Interprofessional Collaboration Improves Patient Safety ; A review

Patient safety is one of the indicators of the quality of health services in the hospital, for that it is necessary to have efforts from the hospital to create a system that can minimize the occurrence of errors and unexpected events that can harm patients, nurses as health workers who are the most numerous in the home. sick and with the patient for 24 hours, has an important role in maintaining patient safety. This study aims to explain how the role of nurses and cooperation between health workers in implementing patient safety measures in the hospital. The method used in this study is a literature review by analyzing and exploring relevant articles and focusing on interprofessional collaboration to improve patient safety. The articles used in this study were taken from 3 direct, proquest and Pubmed science databases published in the last 3 years, namely between 2019-2021, nurses as part of the health team are required to be able to work together with other health professionals in hospitals with various characteristics, including , education, gender, age, employment status and length of work, nurses are required to be committed to maintaining patient safety in the hospital. Keyword : interprofesional collaboration, nurse, patient safety Introduction Patient safety is an important aspect in hospital services, many studies state that the incidence of medical errors and diagnostic errors still occurs in health care centers around the world including in developing countries (1), even though efforts to prevent patient safety incidents have been launched since the last two decades ago (2). In the current era of globalization, hospitals are required to provide quality services to patients, where the quality of health services in hospitals is one of which is determined by patient safety in the hospital (3) (4). Patient safety will be carried out well if the hospital changes the old paradigm, which focuses on disease into a new paradigm, namely patient-centered care (5). The Institute of Medicine (IOM) in 2001 established six dimensions of service quality in the 21st century, namely patient centered, effective, efficient, safe, equitable, and timely (6). Patient center care (PCC) is a service that turns patients into a service center where the hospital provides holistic services, coordination between health workers, patient involvement in care, evidencePreprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 8 April 2021 doi:10.20944/preprints202104.0230.v1 © 2021 by the author(s). Distributed under a Creative Commons CC BY license. based action, use of information technology and appropriate service time and communication between service providers runs smoothly (7). Patient safety is influenced by patient safety culture and the involvement of health workers (8), good teamwork will reduce the risk of medical errors (9), teamwork, communication between health workers and collaboration between health workers are important factors to improve patient safety (10) (11). Medical errors can occur due to incorrect doctor prescriptions, unsafe administration of drugs by nurses, lack of information on pharmacy knowledge from the health care team, and weak collaboration between professions, these can be prevented by increasing the implementation of interprofessional collaboration (12). Interprofessional collaboration is an important component in providing health services to improve patient safety (13). This study aims to analyze the effect of interprofessional collaboration and the role of nurses on improving patient safety in hospitals. Method This research was conducted by conducting literature review of articles in the direct, proquest and pubmed science data base, with the keywords interprofessional education AND patient safety, articles were selected based on the limitations of the year they were published, namely between 2019-2021 with full text and using English. This review literature is based on Preferred Reporting Items for Systematic Reviews and Meta-Analies (PRISMA). The articles found in the data base were then synthesized and analyzed using exclusion and inclusion criteria, the inclusion criteria in this review literature were the implementation of patient safety in the hospital, while the exclusion criteria in this review literature were articles about patient safety carried out in the community. The initial literature search found 176 articles (sciene direct 17 articles, proquest 96 articles, and pubmed 63 articles) 170 potential articles met the criteria, after being selected based on similarity of articles to 165, after reviewing through abstracts there were 147 articles that were irrelevant and could not be accessed in full text So that it becomes 29 articles, out of 29 articles reviewed using the Joanna Briggs Institute (JBI) 10 full text articles meet the criteria. Result The results of 10 articles were obtained from the data base sciene direct, proquest, and pubmed with the keywords interprofessional collaboration AND patient safety, the results are as follows: 1. Article title : Inter-Professionalism in Health Care Post-graduate specialization: an innovative Laboratory. This article explains that Collaboration Between Professionals (IPC) is an important part of a health care system to run well. This is related to improved patient safety and case management, optimal use of skills of each member of the health care team and the provision of better health services. Inter-Professional Education (IPE) is one of the keys in developing positive behaviors that are beneficial to IPC. Methods: An Innovative Laboratory inspired by the Consensus Conference (CC) methodology on "Integrated Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 8 April 2021 doi:10.20944/preprints202104.0230.v1


Introduction
Patient safety is an important aspect in hospital services, many studies state that the incidence of medical errors and diagnostic errors still occurs in health care centers around the world including in developing countries (1), even though efforts to prevent patient safety incidents have been launched since the last two decades ago (2).
In the current era of globalization, hospitals are required to provide quality services to patients, where the quality of health services in hospitals is one of which is determined by patient safety in the hospital (3) (4). Patient safety will be carried out well if the hospital changes the old paradigm, which focuses on disease into a new paradigm, namely patient-centered care (5).
The Institute of Medicine (IOM) in 2001 established six dimensions of service quality in the 21st century, namely patient centered, effective, efficient, safe, equitable, and timely (6). Patient center care (PCC) is a service that turns patients into a service center where the hospital provides holistic services, coordination between health workers, patient involvement in care, evidence-based action, use of information technology and appropriate service time and communication between service providers runs smoothly (7). Patient safety is influenced by patient safety culture and the involvement of health workers (8), good teamwork will reduce the risk of medical errors (9), teamwork, communication between health workers and collaboration between health workers are important factors to improve patient safety (10) (11). Medical errors can occur due to incorrect doctor prescriptions, unsafe administration of drugs by nurses, lack of information on pharmacy knowledge from the health care team, and weak collaboration between professions, these can be prevented by increasing the implementation of interprofessional collaboration (12).
Interprofessional collaboration is an important component in providing health services to improve patient safety (13). This study aims to analyze the effect of interprofessional collaboration and the role of nurses on improving patient safety in hospitals.

Method
This research was conducted by conducting literature review of articles in the direct, proquest and pubmed science data base, with the keywords interprofessional education AND patient safety, articles were selected based on the limitations of the year they were published, namely between 2019-2021 with full text and using English. This review literature is based on Preferred Reporting Items for Systematic Reviews and Meta-Analies (PRISMA). The articles found in the data base were then synthesized and analyzed using exclusion and inclusion criteria, the inclusion criteria in this review literature were the implementation of patient safety in the hospital, while the exclusion criteria in this review literature were articles about patient safety carried out in the community.
The initial literature search found 176 articles (sciene direct 17 articles, proquest 96 articles, and pubmed 63 articles) 170 potential articles met the criteria, after being selected based on similarity of articles to 165, after reviewing through abstracts there were 147 articles that were irrelevant and could not be accessed in full text So that it becomes 29 articles, out of 29 articles reviewed using the Joanna Briggs Institute (JBI) 10 full text articles meet the criteria.

Result
The results of 10 articles were obtained from the data base sciene direct, proquest, and pubmed with the keywords interprofessional collaboration AND patient safety, the results are as follows: 1. Article title : Inter-Professionalism in Health Care Post-graduate specialization: an innovative Laboratory. This article explains that Collaboration Between Professionals (IPC) is an important part of a health care system to run well. This is related to improved patient safety and case management, optimal use of skills of each member of the health care team and the provision of better health services. Inter-Professional Education (IPE) is one of the keys in developing positive behaviors that are beneficial to IPC. Methods: An Innovative Laboratory inspired by the Consensus Conference (CC) methodology on "Integrated Narrative Nursing Assessment". Involves three Postgraduate specialization programs and gets different assignments in CC. Result: there is competency development in students, and acquiring collaborative skills between health professions. Conclusion: This experimental laboratory is useful for providing real IPC experiences to students. They are actually collaborating with different health professionals to achieve a common goal (13).
2. Article title: Inter-professional nursing education and the roles of swift trust, interaction behaviors, and creativity: A cross-sectional questionnaire survey. This article explains that increasing teamwork involving several health workers is one approach in facing today's challenges. Teamwork can be enhanced through interprofessional learning in nursing education. Behaviors that encourage collaboration and creativity in organizations include rapid trust, interactive behavior, and team creativity. Methods: A cross-sectional study was conducted with 210 nursing students in an inter-professional educational institution with an interdisciplinary team. Design: Three questionnaires assessed nursing students' perceptions of rapid trustworthiness, interactive behavior, and creativity: 1) fast trust measures both cognitive-based and affective-based domains; 2) interactive behavior measures the domains of constructive controversy, helping behavior, and spontaneous communication; and 3) team creativity measures collaborative ability. The scale score ranges from 1 to 5; higher scores indicate faster trustworthiness, better interactive behavior, and greater team creativity. Analysis with Pearson correlation coefficient. Results: Cognitive-based rapid confidence correlated positively with all three domains of interactive behavior (p <0.01); All domains of interactive behavior were positively related to team creativity (p <.01). Interactive behavior mediates the relationship between cognitive-based rapid trust and team creativity. Discussion: Increasing cognitive-based rapid confidence and interactive behavior in interdisciplinary education for nursing students can enhance team creativity. Educational institutions engaged in interdisciplinary educational courses for nurses should encourage interactive behavior, which can promote cognitive-based rapid confidence among nursing students and increase collaboration and creativity. (14).
3. Article title: Safety attitudes and working climate after organizational change in a major emergency department in Sweden. The article explains that teamwork can affect the safety climate of staff, which in turn can affect patient safety. Purpose: This study aims to evaluate the effect of organizational change on the assessment process of interprofessional teams on staff perceptions of teamwork and safety attitudes in the ER. Methods: This prospective observational study used a cross-sectional design and measured the ED staff's perceptions of the patient safety-related domain at two time points (before and after organizational intervention), using a safety attitude questionnaire. Results: There are significant differences between before and after organizational changes for safety climate, working conditions, and stress recognition domains. Nurses and physicians showed different basic attitudes and different responses to the intervention between the two time points. 10. Article title: Piloting and evaluating feasibility of a training program to improve patient safety for inter-professional inpatient care teams -Study protocol of a cluster randomized controlled trial. This article explains that improving patient safety is a key goal in the health care system. Patient safety training has often focused on a single topic and profession. Therefore, there is a need for training among health team professionals. In this study, it aims to (1) pilot this training program by comparing two different training formats with the control group and (2) evaluate the feasibility of the intervention. Methods and analysis: (1) For intervention trials, cluster randomized controlled trials will be conducted in three study locations. Therefore, the e-learning group and the mixed learning group would be compared with a waiting control group at three assessment points; (2) The feasibility of the intervention will be evaluated using qualitative methods. We will conduct individual problem-focused interviews as part of the post-intervention measure to gather information on acceptance, implementation, drivers and constraints from a staff perspective. Discussion: This study puts forward a training program that has the potential to improve patient safety in hospitalization. Interprofessional inpatient care team members can receive systematic training in the three competencies that are at the core of patient safety management. development of optimal implementation strategies can encourage the implementation of interventions in health service practices. As a result, the interventions can be used continuously and comprehensively for the continued training of hospital staff (22).