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In the preintervention period, 100% of the errors were reported by the nursing staff; in the postintervention period, 79% were reported by nurses, 7% by physicians, and 14% by pharmacists. The rate of reported errors per 10,000 days of hospitalisation in the steps carried out by the nursing staff increased by a factor of 3.7 (rate ratio, 0.026; 95% CI, 0.01�C0.57; P?Cobimetinib management unit reached a consensus following a review of the literature.14?and?24 Fig. 4 shows the reported causes of MEs, and Fig. 5 the number of errors per month notified in the pre- and postintervention periods. The interventions to promote a culture of safety included multicomponent strategies, with the formation of teams and mechanisms to support communication. Assessing the implemented strategies based on the outcomes was considered of paramount importance.25 In calculating reporting rates, we have used 10,000 days of hospitalisation as the denominator, rather than the 100 commonly used in observational study. We did this because the direct observation method is about 1000 times more efficacious than the method of voluntary reporting, although it Ribociclib tends to miss errors with harm.5?and?21 The substantial increase in reporting unaccompanied by an increase in reports of error with harm implies that the motivation to report of healthcare professionals has increased, as manifested by the 17-fold increase in the reporting of potential errors and errors without harm. The involvement of nursing staff in reporting has increased, as has that of physicians and pharmacists. We were not able to assess the safety climate by means of a survey, as recommended by the Ministerio de Sanidad y Consumo (the Ministry of Health and Consumers),26 nor the training Rolziracetam in safety. The method of training in small groups applied to the nursing staff was more effective than training during clinical sessions, as nurses have reported errors 11 times more often than specialist physicians, who are the smallest professional collective. Consistent with what we found in our study, communications in recent national congresses also mention the lack of electronic prescription support as an important cause of MEs (44%).27 The following measures, among others, are recommended to evaluate the efficacy of patient safety strategies: account of the theoretical model explaining why the safety intervention would work, detailed description of the intervention so it can be repeated, description of how the intervention changes over time, and assessment of the effect of the intervention on outcomes.