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Emergency Department Safety

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https://www.readbyqxmd.com/read/28650384/incident-reporting-in-emergency-medicine-a-thematic-analysis-of-events
#1
Emily Loving Aaronson, David Brown, Theodore Benzer, Shaw Natsui, Elizabeth Mort
BACKGROUND: Incident reporting is a recognized tool for healthcare quality improvement. These systems, which aim to capture near-misses and harm events, enable organizations to gather critical information about failure modes and design mitigation strategies. Although many hospitals have employed these systems, little is known about safety themes in emergency medicine incident reporting. Our objective was to systematically analyze and thematically code 1 year of incident reports. METHODS: A mixed-methods analysis was performed on 1 year of safety reporting data from a large, urban tertiary-care emergency department using a modified grounded theory approach...
June 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28650248/health-services-utilization-among-fee-for-service-medicare-and-medicaid-patients-under-age-65-with-behavioral-health-illness-at-an-urban-safety-net-hospital
#2
Ramon S Cancino, Brian W Jack, John Jarvis, Alice Kate Cummings, Ellie Cooper, Pierre-Yves Cremieux, James F Burgess
BACKGROUND: In 2011, fee-for-service patients with both Medicare and Medicaid (dual eligible) sustained $319.5 billion in health care costs. OBJECTIVE: To describe the emergency department (ED) use and hospital admissions of adult dual eligible patients aged under 65 years who used an urban safety net hospital. METHODS: This was a retrospective database analysis of patients aged between 18 and 65 years with Medicare and Medicaid, who used an urban safety net academic health center between January 1, 2011, and December 31, 2011...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28645288/a-cohort-study-of-a-general-surgery-electronic-consultation-system-safety-implications-and-impact-on-surgical-yield
#3
Jesus G Ulloa, Marika D Russell, Alice Hm Chen, Delphine S Tuot
BACKGROUND: Electronic consultation (eConsult) systems have enhanced access to specialty expertise and enhanced care coordination among primary care and specialty care providers, while maintaining high primary care provider (PCP), specialist and patient satisfaction. Little is known about their impact on the efficiency of specialty care delivery, in particular surgical yield (percent of ambulatory visits resulting in a scheduled surgical case). METHODS: Retrospective cohort of a random selection of 150 electronic consults from PCPs to a safety-net general surgery clinic for the three most common general surgery procedures (herniorrhaphy, cholecystectomy, anorectal procedures) in 2014...
June 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28642372/the-highland-health-advocates-a-preliminary-evaluation-of-a-novel-programme-addressing-the-social-needs-of-emergency-department-patients
#4
Lia Ilona Losonczy, Dennis Hsieh, Michael Wang, Christopher Hahn, Tarak Trivedi, Marcela Rodriguez, Jahan Fahimi, Harrison Alter
OBJECTIVES: Patients commonly come to the emergency department (ED) with social needs. To address this, we created the Highland Health Advocates (HHA), an ED-based help desk and medical-legal partnership using undergraduate volunteers to help patients navigate public resources and provide onsite legal and social work referrals. We were able to provide these services in English and Spanish. We aimed to determine the social needs of the patients who presented to our ED and the potential impact of the programme in resolving those needs and connecting them to a 'medical home' (defined as a consistent, primary source of medical care such as a primary care doctor or clinic)...
June 22, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28640322/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-for-treatment-and-prevention-of-recurrence-of-venous-thromboembolism
#5
Craig I Coleman, Craig Coleman, Thomas J Bunz, Alexander G G Turpie
The efficacy and safety or rivaroxaban versus enoxaparin/vitamin K antagonist for treatment and prevention recurrence of venous thromboembolism (VTE) was demonstrated in the randomised EINSTEIN trials. We assessed the effectiveness and safety of rivaroxaban versus warfarin in VTE patients managed in routine practice. Using US MarketScan claims from 1/2012-6/2015, we included adults with a primary diagnosis of deep vein thrombosis (DVT) or pulmonary embolism (PE) during a hospitalisation/emergency department visit, newly-initiated on rivaroxaban or warfarin within 30-days after the VTE and with ≥180-days of continuous medical/prescription benefits prior to the VTE (baseline)...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28635574/-it-is-all-about-the-form-adrenaline-in-anaphylaxis-intravenous-or-intramuscular-administration
#6
M van der Have, D Dekker, E M J Theunissen, C Snijders, K A H Kaasjager
BACKGROUND: Medication errors are a frequent problem in the accident and emergency (A&E) department. CASE DESCRIPTION: A 17-year-old boy was referred to our A&E department with an anaphylactic reaction to peanuts. Because of various shortcomings in the care process in A&E, adrenaline was administered intravenously instead of intramuscularly, resulting in a broad complex tachycardia. We analysed these shortcomings using the 'Prevention and recovery information system for monitoring and analysis' (PRISMA) method...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28622531/explaining-transgression-in-respiratory-rate-observation-methods-in-the-emergency-department-a-classic-grounded-theory-analysis
#7
Tracy Flenady, Trudy Dwyer, Judith Applegarth
BACKGROUND: Abnormal respiratory rates are one of the first indicators of clinical deterioration in emergency department(ED) patients. Despite the importance of respiratory rate observations, this vital sign is often inaccurately recorded on ED observation charts, compromising patient safety. Concurrently, there is a paucity of research reporting why this phenomenon occurs. OBJECTIVE: To develop a substantive theory explaining ED registered nurses' reasoning when they miss or misreport respiratory rate observations...
June 13, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28620909/pregabalin-and-heart-failure-a-population-based-study
#8
Joanne M-W Ho, Erin M Macdonald, Jin Luo, Tara Gomes, Tony Antoniou, Muhammad M Mamdani, David N Juurlink
PURPOSE: The anticonvulsant pregabalin is increasingly prescribed for pain, seizures, and psychiatric disorders. Although evidence suggests pregabalin can cause edema and heart failure, its cardiac safety profile in clinical practice is unknown. We sought to examine the risk of heart failure among older patients receiving pregabalin compared to those receiving gabapentin. METHODS: We conducted a population-based cohort study of Ontarians aged 66 and older with a history of seizure who received pregabalin or gabapentin between April 2013 and March 2014...
June 16, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28619774/protocol-for-a-multicentre-multistage-prospective-study-in-china-using-system-based-approaches-for-consistent-improvement-in-surgical-safety
#9
Xiaochu Yu, Jingmei Jiang, Changwei Liu, Keng Shen, Zixing Wang, Wei Han, Xingrong Liu, Guole Lin, Ye Zhang, Ying Zhang, Yufen Ma, Haixin Bo, Yupei Zhao
INTRODUCTION: Surgical safety has emerged as a crucial global health issue in the past two decades. Although several safety-enhancing tools are available, the pace of large-scale improvement remains slow, especially in developing countries such as China. The present project (Modern Surgery and Anesthesia Safety Management System Construction and Promotion) aims to develop and validate system-based integrated approaches for reducing perioperative deaths and complications using a multicentre, multistage design...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28617720/development-of-a-trigger-tool-to-identify-adverse-drug-events-in-elderly-patients-with-multimorbidity
#10
María Dolores Toscano Guzmán, Mercedes Galván Banqueri, María José Otero, Eva Rocío Alfaro Lara, Pilar Casajus Lagranja, Bernardo Santos Ramos
PURPOSE: Elderly patients with multimorbidity are especially vulnerable to adverse drug events (ADEs) and had high prevalence rates. Identifying ADEs is essential for enabling timely interventions that can mitigate the adverse events detected and for developing targeted strategies to prevent their occurrence as well as to monitor implementation. The aim of this study was to develop a set with appropriate triggers for detecting potential ADEs in elderly patients with multimorbidity. METHODS: A modified Delphi methodology was used to reach consensus...
June 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28617133/eds-unsuitable-for-mental-health-assessments
#11
(no author information available yet)
The RCN will lobby to ensure emergency departments (EDs) are no longer used as designated places of safety for people experiencing mental health crises.
June 15, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28617117/congress-debate-can-get-lost-in-translation
#12
Roisin Devlin
It has been suggested that RCN congress resolutions rarely spark debate and, with this in mind, the RCN Emergency Care Association (ECA) last month put forward a motion with the RCN mental health forum that emergency departments (EDs) should no longer be seen as designated places of safety for people in mental health crisis.
June 15, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28612694/-anticholinergic-syndrome-caused-by-contaminated-herbal-tea-acting-swiftly-to-identify-the-source
#13
C Oerlemans, I de Vries, A J H P van Riel
BACKGROUND: Despite good manufacturing practice and quality control, consumer products can become contaminated. In some cases, this can result in severe and life-threatening intoxication with potentially fatal consequences. CASE DESCRIPTION: A 27-year-old man and a 28-year-old pregnant woman presented to the Emergency Department with severe anticholinergic syndrome after using a marshmallow root (Althaea officinalis) herbal remedy, mixed into hot chocolate drink, to reduce symptoms of common cold...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28612116/prevention-of-parastomal-hernia-in-the-emergency-setting
#14
Anna Lykke, Johnny F B Andersen, Lars N Jorgensen, Tommie Mynster
AIM: This study assessed safety and efficacy associated with hernia prophylaxis using a retromuscular slowly resorbable synthetic mesh for stoma reinforcement. METHOD: This was a cohort study with a historic reference group. The study took place in a high-volume surgical department. During a 2-year period (July 2012-July 2014), we included 109 patients undergoing emergency surgery with formation of ileostomy or colostomy. All patients received a retromuscular slowly resorbable synthetic mesh (TIGR®, Novus Scientific) at the stoma site...
June 14, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28611886/managing-acute-behavioural-disturbances-in-the-emergency-department-using-the-environment-policies-and-practices-a-systematic-review
#15
Tracey J Weiland, Sean Ivory, Jennie Hutton
INTRODUCTION: Effective strategies for managing acute behavioural disturbances (ABDs) within emergency departments (EDs) are needed given their rising occurrence and negative impact on safety, psychological wellbeing, and staff turnover. Non-pharmacological interventions for ABD management generally fall into four categories: environmental modifications; policies; practice changes; and education. Our objective was to systematically review the efficacy of strategies for ABD management within EDs that involved changes to environment, architecture, policy and practice...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28609441/workplace-violence-against-medical-staff-of-chinese-children-s-hospitals-a-cross-sectional-study
#16
Zhe Li, Chun-Mei Yan, Lei Shi, Hui-Tong Mu, Xin Li, An-Qi Li, Cheng-Song Zhao, Tao Sun, Lei Gao, Li-Hua Fan, Yi Mu
BACKGROUND: In China, medical staff of children's hospitals are commonly exposed to violence. However, few studies on medical violence are conducted in the settings of children's hospitals. The aim of this study is to assess the incidence, magnitude, consequences, and potential risk factors of workplace violence (WPV) against medical staff of children's hospitals. METHODS: A retrospective cross-sectional design was used. A self-administered questionnaire was utilized to collect data on 12 children's hospitals...
2017: PloS One
https://www.readbyqxmd.com/read/28609149/react-a-paraprofessional-training-program-for-first-responders-a-pilot-study
#17
Madeline R Marks, Clint Bowers, Natasha S DePesa, Benjamin Trachik, Frances E Deavers, Nicholas T James
The purpose of this study was to evaluate a newly designed peer support training program for first responders titled Recognize, Evaluate, Advocate, Coordinate, and Track (REACT). REACT was developed in partnership with public safety agencies to address the need for promoting psychological health. This resulted in the development of a program that uses train-the-trainer methodology to address primary prevention of stress injuries. REACT was an all-day training that consisted of four modules, each featuring instruction and practice...
2017: Bulletin of the Menninger Clinic
https://www.readbyqxmd.com/read/28607677/design-and-implementation-of-a-trauma-care-bundle-at-a-community-hospital
#18
Ryan Andres, Elan Hahn, Steffen de Kok, Rafi Setrak, Jeffrey Doyle, Allison Brown
The Niagara Health System (NHS) in Ontario, Canada is comprised of three non-designated trauma center (NTC) hospitals which provide primary care to approximately 100 trauma patients annually. NTCs often lack standardized resources such as trauma surgeons, trauma-trained emergency room physicians, Advanced Trauma Life Support certified staff, trauma protocols, and other resources commonly found at designated trauma centers. Studies indicate that these differences contribute to poorer outcomes for trauma patients treated at community hospitals in Ontario, including the NTC hospitals of the NHS...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28606747/hot-tea-and-tiny-tots-don-t-mix-a-cross-sectional-survey-on-hot-beverage-scalds
#19
J D Burgess, R M Kimble, K A Watt, C M Cameron
OBJECTIVE: Hot beverage scalds are a leading cause of burns in young children. The aim of this study was to look at the circumstances surrounding these injuries in terms of setting, mechanism, supervision and first aid to inform a prevention campaign. METHODS: A cross-sectional study was delivered via iPad to parents and caregivers presenting with a child aged 0-36 months with a hot beverage scald at a major paediatric burns centre. RESULTS: Of the 101 children aged 0-36 months that presented with a hot beverage scald over a 12-month period, 54 participants were included...
June 9, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28605216/drug-avoidance-self-efficacy-among-exclusive-cannabis-users-vs-other-drug-users-visiting-the-emergency-department
#20
Sarah E Clingan, Susan I Woodruff
BACKGROUND: Medical care in the emergency department (ED) is a growing and complex area of outpatient care, with about 256 visits made to EDs every minute in 2013. Studies report that, compared to people who do not use drugs, people who use illicit drugs are more likely to use the ED for their medical care. Self-efficacy has been shown to be a predictor of abstinence or reduced use among drug-using individuals. OBJECTIVES: The current study describes drug avoidance self-efficacy among exclusive cannabis-using individuals and other drug-using individuals who use the ED for any reason...
June 12, 2017: Substance Use & Misuse
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