Fostering a culture of safety is an essential step in ensuring patient safety and quality in primary care. We aimed to evaluate the effectiveness of an educational intervention to improve the safety culture in the family and community medicine teaching units in an Atlantic European Region. Randomized study conducted in family and community medicine teaching units in Galicia (Spain). Participants were all fourth-year residents and their tutors (N = 138). Those who agreed to participate were randomized into one of two groups (27 tutors/26 residents in the intervention group, 23 tutors/ 23 residents in the control one).All were sent the Survey on Patient Safety Culture. After that, the intervention group received specific training in safety; they also recorded incidents over 15 days, documented them following a structured approach, and had feedback on their performance. The control group did not receive any action. All participants completed the same survey four months later. Outcome measures were the changes in safety culture as quantified by the results variables of the Survey: Patient Safety Grade and Number of events reported. We conducted bivariate and adjusted analyses for the outcome measures. To explore the influence of participants’ demographic characteristics and their evaluation of the 12 dimensions of the safety culture, we fitted a multivariate model for each outcome. Trial followed published protocol. There were 19 drop outs. The groups were comparable in outcome and independent variables at start. The experiment did not have any effect on Patient safety grade (− 0.040) in bivariate analysis. The odds of reporting one to two events increased by 1.14 (0.39–3.35), and by 13.75 (2.41–354.37) the odds of reporting 3 or more events. Different dimensions had significant independent effects on each outcome variable. A educational intervention in family and community medicine teaching units may improve the incidents reported. The associations observed among organizational dimensions and outcomes evidence the complexity of patient safety culture measurement and, also, show the paths for improvement. In the future, it would be worthwhile to replicate this study in teaching units from different settings and with different health professionals engaged. It was retrospectively registered with ( ISRCTN41911128 , 31/12/2010).

The increasing concern about bacterial resistance has made the rational prescription of antibiotics even more urgent. The non-pharmacological measures established to reduce the impact of the SARS-CoV-2 pandemic have modified the epidemiology of pediatric infections and, consequently, the use of antibiotics. Interrupted time series (ITS) analyses are quasi-experimental studies that allow for the estimation of causal effects with observational data in “natural experiments”, such as changes in health policies or pandemics. The effect of the SARS-CoV-2 pandemic on the incidence of infectious diseases and the use of antibiotics between 2018 and 2020 in the Health Area of Vigo (Galicia, Spain) was quantified and analyzed. This paper outlines a real-world data study with administrative records from primary care services provided for the pediatric population. The records were related to episodes classified as infectious by the International Classification of Primary Care (ICPC-2) and oral medication in the therapeutic subgroup J01, corresponding to antibiotics for systemic use, according to the World Health Organization’s Anatomical Therapeutic Chemical (ATC) classification system. The records were classified according to incident episodes, age, dose per inhabitant, and year. Segmented regression models were applied using an algorithm that automatically identifies the number and position of the change points. During the SARS-CoV-2 pandemic, the number of infectious diseases being transmitted between individuals, through the air and through the fecal–oral route, significantly decreased, and a slight decrease in infections transmitted via other mechanisms (urinary tract infections) was also found. In parallel, during the months of the pandemic, there has been a marked and significant reduction in antibacterial agent utilization, mainly of penicillins, cephalosporins, and macrolides.

Healthcare workers, especially medical and nursing residents, are exposed to situations that can lead to burnout. The main factors are organizational. However, it is more feasible for professionals to act on personal factors. There is a growing interest in interventions to prevent and reduce burnout. To examine the association between organizational and personal characteristics and burnout in Family and Community Medicine and Nursing residents, using baseline data from a non-randomised comparative study. This study is a secondary cross-sectional analysis of baseline data from a pragmatic non-randomised trial. We analysed sociodemographic, occupational, and psychological variables in relation to burnout. Medical and nursing residents enrolled in 2018–2021 at the teaching units of Vigo, Zaragoza, and Mallorca.” Variables: Sociodemographic, professional, burnout, empathy, resilience, social support, sense of coherence, anxiety and depression, personality, locus of control. Descriptive statistics and bivariate analyses (chi-square and Mann–Whitney U) were performed, and Pearson correlations with 95% confidence intervals were estimated to assess associations between burnout and organizational/personal variables (R 4.1.3). Registered in Clinical Trials with ID: NCT04625582 (November 10, 2020) A total of 147 residents were included at baseline (71% medicine, 29% nursing; 80% women; mean age 27.6 years). Mean burnout scores were 44.1 (SD 18.1) for personal burnout, 47.8 (SD 16.8) for work-related burnout, and 38.2 (SD 16.3) for patient-related burnout. Burnout correlated positively with weekly hours worked (r = 0.32, 95% CI 0.17–0.46), number of patients/day (r = 0.41, 95% CI 0.27–0.54) and monthly on-call shifts (r = 0.29, 95% CI 0.14–0.43), and with anxiety (r = 0.47, 95% CI 0.33–0.60) and depression (r = 0.36, 95% CI 0.21–0.50). Negative correlations were found with resilience (r = –0.38, 95% CI –0.52 to –0.23), social support (r = –0.24, 95% CI –0.39 to –0.08), and sense of coherence (r = –0.52, 95% CI –0.62 to –0.40) (all p < 0.05). Burnout in Family and Community Medicine and Nursing residents is associated with both organizational factors (workload, on-call duties, patient volume) and personal resources (resilience, empathy, sense of coherence). These findings underscore the importance of addressing structural workload while simultaneously enhancing coping resources to prevent burnout during residency training.