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Patient safety in health care

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https://www.readbyqxmd.com/read/28213602/understanding-the-epidemiology-of-avoidable-significant-harm-in-primary-care-protocol-for-a-retrospective-cross-sectional-study
#1
Brian G Bell, Stephen Campbell, Andrew Carson-Stevens, Huw Prosser Evans, Alison Cooper, Christina Sheehan, Sarah Rodgers, Christine Johnson, Adrian Edwards, Sarah Armstrong, Rajnikant Mehta, Antony Chuter, Ailsa Donnelly, Darren M Ashcroft, Joanne Lymn, Pam Smith, Aziz Sheikh, Matthew Boyd, Anthony J Avery
INTRODUCTION: Most patient safety research has focused on specialist-care settings where there is an appreciation of the frequency and causes of medical errors, and the resulting burden of adverse events. There have, however, been few large-scale robust studies that have investigated the extent and severity of avoidable harm in primary care. To address this, we will conduct a 12-month retrospective cross-sectional study involving case note review of primary care patients. METHODS AND ANALYSIS: We will conduct electronic searches of general practice (GP) clinical computer systems to identify patients with avoidable significant harm...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28212969/lessons-learned-when-introducing-pharmacogenomic-panel-testing-into-clinical-practice
#2
Marc B Rosenman, Brian Decker, Kenneth D Levy, Ann M Holmes, Victoria M Pratt, Michael T Eadon
OBJECTIVES: Implementing new programs to support precision medicine in clinical settings is a complex endeavor. We describe challenges and potential solutions based on the Indiana GENomics Implementation: an Opportunity for the Underserved (INGenious) program at Eskenazi Health-one of six sites supported by the Implementing GeNomics In pracTicE network grant of the National Institutes of Health/National Human Genome Research Institute. INGenious is an implementation of a panel of genomic tests...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28210321/telemedicine-in-chronic-obstructive-pulmonary-disease
#3
Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
: Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation...
December 2016: Breathe
https://www.readbyqxmd.com/read/28205460/complaints-against-health-care-professionals-providing-police-custodial-and-forensic-medical-health-care-services-and-sexual-offence-examiner-services-in-england-wales-and-northern-ireland
#4
Kieran M Kennedy, Peter G Green, J Jason Payne-James
Complaints management is an integral component of good clinical governance and an essential contributor to patient safety. Little is known about complaints against health-care professionals (HCPs) in police custodial settings and sexual assault referral centres. This study explored the frequency with which complaints are made against such HCPs working in England, Wales and Northern Ireland. It explored the nature of those complaints and the procedures by which they are investigated. Relevant information was requested from all police services in England, Wales and Northern Ireland; professional regulatory bodies; and the Independent Police Complaints Commission under the Freedom of Information Act (FOIA)...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/28202747/nurse-led-care-for-patients-with-rheumatoid-arthritis-a-systematic-review-of-the-effect-on-quality-of-care
#5
Stephanie Garner, Elena Lopatina, James A Rankin, Deborah A Marshall
OBJECTIVE: In the nurse-led care (NLC) model, nurses take on the primary responsibility for patient management. We systematically assessed the effect of NLC for patients with rheumatoid arthritis (RA) on multiple dimensions of quality of care from the Alberta Quality of Care Matrix for Health. METHODS: We searched MEDLINE, EMBASE, and CINAHL from 1950 to January 2015. English-language studies were included if they reported on NLC for patients with RA and assessed 1 or more dimensions of quality (effectiveness, acceptability, efficiency, accessibility, appropriateness, and safety)...
February 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28197420/the-challenges-of-electronic-health-records-and-diabetes-electronic-prescribing-implications-for-safety-net-care-for-diverse-populations
#6
REVIEW
Neda Ratanawongsa, Lenny L S Chan, Michelle M Fouts, Elizabeth J Murphy
Widespread electronic health record (EHR) implementation creates new challenges in the diabetes care of complex and diverse populations, including safe medication prescribing for patients with limited health literacy and limited English proficiency. This review highlights how the EHR electronic prescribing transformation has affected diabetes care for vulnerable patients and offers recommendations for improving patient safety through EHR electronic prescribing design, implementation, policy, and research. Specifically, we present evidence for (1) the adoption of RxNorm; (2) standardized naming and picklist options for high alert medications such as insulin; (3) the widespread implementation of universal medication schedule and language-concordant labels, with the expansion of electronic prescription 140-character limit; (4) enhanced bidirectional communication with pharmacy partners; and (5) informatics and implementation research in safety net healthcare systems to examine how EHR tools and practices affect diverse vulnerable populations...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28196693/public-perceptions-of-overlapping-surgery
#7
Michael Kent, Richard Whyte, Aaron Fleishman, David Tomich, Lachlan Forrow, James Rodrigue
BACKGROUND: Overlapping surgery is highly contentious, both in regards to the safety of the practice and the degree to which patients should be informed. However, no study has surveyed attitudes of the general public in regards to overlapping surgery, and willingness to consent to such a procedure. STUDY DESIGN: A survey regarding overlapping surgery was completed by participants using Amazon Mechanical Turk (mTurk), an online crowd-sourcing worksite. Responders completed a 51-question survey regarding their knowledge of overlapping surgery, expectations regarding disclosure during the informed consent process, and their willingness to participate in such a procedure...
February 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28196562/deference-to-expertise-making-care-safer
#8
Gwendolyn Cherese Godlock, Rebecca Suzie Miltner, Dori Taylor Sullivan
Since the seminal report by the Institute of Medicine, To Err Is Human, was issued in 1999, significant efforts across the health care industry have been launched to improve the safety and quality of patient care. Recent advances in the safety of health care delivery have included commitment to creating high-reliability organizations (HROs) to enhance existing quality improvement activities. This article will explore key elements of the HRO concept of deference to expertise, describe the structural elements that support nurses and other personnel in speaking up, and provide examples of practical, evidence-based tools to help organizations support and encourage all members of the health care team to speak up...
February 1, 2017: Creative Nursing
https://www.readbyqxmd.com/read/28196076/patient-safety-incidents-are-common-in-primary-care-a-national-prospective-active-incident-reporting-survey
#9
Philippe Michel, Jean Brami, Marc Chanelière, Marion Kret, Anne Mosnier, Isabelle Dupie, Anouk Haeringer-Cholet, Maud Keriel-Gascou, Claire Maradan, Frédéric Villebrun, Meredith Makeham, Jean-Luc Quenon
BACKGROUND: The study objectives were to describe the incidence and the nature of patient safety incidents (PSIs) in primary care general practice settings, and to explore the association between these incidents and practice or organizational characteristics. METHODS: GPs, randomly selected from a national influenza surveillance network (n = 800) across France, prospectively reported any incidents observed each day over a one-week period between May and July 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28193080/inappropriate-packed-rbc-transfusion-in-a-tertiary-care-center
#10
Anahita Sadeghi, Safieh Belali, Ali Ali Asgari, Zahra Morovat, Reza Malekzadeh, Ashkan Emadi
INTRODUCTION: Transfusion of packed red blood cells (pRBC) with appropriate indications is not only important for patient safety and well-being but is also crucial for proper utilization of resources and health care-related cost reduction. We aimed to investigate the clinical appropriateness of blood transfusion in Shariati Hospital, one of the largest academic medical centers in Tehran. METHODS: In this prospective observational study, 1000 transfusions of allogenic pRBCs from April 1st to October 31st, 2015 were included...
February 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28190757/consensus-bundle-on-maternal-mental-health-perinatal-depression-and-anxiety
#11
Susan Kendig, John P Keats, M Camille Hoffman, Lisa B Kay, Emily S Miller, Tiffany A Moore Simas, Ariela Frieder, Barbara Hackley, Pec Indman, Christena Raines, Kisha Semenuk, Katherine L Wisner, Lauren A Lemieux
Perinatal mood and anxiety disorders are among the most common mental health conditions encountered by women of reproductive age. When left untreated, perinatal mood and anxiety disorders can have profound adverse effects on women and their children, ranging from increased risk of poor adherence to medical care, exacerbation of medical conditions, loss of interpersonal and financial resources, smoking and substance use, suicide, and infanticide. Perinatal mood and anxiety disorders are associated with increased risks of maternal and infant mortality and morbidity and are recognized as a significant patient safety issue...
February 4, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28189116/the-internet-of-things-for-basic-nursing-care-a-scoping-review
#12
REVIEW
Riitta Mieronkoski, Iman Azimi, Amir M Rahmani, Riku Aantaa, Virpi Terävä, Pasi Liljeberg, Sanna Salanterä
BACKGROUND: The novel technology of the Internet of Things (IoT) connects objects to the Internet and its most advanced applications refine obtained data for the user. We propose that Internet of Things technology can be used to promote basic nursing care in the hospital environment by improving the quality of care and patient safety. OBJECTIVES: To introduce the concept of Internet of Things to nursing audience by exploring the state of the art of Internet of Things based technology for basic nursing care in the hospital environment...
February 1, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28186008/your-health-care-may-kill-you-medical-errors
#13
James G Anderson, Kathleen Abrahamson
Recent studies of medical errors have estimated errors may account for as many as 251,000 deaths annually in the United States (U.S)., making medical errors the third leading cause of death. Error rates are significantly higher in the U.S. than in other developed countries such as Canada, Australia, New Zealand, Germany and the United Kingdom (U.K). At the same time less than 10 percent of medical errors are reported. This study describes the results of an investigation of the effectiveness of the implementation of the MEDMARX Medication Error Reporting system in 25 hospitals in Pennsylvania...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28185492/avoiding-hospital-admission-in-copd-impact-of-a-specialist-nursing-team
#14
Karen Cox, Susan C Macleod, Caroline J Sim, Arwel W Jones, Jacqui Trueman
Chronic obstructive pulmonary disease (COPD) is a common, preventable and incurable disease. The costs of caring for patients with COPD is estimated to be more than £800 million a year for acute hospital admissions alone ( Department of Health, 2012 ). The hospital-at-home model is increasingly being adopted for COPD patients following British Thoracic Society (BTS) guidelines for the delivery of hospital admission-avoidance schemes ( BTS, 2007 ). The aim of this case-note review was to evaluate the safety and effectiveness of a specialist nurse-led acute respiratory assessment service working with COPD patients in the community...
February 9, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28185490/medication-governance-preventing-errors-and-promoting-patient-safety
#15
Caroline Kavanagh
This article highlights the significance of medication errors, identifying potential issues and support systems required. Medication errors involve different health professionals and present at various stages of the medication cycle. Focusing on a collaborative approach and the role of the nurse is necessary. Special groups, particularly older adults, are considered where multiple conditions and multiple medications increase the risk of adverse drug reactions. Nurses' accountability and their knowledge of medications are taken into account along with the role of nurse educators...
February 9, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28183857/coexistent-sickle-cell-disease-has-no-impact-on-the-safety-or-outcome-of-lytic-therapy-in-acute-ischemic-stroke-findings-from-get-with-the-guidelines-stroke
#16
Robert J Adams, Margueritte Cox, Shelly D Ozark, Julie Kanter, Phillip J Schulte, Ying Xian, Gregg C Fonarow, Eric E Smith, Lee H Schwamm
BACKGROUND AND PURPOSE: The recommended treatment for ischemic stroke is tPA (tissue-type plasminogen activator). Although sickle cell disease (SCD) represents no known contraindication to tPA, National Heart Lung and Blood Institute of the National Institutes of Health recommended acute exchange transfusion for stroke in SCD, not tPA. Data on safety and outcomes of tPA in patients are needed to guide tPA use in SCD. METHODS: We matched patients from the American Heart Association and American Stroke Association Get With The Guidelines-Stroke registry with SCD to patients without SCD and compared usage, complications, and discharge outcomes after tPA...
February 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28183296/validation-study-of-the-polish-version-of-the-evidence-based-practice-profile-questionnaire
#17
Mariusz Panczyk, Jarosława Belowska, Aleksander Zarzeka, Łukasz Samoliński, Halina Żmuda-Trzebiatowska, Joanna Gotlib
BACKGROUND: Decisions about patient care in clinical practice should be made based on proven scientific evidence of efficacy and safety (i.e., evidence-based practice [EBP]). Currently, there are no available tools in Poland for assessing the knowledge and attitudes of specialists in health sciences towards EBP. Therefore, by validating the Polish version of the original English Evidence-Based Practice Profile Questionnaire (EBP(2)Q), we may provide an appropriate instrument for assessing EBP...
February 10, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28182863/randomized-controlled-trial-of-a-community-health-worker-self-management-support-intervention-among-low-income-adults-with-diabetes-seattle-washington-2010-2014
#18
Karin Nelson, Leslie Taylor, Julie Silverman, Meghan Kiefer, Paul Hebert, Dan Lessler, James Krieger
INTRODUCTION: Community health workers (CHWs) can improve diabetes outcomes; however, questions remain about translating research findings into practical low-intensity models for safety-net providers. We tested the effectiveness of a home-based low-intensity CHW intervention for improving health outcomes among low-income adults with diabetes. METHODS: Low-income patients with glycated hemoglobin A1c (HbA1c) of 8.0% or higher in the 12 months before enrollment from 3 safety-net providers were randomized to a 12-month CHW-delivered diabetes self-management intervention or usual care...
February 9, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28182855/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#19
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United states. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effot to reduce the incidence of surgical site infection...
February 6, 2017: AANA Journal
https://www.readbyqxmd.com/read/28182803/patient-level-exclusions-from-mhealth-in-a-safety-net-health-system
#20
Keiki Hinami, Bhrandon A Harris, Ricardo Uriostegui, Wilnise Jasmin, Mario Lopez, William E Trick
Excitement about mobile health (mHealth) for improving care transitions is fueled by widespread adoption of smartphones across all social segments, but new disparities can emerge around nonadopters of technology-based communications. We conducted a cross-sectional survey of urban low-income adults to assess inadequate reading health literacy and limited English proficiency as factors affecting access to and engagement with mHealth. Although the proportion owning smartphones were comparable to national figures, adjusted analysis showed fewer patients with inadequate reading health literacy having Internet access (odds ratio [95% confidence interval]: 0...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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