99241 - Gestione del rischio (FA)

Learning outcomes

At the end of the module, the student knows the strategies, activities, and clinical and organizational tools to identify and reduce the risk of harm to patients, the healthcare team, and visitors, and to ensure the safety of care.

Course contents

1. Introduction to patient safety

- General framework of clinical risk

- The evolution of patient safety and clinical risk management

- Epidemiology of clinical risk

- Clinical risk management in Italy

2. Tools for clinical risk management

- Error: definition, classification, and evaluation in clinical and care processes

- Information sources for healthcare safety

- Incident and near-miss reporting systems

- Information system for reporting Sentinel Events to the Ministry of Health (SIMES)

- Reactive analysis tools (Significant Event Audit SEA, Root Cause Analysis RCA)

3. Best practices and recommendations for healthcare safety

- Proactive analysis tools (AUDIT, FMEA/FMECA, safety visits, direct observations)

- VISITARE and OSSERVARE projects

- Operating room safety (Surgical Safety Check List)

4. Human Factor and patient safety

- Patient Empowerment: involvement of the patient, family members, and caregivers in improving the safety of care

- The human factor: Communication as a contributing factor in the occurrence of adverse events

- Recommendations for managing and communicating adverse events in healthcare

- Clinical Governance Tools (Guidelines, Protocols, Pathways)

Required preliminary knowledge The student must have knowledge of the fundamentals of nursing care, the nursing process, patient safety, the organization of health services, the ethical-deontological and legal aspects of the profession, as well as elements of epidemiology, health statistics, and clinical reasoning applied to the identification and management of care-related risks.

Useful knowledge It is helpful to be familiar with the principles of quality and continuous improvement of care, Evidence-Based Nursing, safe management of drug therapy, effective communication and teamwork, emergency management, and the use of health information systems for monitoring and reporting adverse events.

Readings/Bibliography

AGENAS [https://www.agenas.gov.it/aree-tematiche/qualita-e-sicurezza/rischio-clinico-e-sicurezza-del-paziente]

Cinotti, R., 2004. La gestione del rischio nelle organizzazioni sanitarie. Roma: Il pensiero scientifico editore.

Fidelia, C., La Regina, M., Ricciardi, W. & Tartaglia, R., 2022. Manuale di sicurezza del paziente e gestione del rischio clinico - Handbook of patient safety and clinical risk management. Perugia: Cultura e Salute.

Martini, M. & Pelati, C., 2011. La gestione del rischio clinico. Milano: McGrawHill.

Vincent, C., 2007. Patient safety - La sicurezza del paziente - Edizione Italiana di Bellandi, Pascu, Romano, Tartaglia. Roma: Esse editrice srl.

Vincent, C., 2010. La sicurezza del paziente - Edizione Italiana di Tartaglia, Albolino e Bellandi. 2nd a cura di Milano: Springer- Verlag Italia 2011.

WHO. Global Patient Safety Action Plan 2021–2030 (2021).

WHO. Patient Safety Curriculum Guide: Multi-professional Edition.

Legge 8 marzo 2017, n. 24 (Gelli-Bianco Law) Provisions concerning the safety of care and of the assisted person, as well as concerning the professional liability of practitioners of healthcare professions.

Recommended scientific journals

• International Journal for Quality in Health Care
• BMJ Quality & Safety
• Journal of Patient Safety
• Risk Management and Healthcare Policy
• L'Infermiere (FNOPI)
• Professioni Infermieristiche journal

Additional bibliographic references will be suggested by the instructor during the course

Teaching methods

Lectures and interactive sessions, case presentations, classroom exercises

Assessment methods

The exam will consist of a written test with 3 open-ended questions delivered through the EOL platform.

Evaluation criteria

• Accuracy and completeness of content
• Ability to apply concepts to clinical-care cases
• Use of appropriate professional terminology
• Clarity of exposition, ability to summarize, and organization of the response

Evaluation descriptors for each answer

• 10/10 Complete, accurate, and in-depth response. All content is correct and relevant. Concepts are effectively applied to complex clinical-care situations. Professional terminology is always appropriate and precise. Exposition is clear, well-organized, and concise.
• 9/10 Very good and essentially complete response. Content is correct with minor inaccuracies that are not significant. Good ability to apply to clinical contexts. Adequate technical language. Logical and clear structure.
• 8/10 Good answer, with predominantly correct and sufficiently complete content. Application of concepts to clinical cases is adequate, albeit with some limitations in depth. Professional terminology is generally correct. Presentation is organized and understandable.
• 7/10 Fair answer. It presents essential information but with some omissions or inaccuracies. Application to clinical-care contexts is partial. Professional language is not always precise. Overall organization of the answer is adequate.
• 6/10 Sufficient answer. The fundamental content is present but limited or not in depth. Basic application skills. Professional terminology is used simply and not always appropriately. Presentation is understandable but poorly structured.
• 5/10 Insufficient response. Fragmentary and incomplete knowledge. Difficulty in applying concepts to clinical cases. Professional terminology often inappropriate. Presentation unclear and disorganized.
• 4/10 Seriously insufficient response. Numerous conceptual errors and significant omissions. Application to care contexts absent or inadequate. Incorrect use of professional vocabulary. Poor clarity in presentation.
• 3/10 Very poor response. Limited and predominantly incorrect knowledge. Inability to connect theory and clinical practice. Improper language. Confused presentation.
• 2/10 Almost entirely inadequate response. Incorrect or irrelevant content relative to the prompt. Clinical application absent. Serious terminological and presentational deficiencies.
• 1/10 Minimal response, extremely incomplete and essentially unassessable in terms of subject content.
• 0/10 No response or completely off-topic. Criteria for grade allocation.

The final evaluation is determined by the sum of the scores obtained in the individual answers. For each question, a maximum score of 10 points can be awarded; as there are three questions, the maximum achievable score is 30/30. Distinction may be awarded to students who achieve an excellent evaluation, demonstrating complete mastery of the topics, high analytical and integrative skills, appropriate use of professional language, and absence of conceptual errors in their answers. The test is considered passed with a minimum score of 18/30.

During the test, students are not allowed to use supporting tools such as calculators, dictionaries, codes, handouts, notes, or any other reference material. Therefore, independent preparation of the content under examination is required.

Regarding the assessment of learning, the use of AI is prohibited. Any use constitutes a violation of academic integrity.

Students with SLD or temporary or permanent disabilities: it is recommended to contact the responsible University office in advance (https://site.unibo.it/studenti-con-disabilita-e-dsa/it); it will be their responsibility to propose any adaptations to the interested students, which in any case must be submitted, 15 days in advance, for the approval of the instructor, who will evaluate their appropriateness also in relation to the educational objectives of the course.

Teaching tools

PowerPoint slides, scientific articles, procedures, and guidelines will be used.

Office hours

See the website of Filippo Zanotti