Identified systematic reviews (n=60) classified by patient-safety area (n=14)
| Patient-safety area | Number of systematic reviews (references) | Intervention components relevant to patient safety (effective components are in bold) | |
|---|---|---|---|
| Adverse drug event | Subarea | ||
| CPOE system | 222 23 | CPOE system | |
| Medication review | 424–27 | Medication reconciliation | |
| Computer-assisted decision support/alerts | 328–30 | Computerised advice or decision support; computerised drug-laboratory alerts for clinicians on prescribing or monitoring decisions | |
| Multicomponent interventions | 631–36 | Multicomponent interventions, including pharmacist involvement and support of care teams or physicians; guideline implementation, including academic detailing, reminders and feedback of data; multicomponent intervention, including CPOE system, changes in work schedules, education, support systems for clinical decision-making | |
| Infection* | Device-related infections (CAUTI; CLABSI; VAP) | 437–40 | Care bundles and checklists; empowerment to stop procedure; surveillance; infrastructure and organisational changes; training on appropriate catheter placement; catheter restriction and removal protocols; reminder or stop order to decrease catheter placement; use of specific technologies |
| Sepsis | 141 | Multicomponent programme aimed at improving compliance to sepsis care bundles, including education and decision support tools | |
| Hand-hygiene compliance | 242 43 | Education; audit and feedback; health promotion; variations in the availability and type of products used for hand hygiene | |
| Overall hospital-acquired infection | 144 | Education; protocols to remove catheters | |
| Delirium | 745–51 | Psychiatric assessment; special care; daily visits by a liaison nurse; interdisciplinary team; supportive psychotherapy; multicomponent intervention, including cognitive screening, proactive geriatric consultation and psychotherapy; multicomponent intervention, including early mobility, cognition and orientation, sleep–wake cycle preservation; multicomponent intervention, including physiotherapy, family involvement and staff/family-member education | |
| Adverse event after hospital discharge or clinical handover | 752–58 | Postacute intermediate care units; geriatric assessment; liaison nurse; predischarge assessment of risks; patient engagement; individualised patient record; multidisciplinary discharge planning team; clinical follow-up; nurse-led early-discharge planning programmes | |
| Fall | 459–62 | Addressing risk factors by a multidisciplinary team; care planning; environmental changes; movement alarms; physiotherapy; management of urinary incontinence; multicomponent interventions, including risk alert card, exercise, education, hip protectors and geriatric assessment | |
| Adverse event in surgery | 563–67 | Screening and decolonisation of surgical-site infections; subspecialisation; benchmarking; technology or training; surgical safety checklist | |
| Cardiopulmonary arrest | 468–71 | Critical-care outreach service; rapid response teams | |
| Venous thromboembolism | 272 73 | Alerts and education; real-time audit and feedback; multicomponent interventions to improve appropriate administration of thromboprophylaxis | |
| Staffing | 374–76 | Increasing proportion of support staff; addition of specialist nursing post to staffing; reducing shift length; protected sleep time; night float; education among residents; interdisciplinary team interventions | |
| Pressure ulcer | 177 | Standardisation of interventions; multidisciplinary teams and leadership; designated skin champions; education; audit and feedback | |
| Mechanical complication and underfeeding | 178 | Total parenteral nutrition team: nutrition support for patients who are unable to obtain adequate nutrition either via the oral or enteral route | |
| Clinical pathway | 179 | Clinical pathways: multidisciplinary care plans with essential steps in care, supporting the translation of clinical guidelines into local protocols and application in practice | |
| Safety culture | 180 | Error-prevention training; restructured patient-safety governance; lessons-learnt programme; cause analysis programme; executive rounds | |
| External inspection | 181 | External inspections of compliance with standards (eg, accreditation) | |
*Surgical-site infections were classified as ‘prevention of adverse events in surgery’.
CAUTI, catheter-associated urinary tract infection; CLABSI, central-line-associated bloodstream infection; CPOE, computerised physician order entry; VAP, ventilator-associated pneumonia.