Person-Centered Care Practice, Patient Safety Competence, and Patient Safety Nursing Activities of Nurses Working in Geriatric Hospitals

Round 1

Reviewer 1 Report

Thank you fo le t me reviewing this paper, the topic fits for the journal, the paper is original and well written, I just suggest to cite this paper in the introduction. 

https://doi.org/10.1007/s00414-020-02368-z

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

Dear authors: 

Congratulations for your work. 

I have to pleasure to review it. Here my observations:

• The authors write on introduction that the study analyze factors influencing person centered care practice, patient safety competence and patient safety nursing activities of geriatric nurses in Korea…and provide fundamental data for developing plans to improve the quality of care in geriatric hospitals; however in the purpose of the study write that they want to determine the effects of person-centered care practice and patient safety competence on the patient safety nursing activities. The authors must be clear about the aim of the study. I suggest clarifying.
• I reviewed reference number 16, related with the follow phrase: “patient centered care also reduces fall risks, medication error, nosocomial infection incidence, emergency situations, and mortality rates”. The conclusion of this reference was only about fall risks, and in their conclusion said: “There is limited high quality evidence demonstrating the effectiveness of patient-centered fall prevention interventions so novel solutions are urgently needed and warrant more rigorous, larger scale randomized trials for more robust estimates of effect.”. Nothing about medication error, nosocomial infection incidence, emergency situations, and mortality rates.
• In methods there are a repetitive phrase about the sample size.
• The marital status is a curious data. I couldn't find the importance of this variable.
• In discussion item the authors write that the condition of geriatrics patients are more susceptible to safety accidents, so “this allows the assumptions that nurses working in geriatric hospitals are more sensitized to patient safety”, but also write that “the overall mean score for the level of patient safety competence was 3.92 points, which is lower that the results obtained in other studies with tertiary hospital nurses…”. It´s seem to me contradictory.
• The authors said that “in this study, person-centered care practice was found to have no significant effect on patient safety nursing activities, thus failing to support the result that the former is a key factor for the latter”. This statement reveals that the study in part would try to establish the influence of person-centered care on patient safety, an issue that seems contrary to me in practice, in that it is precisely patient safety that could influence care person-centered. Incidentally, there is occasionally a tension between the two aspects that must be managed, especially when the patient's wishes may threaten their own safety.
• One aspect that article doesn`t take is the fact that perception instruments were used. It should be mentioned overload related instruments on the same people and eventually confirmation biases that could alter perceptions and responses aspects.

Author Response

We would like to pay sincere appreciation for reviewing our article and below is the follow-up to your comments.

Point 1: The authors write on introduction that the study analyze factors influencing person centered care practice, patient safety competence and patient safety nursing activities of geriatric nurses in Korea…and provide fundamental data for developing plans to improve the quality of care in geriatric hospitals; however in the purpose of the study write that they want to determine the effects of person-centered care practice and patient safety competence on the patient safety nursing activities. The authors must be clear about the aim of the study. I suggest clarifying.

Response 1: Yes, I revised it

Point 2: I reviewed reference number 16, related with the follow phrase: “patient centered care also reduces fall risks, medication error, nosocomial infection incidence, emergency situations, and mortality rates”. The conclusion of this reference was only about fall risks, and in their conclusion said: “There is limited high quality evidence demonstrating the effectiveness of patient-centered fall prevention interventions so novel solutions are urgently needed and warrant more rigorous, larger scale randomized trials for more robust estimates of effect.” Nothing about medication error, nosocomial infection incidence, emergency situations, and mortality rates.

Response 2: I rewrote it and added references

Point 3: In methods there are a repetitive phrase about the sample size.

Response 3: I revised it

Point 4: The marital status is a curious data. I couldn't find the importance of this variable.

Response 4: Marital status shows no statistically significant difference in all variables of person-centered care, patient safety competence and patient safety nursing activities. It was indicated by a table 3.

Point 5: In discussion item the authors write that the condition of geriatrics patients are more susceptible to safety accidents, so “this allows the assumptions that nurses working in geriatric hospitals are more sensitized to patient safety”, but also write that “the overall mean score for the level of patient safety competence was 3.92 points, which is lower that the results obtained in other studies with tertiary hospital nurses…”. It´s seem to me contradictory.

Response 5: I added more detailed information and highlighted the need to promote geriatric nurses’ patient safety competence

Point 6: The authors said that “in this study, person-centered care practice was found to have no significant effect on patient safety nursing activities, thus failing to support the result that the former is a key factor for the latter”. This statement reveals that the study in part would try to establish the influence of person-centered care on patient safety, an issue that seems contrary to me in practice, in that it is precisely patient safety that could influence care person-centered. Incidentally, there is occasionally a tension between the two aspects that must be managed, especially when the patient's wishes may threaten their own safety.

Response 6: I totally agree with you. Thus, I added this one in the discussion section saying that the relationship between patients safety and person-centered care is closely related; the patient safety impact on the person-centered care and vice versa in practice. More research is required with two aspects of this issue.

Point 7: One aspect that article doesn`t take is the fact that perception instruments were used. It should be mentioned overload related instruments on the same people and eventually confirmation biases that could alter perceptions and responses aspects.

Response 7: I explained limitaion at the end of the discussion

We believe we have addressed each issue raised by the reviewers and hope you find the revisions to be satisfactory. We look forward to hearing from you. Thank you for your time and consideration.

Sincerely,

Juh Hyun Shin, Ayoung Huh

Reviewer 3 Report

This study uses three validated scales and analyses the interrelationships among them. It is a correlational study and its design limits the conclusions that can be drawn. The sample size (186) is limited to allow generalisations, although the way in which this figure has been calculated has been justified. The study was conducted in 2018, 3 years ago. In this time period there have been notable developments in safe practices and risk management that cannot be considered here. The study does not provide novel information or new aspects that have not been considered in other studies.

Author Response

We would like to pay sincere appreciation for reviewing our article and below is the follow-up to your comments.

Point 1: This study uses three validated scales and analyses the interrelationships among them. It is a correlational study and its design limits the conclusions that can be drawn. The sample size (186) is limited to allow generalisations, although the way in which this figure has been calculated has been justified. The study was conducted in 2018, 3 years ago. In this time period there have been notable developments in safe practices and risk management that cannot be considered here. The study does not provide novel information or new aspects that have not been considered in other studies.

Response 1: I totally agree with it. I put this contents as limitation in this study.

We believe we have addressed each issue raised by the reviewers and hope you find the revisions to be satisfactory. We look forward to hearing from you. Thank you for your time and consideration.

Sincerely,

Juh Hyun Shin, Ayoung Huh

Round 2

Reviewer 2 Report

Dear Authors: 

I think you  have made the suggested corrections. 

Kind regards-

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 3 Report

Authors have answered point-by-point all comments. Their responses are reasonable. The main gap of this study is its scarce novelty. Authors recognize it, however the discussion section could introduce new suggestions or describe implication for the practice. The sample is very limited considering it is a correlational study.

Author Response

Please see the attachment.

Author Response File: Author Response.docx