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Best practice error prevention

Sarah J Hahn, Jennifer M Kinney, Jennifer Heston
Service-learning is a widely used pedagogical practice that integrates community involvement and civic engagement into the classroom. Benefits of service-learning in gerontology include an increased sense of personal growth, greater knowledge of aging, and enhanced interest in aging-related careers. However, relatively little research has specifically explored the challenges associated with intergenerational service-learning. A focus group documented the experiences of 19 students who were required to participate in at least 20 hours of intergenerational service-learning for an introductory gerontology course...
March 13, 2018: Gerontology & Geriatrics Education
Laura Sarfati, Florence Ranchon, Nicolas Vantard, Vérane Schwiertz, Virginie Larbre, Stéphanie Parat, Amélie Faudel, Catherine Rioufol
RATIONALE, AIMS AND OBJECTIVES: In the past 2 decades, there has been an increasing interest in simulation-based learning programs to prevent medication error (ME). To improve knowledge, skills, and attitudes in prescribers, nurses, and pharmaceutical staff, these methods enable training without directly involving patients. However, best practices for simulation for healthcare providers are as yet undefined. By analysing the current state of experience in the field, the present review aims to assess whether human simulation in healthcare helps to reduce ME...
January 31, 2018: Journal of Evaluation in Clinical Practice
Ashley C Crimmins, Ambrose H Wong, James W Bonz, Alina Tsyrulnik, Karen Jubanyik, James D Dziura, Kelly L Dodge, Leigh V Evans
INTRODUCTION: Although error disclosure is critical in promoting safety and patient-centered care, physicians are inconsistently trained in its practice, and few objective methods to assess competence exist. We used an immersive simulation scenario to determine whether providers with varying levels of clinical experience adhere to the disclosure safe practice guidelines when exposed to a serious adverse event simulation scenario. METHODS: This was a prospective cohort study with medical students, junior emergency medicine (EM) residents (PGY 1-2), senior EM residents (PGY 3-4), and attending EM physicians participating in a simulated case in which a scripted medication overdose resulted in an adverse event...
January 17, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Gary Ezzell, Bhisham Chera, Adam Dicker, Eric Ford, Louis Potters, Lakshmi Santanam, Sheri Weintraub
PURPOSE: The Radiation Oncology Incident Learning System (RO-ILS) receives event reports from facilities across the country. This effort extracted common error pathways seen in the data. These pathways, expressed as fault trees, demonstrate the need for, and opportunities for, preventing these errors and/or limiting their propagation to treatment. METHODS AND MATERIALS: As of the third quarter of 2016, 2344 event reports had been submitted to RO-ILS and reviewed...
January 9, 2018: Practical Radiation Oncology
Richard W Willy
Running-related injuries are common and are associated with a high rate of reoccurrence. Biomechanics and errors in applied training loads are often cited as causes of running-related injuries. Clinicians and runners are beginning to utilize wearable technologies to quantify biomechanics and training loads with the hope of reducing the incidence of running-related injuries. Wearable devices can objectively assess biomechanics and training loads in runners, yet guidelines for their use by clinicians and runners are not currently available...
January 2018: Physical Therapy in Sport
Colin G Walsh, Kavya Sharman, George Hripcsak
BACKGROUND: Prior to implementing predictive models in novel settings, analyses of calibration and clinical usefulness remain as important as discrimination, but they are not frequently discussed. Calibration is a model's reflection of actual outcome prevalence in its predictions. Clinical usefulness refers to the utilities, costs, and harms of using a predictive model in practice. A decision analytic approach to calibrating and selecting an optimal intervention threshold may help maximize the impact of readmission risk and other preventive interventions...
December 2017: Journal of Biomedical Informatics
Stan Skinner, Robert Holdefer, John J McAuliffe, Francesco Sala
Error avoidance in medicine follows similar rules that apply within the design and operation of other complex systems. The error-reduction concepts that best fit the conduct of testing during intraoperative neuromonitoring are forgiving design (reversibility of signal loss to avoid/prevent injury) and system redundancy (reduction of false reports by the multiplication of the error rate of tests independently assessing the same structure). However, error reduction in intraoperative neuromonitoring is complicated by the dichotomous roles (and biases) of the neurophysiologist (test recording and interpretation) and surgeon (intervention)...
November 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Stavroula Raptis, Jia Ning Chen, Florencia Saposnik, Roman Pelyavskyy, Andrew Liuni, Gustavo Saposnik
BACKGROUND: Anticoagulation is the therapeutic paradigm for stroke prevention in patients with atrial fibrillation (AF). It is unknown how physicians make treatment decisions in primary stroke prevention for patients with AF. OBJECTIVES: To evaluate the association between family physicians' risk preferences (aversion risk and ambiguity) and therapeutic recommendations (anticoagulation) in the management of AF for primary stroke prevention by applying concepts from behavioral economics...
2017: Patient Preference and Adherence
Edward J Mayeaux, Akiva P Novetsky, David Chelmow, Francisco Garcia, Kim Choma, Angela H Liu, Theognosia Papasozomenos, Mark H Einstein, L Stewart Massad, Nicolas Wentzensen, Alan G Waxman, Christine Conageski, Michelle J Khan, Warner K Huh
OBJECTIVES: The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. The ASCCP Quality Improvement Working Group developed evidence-based guidelines to promote best practices and reduce errors in colposcopy and recommended indicators to measure colposcopy quality...
October 2017: Journal of Lower Genital Tract Disease
Abhishek Bhattacharya, Albert Young, Andrew Wong, Simone Stalling, Maria Wei, Dexter Hadley
Melanoma will affect an estimated 73,000 new cases this year and result in 9,000 deaths, yet precise diagnosis remains a serious problem. Without early detection and preventative care, melanoma can quickly spread to become fatal (Stage IV 5-year survival rate is 20-10%) from a once localized skin lesion (Stage IA 5- year survival rate is 97%). There is no biomarker for melanoma in clinical use, and the current diagnostic criteria for skin lesions remains subjective and imprecise. Accurate diagnosis of melanoma relies on a histopathologic gold standard; thus, aggressive excision of melanocytic skin lesions has been the mainstay of treatment...
2017: AMIA Summits on Translational Science Proceedings
Thomas D Albright
Eyewitness identifications play an important role in the investigation and prosecution of crimes, but it is well known that eyewitnesses make mistakes, often with serious consequences. In light of these concerns, the National Academy of Sciences recently convened a panel of experts to undertake a comprehensive study of current practice and use of eyewitness testimony, with an eye toward understanding why identification errors occur and what can be done to prevent them. The work of this committee led to key findings and recommendations for reform, detailed in a consensus report entitled Identifying the Culprit: Assessing Eyewitness Identification In this review, I focus on the scientific issues that emerged from this study, along with brief discussions of how these issues led to specific recommendations for additional research, best practices for law enforcement, and use of eyewitness evidence by the courts...
July 24, 2017: Proceedings of the National Academy of Sciences of the United States of America
Daniel McNeish
Studies on small sample properties of multilevel models have become increasingly prominent in the methodological literature in response to the frequency with which small sample data appear in empirical studies. Simulation results generally recommend that empirical researchers employ restricted maximum likelihood estimation (REML) with a Kenward-Roger correction with small samples in frequentist contexts to minimize small sample bias in estimation and to prevent inflation of Type-I error rates. However, simulation studies focus on recommendations for best practice, and there is little to no explanation of why traditional maximum likelihood (ML) breaks down with smaller samples, what differentiates REML from ML, or how the Kenward-Roger correction remedies lingering small sample issues...
July 17, 2017: Multivariate Behavioral Research
Christian M Pettker
Despite our best intentions to improve health when a patient presents for care, adverse events are ubiquitous in medical practice today. Known complications related to the course of a patient's illness or condition or to the characteristics of the treatment have been an openly stated part of taking care of patients for centuries. However, it is only in the past decade that preventable adverse events, instances of harm related to error and deviations in accepted practice have become a primary part of these conversations...
April 2017: Seminars in Perinatology
Lynn Gallagher-Ford, Bernadette Melnyk
Healthcare is in crisis in the US, where preventable clinical errors are the third leading cause of death. Now is the time to create healthcare cultures where best practice is the standard.
April 27, 2017: Nursing Management (Harrow)
Brent Luu, George W Rodway
Medical errors associated with low-dose methotrexate may be life-threatening. Prescribers should be cognizant of the medication's toxicities and the persistent challenges in preventing adverse events. This article reviews the properties of methotrexate and its common drug-drug interactions. Best practices from the Institute for Safe Medication Practices, aimed at reducing methotrexate errors, are highlighted.
May 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
Hirofumi Nakada, Seichi Horie, Shoko Kawanami, Jinro Inoue, Yoshinori Iijima, Kiyoharu Sato, Takeshi Abe
We aimed to develop a practical method to estimate oesophageal temperature by measuring multi-locational auditory canal temperatures. This method can be applied to prevent heatstroke by simultaneously and continuously monitoring the core temperatures of people working under hot environments. We asked 11 healthy male volunteers to exercise, generating 80 W for 45 min in a climatic chamber set at 24, 32 and 40 °C, at 50% relative humidity. We also exposed the participants to radiation at 32 °C. We continuously measured temperatures at the oesophagus, rectum and three different locations along the external auditory canal...
April 8, 2017: International Journal of Biometeorology
Carole Mackavey
Optimally, transition in health care should be seamless and incorporate a well-thought-out patient-centered discharge plan; yet, many hospitalized patients are unprepared for discharge, thereby compromising patient safety and quality of care. Transition of care should include a broad range of time-limited services designed to ensure health care continuity to avoid poor outcomes among at-risk populations. This case study demonstrates that advanced practice nurses (APNs) are in the perfect position to bridge the existing gap, reduce readmissions, and improve patient health...
September 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
Ivana Marinović, Srećko Marušić, Iva Mucalo, Jasna Mesarić, Vesna Bačić Vrca
AIM: To evaluate the clinical pharmacist-led medication reconciliation process in clinical practice by quantifying and analyzing unintentional medication discrepancies at hospital admission. METHODS: An observational prospective study was conducted at the Clinical Department of Internal Medicine, University Hospital Dubrava, during a 1-year period (October 2014 - September 2015) as a part of the implementation of Safe Clinical Practice, Medication Reconciliation of the European Network for Patient Safety and Quality of Care Joint Action (PASQ JA) project...
December 31, 2016: Croatian Medical Journal
J A Wahr, J H Abernathy, E H Lazarra, J R Keebler, M H Wall, I Lynch, R Wolfe, R L Cooper
Human error poses significant risk for hospitalized patients causing an estimated 100,000 to 400,000 deaths in the USA annually. Medication errors contribute, with error occurring in 5.3% of medication administrations during surgery. In this study 70.3% of medication errors were deemed preventable. Given the paucity of randomized controlled studies, we undertook a rigorous review of the literature to identify recommendations supported by expert opinions. An extensive literature search pertaining to medication error, medication safety, operating room, and anaesthesia was performed...
January 2017: British Journal of Anaesthesia
Andrew Y-Z Ou, Yu Jiang, Po-Liang Wu, Lui Sha, Richard B Berlin
In a medical environment such as Intensive Care Unit, there are many possible reasons to cause errors, and one important reason is the effect of human intellectual tasks. When designing an interactive healthcare system such as medical Cyber-Physical-Human Systems (CPHSystems), it is important to consider whether the system design can mitigate the errors caused by these tasks or not. In this paper, we first introduce five categories of generic intellectual tasks of humans, where tasks among each category may lead to potential medical errors...
January 2017: Journal of Medical Systems
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