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Journal of Patient Safety

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https://www.readbyqxmd.com/read/28902681/early-warning-scores-to-predict-noncritical-events-overnight-in-hospitalized-medical-patients-a-prospective-case-cohort-study
#1
Jesse Bittman, Aman P Nijjar, Penny Tam, Nadia Khan
BACKGROUND: Physicians are often called to evaluate patients overnight with varying levels of clinical deterioration. Early warning scores predict critical clinical deterioration in patients; however, it is unknown whether they are able to reliably predict which patients will need to be seen overnight and whether these patients will require further resource use. METHODS: A prospective case cohort study of 522 patient nights in a single tertiary care hospital in Vancouver, British Columbia, Canada, was conducted to assess the ability of Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS) to predict patients who will need to be seen overnight by physicians and will require other healthcare resources...
September 12, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28902006/development-of-survey-scales-for-measuring-exposure-and-behavioral-responses-to-disruptive-intraoperative-behavior
#2
Alexander Villafranca, Colin Hamlin, Thomas L Rodebaugh, Sandra Robinson, Eric Jacobsohn
OBJECTIVES: Disruptive intraoperative behavior has detrimental effects to clinicians, institutions, and patients. How clinicians respond to this behavior can either exacerbate or attenuate its effects. Previous investigations of disruptive behavior have used survey scales with significant limitations. The study objective was to develop appropriate scales to measure exposure and responses to disruptive behavior. METHODS: We obtained ethics approval. The scales were developed in a sequence of steps...
September 10, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28902007/a-comparison-of-error-rates-between-intravenous-push-methods-a-prospective-multisite-observational-study
#3
John B Hertig, Daniel D Degnan, Catherine R Scott, Janelle R Lenz, Xiaochun Li, Chelsea M Anderson
OBJECTIVES: Current literature estimates the error rate associated with the preparation and administration of all intravenous (IV) medications to be 9.4% to 97.7% worldwide. This study aims to compare the number of observed medication preparation and administration errors between the only commercially available ready-to-administer product (Simplist) and IV push traditional practice, including a cartridge-based syringe system (Carpuject) and vials and syringes. METHODS: A prospective, multisite, observational study was conducted in 3 health systems in various states within the United States between December 2015 and March 2016 to observe IV push medication preparation and administration...
September 8, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28885382/the-ideal-hospital-discharge-summary-a-survey-of-u-s-physicians
#4
Atsushi Sorita, Paul M Robelia, Sharma B Kattel, Christopher P McCoy, Allan Scott Keller, Jehad Almasri, Mohammad Hassan Murad, James S Newman, Deanne T Kashiwagi
BACKGROUND: Hospital discharge summaries enable communication between inpatient and outpatient physicians. Despite existing guidelines for discharge summaries, they are frequently suboptimal. OBJECTIVE: The aim of this study was to assess physicians' perspectives about discharge summaries and the differences between summaries' authors (hospitalists) and readers (primary care physicians [PCPs]). METHODS: A national survey of 1600 U.S. physicians was undertaken...
September 6, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28885381/characteristics-of-medical-adverse-events-near-misses-associated-with-laparoscopic-thoracoscopic-surgery-a-retrospective-study-based-on-the-japanese-national-database-of-medical-adverse-events
#5
Takashige Abe, Sachiyo Murai, Yasuyuki Nasuhara, Nobuo Shinohara
OBJECTIVES: The aim of this study was to clarify the characteristics of adverse events/near misses during laparoscopic/thoracoscopic surgery. METHODS: Using relevant key words for minimally invasive surgeries, 540 records were identified in the database of the Japan Council for Quality Health Care. After data review and the classification of adverse events, 746 events associated with laparoscopic (laparo group) and/or thoracoscopic (thoraco group) surgery were identified...
September 6, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28877049/medication-errors-at-hospital-admission-and-discharge-risk-factors-and-impact-of-medication-reconciliation-process-to-improve-healthcare
#6
Cyril Breuker, Valérie Macioce, Thibault Mura, Audrey Castet-Nicolas, Yohan Audurier, Catherine Boegner, Anne Jalabert, Maxime Villiet, Antoine Avignon, Ariane Sultan
OBJECTIVE: First, the aim of the study was to assess the prevalence, characteristics, and severity of unintended medication discrepancies (UMDs) and medication errors (MEs) at admission and discharge of hospitalization. Second, the aim of the study was to identify clinical and hospitalization factors associated with risk of UMDs as well as characteristics of the medication reconciliation process associated with UMDs detection. METHODS: This prospective observational study included all adult patients admitted from 2013 to 2015 in the Endocrinology-Diabetology-Nutrition Department of Montpellier Hospital, France...
September 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28872476/do-user-applied-safety-labels-on-medication-syringes-reduce-the-incidence-of-medication-errors-during-rapid-medical-response-intervention-for-deteriorating-patients-on-wards-a-systematic-search-and-review
#7
John Mikhail, Hugh Grantham, Lindy King
INTRODUCTION: Intravenous medication errors (MEs) occur during medical emergency situations. An initiative, not yet in common practice, that could address these errors is safety labeling. The aim of this review was to identify and appraise research evidence related to the impact of user-applied medication safety labeling on reducing the incidence of MEs during rapid medical response intervention for patient deterioration in the ward setting. METHOD: A systematic search and review framework was used to conduct the review...
September 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28858967/applying-decision-science-to-the-prioritization-of-healthcare-associated-infection-initiatives
#8
Terry H Tsai, Michael D Gerst, Cyrus Engineer, Harold P Lehmann
OBJECTIVES: Improving patient quality remains a top priority from the perspectives of both patient outcomes and cost of care. The continuing threat to patient safety has resulted in an increasing number of options for patient safety initiatives, making choices more difficult because of competing priorities. This study provides a proof of concept for using low-cost decision science methods for prioritizing initiatives. METHODS: Using multicriteria decision analysis, we developed a decision support model for aiding the prioritization of the four most common types of healthcare-associated infections: surgical site infections, central line-associated bloodstream infections, ventilator-associated events, and catheter-associated urinary tract infections...
August 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28857951/is-there-a-mismatch-between-the-perspectives-of-patients-and-regulators-on-healthcare-quality-a-survey-study
#9
Renée Bouwman, Manja Bomhoff, Paul Robben, Roland Friele
OBJECTIVES: Internationally, healthcare quality regulators are criticized for failing to respond to patients' complaints. Patient involvement is, therefore, an important item on the policy agenda. However, it can be argued that there is a discrepancy between the patients' perspective and current regulatory approaches.This study examines whether a discrepancy exists between the perspectives of patients and regulators on healthcare quality. METHODS: A questionnaire was sent to 996 people who had registered a complaint with the Dutch Healthcare Inspectorate to measure expectations of and experiences with the Inspectorate...
August 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28858001/prescribing-errors-with-low-molecular-weight-heparins
#10
Marielle Slikkerveer, Afke van de Plas, Johanna H M Driessen, Robin Wijngaard, Frank de Vries, Renske Olie, Nathalie Meertens, Patricia van den Bemt
BACKGROUND: Low-molecular-weight heparins (LMWHs) are used in the prevention and treatment of venous thromboembolism (VTE). Bleeding is the primary major complication of LMWH therapy, which is associated with dose. The administration of appropriate dosages of LMWHs depends on the patient's risk of VTE, risk of bleeding, bodyweight, and renal function. Therefore, LMWH prescribing is prone to errors. However, no earlier study has explored the frequency of prescribing errors with LMWH. PURPOSE: The aim of the study was to determine the frequency and determinants of in-hospital LMWH-prescribing errors...
August 28, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28858000/development-and-psychometric-evaluation-of-the-speaking-up-about-patient-safety-questionnaire
#11
Aline Richard, Yvonne Pfeiffer, David D L Schwappach
OBJECTIVE: Speaking up about safety concerns by staff is important to prevent medical errors. Knowledge about healthcare workers' speaking up behaviors and perceived speaking up climate is useful for healthcare organizations (HCOs) to identify areas for improvement. The aim of this study was to develop a short questionnaire allowing HCOs to assess different aspects of speaking up among healthcare staff. METHODS: Healthcare workers (n = 523) from 2 Swiss hospitals completed a questionnaire covering various aspects of speak up-related behaviors and climate...
August 28, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28858002/patient-recall-of-informed-consent-at-4-weeks-after-total-hip-replacement-with-standardized-versus-procedure-specific-consent-forms
#12
Eoghan Pomeroy, Shahril Shaarani, Robert Kenyon, James Cashman
OBJECTIVES: Informed consent plays a pivotal role in the operative process, and surgeons have an ethical and legal obligation to provide patients with information to allow for shared decision-making. Unfortunately, patient recall after the consent process is frequently poor. This study aims to evaluate the effect of procedure-specific consent forms on patient's recall four weeks after total hip replacement (THR). METHODS: This is a prospective study using a posttest-only control group design...
August 25, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28846553/improved-outcomes-when-surgical-postoperative-complications-are-managed-according-to-the-principles-of-continuity-of-care-and-specificity-of-expertise
#13
COMMENT
Salomone Di Saverio, Gregorio Tugnoli, Arianna Birindelli, Carlo Coniglio, Fausto Catena, Giovanni Gordini
No abstract text is available yet for this article.
August 25, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28820796/provider-approachability-an-all-staff-survey-approach-to-creating-a-culture-of-safety
#14
Mark E Deyo-Svendsen, Karl B Palmer, Jill K Albright, Michael R Phillips, Keith A Schilling, Matthew E Cabrera Svendsen
OBJECTIVES: A culture-of-safety survey of our hospital staff revealed fear-based reluctance to question those in authority. We aimed to examine provider approachability (words and actions that promote trust and reduce or eliminate fear of interaction). METHODS: Providers and staff completed an anonymous facility-wide survey (survey 1) regarding perceptions of provider approachability. Results were safely communicated to providers, and improvement resources were offered...
August 17, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28787397/making-patient-safety-event-data-actionable-understanding-patient-safety-analyst-needs
#15
Joseph Stephen Puthumana, Allan Fong, Joseph Blumenthal, Raj M Ratwani
OBJECTIVES: The increase in patient safety reporting systems has led to the challenge of effectively analyzing these data to identify and mitigate safety hazards. Patient safety analysts, who manage reports, may be ill-equipped to make sense of report data. We sought to understand the cognitive needs of patient safety analysts as they work to leverage patient safety reports to mitigate risk and improve patient care. METHODS: Semistructured interviews were conducted with 21 analysts, from 11 hospitals across 3 healthcare systems...
August 4, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28786836/using-economic-evaluation-to-illustrate-value-of-care-for-improving-patient-safety-and-quality-choosing-the-right-method
#16
William V Padula, Ken K H Lee, Peter J Pronovost
To scale and sustain successful quality improvement (QI) interventions, it is recommended for health system leaders to calculate the economic and financial sustainability of the intervention. Many methods of economic evaluation exist, and the type of method depends on the audience: providers, researchers, and hospital executives. This is a primer to introduce cost-effectiveness analysis, budget impact analysis, and return on investment calculation as 3 distinct methods for each stakeholder needing a measurement of the value of QI at the health system level...
August 3, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28753137/life-threatening-and-fatal-adverse-drug-events-in-a-danish-university-hospital
#17
Olga A Tchijevitch, Lars Peter Nielsen, Marianne Lisby
OBJECTIVES: Detection of adverse drug events (ADEs) in Danish hospitals relies on health care professionals' incident reporting to a national database for adverse events, but the method is incomplete; thus, fatal and life-threatening ADEs may remain unrecognized.The objectives of this study were to examine the occurrence of life-threatening and fatal ADEs in population of hospitalized patients with suspected adverse outcome and to compare these findings with the actual number of reported ADEs in the study period of 3 months...
July 27, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28731933/continuous-capnography-reduces-the-incidence-of-opioid-induced-respiratory-rescue-by-hospital-rapid-resuscitation-team
#18
Mindy Stites, Jennifer Surprise, Jennifer McNiel, David Northrop, Martin De Ruyter
OBJECTIVE: The aim of this study was to determine the impact of end tidal carbon dioxide or capnography monitoring in patients requiring patient-controlled analgesia (PCA) on the incidence of opioid-induced respiratory depression (OIRD) in the setting of rapid response. METHODS: A retrospective analysis was conducted in an urban tertiary care facility on the incidence of OIRD in the setting of rapid response as defined by a positive response to naloxone from January 2012 to December 2015...
July 20, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28731932/investing-in-physicians-is-investing-in-patients-enhancing-patient-safety-through-physician-health-and-well-being-research
#19
Elizabeth Brooks, Doris C Gundersen, Michael H Gendel
Keeping medical practitioners healthy is an important consideration for workforce satisfaction and retention, as well as public safety. However, there is limited evidence demonstrating how to best care for this group. The absence of data is related to the lack of available funding in this area of research. Supporting investigations that examine physician health often "fall through the cracks" of traditional funding opportunities, landing somewhere between patient safety and workforce development priorities...
July 20, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28708671/a-systematic-review-of-primary-care-safety-climate-survey-instruments-their-origins-psychometric-properties-quality-and-usage
#20
Ciara Curran, Sinéad Lydon, Maureen Kelly, Andrew Murphy, Chloe Walsh, Paul OʼConnor
IMPORTANCE: Safety climate (SC) measurement is a common and feasible method of proactive safety assessment in primary care. However, there is no consensus on which instrument is "best" to use. OBJECTIVE: The aim of the study was to identify the origins, psychometric properties, quality, and SC domains measured by survey instruments used to assess SC in primary care settings. DATA SOURCES: Systematic searches were conducted using Medline, Embase, CINAHL, and PsycInfo in February 2016...
July 13, 2017: Journal of Patient Safety
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