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Risk Management and Healthcare Policy

Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem
Purpose: The aim of this study was to determine the incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Patients and methods: This retrospective cohort study was approved by the medical ethical committee, Faculty of Medicine, Maharaj Nakorn Chiang Mai Hospital, Thailand. Data of 19,683 trauma patients who received anesthesia between January 2007 and December 2016, such as patient characteristics, surgery procedures, anesthesia information, anesthetic drugs, and cardiac arrest outcomes, were analyzed...
2018: Risk Management and Healthcare Policy
Osama Y Alshogran, Karem H Alzoubi, Omar F Khabour, Shatha Farah
Background and objective: Self-medication practice involves consumption of medicines by one's own initiative or on the consultation of others without the guidance of a physician. Self-medication and use of over-the-counter drugs are prevalent worldwide public health concerns. University students of medical and nonmedical disciplines may have different levels of health education. This study evaluated the prevalence and patterns of self-medication and the attitudes toward this practice among medical and nonmedical university students in Jordan...
2018: Risk Management and Healthcare Policy
Margaret O'Rourke, Conal Wrigley, Sean Hammond
This paper aims to present best practice in risk management within mental health services. Its purpose is to explore the prevalence of violence within mental health services, to examine the nature of risk, highlight lessons learned and guidance published on safer services, and to identify ways to enhance risk management in mental health care. We reflect on current health care practices in the UK, England and Wales, and Ireland and refer to research and practice from other jurisdictions internationally where it exists...
2018: Risk Management and Healthcare Policy
David Mark Dror, Atanu Majumdar, Arpita Chakraborty
Introduction: This study deals with examining factors that catalyze demand for community-based micro health insurance (MHI) schemes. We hypothesize that demand for health insurance is a collective decision in the context of informality and poverty. Our hypothesis challenges the classical theory of demand which posits individual expected diminishing utility. We examine factors beyond the traditional exogenous variables. Methods: This study uses data collected through a household survey conducted among self-help groups in rural India in the states of Uttar Pradesh and Bihar before the implementation of three community-based MHI schemes...
2018: Risk Management and Healthcare Policy
Aubrey M Moe, Ellen B Rubinstein, Colin J Gallagher, David M Weiss, Amanda Stewart, Nicholas Jk Breitborde
Psychotic spectrum disorders are serious illnesses with symptoms that significantly impact functioning and quality of life. An accumulating body of literature has demonstrated that specialized treatments that are offered early after symptom onset are disproportionately more effective in managing symptoms and improving outcomes than when these same treatments are provided later in the course of illness. Specialized, multicomponent treatment packages are of particular importance, which are comprised of services offered as soon as possible after the onset of psychosis with the goal of addressing multiple care needs within a single care setting...
2018: Risk Management and Healthcare Policy
Aditi Karnad, Annie Pannelay, Anelia Boshnakova, Alan D Lovell, Robert G Cook
Purpose: Stroke is a leading cause of death and disability, although studies show that 90% of strokes can be prevented. The evidence base for stroke prevention is well established, and this study aimed to investigate how well European countries are adopting the European Society of Cardiology (ESC) guidelines, particularly toward implementation of the recommended best practice in stroke prevention. Materials and methods: We developed a stroke prevention scorecard - populated with World Health Organization (WHO) data, secondary research, time-series data, and a survey of 550 physicians - to benchmark 11 European countries in the context of the ESC guidelines...
2018: Risk Management and Healthcare Policy
Alyssa M Peckham, Maria J Ananickal, David A Sclar
The abuse potential of gabapentin is well documented; with gabapentin having been noted as an agent highly sought after for use in potentiating opioids. When combined with opioids, the risk of respiratory depression and opioid-related mortality increases significantly. In the US, gabapentin was approved by the Food and Drug Administration as a non-controlled substance. To date, and in spite of empirical evidence suggestive of diversion and abuse with opioids, gabapentin remains a non-controlled substance at the federal level...
2018: Risk Management and Healthcare Policy
Valy Fontil, Courtney R Lyles, Dean Schillinger, Margaret A Handley, Sara Ackerman, Gato Gourley, Kirsten Bibbins-Domingo, Urmimala Sarkar
Background: Clinical performance measures, such as for cholesterol control targets, have played an integral role in assessing the value of care and translating evidence into clinical practice. New guidelines often require development of corresponding performance metrics and systems changes that can be especially challenging in safety-net health care institutions. Understanding how public health care institutions respond to changing practice guidelines may be critical to informing how we adopt evolving evidence in clinical settings that care for the most vulnerable populations...
2018: Risk Management and Healthcare Policy
Xiao Ping Xu, Dong Ning Deng, Yong Hong Gu, Chui Shan Ng, Xiao Cai, Jun Xu, Xin Shi Zhang, Dong Ge Ke, Qian Hui Yu, Chi Kuen Chan
Background: The World Health Organization highlights that patient safety interventions are not lacking but that the local context affects their successful implementation. Increasing attention is being paid to patient safety in Mainland China, yet few studies focus on patient safety in organizations with mixed cultures. This paper evaluates the current patient safety culture in an experimental Chinese hospital with a Hong Kong hospital management culture, and it aims to explore the application of Hong Kong's patient safety strategies in the context of Mainland China...
2018: Risk Management and Healthcare Policy
Bernd Froessler, Alexandra M Rueger, Mark P Connolly
Background: Perioperative administration of ferric carboxymaltose (FCM) was previously shown to reduce both the need for transfusions and the hospital length of stay in patients with preoperative iron deficiency anemia (IDA). In this study, we estimated the economic consequences of perioperative administration using FCM vs usual care in patients with IDA from the perspective of a German hospital using decision-analytic modeling. Materials and methods: The model was populated with clinical inputs (transfusion rates, blood units transfused, hospital length of stay) from a previously reported randomized trial comparing FCM vs usual care for managing IDA patients undergoing elective abdominal surgery...
2018: Risk Management and Healthcare Policy
Eman AlOtaibi, Mohammed AlAteeq
Background: Family management of asthmatic children is affected by several factors, primarily the parent's knowledge and attitude toward asthma. Objective: The aim of this study was to explore the knowledge and practice of parents and guardians about asthma in their children. Methods: Two hundred and thirty-one self-administered questionnaires were distributed to parents and guardians attending, with their children, general pediatric and pediatric pulmonology outpatient clinics at King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City for National Guard, Riyadh, Saudi Arabia, during the period from August 2016 to March 2017...
2018: Risk Management and Healthcare Policy
Ger T Rijkers, Laura Ie Yousif, Simone Mc Spoorenberg, Frans J van Overveld
Pneumococcal pneumonia is a serious disease with considerable morbidity and mortality in the elderly. Despite adequate antibiotic treatment, the long-term mortality of pneumococcal pneumonia remains high. Preventive measures in the form of vaccination, therefore, are warranted. Twenty-three-valent polysaccharide vaccines have a broad coverage but limited efficacy. Pneumococcal conjugate vaccines have been shown in children to be able to prevent invasive and mucosal pneumococcal diseases. It should be realized that the serotype composition of current pneumococcal conjugate vaccines is not tailored for the elderly, and that replacement disease can occur...
2018: Risk Management and Healthcare Policy
Pavani Rangachari
Background: Despite the regulatory impetus toward meaningful use of electronic health record (EHR) Medication Reconciliation (MedRec) to prevent medication errors during care transitions, hospital adherence has lagged for one chief reason: low physician engagement, stemming from lack of consensus about which physician is responsible for managing a patient's medication list. In October 2016, Augusta University received a 2-year grant from the Agency for Healthcare Research and Quality to implement a Social Knowledge Networking (SKN) system for enabling its health system (AU Health) to progress from "limited use" of EHR MedRec technology to "meaningful use...
2018: Risk Management and Healthcare Policy
Zerihun Ataro, Abraham Geremew, Fekadu Urgessa
Background: Occupational exposure to chemicals in garages causes a wide range of biological effects, depending upon the level and duration of exposure. In Ethiopia, there have been few studies conducted to assess the exposure of garage workers to chemicals. Preceding studies have not explored the effect of working in garage on blood pressure and hematological parameters. Therefore, this study aimed to assess differences in blood pressure and hematological parameters among garage workers compared to the Haramaya University community, Harar, eastern Ethiopia...
2018: Risk Management and Healthcare Policy
Monali S Malvankar-Mehta, Ryan Wilson, Erik Leci, Kelly Hatch, Sapna Sharan
Background: The objective of this research was to conduct a systematic review and cost analysis to summarize, from the Ministry of Health perspective, the costs families might incur because of their child's prescription for refractive errors and amblyopia correction. Methods: Databases including MEDLINE, Embase, BIOSIS, CINAHL, HEED, ISI Web of Science, and the Cochrane Library as well as the gray literature were searched. Systematic review was conducted using EPPI-Reviewer 4...
2018: Risk Management and Healthcare Policy
Nonthaphat Theerawasttanasiri, Surasak Taneepanichskul, Wichain Pingchai, Yuwaree Nimchareon, Sangworn Sriwichai
Introduction: Many studies have shown that fluoride can cross the placenta and that exposure to high fluoride during pregnancy may result in premature birth and/or a low birth weight. Lamphun is one of six provinces in Thailand where natural water fluoride (WF) concentrations >10.0 mg/L were found, and it was also found that >50% of households used water with high fluoride levels. Nevertheless, geographical information system (GIS) and maps of endemic fluoride areas are lacking...
2018: Risk Management and Healthcare Policy
Roger Lee Mendoza
Purpose: While the individual and social costs of alcoholism or alcohol use disorder are well established, few are aware that medical problems can arise during detoxification, some of which can be life-threatening. This study determines if sustained treatment for Alcohol Withdrawal Syndrome (AWS) might be based on the strategic choices and expectations of patients and health care providers alike, as well as the risk mitigation options available to them. Design/approach: AWS was modeled as a Stag Hunt to explain both risk and decision-making in medical treatments for detoxification, since it can deduce a set of equilibrium strategies available to both patient and provider...
2018: Risk Management and Healthcare Policy
Louise M Henderson, Laura M Jones, Mary W Marsh, Alison T Brenner, Adam O Goldstein, Thad S Benefield, Mikael Anne Greenwood-Hickman, Paul L Molina, M Patricia Rivera, Daniel S Reuland
Introduction: The US Preventive Services Task Force recommended annual lung cancer screening with low-dose computed tomography (LDCT) for high-risk patients in December 2013. We compared lung cancer screening-related opinions and practices among attending and resident primary care physicians (PCPs). Methods: In 2015, we conducted a 23-item survey among physicians at a large academic medical center. We surveyed 100 resident PCPs (30% response rate) and 86 attending PCPs (49% response rate) in Family Medicine and Internal Medicine...
2017: Risk Management and Healthcare Policy
Sara Koo, Laura Jane Neilson, Christian Von Wagner, Colin John Rees
Colorectal cancer (CRC) is the third most common cancer in the UK. The English National Health Service (NHS) Bowel Cancer Screening Program (BCSP) was introduced in 2006 to improve CRC mortality by earlier detection of CRC. It is now offered to patients aged 60-74 years and involves a home-based guaiac fecal occult blood test (gFOBt) biennially, and if positive, patients are offered a colonoscopy. This has been associated with a 15% reduction in mortality. In 2013, an additional arm to BCSP was introduced, Bowelscope...
2017: Risk Management and Healthcare Policy
Tiziana Ramaci, Monica Pellerone, Caterina Ledda, Venerando Rapisarda
BACKGROUND: Job insecurity resulting from new types of employment contracts, together with organizational dynamics such as restructuring and internationalization, is emerging as an important source of organizational and individual stress, often transforming the workplace into a hostile and, above all, extremely demanding context from a psychological point of view. MATERIALS AND METHODS: The aim of this study was to identify the possible relationships between individual and organizational dimensions of work (such as engagement, autonomy, personal and collective efficacy at work, and satisfaction) and their impact on stress levels...
2017: Risk Management and Healthcare Policy
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