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https://www.readbyqxmd.com/read/28437546/root-cause-analysis-and-actions-for-the-prevention-of-medical-errors-quality-improvement-and-resident-education
#1
Ryan Charles, Brandon Hood, Joseph M DeRosier, John W Gosbee, James P Bagian, Ying Li, Michelle S Caird, J Sybil Biermann, Mark E Hake
The quality of care delivered by orthopedic surgeons continues to grow in importance. Multiple orthopedic programs, organizations, and committees have been created to measure the quality of surgical care and reduce the incidence of medical adverse events. Structured root cause analysis and actions (RCA2) has become an area of interest. If performed thoroughly, RCA2 has been shown to reduce surgical errors across many subspecialties. The Accreditation Council for Graduate Medical Education has a new mandate for programs to involve residents in quality improvement processes...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28436158/collaborating-on-medication-errors-in-nursing
#2
Marketa Marvanova, Paul J Henkel
BACKGROUND: Nurse educators are faced with changing roles and expanding responsibilities for medication administration and monitoring in pursuit of improved patient safety. The aims of this study were to develop, implement and evaluate clinical simulation experiences that included, along with nursing faculty members, a pharmacist educator for the teaching of preventable medication errors in undergraduate nursing education. METHODS: Four clinical simulation scenarios using high-fidelity patient simulators were developed focusing on select medication problems in nursing practice...
April 24, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28435497/improved-accuracy-and-quality-of-information-during-emergency-department-care-transitions
#3
Nnaemeka Okafor, Justin Mazzillo, Sara Miller, Kimberly A Chambers, Samar Yusuf, Vanessa Garza-Miranda, Yashwant Chathampally
INTRODUCTION: Suboptimal communication during emergency department (ED) care transitions has been shown to contribute to medical errors, sometimes resulting in patient injury and litigation. The study objective was to determine whether a standardized checkout process would decrease the number of relevant missed clinical items (MCI). METHODS: In this prospective pre- and post-intervention study conducted in an urban academic ED, we collected data on omitted or inaccurately conveyed medical information before and after the initiation of a standardized checkout process...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#4
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435344/development-of-performance-and-error-metrics-for-ultrasound-guided-axillary-brachial-plexus-block
#5
Osman M Ahmed, Brian D O'Donnell, Anthony G Gallagher, George D Shorten
PURPOSE: Change in the landscape of medical education coupled with a paradigm shift toward outcome-based training mandates the trainee to demonstrate specific predefined performance benchmarks in order to progress through training. A valid and reliable assessment tool is a prerequisite for this process. The objective of this study was to characterize ultrasound-guided axillary brachial plexus block to develop performance and error metrics and to verify face and content validity using a modified Delphi method...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28434425/augmented-reality-in-neurosurgery-a-review-of-current-concepts-and-emerging-applications
#6
Daipayan Guha, Naif M Alotaibi, Nhu Nguyen, Shaurya Gupta, Christopher McFaul, Victor X D Yang
Augmented reality (AR) superimposes computer-generated virtual objects onto the user's view of the real world. Among medical disciplines, neurosurgery has long been at the forefront of image-guided surgery, and it continues to push the frontiers of AR technology in the operating room. In this systematic review, we explore the history of AR in neurosurgery and examine the literature on current neurosurgical applications of AR. Significant challenges to surgical AR exist, including compounded sources of registration error, impaired depth perception, visual and tactile temporal asynchrony, and operator inattentional blindness...
April 24, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28433827/a-comparison-of-medication-administration-errors-from-original-medication-packaging-and-multi-compartment-compliance-aids-in-care-homes-a-prospective-observational-study
#7
Julia Fiona-Maree Gilmartin-Thomas, Felicity Smith, Rory Wolfe, Yogini Jani
BACKGROUND: No published study has been specifically designed to compare medication administration errors between original medication packaging and multi-compartment compliance aids in care homes, using direct observation. OBJECTIVES: Compare the effect of original medication packaging and multi-compartment compliance aids on medication administration accuracy. DESIGN: Prospective observational. SETTING: Ten Greater London care homes...
March 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28433436/subharmonic-aided-pressure-estimation-for-monitoring-interstitial-fluid-pressure-in-tumors-calibration-and-treatment-with-paclitaxel-in-breast-cancer-xenografts
#8
Valgerdur G Halldorsdottir, Jaydev K Dave, Andrew Marshall, Anya I Forsberg, Traci B Fox, John R Eisenbrey, Priscilla Machado, Ji-Bin Liu, Daniel A Merton, Flemming Forsberg
Interstitial fluid pressure (IFP) in rats with breast cancer xenografts was non-invasively estimated using subharmonic-aided pressure estimation (SHAPE) versus an invasive pressure monitor. Moreover, monitoring of IFP changes after chemotherapy was assessed. Eighty-nine rats (calibration n = 25, treatment n = 64) were injected with 5 × 10(6) breast cancer cells (MDA-MB-231). Radiofrequency signals were acquired (39 rats successfully imaged) with a Sonix RP scanner (BK Ultrasound, Richmond, BC, Canada) using a linear array (L9-4, transmit/receive: 8/4 MHz) after administration of Definity (Lantheus Medical Imaging, North Billerica, MA, USA; 180 μL/kg) and compared with readings from an invasive pressure monitor (Stryker, Berkshire, UK)...
April 19, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28432189/safety-and-efficiency-of-a-new-generic-package-labelling-a-before-and-after-study-in-a-simulated-setting
#9
Beate Hennie Garcia, Renate Elenjord, Camilla Bjornstad, Kjell Hermann Halvorsen, Sigurd Hortemo, Steinar Madsen
BACKGROUND: Medication errors are frequent and may cause harm to patients and increase healthcare expenses. AIM: To explore whether a new labelling influences time and errors when preparing medications in accordance with medication charts in an experimental setting. METHOD: We carried out an uncontrolled before and after study with 3 months inbetween experiments. Phase I used original labelling and phase II used new generic labelling. We set up an experimental medicine room, simulating a real-life setting...
April 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28432040/usability-acceptability-and-adherence-to-an-electronic-self-monitoring-system-in-patients-with-major-depression-discharged-from-inpatient-wards
#10
Lise Lauritsen, Louise Andersen, Emilia Olsson, Stine Rauff Søndergaard, Lasse Benn Nørregaard, Philip Kaare Løventoft, Signe Dunker Svendsen, Erik Frøkjær, Hans Mørch Jensen, Ida Hageman, Lars Vedel Kessing, Klaus Martiny
BACKGROUND: Patients suffering from depression have a high risk of relapse and readmission in the weeks following discharge from inpatient wards. Electronic self-monitoring systems that offer patient-communication features are now available to offer daily support to patients, but the usability, acceptability, and adherence to these systems has only been sparsely investigated. OBJECTIVE: We aim to test the usability, acceptability, adherence, and clinical outcome of a newly developed computer-based electronic self-assessment system (the Daybuilder system) in patients suffering from depression, in the period from discharge until commencing outpatient treatment in the Intensive Outpatient Unit for Affective Disorders...
April 21, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28431419/creation-and-validation-of-an-automated-algorithm-to-determine-postoperative-ventilator-requirements-after-cardiac-surgery
#11
Eilon Gabel, Ira S Hofer, Nancy Satou, Tristan Grogan, Richard Shemin, Aman Mahajan, Maxime Cannesson
BACKGROUND: In medical practice today, clinical data registries have become a powerful tool for measuring and driving quality improvement, especially among multicenter projects. Registries face the known problem of trying to create dependable and clear metrics from electronic medical records data, which are typically scattered and often based on unreliable data sources. The Society for Thoracic Surgery (STS) is one such example, and it supports manually collected data by trained clinical staff in an effort to obtain the highest-fidelity data possible...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431271/investigation-of-pathology-malpractice-claims-in-china-from-2002-2015
#12
Yuan Li, Dong Gao, Meng Tu, Ying-Zhen Luo, Zhen-Hua Deng
OBJECTIVE: To examine pathology-related medical claims in China and identify the most common errors to result in such claims. METHOD: A retrospective analysis was performed of 71 forensic evaluation reports carried out in two Chinese institutes of forensic medicine between 2002 and 2015 due to suspicion of medical malpractice. The judicial outcomes of each case were also reviewed when available. RESULTS: Of 71 cases, 54 cases had judicial outcomes...
April 15, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28430956/achieving-high-reliability-in-histology-%C3%A2-an-improvement-series-to-reduce-errors
#13
Yael K Heher, Yigu Chen, Sergey Pyatibrat, Edward Yoon, Jeffrey D Goldsmith, Kenneth E Sands
Objectives: Despite sweeping medical advances in other fields, histology processes have by and large remained constant over the past 175 years. Patient label identification errors are a known liability in the laboratory and can be devastating, resulting in incorrect diagnoses and inappropriate treatment. The objective of this study was to identify vulnerable steps in the histology workflow and reduce the frequency of labeling errors (LEs). Methods: In this 36-month study period, a numerical step key (SK) was developed to capture LEs...
November 1, 2016: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28430833/on-the-need-for-quantitative-bias-analysis-in-the-peer-review-process
#14
Matthew P Fox, Timothy L Lash
Peer review is central to the process through which epidemiologists generate evidence to inform public health and medical interventions. Reviewers thereby act as critical gatekeepers to high-quality research. They are asked to carefully consider the validity of the proposed work or research findings by paying careful attention to the methodology and critiquing the importance of the insight gained. However, although many have noted problems with the peer-review system for both manuscripts and grant submissions, few solutions have been proposed to improve the process...
April 18, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28430330/long-term-visual-outcomes-in-children-with-primary-congenital-glaucoma
#15
Sanaa A Yassin
PURPOSE: To determine the long-term visual outcomes and risk factors for visual loss in children with primary congenital glaucoma (PCG) who underwent angle surgery over a 21-year period. METHODS: This was a retrospective study of patients who underwent trabeculotomy, trabeculectomy, or combined trabeculotomy-trabeculectomy for PCG. Visual acuity (VA), surgeries, and underlying cause of visual impairment were recorded and compared. Main outcome measures were final best-corrected good VA (20/20 to 20/50), moderate VA (<20/50 to 20/200), or poor VA (<20/200); age at surgery, sex, laterality, type of initial glaucoma surgery, and number of surgeries were recorded...
April 20, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28429391/technical-note-direct-measurement-of-continuous-tmr-data-with-a-1d-tank-and-automated-couch-movements
#16
Nels C Knutson, Matthew C Schmidt, Matthew D Belley, Ngoc Nguyen, H Harold Li, Erno Sajo, Michael Price
PURPOSE: Real-time dynamic control of the linear accelerator, couch, and imaging parameters during radiation delivery was investigated as a novel technique for acquiring tissue maximum ratio (TMR) data. METHODS: TrueBeam Developer Mode (Varian Medical Systems, Palo Alto, CA) was used to control the linear accelerator using the Extensible Markup Language (XML). A single XML file was used to dynamically manipulate the machine, couch, and imaging parameters during radiation delivery...
April 21, 2017: Medical Physics
https://www.readbyqxmd.com/read/28429389/evaluation-of-real-time-data-obtained-from-gravimetric-preparation-of-antineoplastic-agents-shows-medication-errors-with-possible-critical-therapeutic-impact-results-of-a-large-scale-multicentre-multinational-retrospective-study
#17
R Terkola, M Czejka, J Bérubé
WHAT IS KNOWN AND OBJECTIVE: Medication errors are a significant cause of morbidity and mortality especially with antineoplastic drugs, owing to their narrow therapeutic index. Gravimetric workflow software systems have the potential to reduce volumetric errors during intravenous antineoplastic drug preparation which may occur when verification is reliant on visual inspection. Our aim was to detect medication errors with possible critical therapeutic impact as determined by the rate of prevented medication errors in chemotherapy compounding after implementation of gravimetric measurement...
April 21, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28428252/low-frequency-blood-pressure-oscillations-and-inotrope-treatment-failure-in-premature-infants
#18
Zachary Andrew Vesoulis, Jessica Hao, Christopher McPherson, Nathalie El Ters, Amit M Mathur
BACKGROUND: The underlying mechanism as to why some hypotensive preterm infants do not respond to inotropic medications remains unclear. For these infants, we hypothesize that impaired vasomotor function is a significant factor and is manifested through a decrease in low-frequency blood pressure variability across regulatory components of vascular tone. METHODS: Infants born 28 weeks estimated gestational age underwent prospective recording of mean arterial blood pressure (MABP) for 72h after birth...
April 20, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28427898/pharmacist-impact-on-pediatric-vaccination-errors-and-missed-opportunities-in-the-setting-of-clinical-decision-support
#19
Kelly A Wise, Sonya J Sebastian, Anna C Haas-Gehres, Melissa D Moore-Clingenpeel, Kristen E Lamberjack
OBJECTIVE: To determine pharmacist impact on vaccination errors and missed opportunities in the pediatric primary care setting with the presence of clinical decision support (CDS) by comparing a clinic with a pharmacist and CDS to a clinic with CDS alone. DESIGN: A retrospective chart review of patients' electronic medical records compared vaccination errors and missed opportunities between 2 pediatric primary care clinics. SETTING: Two urban, pediatric primary care clinics were selected for the study...
April 17, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28426541/transfer-between-hospitals-is-a-risk-situation-for-patients-after-lung-cancer-surgery
#20
Trine Oksholm, Tone Rustoen, Mirjam Ekstedt
BACKGROUND: Patients with lung cancer often undergo surgery shortly after diagnosis. Despite undergoing extensive operation, many patients are transferred to a local hospital a few days after surgery. Transitions between different levels of care are risky due to common medication and follow-up errors. OBJECTIVE: The study purpose was to explore patients' experiences of transfer between hospitals after lung cancer surgery. The study aim was to improve the quality of transitional care...
April 20, 2017: Cancer Nursing
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