A Systematic Literature Review of Safety Culture in Hemodialysis Settings

Abstract

Background

Safety culture is an important aspect of quality in healthcare settings. There are many risks that patients can encounter in hemodialysis settings one of which is the infection risks due to the regular need to access bloodstreams using catheters and needles. Implementation of prevention guidelines, protocols and strategies that reinforce safety culture excellence are essential to mitigate risks. The objective of this study was to identify and characterize the main strategies that enhance and improve patient safety culture in hemodialysis settings.

Methods

Medline (via PubMed) and Scopus were searched from 2010 to 2020 in English. Terms defining safety culture, patient safety were combined with the term hemodialysis during the search. The studies were chosen based on inclusion criteria.

Results

A total of 17 articles reporting on six countries were identified that met inclusion criteria following the PRISMA statement. From the 17 papers, practices that were successfully applied to improve safety culture in hemodialysis settings included (i) training of nurses on the technologies used in hemodialysis treatment, (ii) proactive risk identification tools to prevent infections (iii) root cause analysis in evaluating the errors, (iv) hemodialysis checklist to be used by the dialysis nurses to reduce the adverse events, and (v) effective communication and mutual trust between the employee and leadership to support no-blame environment, and improve the safety culture.

Conclusion

This systematic review provided significant insights on the strategies that healthcare safety managers and policy makers can implement to enhance safety culture in hemodialysis settings.

Keywords:

• safety culture
• patient safety
• kidney care
• hemodialysis
• quality improvement
• medical error

Acknowledgement

This work was supported, in part, by the Khalifa University of Science and Technology under Award RCII-2019-002- Research Center for Digital Supply Chain and Operations Management. The funding body had no direct involvement in the design, data collection, analysis, and interpretation or in writing the manuscript. Professor Krista Lentine is supported by the Mid-America Transplant / Jane A. Beckman Endowed Chair in Transplantation.

Disclosure

Professor Krista Lentine reports personal fees from CareDx, personal fees from Sanofi, outside the submitted work. The authors report no other conflicts of interest in this work.