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Journal of Patient Safety

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https://www.readbyqxmd.com/read/30431554/the-ambulatory-version-of-the-safety-attitude-questionnaire-psychometric-validation-and-measurement-properties-in-nigerian-clinical-setting
#1
Daprim Samuel Ogaji, Mabel Emudiaga-Ohwerhi, Adedotun Daniel Adesina
BACKGROUND: Understanding the safety culture of health care providers can help administrators improve patient safety. However, it is difficult to measure complex constructs such as safety culture without valid and reliable tools. This study determined the measurement properties of the ambulatory version of the safety attitude questionnaire (SAQ-AV) in the Nigerian clinical setting. METHODS: A multiphase, iterative research involving clinical staff in primary and tertiary level of care in South-south Nigeria...
November 13, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30431553/extended-patient-alone-time-in-emergency-department-leads-to-increased-risk-of-30-day-hospitalization
#2
Adam J VanDeusen, Kalyan S Pasupathy, Todd R Huschka, Heather A Heaton, Thomas R Hellmich, Mustafa Y Sir
OBJECTIVES: This study was conducted to describe patients at risk for prolonged time alone in the emergency department (ED) and to determine the relationship between clinical outcomes, specifically 30-day hospitalization, and patient alone time (PAT) in the ED. METHODS: An observational cohort design was used to evaluate PAT and patient characteristics in the ED. The study was conducted in a tertiary academic ED that has both adult and pediatric ED facilities and of patients placed in an acute care room for treatment between May 1 and July 31, 2016, excluding behavioral health patients...
November 13, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30431552/health-information-and-the-quality-and-safety-of-care-for-people-with-disability-an-analysis-of-australian-reports-of-reviewable-deaths-in-residential-care
#3
Maria R Dahm, Andrew Georgiou, Susan Balandin, Sophie Hill, Bronwyn Hemsley
OBJECTIVE: Many Australians with disability live in residential care and require assistance to manage their health information across hybrid care settings encompassing residential care, primary and tertiary care, and allied health. In this study, we examined case study reports on people with disability living in residential care in New South Wales, Australia to (a) identify threats to the quality of care and safety for this vulnerable patient group in relation to health documentation and information infrastructure and (b) evaluate the applicability of a conceptual health information infrastructure model...
November 13, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30418425/dissecting-communication-barriers-in-healthcare-a-path-to-enhancing-communication-resiliency-reliability-and-patient-safety
#4
Oren T Guttman, Elizabeth H Lazzara, Joseph R Keebler, Kristen L W Webster, Logan M Gisick, Anthony L Baker
Suboptimal exchange of information can have tragic consequences to patient's safety and survival. To this end, the Joint Commission lists communication error among the most common attributable causes of sentinel events. The risk management literature further supports this finding, ascribing communication error as a major factor (70%) in adverse events. Despite numerous strategies to improve patient safety, which are rooted in other high reliability industries (e.g., commercial aviation and naval aviation), communication remains an adaptive challenge that has proven difficult to overcome in the sociotechnical landscape that defines healthcare...
November 9, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30418424/validating-a-trigger-tool-for-detecting-adverse-drug-events-in-elderly-patients-with-multimorbidity-trigger-chron
#5
María Dolores Toscano Guzmán, Mercedes Galván Banqueri, María José Otero, Susana Sánchez Fidalgo, Isabel Font Noguera, María Concepción Pérez Guerrero
PURPOSE: The aims of the study were to evaluate the performance of an initial list developed to detect adverse drug events (ADEs) in elderly patients with multimorbidity in clinical practice, to explore the possibility of shortening the list, and to use this tool to study the incidence and characteristics of the ADEs among this population. METHODS: This observational study was conducted at 12 Spanish hospitals. A random sample of five charts from each hospital was selected weekly for retrospective review for a 12-week period...
November 9, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30407963/the-correlation-between-neonatal-intensive-care-unit-safety-culture-and-quality-of-care
#6
Jochen Profit, Paul J Sharek, Xin Cui, Courtney C Nisbet, Eric J Thomas, Daniel S Tawfik, Henry C Lee, David Draper, J Bryan Sexton
OBJECTIVES: Key validated clinical metrics are being used individually and in aggregate (Baby-MONITOR) to monitor the performance of neonatal intensive care units (NICUs). The degree to which perceptions of key components of safety culture, safety climate, and teamwork are related to aspects of NICU quality of care is poorly understood. The objective of this study was to test whether NICU performance on key clinical metrics correlates with caregiver perceptions of safety culture. STUDY DESIGN: Cross-sectional study of 6253 very low-birth-weight infants in 44 NICUs...
November 7, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30407962/risk-management-in-the-ambulatory-care-process-in-a-mutual-benefit-association-covering-work-related-accidents-and-diseases-applying-modified-failure-mode-and-effect-analysis-fmea-methodology
#7
Norma Grau, Rafael Manzanera, Carola Orrego, Jordi Ortner, Albert Vives, Carme Saurí, Diego Moya, José Miguel Martínez
AIM: To assess the impact of different forms of use of failure mode and effect analysis methodology for risk prioritization in the ambulatory care process in a mutual benefit association covering work-related accidents and diseases. METHODS: The study is based on a previously drafted and individually prioritized risk map by a multidisciplinary team made up of patient safety committee members from health care centers and clinics in a mutual benefit association covering work-related accidents and diseases...
November 7, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30383622/advancing-patient-safety-through-the-clinical-application-of-a-framework-focused-on-communication
#8
Milisa Manojlovich, Timothy P Hofer, Sarah L Krein
OBJECTIVES: The study of communication has evolved from diverse academic disciplines, yet those diverse fields are not well represented in theoretical frameworks that describe communication in health care, narrowing our ability to explain how communication affects patient safety. The purpose of this review article is to describe a conceptual framework of communication drawn from multiple academic disciplines and apply it to health care, specifically for examining communication between providers about the clinical care of their patients...
October 31, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30383621/the-role-of-education-in-developing-a-culture-of-safety-through-the-perceptions-of-undergraduate-nursing-students-an-integrative-literature-review
#9
Amie L Bedgood, Susan Mellott
OBJECTIVE: This integrative literature review seeks to examine research-based knowledge about the role of education in developing a culture of safety through the perspectives of undergraduate nursing students. METHODS: An integrative literature review of nursing and health databases was conducted and literature from 2009 to 2018 were reviewed. Studies focusing on patient safety education in undergraduate nursing students were analyzed to identify the current state of safety education in academia...
October 31, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30365407/clinical-economic-and-organizational-impact-of-the-clinical-pharmacist-in-an-orthopedic-and-trauma-surgery-department
#10
Pierre Renaudin, Annabelle Coste, Yohan Audurier, Julie Berbis, François Canovas, Anne Jalabert, Audrey Castet-Nicolas, Gregoire Mercier, Maxime Villiet, Louis Dagneaux, Cyril Breuker
AIM: The aim of this study was to evaluate the clinical, economic, and organizational impact of clinical pharmacist services added to an adult orthopedic and trauma surgery unit in a university hospital. METHODS: This was a prospective, observational study performed from January to February 2017. All pharmacists' interventions were documented, and their clinical, economic, and organizational impact and the probability of adverse drug events (ADEs) were assessed using the clinical, economic and organizational scale three-dimensional scale...
October 25, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30308592/examining-medical-office-owners-and-clinicians-perceptions-on-patient-safety-climate
#11
Olena Mazurenko, Jason Richter, Abby Swanson Kazley, Eric Ford
OBJECTIVE: An essential element of effective medical practice management is having a shared set of beliefs among members regarding patient safety climate. Recognizing the need for improving patient safety, the Agency for Healthcare Research and Quality began a series of surveys to assess medical practice members' attitudes and beliefs on patient safety climate. The aim of the study was to examine owners and clinicians perceptions of their medical practice's patient safety climate. METHODS: We used the 2010-2011 Medical Office Survey on Patient Safety Culture collected by the Agency for Healthcare Research and Quality...
October 10, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30308591/infrastructure-design-a-critical-element-in-the-care-of-the-patient-with-obesity
#12
Vilma E Ortiz, Rick J Ottolino, Mary W Matz, Raul N Uppot, Bob Winters
The worldwide rate of obesity continues to rise, causing healthcare systems to morph to meet the demands posed by the concomitant increase in comorbidities associated with this condition. Increasing patient weight imposes its own constraints on the safety of patients and providers; therefore, a sound healthcare facility infrastructure is required to properly address the medical needs of patients with obesity. Currently, most healthcare systems-in their attitudes, equipment, and facility design-are ill equipped to meet the needs of this epidemic...
October 10, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30308590/an-analysis-of-the-fda-maude-database-and-the-search-for-cobalt-toxicity-in-class-3-johnson-johnson-depuy-metal-on-metal-hip-implants
#13
Kevin T Kavanagh, Steve S Kraman, Sean P Kavanagh
INTRODUCTION: This study was designed to determine whether systemic cobalt toxicity as an adverse event could be documented using the Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience (MAUDE) database for cobalt-chromium containing hip implant recipients. Class 3 Johnson & Johnson (J&J)/DePuy devices were chosen for analysis because of the large number of adverse event reports related to their Pinnacle and ASR XL Acetabular hip replacement systems...
October 10, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30308589/quality-improvement-program-outcomes-for-endotracheal-intubation-in-the-emergency-department
#14
Sung Yeon Hwang, Joo Hyun Park, Hee Yoon, Won Chul Cha, Ik Joon Jo, Min Seob Sim, Keun Jeong Song, Hyo Jung Woo, Sung Geun Jeong, Tae Gun Shin
OBJECTIVES: We describe our 3-year experience with endotracheal intubation (ETI) outcomes during a multidisciplinary emergency department (ED)-based quality improvement (QI) program. METHODS: This was a single-center, observational study taking place during a QI program. We used a registry for airway management performed in the ED from April 2014 to February 2017. The QI program focused on procedural standardization, airway management education, and comprehensive preparation of airway equipment...
October 10, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30252771/antithrombotic-stewardship-assessing-use-of-computerized-clinical-decision-support-tools-to-enhance-safe-prescribing-of-direct-oral-anticoagulants-in-hospitalized-patients
#15
Tania Ahuja, Veronica Raco, John Papadopoulos, David Green
Prescribing patterns for oral anticoagulants in patients with nonvalvular atrial fibrillation and venous thromboembolism is shifting from vitamin K antagonists, such as warfarin to the direct oral anticoagulants (DOACs), such as dabigatran, rivaroxaban, and apixaban. Although many hospital systems have implemented clinical decision support or enhanced monitoring for patients prescribed warfarin, there is limited evidence to suggest similar levels of enhanced monitoring for DOACs. The antithrombotic stewardship team at our institution developed guidelines and implemented computerized clinical decision support (CCDS) tools to enhance medication and patient safety related to the DOACs...
September 25, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30211785/resilience-from-a-stakeholder-perspective-the-role-of-next-of-kin-in-cancer-care
#16
Inger Johanne Bergerød, Geir S Braut, Siri Wiig
OBJECTIVE: The aim of this article was to provide new knowledge on how next of kin are co-creators of resilient performance, as seen from the viewpoint of the healthcare personnel and managers. The following research question guided the study: How are next of kin involved in shaping resilience within cancer care in hospitals? METHODS: The design of the study is a case study of cancer departments in two Norwegian hospitals. Data collection included a total of 32 qualitative semistructured interviews at two organizational levels (managers and staff)...
September 11, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30192260/does-free-text-information-in-falls-incident-reports-assist-to-explain-how-and-why-the-falls-occurred-in-a-hospital-setting
#17
Lex D de Jong, Jacqueline Francis-Coad, Nicholas Waldron, Katharine Ingram, Steven M McPhail, Christopher Etherton-Beer, Terry P Haines, Leon Flicker, Tammy Weselman, Anne-Marie Hill
OBJECTIVE: The aim of this study was to explore whether information captured in falls reports in incident management systems could be used to explain how and why the falls occurred, with a view to identifying whether such reports can be a source of subsequent learnings that inform practice change. METHODS: An analysis of prospectively collected falls incident reports found in the incident management systems from eight Western Australian hospitals during a stepped-wedge cluster-randomized controlled trial...
September 5, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30138158/patient-safety-culture-health-information-technology-implementation-and-medical-office-problems-that-could-lead-to-diagnostic-error
#18
Joanne R Campione, Russell E Mardon, Kathryn M McDonald
BACKGROUND: Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment or by leading to unnecessary or harmful treatment. OBJECTIVES: The aim of the study was to investigate the relationship between patient safety culture, health information technology (IT) implementation, and the frequency of problems that could lead to diagnostic errors in the medical office setting, such as unavailable test results, unavailable medical records, or unpursued abnormal results...
August 22, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30125891/improved-compliance-and-comprehension-of-a-surgical-safety-checklist-with-customized-versus-standard-training-a-randomized-trial
#19
David Rakoff, Krishna Akella, Chandrashekar Guruvegowda, Sunil Chhajwani, SriKrishna Seshadri, Srikanth Sola
OBJECTIVE: This study aimed to determine the effect of customized training versus standard readily available training on surgical safety checklist (SSCL) compliance and comprehension. BACKGROUND: The success of the SSCL in reducing surgical mortality and morbidity depends largely on the degree of compliance among health care workers with the checklist's components. We hypothesized that a customized training program would improve comprehension of the SSCL components among health care workers...
September 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/30124578/therapeutic-duplication-of-long-acting-injectable-drugs
#20
Shih-Chieh Shao, Edward Chia-Cheng Lai, Yuk-Ying Chan, Ming-Jui Hung, Hui-Yu Chen
Long-acting medications are widely used to provide convenient ways of managing diseases, but they may cause serious harm to patients when prescribed erroneously. We present a case of hypocalcaemia as a result of therapeutic duplication of 2 long-acting bisphosphonates prescribed within days of each other by different physicians. We describe how we prevented similar medication errors through improvements in medical informatics systems. This case emphasizes the need for enhancements in medical informatics systems to avoid therapeutic duplication of long-acting medications in the interest of patient safety...
September 2018: Journal of Patient Safety
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