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Aims: To examine the association between nursing unit safety culture, quality of care, missed care and nurse staffing levels, and inpatient falls using two data sources: incidence of falls and nurses' perceptions of fall frequency in their units. The study explores the association between the two sources of patient falls and identifies if nurses' perceptions of patient fall frequency reflect the actual patient falls recorded in the incident management system. Background: Inpatient falls are associated with severe complications that result in extended hospitalisation and increased financial consequences for patients and healthcare services. Design: A multi‐source cross‐sectional study guided by the STROBE guidelines. Methods: A purposive sample of 33 nursing units (619 nurses) from five hospitals completed an online survey from August to November 2021. The survey measured safety culture, quality of care, missed care, nurse staffing levels and nurses' perceptions of patient fall frequency. In addition, secondary data on falls from participating units between 2018 and 2021 were also collected. Generalised linear models were fitted to examine the association between study variables. Results: Nursing units with strong safety climate and working conditions and lower missed care were associated with lower rates of falls using both data sources. Nurses' perceptions of the frequency of falls in their units were reflective of the actual incidence rate of falls, but the association was not statistically significant. Conclusion: Nursing units with a strong safety climate and better collaborations between nurses and other professionals, including physicians and pharmacists, were associated with lower incidents of patient falls. Relevance to Clinical Practice: This study provided evidence for healthcare services and hospital managers to minimise patient falls. Patient or Public Contribution: Patients who had experienced a fall, which was reported in the incident management system, from the included units in the five hospitals were part of this study. [ABSTRACT FROM AUTHOR]

Introduction: A lack of patient safety research hampers capacity to improve safety in healthcare. Ultrasound is often considered 'safe' as it does not use ionising radiation, a simplistic view of patient safety. Understanding sonographers' actions towards patient safety is crucial; however, self-reported measures cannot always predict behaviour. This study is part of a PhD exploring patient safety in medical diagnostic ultrasound. The aim of this paper is to explore sonographers' responses to the patient safety concerns identified in Part one of this study. The ultimate aim of the study is to inform the final phase of the doctoral study which will consider the next steps in improving the quality and safety of healthcare experienced by patients. Methods: A qualitative study using semi-structured, one-on-one interviews. The Theory of Planned Behaviour (TPB) explained how sonographers respond to perceived patient safety risks in practice. Results: Thirty-one sonographers were interviewed. Based on the seven themes identified in Part one of the study, results showed that incongruences exist between identifying patient safety risks and the actions taken in practice to manage these risks. Conclusion: The TPB showed that behavioural, normative and control beliefs impact sonographers' responses to perceived patient safety risks in practice and can lead to risk avoidance. Lack of regulation in ultrasound creates a challenge in dealing with Fitness to Practice issues. Collective actions are required to support sonographers in taking appropriate actions to enhance patient safety from multiple stakeholders including accreditation bodies, regulatory authorities, educational institutions and employers. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To guide you in dealing with missing and erroneous data in cross-sectional nurse staffing surveys • To understand that methods of managing missing and erroneous survey data are important for transparent and replicable research • To ensure surveys are piloted and contain unambiguous questions so that participants understand them Background: Analysis can be problematic in research when data are missing or erroneous. Various methods are available for managing missing and erroneous data, but little is known about which are the best to use when conducting cross-sectional surveys of nurse staffing. Aim: To explore how missing and erroneous data were managed in a study that involved a cross-sectional survey of nurse staffing. Discussion: The article describes a study that used a cross-sectional survey to estimate the ratio of registered nurses to patients, using self-reported data by nurses. It details the techniques used in the study to manage missing and erroneous data and presents the results of the survey before and after the treatment of missing data. Conclusion: Managing missing data effectively and reporting procedures transparently reduces the possibility of bias in a study's results and increases its reproducibility. Nurse researchers need to understand the methods available to handle missing and erroneous data. Surveys must contain unambiguous questions, as every participant should have the same understanding of a question's meaning. Implication for practice: Researchers should pilot surveys – even when using validated tools – to ensure participants interpret the questions as intended. [ABSTRACT FROM AUTHOR]

Introduction: Patient safety has been an undervalued component of quality healthcare but is a challenging area of research. Ultrasound is the most common imaging modality in the world. Research on patient safety in ultrasound is generally focused on bioeffects and safe operation of ultrasound equipment. However, other safety issues exist in practice that warrant consideration. This paper forms the first part of a PhD study exploring patient safety in medical diagnostic ultrasound, beyond the notion of bioeffects. The ultimate aim of the study is to inform the final phase of the research study which will consider the next steps in improving the quality and safety of healthcare experienced by patients. Methods: A qualitative study using semi-structured, one-on-one interviews. A thematic analysis categorised data into codes and generated final themes. Results: A heterogeneous mix of 31 sonographers, who reflected the profile of the profession in Australia, were interviewed between September 2019 and January 2020. Seven themes emerged from the analysis. These were bioeffects, physical safety, workload, reporting, professionalism, intimate examinations and infection control. Conclusion: This study presents a comprehensive analysis of sonographers' perceptions of patient safety in ultrasound imaging, not previously available in the literature. Consistent with the literature, patient safety in ultrasound tends to be viewed in technical terms through the potential for bioeffects of tissue damage or physical harm to the patient. However, other patient safety issues have emerged, and while not as well recognised, have the potential to negatively impact on patient safety. [ABSTRACT FROM AUTHOR]