Patient Safety in Primary Care: A Nursing Concept Analysis

Introduction

Patient safety in nursing has an immediate impact on the quality of care in healthcare environments, the competence of medical service providers, and overall patient satisfaction. The volume of conditions, treatment options, and innovative interventions within primary care has progressively increased over time, raising numerous questions regarding patient wellbeing and the risks associated with these new advancements. Many experts have identified that primary care providers and professionals must recognize the potential for unnecessary physical or psychological harm — or possible harm — to patients, and respond adequately and in a timely manner to prevent adverse outcomes.

Very little literature exists on the probable dangers facing primary care patients and the impact of those dangers on patients' overall health over time. Research clearly indicates that safety incidents in primary care are extremely significant, ranging from prescription errors and incorrect diagnoses to inappropriate therapy and, in some cases, patient death. Based on this evidence, researchers have concluded that a concept analysis of patient safety is an essential first step in building a knowledge foundation for conducting clinical studies in this area (Kadhim, 2017).

Methodology

The following criteria were applied in this research: (a) peer-reviewed scholarly articles, (b) English-language articles, and (c) full text availability. The keywords used were: (a) safety, (b) patient safety, (c) primary care, and (d) nursing. The analysis employs Walker and Avant's (2011) method of concept analysis. According to Walker and Avant (2011), concept analysis is a method for explaining phenomena within nursing, as it enables theorists, analysts, and clinicians to understand the range of possibilities within a concept of interest.

The technique is clearly identified in eight steps: (1) selecting a concept; (2) stating the purpose of the analysis; (3) identifying the uses of the concept; (4) identifying the defining attributes; (5) identifying or constructing a model case; (6) identifying or constructing borderline, related, contrary, invented, and illegitimate cases; (7) identifying antecedents and consequences; and (8) identifying empirical referents (Walker and Avant, 2011; Kadhim, 2017).

Concept Analysis: Objective and Functions

The objective of this concept analysis is to examine and evaluate the concept of "patient safety in primary care," identify the defining characteristics of the concept as observed in the research literature, and clarify the significance of the concept based on available evidence. This examination also aims to recognize how researchers within the literature have applied the concept. The analysis is additionally useful in the development and evaluation of instruments designed to assess patient safety in primary care.

Patient safety within the nursing realm is defined as the prevention, avoidance, and amelioration of adverse outcomes or injuries arising from the healthcare process. The concept of patient safety is also applied in medicine, where it refers to the reduction and minimization of unsafe behaviors within the healthcare system and the use of best practices proven to produce optimal patient outcomes. In psychology, the term is used to describe freedom from unintentional or avoidable injuries caused by medical treatment. Within business administration, scholars have applied the concept as worker or customer safety, and in education it appears as the concept of cultural safety (Kadhim, 2017).

Defining Characteristics of Patient Safety

According to Walker and Avant (2011), defining attributes are the most critical component of concept analysis and are recognized by the characteristics of a concept that appear repeatedly in the literature. Three defining characteristics of the concept of patient safety in primary care were established through the literature review: (a) knowledge, (b) relief from injury, and (c) dedication.

Knowledge: Throughout the literature, knowledge is repeatedly identified as an essential characteristic of patient safety in primary care. Healthcare providers must possess adequate knowledge in order to deliver care that is free from risk.

Relief from injury: Primary care practices that ensure injury-free healthcare delivery include appropriate diagnosis of the patient's condition, correct medication, proper use of technology, incident reporting, patient assessment, competence among providers, and adherence to clinical guidelines.

Dedication: Dedication is a significant characteristic associated with patient safety. A primary care provider who is committed to patient safety demonstrates that dedication by learning from medication errors rather than repeating them, or by sharing knowledge of safety situations with colleagues (Kadhim, 2017).

Conclusion

The concept of patient safety in primary care was selected for concept analysis because patient safety is increasingly at risk in healthcare environments, particularly in primary care settings worldwide. Nursing and other healthcare literature provide evidence of patient safety incidents in primary care environments. This analysis presented clearly defined characteristics of the concept of patient safety in primary care, which include: (a) knowledge, (b) relief from injury, and (c) dedication to patient safety. These characteristics are further illustrated through the model situation and additional cases, which help explain the characteristics and deepen understanding of the concept. The analysis has also identified the antecedents and consequences associated with the concept.

Researchers have noted in the literature that patient safety is a continually evolving and ongoing process within healthcare, particularly in primary care. It is therefore recommended that further research and clinical studies be conducted to ensure optimal patient safety in primary care and to improve the quality of care in primary care environments (Kadhim, 2017).

References

Berland, A., Gundersen, D., & Bentsen, S. (2012). Patient safety and falls: A qualitative study of home care nurses in Norway. Nursing & Health Sciences, 14(4), 452–457.

Kadhim, J. J. (2017). Patient safety in primary care: A concept analysis in nursing. Kufa Journal for Nursing Sciences, 7(1).

Martijn, L. M., Jacobs, A. E., Maassen, I. M., Buitendijk, S. E., & Wensing, M. M. (2013). Patient safety in midwifery-led care in the Netherlands. Midwifery, 29(1), 60–66.

Walker, L. O., & Avant, K. C. (2011). Strategies for theory construction in nursing (5th ed.). Pearson Prentice Hall.