Patients for patient safety: A systematic review

Article type
Authors
Li Y1, Huang Y1, Nie Y1, Li J1, Zhang M2
1Dept. of evidence-based medicine and clinical epidemiology
2Chinese Cochrane Center
Abstract
Background: Patients play an important role in improving patient safety. However, little is known about how and when to involve patients, and the effects after involvement in patient safety.

Objectives: To systematically review the literature, summarize and compare the information on patients for patient safety at home and abroad, including patients' knowledge, attitude, influencing factors and the effects after participation in order to provide evidence-based suggestions for education, training and research of patients for patient safety in China.

Methods: We systematically searched the Chinese Biomedical Literature Database, EMBASE and MEDLINE to identify primary studies about patients for patient safety. Two researchers independently identified the eligible studies, assessed the risk of bias using the Cochrane Handbook 5.0 and Critical Appraisal Skills Programme, and extracted data. A meta-ethnographic approach was used to summarize the results.

Results: We identified 28 eligible studies with five conducted in China. Except for one randomized controlled trial (RCT), the studies had cross-sectional designs. 1. Patients' perceptions and attitudes: patients' knowledge of patient safety was generally poor, but patients were eager to participate. 2. Factors affecting patients' involvement: patient’s characteristics (gender, age, race and education), disease-related factors (severity of disease, symptoms, treatment and prognosis), medical staff-related factors (attitude of medical staff), and emotional factors (feeling uncomfortable). 3. How to participate: improving patients' knowledge, acquiring therapeutic information, cooperating, reminding and communicating with medical staff, etc. 4. Outcomes after involvement: patients' participation can effectively standardize the performance of physicians, prevent unsafe incidents, reduce harms, and promote patient safety.

Conclusions: Current studies cover a wide range of topics related to patients engaging in patient safety, but research in China is very limited and covers only the patients' knowledge and willingness. Future studies should emphasize the ways to promote patients' involvement in patient safety and the outcomes after involvement.

*This study is funded by NSFC 70973083 and CMB.