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Journal of Patient Safety

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https://www.readbyqxmd.com/read/28622155/triad-ix-can-a-patient-testimonial-safely-help-ensure-prehospital-appropriate-critical-versus-end-of-life-care
#1
Ferdinando Mirarchi, Christopher Cammarata, Timothy E Cooney, Kristin Juhasz, Stanley A Terman
OBJECTIVE: The present study sought to assess the clarity of Physician Orders for Life-Sustaining Treatment (POLST) or Living Will (LW) documents alone or in combination with a video message/testimonial (VM). METHODS: Emergency medical services (EMS) personnel responded to survey questions about the meaning of stand-alone POLST and LW documents and those used in conjunction with emergent care scenarios. Personnel were randomized to receive documents only or documents with VM...
June 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28617720/development-of-a-trigger-tool-to-identify-adverse-drug-events-in-elderly-patients-with-multimorbidity
#2
María Dolores Toscano Guzmán, Mercedes Galván Banqueri, María José Otero, Eva Rocío Alfaro Lara, Pilar Casajus Lagranja, Bernardo Santos Ramos
PURPOSE: Elderly patients with multimorbidity are especially vulnerable to adverse drug events (ADEs) and had high prevalence rates. Identifying ADEs is essential for enabling timely interventions that can mitigate the adverse events detected and for developing targeted strategies to prevent their occurrence as well as to monitor implementation. The aim of this study was to develop a set with appropriate triggers for detecting potential ADEs in elderly patients with multimorbidity. METHODS: A modified Delphi methodology was used to reach consensus...
June 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28598897/adverse-events-detection-through-global-trigger-tool-methodology-results-from-a-5-year-study-in-an-italian-hospital-and-opportunities-to-improve-interrater-reliability
#3
Alberto Mortaro, Francesca Moretti, Diana Pascu, Lorella Tessari, Stefano Tardivo, Serena Pancheri, Garon Marta, Gabriele Romano, Mariangela Mazzi, Paolo Montresor, James M Naessens
OBJECTIVE: Global Trigger Tool (GTT) has been proposed as a low-cost method to detect adverse events (AEs). The validity of the methodology has been questioned because of moderate interrater agreement. Continuous training has been suggested as a means to improve consistency over time. We present the main findings of the implementation of the Italian version of the GTT and evaluate efforts to improve the interrater reliability over time. METHODS: The Italian version of the GTT was developed and implemented at the San Bonifacio Hospital, a 270-bed secondary care acute hospital in Verona, Italy...
June 9, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28594650/impact-of-an-obstetrical-hospitalist-program-on-the-safety-events-in-a-mid-sized-obstetrical-unit
#4
Julie Z Decesare, Suzanne Y Bush, Ashley N Morton
OBJECTIVE: Because internal medicine hospitalist programs were developed to address issues in medicine such as a need to improve quality, improve efficiency, and decrease healthcare cost, obstetrical (OB) hospitalist models were developed to address needs specific to the obstetrics and gynecology field. Our objective was to compare outcomes measured by occurrence of safety events before and after implementation of an OB hospitalist program in a mid-sized OB unit. METHODS: From July 2012 to September 2014, 11 safety events occurred on the labor and delivery floor...
June 8, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28590949/quantitative-assessment-of-statistical-reviews-of-patient-safety-research-articles
#5
Jeffrey R Daniels, Franklin Dexter, Jennifer L Espy, Sorin J Brull
OBJECTIVES: For 8.5 consecutive years, all patient safety articles of a journal underwent statistical review before publication. We sought to establish the prevalence of statistical themes in the statistical reviews, consideration of contemporary statistical methods, and their associations with time to journal receipt of authors' revision. METHODS: An initial set of statistical themes was created using the statistical editor's notes. For example, for the statistical theme of "CONSORT checklist," the search term needed was "CONSORT...
June 6, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28582277/simulation-based-assessment-identifies-longitudinal-changes-in-cognitive-skills-in-an-anesthesiology-residency-training-program
#6
Avner Sidi, Nikolaus Gravenstein, Terrie Vasilopoulos, Samsun Lampotang
OBJECTIVES: We describe observed improvements in nontechnical or "higher-order" deficiencies and cognitive performance skills in an anesthesia residency cohort for a 1-year time interval. Our main objectives were to evaluate higher-order, cognitive performance and to demonstrate that simulation can effectively serve as an assessment of cognitive skills and can help detect "higher-order" deficiencies, which are not as well identified through more traditional assessment tools. We hypothesized that simulation can identify longitudinal changes in cognitive skills and that cognitive performance deficiencies can then be remediated over time...
June 2, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28574959/intravenous-smart-pump-drug-library-compliance-a-descriptive-study-of-44-hospitals
#7
Karen K Giuliano, Wan-Ting Su, Daniel D Degnan, Kristy Fitzgerald, Richard J Zink, Poching DeLaurentis
BACKGROUND: Although intravenous (IV) smart pumps with built-in dose-error reduction systems (DERS) can reduce IV medication administration error, most serious adverse events still occur during IV medication administration. Sources of error include overriding DERS and manually bypassing drug libraries and the DERS. METHODS: Our purpose was to use the Regenstrief National Center for Medical Device Informatics data set to better understand IV smart pump drug library and DERS compliance...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28574958/re-cell-phone-calls-in-the-operating-theater-and-staff-distractions-an-observational-study-avidan-a-yavobi-g-weissman-c-levin-p-j-patient-saf-2017
#8
Emma Sewart, Matthew Willett, Orla Gillman, Daniel Muller, Esther Shin, Maud Nauta, Wai Yoong
No abstract text is available yet for this article.
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28574957/-attention-everyone-time-out-safety-attitudes-and-checklist-practices-in-anesthesiology-in-germany-a-cross-sectional-study
#9
Christopher Neuhaus, Aline Spies, Henryk Wilk, Markus A Weigand, Christoph Lichtenstern
BACKGROUND: The use of perioperative checklists has generated a growing body of evidence pointing toward reduction of mortality and morbidity, improved compliance with guidelines, reduction of adverse events, and improvements in human factor-related areas. Usual quality management metrics generally fall short in assessing compliance with their perioperative application. Our study assessed application attitudes and compliance with safety measures centered around the World Health Organization (WHO) "Safe Surgery Saves Lives" campaign as perceived by anesthesia professionals in Germany...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28574956/identifying-high-alert-medications-in-a-university-hospital-by-applying-data-from-the-medication-error-reporting-system
#10
Lotta Tyynismaa, Anni Honkala, Marja Airaksinen, Kenneth Shermock, Lasse Lehtonen
OBJECTIVES: To facilitate safe use of high-alert medications, lists of medications posing higher risks for medication errors (MEs) and harmful effects have been compiled. These lists can be general or reflect clinical practices in specific settings. Less common has been to compile a hospital-specific list applying data from the organization's ME reporting system. Our objective was to demonstrate a method for compiling such a high-alert medication list in a university hospital. METHODS: Of the eighteen 136 MEs reported during 2007 to 2013, ME reports with medications coded as a contributing factor to the incident were included (n = 249)...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28574955/safety-culture-in-the-operating-room-variability-among-perioperative-healthcare-workers
#11
Marc Philip T Pimentel, Stephanie Choi, Karen Fiumara, Allen Kachalia, Richard D Urman
INTRODUCTION: Safety culture is defined as the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine an organization's health and safety management. There is a lack of studies assessing patient safety culture in the perioperative setting. OBJECTIVES: We examined safety culture at a single tertiary care hospital, across all types of surgery, using previously collected data from a validated survey tool...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28562423/a-report-of-information-technology-and-health-deficiencies-in-u-s-nursing-homes
#12
Gregory L Alexander, Richard W Madsen
OBJECTIVE: The aim of the study was to investigate the impact of nursing home (NH) information technology (IT) sophistication on publically reported health safety deficiency scores documented during standard inspections. METHODS: The sample included 807 NHs from every U.S. state. A total of 2187 health inspections were documented in these facilities. A national IT sophistication survey describing IT capabilities, extent of IT use, and degree of IT integration in resident care, clinical support, and administrative activities in U...
May 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28492422/increasing-patient-clinician-concordance-about-medical-error-disclosure-through-the-patient-tips-model
#13
William Martinez, David Browning, Pamela Varrin, Barbara Sarnoff Lee, Sigall K Bell
OBJECTIVE: To test whether an educational model involving patients and family members (P/F) in medical error disclosure training for interprofessional clinicians can narrow existing gaps between clinician and P/F views about disclosure. METHOD: Parallel presurveys/postsurveys using Likert scale questions for clinicians and P/F. RESULTS: Baseline surveys were completed by 91% (50/55) of clinicians who attended the workshops and 74% (65/88) of P/F from a hospital patient and family advisory council...
May 10, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28471774/adapting-cognitive-task-analysis-to-investigate-clinical-decision-making-and-medication-safety-incidents
#14
Alissa L Russ, Laura G Militello, Peter A Glassman, Karen J Arthur, Alan J Zillich, Michael Weiner
OBJECTIVES: Cognitive task analysis (CTA) can yield valuable insights into healthcare professionals' cognition and inform system design to promote safe, quality care. Our objective was to adapt CTA-the critical decision method, specifically-to investigate patient safety incidents, overcome barriers to implementing this method, and facilitate more widespread use of cognitive task analysis in healthcare. METHODS: We adapted CTA to facilitate recruitment of healthcare professionals and developed a data collection tool to capture incidents as they occurred...
May 3, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28452918/detecting-medication-administration-errors
#15
Marianne L Durham, Ann Jankiewicz
No abstract text is available yet for this article.
April 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28452917/quality-of-handoffs-in-community-pharmacies
#16
Ephrem Abebe, Jamie A Stone, Corey A Lester, Michelle A Chui
OBJECTIVES: The aims of the study were to characterize handoffs in community pharmacies and to examine factors that contribute to perceived handoff quality. METHODS: A cross-sectional study of community pharmacists in a Midwest State of the United States. Self-administered questionnaires were used to collect information on participant and practice setting characteristics. Data were analyzed using descriptive statistics and multivariate logistic regression. RESULTS: A total of 445 completed surveys were returned (response rate, 82%)...
April 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28452916/never-events-in-uk-general-practice-a-survey-of-the-views-of-general-practitioners-on-their-frequency-and-acceptability-as-a-safety-improvement-approach
#17
Susan J Stocks, Rahul Alam, Paul Bowie, Stephen Campbell, Carl de Wet, Aneez Esmail, Sudeh Cheraghi-Sohi
BACKGROUND: Never events (NEs) are serious preventable patient safety incidents and are a component of formal quality and safety improvement (Q&SI) policies in the United Kingdom and elsewhere. A preliminary list of NEs for UK general practice has been developed, but the frequency of these events, or their acceptability to general practitioner (GPs) as a Q&SI approach, is currently unknown. The study aims to estimate (1) the frequency of 10 NEs occurring within GPs' own practices and (2) the extent to which the NE approach is perceived as acceptable for use...
April 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28452915/leapfrog-hospital-safety-score-magnet-designation-and-healthcare-associated-infections-in-united-states-hospitals
#18
Amy L Pakyz, Hui Wang, Yasar A Ozcan, Michael B Edmond, Timothy J Vogus
OBJECTIVE: Healthcare-associated infections (HAIs) pose a challenge to patient safety. Although studies have explored individual level, few have focused on organizational factors such as a hospital's safety infrastructure (indicated by Leapfrog Hospital Safety Score) or workplace quality (Magnet recognition). The aim of the study was to determine whether Magnet and hospitals with better Leapfrog Hospital Safety Scores have fewer HAIs. METHODS: Ordered probit regression analyses tested associations between Safety Score, Magnet status, and standardized infection ratios, depicting whether a hospital had a Clostridium difficile infection (CDI) and methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection standardized infection ratio that was "better," "no different," or "worse" than a National Benchmark as per Centers for Disease Control and Prevention's National Healthcare Safety Network definitions...
April 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28452914/cost-benefit-analysis-of-a-support-program-for-nursing-staff
#19
Dane Moran, Albert W Wu, Cheryl Connors, Meera R Chappidi, Sushama K Sreedhara, Jessica H Selter, William V Padula
OBJECTIVES: A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit. METHODS: A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis...
April 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28452913/improving-patient-safety-in-handover-from-intensive-care-unit-to-general-ward-a-systematic-review
#20
Ida Wibrandt, Anne Lippert
OBJECTIVES: Despite of the increasing knowledge about patient safety improvements in the handover process in hospitals, we still lack knowledge about what magnitude of patient safety gains can be expected from improvements in handover between the intensive care unit (ICU) and the general ward. The aim of this systematic review was to investigate which handover tools are devised and evaluated with the aim of improving patient safety in the handover process from ICU to ward and whether the described handover tools fulfill their purpose...
April 27, 2017: Journal of Patient Safety
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