Evidence that matters: Do Cochrane reviews support the WHO Patient Safety Solutions?

Article type
Authors
SolĂ  I, Bonfill X, Pardo J, Safety Systematic Reviews Iberoamerican Group P
Abstract
Background: With the growing recognition worldwide of safety problems in healthcare, the World Health Organization (WHO) has recently launched nine 'Patient Safety Solutions' (PSS), to minimize patients' risk of harm in healthcare systems. To reach a safer practice, healthcare professionals are incorporating evidence-based knowledge into their clinical decision-making practices. Despite this, some of the proposed PSS are based on expert opinion or consensus. It would be important to evaluate if these proposed interventions to prevent patient harm in healthcare are supported by high quality evidence.
Objectives: To assess how the interventions proposed by the WHO as solutions to patient safety are supported by results of Cochrane reviews or other published systematic reviews.
Methods: We will develop a specific strategy for each of the PSS to search the Cochrane Database of Systematic Reviews (The Cochrane Library 2007, Issue 3). We will adapt these strategies to search additional reviews in MEDLINE, EMBASE and the Center for Reviews and Dissemination databases. Once identified, we will extract data from the eligible reviews on structured forms about their methodology and main results.
Results: A preliminary search showed that only two of the nine proposed PSS have been assessed by Cochrane reviews. A Cochrane review highlights the paucity of evidence to support the choice of interventions to improve adherence to handwashing (PSS 9). A protocol of Cochrane review will evaluate the effects of handwashing promotion on diarrhoeal episodes, and an additional title will assess handwashing procedures for preventing nosocomial infections. A series of two protocols and a review title will assess the effects of interventions for reducing medication errors in hospitalized adults and children, and to reduce preventable drug-related hospital admissions (PSS 1). We are undertaken searches in the rest of databases and the analysis of data.
Conclusions: A preliminary search shows that there is a shortage of systematic reviews assessing the efficacy of strategies proposed as Patient Safety Solutions. Once we finish the final analysis of reviews, we will be able to identify gaps, and provide specific guidance for future relevant research.