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A Dahan, L P H J Aarts
In 2005, the Dutch Society of Anaesthesiologists showed that handovers during anaesthetic care increase complication and mortality rates, an observation that has recently been confirmed by a Canadian study. In contrast to surgical care, handovers in anaesthetic care are quite common for various reasons including end of shift, tiredness after night duty, and activities outside the operating centre. The quality of handovers could be improved by training on an anaesthesia simulator, with emphasis on communication, reduction of information loss and using checklists...
2018: Nederlands Tijdschrift Voor Geneeskunde
Amy J Spooner, Leanne M Aitken, Wendy Chaboyer
BACKGROUND: Miscommunication during handover has been linked to adverse patient events and is an international patient safety priority. Despite the development of handover resources, standardized handover tools for nursing team leaders (TLs) in intensive care are limited. AIMS: The study aim was to implement and evaluate an evidence-based electronic minimum data set for nursing TL shift-to-shift handover in the intensive care unit using the knowledge-to-action (KTA) framework...
March 8, 2018: Worldviews on Evidence-based Nursing
Andrew J Lautz, Kelly C Martin, Akira Nishisaki, Christopher P Bonafide, Roberta L Hales, Elizabeth A Hunt, Vinay M Nadkarni, Robert M Sutton, Donald L Boyer
OBJECTIVES: Miscommunication has been implicated as a leading cause of medical errors, and standardized handover programs have been associated with improved patient outcomes. However, the role of structured handovers in pediatric emergencies remains unclear. We sought to determine if training with an airway, breathing, circulation, situation, background, assessment, recommendation handover tool could improve the transmission of essential patient information during multidisciplinary simulations of critically ill children...
March 7, 2018: Hospital Pediatrics
Susan C Lee, Megan E Atkinson, Charles G Minard, Alice O'Brien
BACKGROUND: Handovers in patient care are increasingly common occurrences in medicine and are highly susceptible to communication failures. Intraoperative anaesthesiology handovers are especially challenging because of concurrent management of the patient. Our goal was to develop and use an electronic handover checklist as an educational tool to teach anaesthesiology trainees a standardised method of handing over a case intraoperatively. We hypothesised that the use of the checklist would systematically enhance the transfer of accurate and complete information...
March 6, 2018: Clinical Teacher
A Dang, S Miller, D Horvat, T Klassen-Ross, M Graveline, R Collins, R Olson
Background: Across our province, post-radiotherapy (rt) handover notes are sent to family physicians (fps) after rt. Based on previous fp feedback, we created a revised post-radiotherapy handover note with more information requested by fps. The purpose of this study was to determine whether the revised handover note improved the note as a communication aid. Methods: Potential common and rare treatment side effects, oncologist contact information, and treatment intent were added to the revised handover note...
February 2018: Current Oncology
Tatiana Gualotuña, Elsa Macías, Álvaro Suárez, Efraín R Fonseca C, Andrés Rivadeneira
Low-cost video surveillance systems are attractive for Smart Home applications (especially in emerging economies). Those systems use the flexibility of the Internet of Things to operate the video camera only when an intrusion is detected. We are the only ones that focus on the design of protocols based on intelligent agents to communicate the video of an intrusion in real time to the guards by wireless or mobile networks. The goal is to communicate, in real time, the video to the guards who can be moving towards the smart home...
March 1, 2018: Sensors
Shobhana Nagraj, Juliet Harrison, Lawrence Hill, Lesley Bowker, Susanne Lindqvist
BACKGROUND: Collaborative practice between paramedics and medical staff is essential for ensuring the safe handover of patients. Handover of care is a critical time in the patient journey, when effective communication and collaborative practice are central to promoting patient safety and to avoiding medical error. To encourage effective collaboration between paramedic and medical students, an innovative, practice-based simulation exercise, known as interprofessional clinical skills (ICS) was developed at the University of East Anglia, UK...
February 23, 2018: Clinical Teacher
Rikke von Benzon Hollesen, Rie Laurine Rosenthal Johansen, Christina Rørbye, Louise Munk, Pierre Barker, Anette Kjaerbye-Thygesen
BACKGROUND: A safe delivery is part of a good start in life, and a continuous focus on preventing harm during delivery is crucial, even in settings with a good safety record. In January 2013, the labour unit at Copenhagen University Hospital, Hvidovre, undertook a quality improvement (QI) project to prevent asphyxia and reduced the percentage of newborns with asphyxia by 48%. METHODS: The change theory consisted of two primary elements: (1) the clinical content, including three clinical bundles of evidence-based care, a 'delivery bundle', an 'oxytocin bundle' and a 'vacuum extraction bundle'; (2) an implementation theory, including improving skills in interpretation of cardiotocography, use of QI methods and participation in a national learning network...
February 3, 2018: BMJ Quality & Safety
G Sirgo Rodríguez, M Chico Fernández, F Gordo Vidal, M García Arias, M S Holanda Peña, B Azcarate Ayerdi, E Bisbal Andrés, A Ferrándiz Sellés, P J Lorente García, M García García, P Merino de Cos, J M Allegue Gallego, A García de Lorenzo Y Mateos, J Trenado Álvarez, P Rebollo Gómez, M C Martín Delgado
Handover is a frequent and complex task that also implies the transfer of the responsibility of the care. The deficiencies in this process are associated with important gaps in clinical safety and also in patient and professional dissatisfaction, as well as increasing health cost. Efforts to standardize this process have increased in recent years, appearing numerous mnemonic tools. Despite this, local are heterogeneous and the level of training in this area is low. The purpose of this review is to highlight the importance of IT while providing a methodological structure that favors effective IT in ICU, reducing the risk associated with this process...
February 6, 2018: Medicina Intensiva
Atilio Barbeito, Aalok V Agarwala, Amanda Lorinc
Handovers around the time of surgery are common, yet complex and error prone. Interventions aimed at improving handovers have shown increased provider satisfaction and teamwork, improved efficiency, and improved communication and have been shown to reduce errors and improve clinical outcomes in some studies. Common recommendations in the literature include a standardized institutional process that allows flexibility among different units and settings, the completion of urgent tasks before information transfer, the presence of all members of the team for the duration of the handover, a structured conversation that uses a cognitive aid, and education in team skills and communication...
March 2018: Anesthesiology Clinics
Philip E Greilich, Mary Eleanor Phelps, William Daniel
Diffusing innovation and best practices in healthcare are among the most challenging aspects of advancing patient safety and quality improvement. Recommendations from the Baldrige Foundation, Institute for Healthcare Improvement, and The Joint Commission provide guidance on the principles for successful diffusion. Perioperative leaders are encouraged to applying these principles to high priority areas such as handovers, enhanced recovery and patient blood management. Completing a successful pilot project can be exciting, however, effective diffusion is essential to achieving meaningful and lasting impact on the service line and health system...
March 2018: Anesthesiology Clinics
Sam Nahas, Adam Ali, Kiran Majid, Roshan Joseph, Chris Huber, Victor Babu
BACKGROUND: The National Health Service was estimated to be in £2.45 billion deficit in 2015 to 2016. Trauma theatre utilization and efficiency has never been so important as it is estimated to cost £15/minute. METHODS: Structured questionnaires were given to 23 members of staff at our Trust who are actively involved in the organization or delivery of orthopaedic trauma lists at least once per week. This was used to identify key factors that may improve theatre efficiency...
February 8, 2018: International Journal of Health Planning and Management
Yuh-Shyan Chen, Yi-Ting Tsai
Mobility management for supporting the location tracking and location-based service (LBS) is an important issue of smart city by providing the means for the smooth transportation of people and goods. The mobility is useful to contribute the innovation in both public and private transportation infrastructures for smart cities. With the assistance of edge/fog computing, this paper presents a fully new mobility management using the proposed follow-me cloud-cloudlet (FMCL) approach in fog-computing-based radio access networks (Fog-RANs) for smart cities...
February 6, 2018: Sensors
Alejandra Bravo-Molina, José Patricio Linares-Palomino, Blanca Vera-Arroyo, Luis Miguel Salmerón-Febres, Eduardo Ros-Díe
BACKGROUND: The aim of this cohort study was to assess the inter-observer agreement of three diabetic foot classification systems: the Wagner, the University of Texas and the PEDIS. METHODS: We included 250 consecutive patients diagnosed of diabetic foot syndrome in 2009-2013. Wound scores were recorded at admission and a reevaluation was performed simultaneously or 24h later by a different evaluator. Demographical, laboratory data and associated risk factors were obtained from the patients' medical records...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Meng-Ping Wu, Chao-Ming Huang, Wen-Jung Sun, Chih-Yuan Shih, Su-Hsuan Hsu, Sheng-Jean Huang
The home-based medical care integrated plan under Taiwan National Health Insurance has changed from paying for home-based medical care, home-based nursing, home-based respiratory treatment, and palliative care to paying for a single, continuous home-based care service package. Formerly, physician-visit regulations limited home visits for home-based nursing to providing medical related assessments only. This limitation not only did not provide practical assistance to the public but also caused additional problems for those with mobility problems or who faced difficulties in making visits hospital...
February 2018: Hu Li za Zhi the Journal of Nursing
Mahbube Arabbeigi, Ahmad Arzani, Mohammad Mahdi Majidi, Badraldin Ebrahim Sayed-Tabatabaei, Prasenjit Saha
Aegilops cylindrica , a salt-tolerant gene pool of wheat, is a useful plant model for understanding mechanism of salt tolerance. A salt-tolerant USL26 and a salt-sensitive K44 genotypes of A. cylindrica , originating from Uremia Salt Lake shores in Northwest Iran and a non-saline Kurdestan province in West Iran, respectively, were identified based on screening evaluation and used for this work. The objective of the current study was to investigate the expression patterns of four genes related to ion homeostasis in this species...
February 2018: Physiology and Molecular Biology of Plants: An International Journal of Functional Plant Biology
Melissa Desmedt, Jochen Bergs, Benjamin Willaert, Ward Schrooten, Annemie Vlayen, Johan Hellings, Neree Claes, Dominique Vandijck
OBJECTIVES: The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents' profession was examined. METHODS: A cross-sectional study was conducted by administering the SCOPE-Primary Care questionnaire in two home care service organizations. RESULTS: In total, 1875 valid questionnaires were returned from 2930 employees, representing a response rate of 64%...
February 1, 2018: Journal of Patient Safety
U Hamsen, C Waydhas, R Wildenauer, T A Schildhauer, W Schwenk
BACKGROUND: Unplanned admissions or readmissions to the intensive care unit lead to a poorer outcome and present medical, logistic and economic challenges for a clinic. How often and what are the reasons for readmission to the intensive care unit? Which strategies and guidelines to avoid readmission are recommended. MATERIAL AND METHODS: Analysis and discussion of available studies and recommendations of national and international societies. RESULTS: Many studies show that unplanned admissions and readmissions to the intensive care unit represent an independent risk factor for a poor outcome for patients...
January 30, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Dorothea Eisenmann, Fabian Stroben, Jan D Gerken, Aristomenis K Exadaktylos, Mareen Machner, Wolf E Hautz
Introduction: Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED) is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care...
January 2018: Western Journal of Emergency Medicine
Karolina Zjadewicz, Kirsten S Deemer, Jennifer Coulthard, Christopher J Doig, Paul J Boiteau
The purpose is to provide a descriptive overview of relevant material exploring improvement of handovers from the operating room (OR) to intensive care unit (ICU). An online search (MEDLINE, Cochrane, EMBASE, CINAHL, and Joanna Briggs), including gray literature and relevant reference lists, was completed. In all, 4574 unique citations were screened and 155 full-text reviews performed; 65 articles were included in the final analysis. The majority of articles discuss an ideal structure for handover (n = 63; 97%); 43 (66%) articles mentioned strategies for implementing such an approach...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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