Abstract

Purpose: Because the patient's perception of safety in the healthcare system has not been adequately examined, the purpose of this study was to discover an Emergency Department patient's perception of safety so as to add an element currently absent in safe patient care provision. Background: That there is a real and significant problem in the United States healthcare system of providing safe, efficient care to patients is not in dispute. Many agencies, academic researchers, and experts in their fields have studied preventable healthcare errors and proposed and implemented solutions. Yet a careful review of current solutions reveals that patients are not adequately empowered to take an active role in their care, and this fact puts them at greater risk of experiencing a poor outcome due to preventable error. Specifically, patients have not been asked how they, from their role and view as patient, perceive safety. Methods: This study was undertaken using a qualitative, ethnographic methodology. Eight female and six male participants (six Hispanics, five whites, and three African Americans) with an age range of 22 to 85 years (mean age of 48.5) completed one focused, ethnographic, in-person interview. Content analysis was used to analyze the data. Results: One main theme, Competent Caring emerged supported by three domains (Accurate Caring, Protective Caring, and Communicative Caring). Examples of patients' perceptions help define several sub-domains which underlie the three domains. Implications: Safe care for patients is patient involvement in their care as well as making decisions with their healthcare providers. Healthcare providers can meet these expectations by: (a) communicating care information using language understandable to the patient and allowing adequate time for questions to be answered; (b) updating patients about their care on both a scheduled and as needed basis; and (c) not allowing healthcare staff “insider knowledge” to discount patient concerns. Safe care provision also involves meeting physical comfort needs (such as pillows, blankets, food, water, and medicine for noxious symptom control), meeting psychological comfort needs including empathy, and protecting patient physical safety by removing obstacles in their care area, following hand washing guidelines, and identifying the patient through such practices as arm band checking and name / birth date verification.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3434201; ProQuest document ID: 846020719. The author still retains copyright.

Paul R. Clark

Author Details

Dr. Paul R. Clark, PhD, RN, MA

Sigma Membership

Iota Zeta

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Ethnography

Research Approach

Qualitative Research

Keywords:

Emergency Department Nursing, Nursing Management, Making Patients Secure

Advisors

Dunn, Kelly

Degree

PhD

Degree Grantor

The University of Texas Health Science Center at San Antonio

Degree Year

2010

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2020-02-20

Full Text of Presentation

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