Mapping of Disclosure Practices in Hospital Settings: Scoping Review
scoping review
DOI:
https://doi.org/10.9789/2175-5361.rpcfo.v17.13542Keywords:
Comunicação em saúde, Pacientes internados, Revelação da verdade, Segurança do pacienteAbstract
Objective: to map the disclosure practices of adverse events to hospitalized patients and their companions, related to patient safety, in hospital settings. Method: this is a qualitative research, of the scoping review type, developed based on the methodology applied by the Joanna Briggs Institute for scoping reviews. Results: a total of 3876 articles were identified in the cited databases, and 180 publications in the gray literature. After the exclusion of duplicate studies, validation of inclusion criteria, and full-text reading, 25 scientific publications were selected for analysis. Final Considerations: from the scoping review, various strategies for executing the practice of disclosure were observed, among which the apology emerged as a way to reduce the impact of adverse events and demonstrate empathy, respect, and responsibility on the part of healthcare professionals.
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Brasil. Agência Nacional de Vigilância Sanitária Assistência Segura: Uma Reflexão Teórica Aplicada à Prática Agência Nacional de Vigilância Sanitária. Brasília: Anvisa, 2017. [acesso em 10 de junho de 2024]. Disponível em: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/caderno-1-assistencia-segura-uma-reflexao-teorica-aplicada-a-pratica.pdf.
Sousa P, Mendes W. Segurança do paciente: criando organizações de saúde seguras – 2.ed (revista e ampliada) – Rio de Janeiro, RJ : CDEAD, ENSP, Fiocruz, 2019. 268 p. [acesso em 10 de maio de 2024]. Disponível em: https://books.scielo.org/id/bskw2/pdf/sousa-9788575416426.pdf.
Busch IM, Saxena A, Wu AW. Putting the Patient in Patient Safety Investigations: Barriers and Strategies for Involvement. Journal of patient safety. [Internet]. 2022 [cited 2024 may 05];17(5). Available from: https://doi.org/10.1097/PTS.0000000000000699.
Munn Z, Pollock D, Khalil H, Alexander L, Mclnerney P, Godfrey CM et al. What are scoping reviews? Providing a formal definition of scoping reviews as a type of evidence synthesis. JBI evidence synthesis. [Internet]. 2022 [cited 2024 may 05];20(4). Available from: https://doi.org/10.11124/JBIES-21-00483.
Tricco AC, Lillie E, Zarin W, O’Brien K, Colquhoun H, Levac D et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. [Internet]. 2018 [cited 2024 may 05];169. Available from: https://doi.org/10.7326/M18-0850.
Tricco AC, Lillie E, Zarin W, O’Brien K, Colquhoun H, Kastner M et al. A scoping review on the conduct and reporting of scoping reviews. BMC Med Res Methodol. [Internet]. 2016 [cited 2024 may 08];16(15). Available from: https://doi.org/10.1186/s12874-016-0116-4.
Descritores em Ciências da Saúde: DeCS [Internet]. ed. 2023. São Paulo (SP): BIREME / OPAS / OMS, 2023 [acesso em 04 de abril de 2024]. Disponível em: http://decs.bvsalud.org.
Wagner LM, Damianakis T, Pho L, Tourangeau A. Barriers and facilitators to communicating nursing errors in long-term care settings. Journal of patient safety. [Internet]. 2013 [cited 2024 may 08];9(1). Available from: https://doi.org/10.1097/PTS.0b013e3182699919.
Martín-Delgado MC, Fernández-Maillo M, Bañeres-Amella J, Campillo-Artero C, Cabré-Pericas L, Anglés-Coll R et al. Conferencia de consenso sobre información de eventos adversos a pacientes y familiares. Rev Calidad Asist. [Internet]. 2014 [cited 2024 may 08]; 28(6). Available from: https://doi.org/10.1016/j.cali.2013.07.004.
Petronio S, Torke A, Bosslet G, Isenberg S, Wocial L, Helft PR. Disclosing medical mistakes: a communication management plan for physicians. The Permanente journal. [Internet]. 2023 [cited 2024 may 10];17(2). Available from: https://doi.org/10.7812/TPP/12-106.
Birks Y, Harrison R, Bosanquet K, Hall J, Harden M, Entwistle V et al. An exploration of the implementation of open disclosure of adverse events in the UK: a scoping review and qualitative exploration. NIHR Journals Library. [Internet]. 2014 [cited 2024 may 10]. Available from: https://doi:10.3310/hsdr02200.
Watson BM, Angus D, Gore L, Farmer J. Communication in open disclosure conversations about adverse events in hospitals. Language & Communication. [Internet]. 2015 [cited 2024 may 10];41. Available from: https://doi.org/10.1016/j.langcom.2014.10.013.
Birks Y. Duty of candour and the disclosure of adverse events to patients and families. Clinical Risk. NIHR Journals Library. [Internet]. 2014 [cited 2024 may 13];20(1-2). Available from: doi:10.1177/1356262213516937.
Elwy AR, Bokhour BG, Maguire EM, Wagner TH, Asch SM, Gifford AL et al. Improving healthcare systems' disclosures of large-scale adverse events: a Department of Veterans Affairs leadership, policymaker, research and stakeholder partnership. Journal of general internal medicine. [Internet]. 2014 [cited 2024 may 08];29(4). Available from: https://doi.org/10.1007/s11606-014-3034-3.
Sukalich S, Elliott JO, Ruffner G. Teaching medical error disclosure to residents using patient-centered simulation training. Academic medicine: journal of the Association of American Medical Colleges. [Internet]. 2014 [cited 2024 may 10];89(1). Available from: https://doi.org/10.1097/ACM.0000000000000046.
Mira JJ, Lorenzo S. Algo no estamos haciendo bien cuando informamos a los/las pacientes tras un evento adverso. Gac Sanit [Internet]. 2015 [cited 2024 may 13]; 29(5). Available from: https://dx.doi.org/10.1016/j.gaceta.2015.04.004.
McLennan S, Rich LE, Truog RD. Apologies in medicine: legal protection is not enough. CMAJ: Canadian Medical Association journal = journal de l'Association medicale canadienne. [Internet]. 2015 [cited 2024 may 13];187(5). Available from: https://doi.org/10.1503/cmaj.131860.
McLennan S. The law as a barrier to error disclosure: A misguided focus? Trends in Anaesthesia and Critical Care. [Internet]. 2018 [cited 2024 may 11];9. Available from: https://doi.org/10.1016/j.tacc.2018.02.002.
Dahan S, Ducard D, Caeymaex L. Apology in cases of medical error disclosure: Thoughts based on a preliminary study. PloS one. [Internet]. 2017 [cited 2024 may 11]; 12(7):e0181854. Available from: https://doi.org/10.1371/journal.pone.0181854.
Cernadas JMC. La comunicación del error a los pacientes y padres y el pedido de disculpas. Arch Argent Pediatr. [Internet]. 2017 [cited 2024 may 11];115(3). Available from: https://www.sap.org.ar/docs/publicaciones/archivosarg/2017/v115n3a01.pdf.
Mira JJ, Lorenzo S, Carrillo I, Ferrús L, Silvestre C, Astier P et al. Lessons learned for reducing the negative impact of adverse events on patients, health professionals and healthcare organizations. International journal for quality in health care: journal of the International Society for Quality in Health Care. [Internet]. 2017 [cited 2024 may 11]; 29(4). Available from: https://doi.org/10.1093/intqhc/mzx056.
Hannawa AF. What constitutes "competent error disclosure"? Insights from a national focus group study in Switzerland. Swiss medical weekly. [Internet]. 2017 [cited 2024 may 11];147:w14427. Available from: https://doi.org/10.4414/smw.2017.14427.
Kilng S. Disclosing medical error – changing the culture of medicin. Allergy Society of South Africa (ALLSA). [Internet]. 2018 [cited 2024 jun 08];31(2). Available from: https://journals.co.za/doi/epdf/10.10520/EJC-1094c2a64b.
Moffatt-Bruce SD, Ferdinand FD , Fann JI. Patient Safety: Disclosure of Medical Errors and Risk Mitigation. Ann Thorac Surg. [Internet]. 2016 [cited 2024 may 11];102. Available from: http://dx.doi.org/10.1016/j.athoracsur.2016.06.033.
Crimmins AC, Wong AH, Bonz JW, Tsyrulnik A, Jubanyik K, Dziura JD et al. "To Err Is Human" but Disclosure Must be Taught: A Simulation-Based Assessment Study. Simulation in healthcare: journal of the Society for Simulation in Healthcare. [Internet]. 2018 [cited 2024 may 10];13(2). Available from: https://doi.org/10.1097/SIH.0000000000000273.
Peterson KA, Rutherford M, Drvol D, Barkman D, Phipps AR, Hales, R et al. Disclosure of Adverse Events: A Guide for Clinicians. Pediatric quality & safety. [Internet]. 2019 [cited 2024 jun 15];4(4): e185. Available from: https://doi.org/10.1097/pq9.0000000000000185.
Choi EY, Pyo J, Ock M, Lee SI. Nurses' Perceptions Regarding Disclosure of Patient Safety Incidents in Korea: A Qualitative Study. Asian nursing research. [Internet]. 2019 [cited 2024 jun 15];13(3). Available from: https://doi.org/10.1016/j.anr.2019.05.002.
Prentice JC, Bell SK, Thomas EJ, Schneider EC, Weingart S.N, Weissman JS, Schlesinger MJ. Association of open communication and the emotional and behavioural impact of medical error on patients and families: state-wide cross-sectional survey. BMJ quality e safety. [Internet]. 2020 [cited 2024 jun 08];29(11). Available from: https://doi.org/10.1136/bmjqs-2019-010367.
Carmack HJ. Hospital Image Repair Strategies, Organizational Apology, and Medical Errors: An Analysis of the CoxHealth Brain Over-Radiation Case. Health communication. [Internet]. 2020 [cited 2024 jun 08];35(12). Available from: https://doi.org/10.1080/10410236.2019.1652071.
Dijkstra RI, Roodbeen RTJ, Bouwman RJR, Pemberton A, Friele R. Patients at the centre after a health care incident: A scoping review of hospital strategies targeting communication and nonmaterial restoration. Health expectations. [Internet]. 2022 [cited 2024 jun 09];25(1). Available from: https://doi.org/10.1111/hex.13376.
Ross NE, Newman WJ. The Role of Apology Laws in Medical Malpractice. J Am Acad Psychiatry Law. [Internet]. 2021 [cited 2024 jun 07];49(3). Available from: https://doi.org/10.29158/JAAPL.200107-20.
Albuquerque A. Disclosure de incidentes de segurança do paciente sob a ótica do Direito do Paciente. Cadernos Ibero-Americanos de Direito Sanitário. [Internet]. 2022 [acesso em 07 de junho de 2024];11(3). Disponível em: https://doi.org/10.17566/ciads.v11i3.925.
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