***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Involvement of patients in the detection and prevention of safety related events and medical errors have been widely recommended . However , it has also been question ed whether patients at large are willing and able to identify safety-related events in their care . The aim of this study was to develop and pilot test a brief patient safety survey applicable to inpatient care in Swiss hospitals . Methods A survey instrument was developed in an iterative procedure . The instrument asks patients to report whether they have experienced specific undesirable events during their hospital stay . The preliminary version was developed together with experts and tested in focus groups with patients . The adapted survey instrument was pilot-tested in r and om sample s of patients of two Swiss hospitals ( n = 400 ) . Responders to the survey that had reported experience of any incident were sample d for qualitative interviews ( n = 18 ) . Based on the interview , the research er classified the reported incidents as confirmed or discarded . Results The survey was generally well accepted in the focus groups and interviews . In the quantitative pilot test , 125 patients returned the survey ( response rate : 31 % ) . The mean age of responders was 55 years ( range 17–91 , SD 18 years ) and 62.5 % were female . The 125 participating patients reported 94 " definitive " and 34 " uncertain " events . 14 % of the patients rated any of the experienced events as " serious " . The definitive and uncertain events reported with highest frequency were phlebitis , missing h and hygiene , allergic drug reaction , unavailability of documents , and infection . 23 % of patients reported some or serious concerns about their safety . The qualitative interviews indicate that both , the extent of patients ' uncertainty in the classification of events and the likelihood of confirmation by the interviewer vary very much by type of incident . Unexpectedly , many patients reported problems and incidents related to food and dietary intake . Overall , the in-depth interviews confirmed experiences from the focus groups that many patients feel reluctant to report undesirable events without acknowledging the presence or absence of individual responsibility or failure . Many patients reported that they did not ask or communicate about errors or near misses with staff and some patients even develop strategies to improve their safety but do not disclose these to staff . Conclusion Many patients experience undesirable events during hospitalization and a significant number of patients is seriously concerned about their safety . Surveying patients about experiences with safety-related events in hospital seems a valuable tool for identifying and monitoring problematic areas of care and undesirable events . Evidence from the qualitative interviews indicates that safety remains an unsaid word between patients and their care providers PURPOSE : Little is known about how well hospitalized patients can identify errors or injuries in their care . Accordingly , the purpose of this study was to elicit incident reports from hospital in patients in order to identify and characterize adverse events and near-miss errors . SUBJECTS : We conducted a prospect i ve cohort study of 228 adult in patients on a medicine unit of a Boston teaching hospital . METHODS : Investigators review ed medical records  and interviewed  patients during the hospitalization and by telephone 10 days after discharge about “ problems , ” “ mistakes , ” and “ injuries ” that occurred . Physician investigators classified patients ’ reports . We calculated event rates and used multivariable Poisson regression models to examine the factors associated with patient-reported events . RESULTS : Of 264 eligible patients , 228 ( 86 % ) agreed to participate and completed 528 interviews . Seventeen patients ( 8 % ) experienced 20 adverse events ; 1 was serious . Eight patients ( 4 % ) experienced 13 near misses ; 5 were serious or life threatening . Eleven ( 55 % ) of 20 adverse events and 4 ( 31 % ) of 13 near misses were documented in the medical record , but none were found in the hospital incident reporting system . Patients with 3 or more drug allergies were more likely to report errors compared with patients without drug allergies ( incidence rate ratio 4.7 , 95 % CI 1.7 , 13.4 ) . CONCLUSIONS : In patients can identify adverse events affecting their care . Many patient-identified events are not captured by the hospital incident reporting system or recorded in the medical record . Engaging hospitalized patients as partners in identifying medical errors and injuries is a potentially promising approach for enhancing patient safety OBJECTIVE To quantify the different behavioral components of healthcare workers ' motivation to comply with h and hygiene in a healthcare institution with a 10-year history of h and hygiene campaigning . DESIGN Cross-sectional study , by use of an anonymous , self-administered question naire . SETTING A 2,200-bed university teaching hospital . PARTICIPANTS A stratified r and om sample of 2,961 medical and nursing staff . RESULTS A total of 1,042 question naires ( 35.2 % ) were returned . Of the respondents , 271 ( 26.0 % ) were physicians , 629 ( 60.4 % ) were nurses , and 141 ( 13.5 % ) were nursing assistants . Overall , 1,008 respondents provided information about sex ; 718 ( 71.2 % ) of these were women . Respondents provided demographic information and data about various behavioral , normative , and control beliefs that determined their intentions with respect to performing h and hygiene . Among behavioral beliefs , the perception that healthcare-associated infections are severe for patients was highly ranked as a determinant of behavior by 331 ( 32.1 % ) of the respondents , and the perception that h and hygiene is effective at preventing these infections was ranked highly by 891 respondents ( 86.0 % ) . Among normative beliefs , perceived social pressure from patients to perform h and hygiene was ranked highly by 760 respondents ( 73.7 % ) , pressure from superiors was ranked highly by 687 ( 66.8 % ) , pressure from colleagues was ranked highly by 596 ( 57.9 % ) , and pressure from the person perceived to be most influential was ranked highly by 687 ( 68.8 % ) . Among control beliefs , the perception that h and hygiene is relatively easy to perform was rated highly by 670 respondents ( 65.1 % ) . High self-reported rates of adherence to h and hygiene ( defined as performance of proper h and hygiene during 80 % or more of h and hygiene opportunities ) was independently associated with female sex , receipt of training in h and hygiene , participation in a previous h and hygiene campaign , peer pressure from colleagues , perceived good adherence by colleagues , and the perception that h and hygiene is relatively easy to perform . CONCLUSIONS In a setting with a long tradition of h and hygiene campaigns , behavioral beliefs are strongly in favor of h and hygiene , but adherence is driven by peer pressure and the perception of high self-efficacy , rather than by reasoning about the impact of h and hygiene on patient safety . Female sex , training , and campaign exposure increased the likelihood of compliance with h and hygiene . This additional insight can help to shape future promotional activity The purpose of this study was to explore patient opinion about asking healthcare professionals to wash their h and s prior to a clinical procedure and to explore if MRSA status and access to patient information about infection control would influence anxiety about asking . A descriptive survey was undertaken using a semi-structured question naire . The question naire was distributed to a r and omised convenience sample of 185 in- patients across all departments of an acute NHS Trust hospital ( response rate 59.4 % ) . Spearman 's rank order and Kendall Tau-b tests were used to analyse specific correlations . Respondents were more confident than anxious to be involved in a campaign that asked patients to ask staff to wash their h and s. Patients were more anxious to ask if previous admission episodes were fewer , if their knowledge of MRSA was high and if there was less information about infection control available . Less anxiety was associated with patients who had MRSA in the past and the suggestion that staff wore badges saying ' It 's OK to ask ' OBJECTIVE Communication failures account for many adverse drug events ( ADEs ) in adult primary care . Improving patient-physician communication may improve medication safety . Accordingly , the goal of this study was to learn whether electronic medication safety messages directed to patients can improve communication about medications and identify ADEs . DESIGN We studied adult patients enrolled in a patient Internet portal at three primary care practice s affiliated with a teaching hospital .  MedCheck , a medication safety application , sent patients a secure electronic message 10 days after they received a new or changed prescription . MedCheck asked if the patient had filled the prescription or experienced medication-related problems , and then forwarded the patient 's response to their primary care physician . MEASUREMENTS We selected a stratified r and om sample of 267 subjects from 1821 patients who received and opened a MedCheck message from April 2001 to June 2002 . We review ed subjects ' medical records for three months following their first MedCheck message . We analyzed patient and clinician response rates and times , examined patient-clinician communication about medications , and identified ADEs . RESULTS Patients opened 79 % of MedCheck messages and responded to 12 % ; 77 % responded within 1 day . Patients often identified problems filling their prescriptions ( 48 % ) , problems with drug effectiveness ( 12 % ) , and medication symptoms ( 10 % ) . Clinicians responded to 68 % of patients ' messages ; 93 % answered within 1 week . Clinicians often supplied or requested information ( 19 % ) , or made multiple recommendations ( 15 % ) . Patients experienced 21 total ADEs ; they reported 17 electronically . CONCLUSION Patients and physicians responded promptly to patient-directed electronic medication messages , identifying and addressing medication-related problems including ADEs BACKGROUND Patient safety ' best practice s ' that call for patient participation to prevent adverse drug events have not been rigorously evaluated . OBJECTIVE To consider lessons learned from a patient partnership intervention to prevent adverse drug events among medical in- patients . DESIGN Prospect i ve r and omized , controlled pilot trial . SETTING Boston teaching hospital . Patients . Two hundred and nine adult in- patients on a general medicine unit . INTERVENTION Intervention  patients ( n = 107 ) received drug safety information and their medication list ; controls ( n = 102 ) received drug safety information only .  Measurements . Adverse drug events and close-call drug errors were identified using chart review and incident reports from nurses , pharmacists , and physicians . Patients and clinicians were surveyed about the intervention . RESULTS In 1053 patient-days at risk , 11 patients experienced 12 adverse drug events and 16 patients experienced 18 close calls . There was a non-significant difference between intervention patients and controls in survey responses and in the adverse drug event rate ( 8.4 % versus 2.9 % , P = 0.12 ) and close-call rate ( 7.5 % versus 9.8 % , P = 0.57 ) . Eleven percent of patients were aware of drug-related mistakes during the hospitalization . Among nurse respondents , 29 % indicated that at least one medication error was prevented when a patient or family member identified a problem . CONCLUSION Partnering with in- patients to prevent adverse drug events is a promising strategy but requires further study to document its efficacy OBJECTIVE To determine the effect of an  inpatient self-medication program ( SMP )  on the ability to self-medicate , patient medication knowledge , compliance , and patient morale . DESIGN R and omized controlled clinical trial . POPULATION One hundred seven consecutive patients admitted to a geriatric assessment and rehabilitation program were r and omized to either participate in the SMP or to receive st and ard care . INTERVENTION The SMP was a three-stage program in which patients were given increasing responsibility for the administration of their own medications . MEASUREMENTS Ability to self-medicate on discharge from hospital ; medication compliance at 1 month ; patient medication knowledge ; Philadelphia Morale Scale . MAIN RESULTS Participation in the self-medication program did not increase the proportion of  patients who were able to self-medicate on discharge from hospital . Compliance was improved by the program . On a proportional basis , the self-medication group made significantly fewer medication errors than the control group at 1-month follow-up ( 0.045 vs 0.086 , P < .001 ) . There were no significant differences in morale or medication knowledge between the SMP and control groups , although both groups made significant gains in knowledge about the names , administration times , and purpose s of their medications from admission to follow-up ( P < .001 ) . CONCLUSIONS A SMP can improve compliance in geriatric patients who are discharged to the community . Participation in a SMP does not improve patients ' morale nor does it improve their medication knowledge more than pharmacy counselling alone . Participation in a SMP is unlikely to increase the probability that patients will be able to self-medicate on discharge . Cognitive factors limit patients ' ability to self-medicate M and atory reporting and disclosure of health care-acquired infections have result ed in controversy over the perceived notion that consumers will not underst and how to interpret data and that such information may negatively influence utilization of hospitals . The objective was to determine consumers ’ attitudes about health care-acquired infections , h and hygiene practice s , and patient empowerment . A telephone survey based on a r and om digit dialing sample of all households in the United States was conducted . Consumers were asked about choosing a hospital , h and hygiene practice s , and health care-acquired infections . Some 94 % of respondents rated environmental cleanliness as very important . Hospital infection rates would influence decision making for 93 % of consumers . Four in 5 consumers said they would ask their health care worker to wash and sanitize his or her h and s. Our findings strongly suggest that ( 1 ) consumers will use infection data in selecting and /or leaving a hospital system and ( 2 ) consumers are ready to be empowered with information to ensure a positive outcome PURPOSE / OB 
    Output:
    
Patients share a positive attitude about engaging in their safety at a general level , but their intentions and actual behaviors vary considerably .
Studies applied theories of planned behavior and indicate that self-efficacy , preventability of incidents , and effectiveness of actions seem to be central to patients ’ intention to engage in error prevention .
Interventions embedded within clinical setting s have been effective to some extent .
Evidence suggests that involvement in safety may be successful if interventions promote complex behavioral change and are sensitively implemented in health care setting