Background
Patient safety events are incidents of potential or actual harm to a patient resulting from receiving healthcare. Recent literature review evidence demonstrates that people from culturally and linguistically diverse (CALD) backgrounds are at higher risk of experiencing patient safety events due to a multitude of factors. Yet evidence is lacking of the extent and types of patient safety events occurring among people from CALD backgrounds in the context of cancer care. This study aimed to determine the frequency and nature of safety events for people from CALD backgrounds accessing cancer services in New South Wales, and to examine associations between the occurrence of patient safety events and socio-cultural factors identifiable from administrative datasets.
Method
A two-stage retrospective medical record review was conducted using an adapted Oncology Trigger Tool at two cancer services in New South Wales (NSW) that served substantial populations from CALD backgrounds. Based on the sample size requirements, medical records of those from CALD backgrounds were identified based on administrative data of language spoken at home, preferred language and interpreter required. In the first stage, a data extraction tool was used to collect administrative and safety events related data by two researchers. In the second stage, a medical oncologist reviewed the data collected for further validation and exclusion. Data analysis was conducted using SPSS software.
Result
Three hundred patient records were included (150 at each service), of which 104 records documented at least one patient safety event. A total of 161 safety events were identified from the 104 patient records, most commonly in inpatient settings (117/161, 72.6%%) rather than outpatient settings. Medication related events were most frequently recorded (54/161, 33.6%) and represented the highest proportion of safety events in both inpatient (34/117, 29%) and outpatient (20/44, 45.5%) settings. Wrong dosage-related medication safety events occurred more often in outpatient settings while prescription and administration-related medication safety events occurred more in inpatient setting. Correlation analysis demonstrated significant correlation between the number of safety events that occurred over a 12-month period with preferred language being other than English (r=0.131, p=0.024, n=298) and with interpreter required (r=0.175, p=0.002, n=300) socio-cultural variables.
Discussion and Conclusion
The findings indicate that strengthening medication management practices with consumers from CALD backgrounds may enhance their medication safety. Using culturally and linguistically adapted medication lists could be used to support this.