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Quality and safety in Healthcare

Abigail R A Aiken, Elisa Padron, Kathleen Broussard, Dana Johnson
BACKGROUND: In Northern Ireland, abortion is illegal except in very limited circumstances to preserve a woman's life or to prevent permanent or long-term injury to her physical or mental health. Abortions conducted outside the law are a criminal offence punishable by imprisonment. We assessed the impacts of Northern Ireland's abortion laws on women's decision-making and experiences in accessing abortion. METHODS: Between April 2017 and February 2018 we interviewed 30 women living in Northern Ireland who had sought abortion by travelling to a clinic in Great Britain or by using online telemedicine to self-manage a medication abortion at home...
October 19, 2018: BMJ sexual & reproductive health
Lianne Jeffs, G Ross Baker, Ru Taggar, Pam Hubley, Joy Richards, Jane Merkley, Judy Shearer, Hailey Webster, Melissa Dizon, Jessie Ho Fong
To lead effectively within their organizations, nurse executives must possess quality and safety literacy and be able to engage and motivate clinicians to participate in safety and quality initiatives. Given the paucity of research in Canada, a study was undertaken to explore nurse executives' understanding of the key concepts and strategies associated with patient safety and quality improvement, and their engagement with patient safety and quality improvement in their hospitals and healthcare systems. This study used an exploratory qualitative design with a content analysis approach on 20 nurse executives working in hospitals in Ontario...
June 2018: Nursing Leadership
Lianne Jeffs
Now more than ever with the increasing complexity of care needs and the aging nursing workforce, nurse executives need to embrace the opportunity to acquire and enhance their transformation leadership competencies to advance and accelerate patient safety and quality improvement in healthcare. This paper calls for nurse leaders to engage in authentic, complex and resilient leadership to meet the evolving challenges and advances in technology in healthcare amidst achieving the quadruple aim of improving the care experience, improving population health, reducing the cost of care and improving the provider experience...
June 2018: Nursing Leadership
Lynn M Nagle
The editor-in-chief discusses the central theme of this issue of the Canadian Journal of Nursing Leadership - advancing quality and safety in healthcare. As she explains, authors in this issue represent a range of perspectives and highlight nursing leadership strategies, competencies, and obligations to ensure quality and safety in Canadian healthcare organizations.
June 2018: Nursing Leadership
Anna Schneider, Markus Wehler, Matthias Weigl
BACKGROUND: Interruptions are endemic in healthcare work environments. Yet, they can have positive effects in some instances and negative in others, with their net effect on quality of care still poorly understood. We aimed to distinguish beneficial and detrimental forms of interruptions of emergency department (ED) providers using patients' perceptions of ED care as a quality measure. METHODS: An observational design was established. The study setting was an interdisciplinary ED of an academic tertiary referral hospital...
October 18, 2018: BMJ Quality & Safety
Katherine Carroll, Jessica Mesman, Heidi McLeod, Judy Boughey, Gary Keeney, Elizabeth Habermann
Utilising frozen section technologies, Mayo Clinic has one of the lowest reoperation rates for breast lumpectomy in the United States. The research reported on sought to understand the successful teamwork between the Breast Surgery Team and the Frozen Section Laboratory at Mayo Clinic. Researchers worked collaboratively with healthcare staff from breast surgery and the frozen section pathology laboratory to identify communication styles and strategies that contribute to the timely and accurate intraoperative evaluation of breast cancer specimens...
October 18, 2018: Journal of Interprofessional Care
Denham L Phipps, Christian E L Jones, Dianne Parker, Darren M Ashcroft
BACKGROUND: While efforts have been made to bring about quality and safety improvement in healthcare, it remains by no means certain that an improvement project will succeed. This suggests a need to better understand the process and conditions of improvement. The current study addresses this question by examining English community pharmacies attempting to undertake improvement activities. METHOD: The study used a longitudinal qualitative design, involving a sample of ten community pharmacies...
October 17, 2018: BMC Health Services Research
Jorge Gomes, Mário Romão
The use of information systems in healthcare (HIS) has been recognised as having crucial importance in improving the efficiency, cost-effectiveness, quality, and safety of medical care delivery. HIS has the potential to improve individuals' health and providers' performance by producing better quality, cost savings, and greater patient involvement in their own health. There have been two major drivers for the HIS investments in healthcare: The ever-increasing burden from chronic disease with costs growing significantly faster and the recognition of the need for greatly improved quality and safety in health delivery...
October 16, 2018: Journal of Medical Systems
Mohamed Mahjoub, Sihem Ben Fredj, Nebiha Bouafia, Rym Bouriga, Naceur Ben Jalleb, Mansour Njah
BACKGROUND: promoting patient safety culture is a strategic priority and converges towards improving quality of health care. The healthcare professionals-patient relationship is an essential concept of patient safety culture. However, the increase of patient safety awareness is still delayed in Tunisia. OBJECTIVE: to assess and analyze the healthcare professional-patient relationship level among all healthcare professionals' categories in university hospital centre (UHC)FarhatHached, Sousse¬ Tunisia in order to further direct our strategies...
February 2018: La Tunisie Médicale
Kristina K Davis, Aisha Syeda
Patient and Family Engagement in Primary Care and Safe Transitions to New Appointments are both recent toolkits developed for the Agency for Healthcare Research and Quality (AHRQ). Both available on AHRQ's Patient Safety Tools and Resources webpage, these tools were designed to be used by clinicians, staff, patients, and family members in outpatient settings. While designed broadly for any staff, the techniques and skills necessary to use the toolkits fully align well with the role of health educators building on core skills already employed...
November 2018: Health Promotion Practice
Mariana Del Grossi Moura, Luciane Cruz Lopes, Marcus Tolentino Silva, Sílvio Barberato-Filho, Rogério Heládio Lopes Motta, Cristiane de Cássia Bergamaschi
BACKGROUND: Rheumatoid arthritis affects 1% of the world's population and its current treatment options are costly. There are not enough studies that evaluated the efficacy and safety of anti-inflammatory drugs medications used to reduce rheumatoid arthritis's symptoms. This study will evaluate the effectiveness and the safety of steroid and nonsteroidal anti-inflammatory drugs for the treatment of patients with rheumatoid arthritis. METHODS: Randomized clinical trials eligible for our systematic review will enroll adults with rheumatoid arthritis treated with anti-inflammatory drugs compared with a control group (placebo or active control) at any dose, duration, and route of administration and double blind studies...
October 2018: Medicine (Baltimore)
Sachiko Ozawa, Manuela Villar-Uribe, Daniel R Evans, Vivek Kulkarni, Por Ir
Unnecessary injections increase the risk of blood-borne infections as well as pose an avoidable financial burden on patients. Perceptions in rural Cambodia that medical drug injections provide the best quality medical care have resulted in a large proportion of the population seeking injections across medical conditions. As private providers have a higher propensity to offer injections, patients pursue more expensive care contributing to a greater financial burden. This study aimed to use an educational intervention to improve participant knowledge about injections and health insurance in order to build informed trust in safer injection practices and health insurance...
October 11, 2018: Health Policy and Planning
Danny J Avalos, Irene Sarosiek, Priyadarshini Loganathan, Richard W McCallum
Diabetic gastroparesis (DMGP) is a condition of delayed gastric emptying after gastric outlet obstruction has been excluded. Symptoms of nausea, vomiting, early satiety, bloating, and abdominal pain are associated with DMGP. Uncontrolled symptoms can lead to overall poor quality of life and financial burdens on the healthcare system. A combination of antiemetics and prokinetics is used in symptom control; metoclopramide is the main prokinetic available for clinical use and is the only U.S. Food and Drug Administration-approved agent in the United States...
2018: Clinical and Experimental Gastroenterology
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
Olakotan Olufisayo, Maryati Mohd Yusof, Sharifa Ezat Wan Puteh
Despite the widespread use of clinical decision support systems with its alert function, there has been an increase in medical errors, adverse events as well as issues regarding patient safety, quality and efficiency. The appropriateness of CDSS must be properly evaluated by ensuring that CDSS provides clinicians with useful information at the point of care. Inefficient clinical workflow affects clinical processes; hence, it is necessary to identify processes in the healthcare system that affect provider's workflow...
2018: Studies in Health Technology and Informatics
Anaeze C Offodile, Cindy Gu, Stefanos Boukovalas, Christopher J Coroneos, Abhishek Chatterjee, Rene D Largo, Charles Butler
PURPOSE: Enhanced recovery after surgery (ERAS) pathways are increasingly promoted in post-mastectomy reconstruction, with several articles reporting their benefits and safety. This meta-analysis appraises the evidence for ERAS pathways in breast reconstruction. METHODS: A systematic search of Medline, EMBASE, and Cochrane databases was performed to identify reports of ERAS protocols in post-mastectomy breast reconstruction. Two reviewers screened studies using predetermined inclusion criteria...
October 10, 2018: Breast Cancer Research and Treatment
Bettina Bӧttcher, Nasser Abu-El-Noor, Belal Aldabbour, Fadel Naim Naim, Yousef Aljeesh
BACKGROUND: Maternal mortality is an important health indicator for the overall health of a population. This study assessed the causes and contributing factors to maternal mortality that occurred in the Gaza-Strip between July 2014 and June 2015. METHODS: This is a retrospective study that used both quantitative and qualitative data. The data were collected from available medical records, investigation reports, death certificates, and field interviews with healthcare professionals as well as families...
October 11, 2018: BMC Pregnancy and Childbirth
Jay A Harolds
The ability to come back from challenges such as the many factors predisposing to burnout is resilience. Individual strategies to prevent and recover from burnout can be learned and practiced. This includes mindfulness, meditation, yoga, various stress reduction techniques, coaching, counseling, mentoring, discussions in small groups, workshops, and better work life balance. Other approaches include building a support network, taking care of one's personal health, pursuing narrative medicine, engaging in reflection, emphasizing positive psychology approaches including learned optimism, encouraging a growth mindset, and volunteering...
October 8, 2018: Clinical Nuclear Medicine
M A Gómez-Ríos, A Abad-Gurumeta, R Casans-Francés, J M Calvo-Vecino
Healthcare is in constant transformation. Health systems should focus on improving efficiency to meet a growing demand for high-quality, low-cost health care. The operating room is one of the biggest sources of revenue and one of the largest areas of expense. Therefore, operating room management is a critical key to success. The aim of this article is to analyze the current principles of organization, optimization and clinical management of the operating room and its impact on the quality and safety of care...
October 4, 2018: Revista Española de Anestesiología y Reanimación
Kevin W Olden, William D Chey, Reshma Shringarpure, Jean Paul Nicandro, Emil Chuang, David L Earnest
OBJECTIVE: Severe diarrhea-predominant irritable bowel syndrome (IBS-D) is associated with decreased health-related quality of life (HRQOL) and increased health care costs. Treatment recommendations for IBS-D often start with traditional pharmacotherapy (TP), with escalation to alosetron, rifaximin or eluxadoline if there is no success. There has been no previous head-to-head clinical trial comparing IBS-D treatment outcome for alosetron versus TP. This study evaluated resource use, work productivity, health-related quality of life, and global symptom response in women with IBS-D who were treated with alosetron or TP...
October 8, 2018: Current Medical Research and Opinion
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