:25. (PMID: 22047181) ; Soc Sci Med. 2010 Jan;70(1):89-97. (PMID: 19850390) ; BMJ. 2012;344:e832. (PMID: 22416061) ; BMJ Qual Saf. 2012 Oct;21(10):843-9. (PMID: 22773891) ; Int J Surg. 2012;10(9):493-9. (PMID: 22846618) ; BMJ Qual Saf. 2014 Apr;23(4):325-31. (PMID: 24239992) ; J Infect Dis. 2007 Nov 15;196 Suppl 2:S168-75. (PMID: 17940946) ; BMJ. 1998 Oct 10;317(7164):1007-10. (PMID: 9765175) ; Confl Health. 2010 Nov 08;4:17. (PMID: 21059195) ; Paediatr Anaesth. 2011 Jul;21(7):825-8. (PMID: 21208335) ; Qual Health Res. 2014 Jan;24(1):55-66. (PMID: 24259534) ; Disaster Med Public Health Prep. 2009 Jun;3(2):88-96. (PMID: 19491603) ; Ann Fam Med. 2011 Mar-Apr;9(2):100-3. (PMID: 21403134) ; BMJ. 2000 Jul 22;321(7255):232-5. (PMID: 10903662) ; Anesth Essays Res. 2010 Jul-Dec;4(2):64-8. (PMID: 25885231) ; Nurse Educ Today. 2004 Feb;24(2):105-12. (PMID: 14769454) ; Qual Health Res. 2007 Nov;17(9):1280-91. (PMID: 17968044) ; N Engl J Med. 2009 Jan 29;360(5):491-9. (PMID: 19144931) ; Anaesthesia. 2007 Jan;62(1):4-11. (PMID: 17156220) ; Philos Ethics Humanit Med. 2012;7:11. (PMID: 22974272) ; Soc Sci Med. 2010 Jan;70(1):80-8. (PMID: 19853342) ; BMJ Qual Saf. 2011 Apr;20(4):338-43. (PMID: 21303770) ; BMJ Qual Saf. 2014 Jul;23(7):556-64. (PMID: 24351971) ; Midwifery. 2010 Oct;26(5):497-503. (PMID: 20692077) ; Soc Sci Med. 2010 Jan;70(1):45-52. (PMID: 19880236) ; Nurse Res. 2013 May;20(5):28-32. (PMID: 23687846) ; Soc Sci Med. 2009 May;68(9):1728-36. (PMID: 19285371) ; Am J Public Health. 2012 Apr;102(4):645-50. (PMID: 22397345) ; Bull World Health Organ. 2004 Dec;82(12):892. (PMID: 15654400) Contributed Indexing: Keywords: ANAESTHETICS; QUALITATIVE RESEARCH; SURGERY Entry Date(s): Date Created: 20160427 Date Completed: 20161229 Latest Revision: 20190202 Update Code: 20240513 PubMed Central ID: PMC4853980

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Qualitative study exploring surgical team members' perception of patient safety in conflict-ridden Eastern Democratic Republic of Congo.