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Patient safety culture

Christoph Funk, Adrian Roth
Drug-induced liver injury (DILI) is a major concern for drug developers, regulators and clinicians. It is triggered by drug and xenobiotic insults leading to liver impairment or damage, in the worst-case liver failure. In contrast to acute "intrinsic" hepatotoxicity, DILI typically manifests in a very small subset of the population under treatment with no clear dose relationship and inconsistent temporal patterns and is therefore termed an idiosyncratic event. Involved are multifactorial, compound-dependent mechanisms and host-specific factors, making the prediction in preclinical test systems very challenging...
October 20, 2016: Archives of Toxicology
Sirinrat Srikulnath, Vipa Surojanametakul, Pailin Chamnansin, Hirotoshi Tamura, Masahiro Shoji
Celiac disease (CD) and gluten-related disorders are significant health and social issues in Western countries, and CD individuals need to exclude gluten from their diets. The adverse health impacts of CD have extended to Asian countries in which CD was not a problem previously. Thai commercial food products that do not contain wheat, rye, barley, or gluten on their labels were surveyed as to whether they were suitable for CD individuals by examining the absence of gluten or the presence of gluten <20 ppm...
October 19, 2016: Journal of AOAC International
Insa Joost, Johannes Steinfurt, Philipp T Meyer, Winfried V Kern, Siegbert Rieg
BACKGROUND: Ustekinumab (Stelara®), a human monoclonal antibody targeting the p40-subunit of interleukin (IL)-12 and IL-23, is indicated for moderate to severe plaque psoriasis and psoriatic arthritis. In large multicenter, prospective trials assessing efficacy and safety of ustekinumab increased rates of severe infections have not been observed so far. CASE PRESENTATION: Here, we report the case of a 64-year old woman presenting with chills, pain and swelling of her right foot with dark maculae at the sole, and elevated inflammatory markers...
October 20, 2016: BMC Infectious Diseases
Michael Hochman, Medell Briggs-Malonson, Erin Wilkes, Jonathan Bergman, Lauren Patty Daskivich, Tannaz Moin, Ilanit Brook, Gery W Ryan, Robert H Brook, Carol M Mangione
In 2007, the Martin Luther King, Jr.-Harbor Hospital (MLK-Harbor), which served a large safety-net population in South Los Angeles, closed due to quality challenges. Shortly thereafter, an agreement was made to establish a new hospital, Martin Luther King, Jr. Community Hospital (MLKCH), to serve the unmet needs of the community. To assist the newly appointed MLKCH Board of Directors in building a culture of quality, we conducted a series of interviews with five high-performing hospital systems. In this report, we describe our findings...
2016: Journal of Health Care for the Poor and Underserved
Joshua N Hook, David Boan, Don E Davis, Jamie D Aten, John M Ruiz, Thomas Maryon
Hospital safety culture is an integral part of providing high quality care for patients, as well as promoting a safe and healthy environment for healthcare workers. In this article, we explore the extent to which cultural humility, which involves openness to cultural diverse individuals and groups, is related to hospital safety culture. A sample of 2011 hospital employees from four hospitals completed measures of organizational cultural humility and hospital safety culture. Higher perceptions of organizational cultural humility were associated with higher levels of general perceptions of hospital safety, as well as more positive ratings on non-punitive response to error (i...
October 17, 2016: Journal of Clinical Psychology in Medical Settings
Yetunde A Onimode, John E Ejeh, Akintunde T Orunmuyi
OBJECTIVE: Radioactive iodine therapy (RAIT) is established as an efficient means of treating toxic goiter (TG) globally. The field of nuclear medicine (NM) still appears novel to many Nigerian clinicians and patients. A culturally embedded dread of radiation may raise ethical and moral concerns about potential adverse effects in the wake of RAIT in our setting. An adverse drug reaction may be described as "a response to a drug which is noxious and unintended, and which occurs at doses normally used in man"...
October 5, 2016: Molecular Imaging and Radionuclide Therapy
Ramon Mir-Abellán, Anna Falcó-Pegueroles, María Luisa de la Puente-Martorell
OBJECTIVE: To describe attitudes towards patient safety culture among workers in a hospital setting and determine the influence of socio-demographic and professional variables. METHODS: The Hospital Survey on Patient Safety Culture was distributed among a sample of professionals and nursing assistants. A dimension was considered a strength if positive responses exceeded 75% and an opportunity for improvement if more than 50% of responses were negative. RESULTS: 59% (n=123) of respondents rated safety between 7 and 8...
October 14, 2016: Gaceta Sanitaria
Floriana Pinto, Gianni Biancofiore
BACKGROUND: The ABCDE (Awakening and Breathing coordination of daily sedation and ventilator removal trials; Choice of sedative or analgesic exposure; Delirium monitoring and management; and Early mobility and exercise) bundle is a multidisciplinary set of evidence-based practices for improving patient outcomes in the intensive care unit. Nurses are critical to all the bundle's requirements. Therefore, understanding their knowledge, attitudes, and perception of the different bundle's components might help for an easier implementation into everyday clinical practice...
November 2016: Dimensions of Critical Care Nursing: DCCN
Kenneth N Olivier, David E Griffith, Gina Eagle, John P McGinnis Ii, Liza Micioni, Keith Liu, Charles L Daley, Kevin L Winthrop, Stephen Ruoss, Doreen J Addrizzo-Harris, Patrick A Flume, Daniel Dorgan, Matthias Salathe, Barbara A Brown-Elliott, Renu Gupta, Richard J Wallace
Rationale Lengthy multi-drug, toxic, and low efficacy regimens limit management of pulmonary nontuberculous mycobacterial (PNTM) disease. Objective This phase 2 study investigated efficacy and safety of liposomal amikacin for inhalation (LAI) in treatment-refractory PNTM (Mycobacterium avium complex [MAC] or Mycobacterium abscessus) disease. Methods During the double-blind phase, patients were randomly assigned to LAI (590 mg) or placebo once daily added to their multi-drug regimen for 84 days. Both groups could receive open-label LAI for 84 additional days...
October 17, 2016: American Journal of Respiratory and Critical Care Medicine
Judit Lám, Gergő Merész, Gyula Bakacsi, Éva Belicza, Cecília Surján, Erika Takács
INTRODUCTION: The accreditation system for health care providers was developed in Hungary aiming to increase safety, efficiency, and efficacy of care and optimise its organisational operation. AIM: The aim of this study was to assess changes of organisational culture in pilot institutes of the accreditation program. METHOD: 7 volunteer pilot institutes using an internationally validated questionnaire were included. The impact study was performed in 2 rounds: the first before the introduction of the accreditation program, and the second a year later, when the standards were already known...
October 2016: Orvosi Hetilap
Andrew Petrosoniak, Marc Auerbach, Ambrose H Wong, Christopher M Hicks
In situ simulation (ISS), a point of care training strategy that occurs within the patient care environment involving actual healthcare team members, provides additional benefits to centre-based simulation. ISS can serve several roles within emergency medicine (EM): improves provider/team performance, identifies and mitigates threats to patient safety and improves systems and infrastructure. The effective use of ISS fosters inter-professional team training and a culture of safety essential for high performance EM teams and resilient systems...
October 17, 2016: Emergency Medicine Australasia: EMA
Tiemei Zhao, Liang-An Chen, Ping Wang, Guizhen Tian, Feng Ye, Huili Zhu, Bei He, Baiying Zhang, Changzhou Shao, Zhijun Jie, Xiwen Gao, Dongxia Wang, Weidong Song, Zhijie Pan, Jin Chen, Xingyi Zhang, Zhancheng Gao, Ping Chen, Youning Liu
BACKGROUND: To compare 5-day regimen of levofloxacin 750 mg IV daily with 7-14-day conventional regimen of levofloxacin 500 mg intravenous to oral (IV/PO) daily for treatment of community-acquired pneumonia (CAP) in Chinese population. METHODS: This was a non-inferiority study to assess the difference of clinical efficacy at the end of treatment (EOT) between two regimens. Adult CAP patients with CURB-65 score 0-2 were enrolled from 17 hospitals in China from November 2012 to July 2014...
September 2016: Journal of Thoracic Disease
Patrick J van der Geest, Mostafa Mohseni, Daan Nieboer, Servet Duran, A B Johan Groeneveld
OBJECTIVES: We aimed to study the safety and efficacy of PCT in guiding blood culture taking in critically ill patients with suspected infection. METHODS: We performed a cluster-randomized, multi-center, single-blinded, cross-over trial. Patients suspected of infection in whom taking blood for culture was indicated were included. The participating ICU's were stratified and randomized by treatment regimen into a control group and PCT-guided group. All patients included into this trial followed the regimen which was allocated to the ICU for that period...
October 13, 2016: Clinical Microbiology and Infection
Tonia Crawford, Peter Roger, Sally Candlin
OBJECTIVE: Patient education is an important part of nurses' roles; however the inconsistent quality of communication skills, including those of registered nurses (RNs) from culturally and linguistically diverse (CALD) backgrounds, risk patient safety. Empowerment in patient education has been found to influence patients' self-efficacy and participation in decision-making. Discourse analysis of a whole interaction is used in this paper to trace the consequences of patient education where empowering discourse is displayed by an RN from a CALD background...
September 22, 2016: Patient Education and Counseling
Víctor Daniel Rosenthal, Hail M Al-Abdely, Amani Ali El-Kholy, Safa A Aziz AlKhawaja, Hakan Leblebicioglu, Yatin Mehta, Vineya Rai, Nguyen Viet Hung, Souha Sami Kanj, Mona Foda Salama, Estuardo Salgado-Yepez, Naheed Elahi, Rayo Morfin Otero, Anucha Apisarnthanarak, Braulio Matias De Carvalho, Bat Erdene Ider, Dale Fisher, Maria Carmen S G Buenaflor, Michael M Petrov, Ana Marcela Quesada-Mora, Farid Zand, Vaidotas Gurskis, Tanja Anguseva, Aamer Ikram, Daisy Aguilar de Moros, Wieslawa Duszynska, Nepomuceno Mejia, Florin George Horhat, Vladislav Belskiy, Vesna Mioljevic, Gabriela Di Silvestre, Katarina Furova, Gloria Y Ramos-Ortiz, May Osman Gamar Elanbya, Hindra Irawan Satari, Umesh Gupta, Tarek Dendane, Lul Raka, Humberto Guanche-Garcell, Bijie Hu, Denis Padgett, Kushlani Jayatilleke, Najla Ben Jaballah, Eleni Apostolopoulou, Walter Enrique Prudencio Leon, Alejandra Sepulveda-Chavez, Hector Miguel Telechea, Andrew Trotter, Carlos Alvarez-Moreno, Luis Kushner-Davalos
BACKGROUND: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days...
October 11, 2016: American Journal of Infection Control
Susanne Salmela, Camilla Koskinen, Katie Eriksson
AIMS: To identify the distinctive foundations of the care culture and how nurse leaders (NL) can manage and strengthen these in a quest for ethically sustainable caring cultures. BACKGROUND: Sustainability presupposes an ethical leadership, a management of the good care and a well-educated staff, but research on NLs as managers of ethically sustainable caring cultures is not available. DESIGN: The study has a quantitative design with elements of a qualitative research approach...
October 12, 2016: Journal of Advanced Nursing
Jacqueline M Van Wyk, Soornarain S Naidoo, Kogie Moodley, Susan B Higgins-Opitz
INTRODUCTION: Following policy implementations to redress previous racial and gender discrepancies, this study explored how gender impacted on the clinical experiences of final-year medical students during their undergraduate training. It also gathered their perceptions and expectations for the future. METHODS: This cross-sectional, mixed-method study used a purposive sampling method to collect data from the participants (n=94). Each respondent was interviewed by two members of the research team...
2016: Advances in Medical Education and Practice
Violaine K Harris, Tamara Vyshkina, Saud A Sadiq
BACKGROUND AIMS: There is a critical unmet need to develop regenerative therapies for the demyelinating disease multiple sclerosis (MS). We previously characterized the immunoregulatory and trophic properties of neural progenitors derived from bone marrow mesenchymal stromal cells (MSC-NPs) and established that cells derived from MS and non-MS patients alike were therapeutically viable. In an experimental model of MS, intrathecal MSC-NP injection resulted in disease amelioration with decreased T-cell infiltration, and less severe lesion pathology associated with recruitment of resident progenitors to inflammatory sites...
October 7, 2016: Cytotherapy
Rohan Merani, Zachary E McPherson, Alan P Luckie, Jagjit S Gilhotra, Jim Runciman, Shane Durkin, James Muecke, Mark Donaldson, Albert Aralar, Anupam Rao, Peter E Davies
PURPOSE: To determine the incidence of endophthalmitis in a large clinical series using aqueous chlorhexidine for antisepsis before intravitreal injection and to review the ophthalmic literature regarding chlorhexidine efficacy and safety. DESIGN: Multicenter retrospective case series. PARTICIPANTS: All patients receiving intravitreal injections from 7 retinal specialists. METHODS: An audit of intravitreal injections performed by retinal specialists who exclusively used aqueous chlorhexidine 0...
October 6, 2016: Ophthalmology
Yi-Chun Lin, Horng-Jyh Harn, Po-Cheng Lin, Ming-Hsi Chuang, Chun-Hung Chen, Shinn-Zong Lin, Tzyy-Wen Chiou
Human adipose-derived stem cells (ADSCs) are a promising source of autologous stem cells for personalized cell-based therapies. Culture expansion of ADSCs provides an attractive opportunity for liver cirrhosis patients. However, safety and stability issues can pose big challenges for personalized autologous stem cell products. In the present study, we addressed whether the commercial production program could provide a consistent product for liver cirrhosis therapy. We collected adipose tissue from three human donors by lipoaspirate and isolated ADSCs, which were expanded in culture to reach 1 × 10(8) cells (an approximately 1000-fold expansion) within four passages...
October 6, 2016: Cell Transplantation
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