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Patient safety in health care

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https://www.readbyqxmd.com/read/28431844/health-care-associated-infections-studies-project-an-american-journal-of-infection-control-and-national-healthcare-safety-network-data-quality-collaboration
#1
Henrietta Smith, Janet E Brooks, Denise Leaptrot, Katherine Allen-Bridson, Angela Anttila, Cindy Gross, Joan N Hebden, Georganne Ryan, Eileen Scalise, Marc-Oliver Wright
This case study is part of a series centered on the Centers for Disease Control and Prevention's National Healthcare Safety Network's (NHSN) health care-associated infection (HAI) surveillance definitions. The intent of the case study series is to foster standardized application of the NHSN's HAI surveillance definitions among infection preventionists and accurate determination of HAI events. This specific case study focuses on the definitions found within the surgical site infection (SSI) protocol. It aims to reflect the real life and complex patient scenario surrounding a bloodstream infection that is secondary to an SSI and the application of the Present at the Time of Surgery event detail...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28430978/culture-matters-indigenizing-patient-safety-in-bhutan
#2
Rinchen Pelzang, Megan-Jane Johnstone, Alison M Hutchinson
Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan's traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan's traditional cultural values on staff attitudes towards patient safety and quality care...
April 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28430065/ethical-issues-in-fecal-microbiota-transplantation-in-practice
#3
Yonghui Ma, Jiayu Liu, Catherine Rhodes, Yongzhan Nie, Faming Zhang
Fecal microbiota transplantation (FMT) has demonstrated efficacy and is increasingly being used in the treatment of patients with recurrent Clostridium difficile infection. Despite a lack of high-quality trials to provide more information on the long-term effects of FMT, there has been great enthusiasm about the potential for expanding its applications. However, FMT presents many serious ethical and social challenges that must be addressed as part of a successful regulatory policy response. In this article, we draw on a sample of the scientific and bioethics literatures to examine clusters of ethical and social issues arising in five main areas: (1) informed consent and the vulnerability of patients; (2) determining what a "suitable healthy donor" is; (3) safety and risk; (4) commercialization and potential exploitation of vulnerable patients; and (5) public health implications...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28429988/patient-safety-in-nursing-homes-in-sweden-nurses-views-on-safety-and-their-role
#4
Frieda Andersson, Katarina Hjelm
Objective Knowledge about patient safety in nursing homes is limited. The aim of this study was to describe what patient safety means to nurses working in nursing homes for the elderly and how these nurses address patient safety. Method Qualitative study of semi-structured interviews with 15 nurses aged 27-62 years. Qualitative content analysis was applied. Results Nurses describe the meaning of patient safety in terms of proper care and treatment, and a sense of security. Based on nurses' description of patient safety, several factors were identified as prerequisites to achieve safe health care: competence; clear information transfer between health care organizations; continuity of care and appropriate environment...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28424821/noacs-for-treatment-of-venous-thromboembolism-in-clinical-practice
#5
Sam Schulman, Daniel Singer, Walter Ageno, Ivan B Casella, Marc Desch, Samuel Z Goldhaber
Randomised controlled trials have provided important information on the efficacy and safety of the non-vitamin K antagonist oral anticoagulants (NOACs) for treatment of venous thromboembolism (VTE), leading to registration and increasing use in clinical practice. Many questions remain to be answered, and observational studies are often more suitable for answering "real-world" questions than randomised controlled trials. Patient satisfaction, quality of life, and adherence and persistence in clinical practice with the drug regimen can only be assessed with an open-label design...
April 20, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28424302/assessing-the-safety-culture-of-care-homes-a-multimethod-evaluation-of-the-adaptation-face-validity-and-feasibility-of-the-manchester-patient-safety-framework
#6
Martin Marshall, Lesley Cruickshank, Jenny Shand, Sarah Perry, James Anderson, Li Wei, Dianne Parker, Debra de Silva
BACKGROUND: Understanding the cultural characteristics of healthcare organisations is widely recognised to be an important component of patient safety. A growing number of vulnerable older people are living in care homes but little attention has been paid to safety culture in this sector. In this study, we aimed to adapt the Manchester Patient Safety Framework (MaPSaF), a commonly used tool in the health sector, for use in care homes and then to test its face validity and preliminary feasibility as a tool for developing a better understanding of safety culture in the sector...
April 19, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28424074/implementation-and-adaptation-of-the-re-engineered-discharge-red-in-five-california-hospitals-a-qualitative-research-study
#7
S E Mitchell, G M Weigel, V Laurens, J Martin, B W Jack
BACKGROUND: Project Re-Engineered Discharge (RED) is an evidence-based strategy to reduce readmissions disseminated and adapted by various health systems across the country. To date, little is known about how adapting Project RED from its original protocol impacts RED implementation and/or sustainability. The goal of this study was to identify and characterize contextual factors influencing how five California hospitals adapted and implemented RED and the subsequent impact on RED program sustainability...
April 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28423854/exploring-the-notion-of-hazards-for-health-it
#8
Ibrahim Habli, Sean White, Stuart Harrison, Manpreet Pujara
Safety analysis is centred on identifying a set of hazards that form the basis of risk assessment. In healthcare, hazards are potential sources of harm to patients and as such the risk of these has to be assessed and managed. With the increased reliance on Health IT systems in health and social care settings, some of these hazards are associated with the development and use of these systems. In this paper we examine current practices in hazard identification, focusing on how clinicians and engineers approach this task within the Health IT safety assurance process...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423759/developing-the-safety-case-for-medipi-an-open-source-platform-for-self-management
#9
Andrew Carr, Damian Murphy, Ian Dugdale, Anne Dyson, Ibrahim Habli, Richard Robinson
mHealth and Telehealth technologies are increasingly used to provide personalised, interactive and timely access to health data, thereby helping patients take a more active role in their care process. However, similar to any intervention, the use of these technologies has to be assured to justify that they do not compromise patient safety. In this paper, we discuss the development of a safety case for MediPi; a research prototype for a low-cost open-source digital platform that collects physiological data from patients, at home, and makes it available to decision-support systems used by clinicians...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423156/creation-of-an-internal-teledermatology-store-and-forward-system-in-an-existing-electronic-health-record-a-pilot-study-in-a-safety-net-public-health-and-hospital-system
#10
Zachary A Carter, Shauna Goldman, Kristen Anderson, Xiaxiao Li, Linda S Hynan, Benjamin F Chong, Arturo R Dominguez
Importance: External store-and-forward (SAF) teledermatology systems operate separately from the primary health record and have many limitations, including care fragmentation, inadequate communication among clinicians, and privacy and security concerns, among others. Development of internal SAF workflows within existing electronic health records (EHRs) should be the standard for large health care organizations for delivering high-quality dermatologic care, improving access, and capturing other telemedicine benchmark data...
April 19, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28421661/safety-in-psychiatric-inpatient-care-the-impact-of-risk-management-culture-on-mental-health-nursing-practice
#11
Allie Slemon, Emily Jenkins, Vicky Bungay
The discourse of safety has informed the care of individuals with mental illness through institutionalization and into modern psychiatric nursing practices. Confinement arose from safety: out of both societal stigma and fear for public safety, as well as benevolently paternalistic aims to protect individuals from self-harm. In this paper, we argue that within current psychiatric inpatient environments, safety is maintained as the predominant value, and risk management is the cornerstone of nursing care. Practices that accord with this value are legitimized and perpetuated through the safety discourse, despite evidence refuting their efficacy, and patient perspectives demonstrating harm...
April 18, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28421638/renal-replacement-therapy-and-incremental-hemodialysis-for-veterans-with-advanced-chronic-kidney-disease
#12
Kamyar Kalantar-Zadeh, Susan T Crowley, Srinivasan Beddhu, Joline L T Chen, John T Daugirdas, David S Goldfarb, Anna Jin, Csaba P Kovesdy, David J Leehey, Hamid Moradi, Sankar D Navaneethan, Keith C Norris, Yoshitsugu Obi, Ann O'Hare, Tariq Shafi, Elani Streja, Mark L Unruh, Tushar J Vachharajani, Steven Weisbord, Connie M Rhee
Each year approximately 13,000 Veterans transition to maintenance dialysis, mostly in the traditional form of thrice-weekly hemodialysis from the start. Among >6000 dialysis units nationwide, there are currently approximately 70 Veterans Affairs (VA) dialysis centers. Given this number of VA dialysis centers and their limited capacity, only 10% of all incident dialysis Veterans initiate treatment in a VA center. Evidence suggests that, among Veterans, the receipt of care within the VA system is associated with favorable outcomes, potentially because of the enhanced access to healthcare resources...
April 18, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28421454/quality-indicators-in-endoscopic-ablation-for-barrett-s-esophagus
#13
REVIEW
Samuel Han, Sachin Wani
Barrett's esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety...
April 18, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28419657/a-new-approach-to-clinical-research-integrating-clinical-care-quality-reporting-and-research-using-a-wound-care-network-based-learning-healthcare-system
#14
Thomas E Serena, Caroline E Fife, Kristen A Eckert, Raphael A Yaakov, Marissa J Carter
The disparity between ideal evidence from randomized controlled trials and real-world evidence in medical research has prompted the United States Food and Drug Administration to consider the use of real-world data to better understand safety and effectiveness of new devices for a broader patient population and to prioritize real-world data in regulatory decision making. As the healthcare system transitions from volume- to value-based care, there is a growing need to harness the power of real-world data to change the paradigm for wound care clinical research and enable more generalizable clinical trials...
April 17, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28419267/a-national-survey-assessing-the-number-of-records-allowed-open-in-electronic-health-records-at-hospitals-and-ambulatory-sites
#15
Jason S Adelman, Matthew A Berger, Amisha Rai, William L Galanter, Bruce L Lambert, Gordon D Schiff, David K Vawdrey, Robert A Green, Hojjat Salmasian, Ross Koppel, Clyde B Schechter, Jo R Applebaum, William N Southern
To reduce the risk of wrong-patient errors, safety experts recommend limiting the number of patient records providers can open at once in electronic health records (EHRs). However, it is unknown whether health care organizations follow this recommendation or what rationales drive their decisions. To address this gap, we conducted an electronic survey via 2 national listservs. Among 167 inpatient and outpatient study facilities using EHR systems designed to open multiple records at once, 44.3% were configured to allow ≥3 records open at once (unrestricted), 38...
April 17, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28418280/twenty-first-century-pathologists-advocacy
#16
Timothy Craig Allen
Pathologists' advocacy plays a central role in the establishment of continuously improving patient care quality and patient safety, and in the maintenance and progress of pathology as a profession. Pathology advocacy's primary goal is the betterment of patient safety and quality medical care; however, payment is a necessary and appropriate component to both, and has a central role in advocacy. Now is the time to become involved in pathology advocacy; the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (MACRA) and the Protecting Access to Medicare Act of 2014 (PAMA) are two of the most consequential pieces of legislation impacting the pathology and laboratory industry in the last 20 years...
April 18, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28417894/quality-improvement-and-reporting-systems-what-the-oral-and-maxillofacial-surgeon-should-know
#17
REVIEW
Justine S Moe, Shelly Abramowicz, Steven M Roser
Health care is an inherently dangerous environment, and patient safety should be an explicit goal of oral and maxillofacial surgery. Important components of a safety program include a nonpunitive safety culture, the implementation of patient safety practices, standardized incident reporting and adverse event analysis, regular self-assessment, and internal and external benchmarking. Implementation of a safety program requires the strong commitment of leadership and the engagement and empowerment of all employees...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417838/transferring-aviation-practices-into-clinical-medicine-for-the-promotion-of-high-reliability
#18
Nicole Powell-Dunford, Mark K McPherson, Joseph S Pina, Steven J Gaydos
BACKGROUND: Aviation is a classic example of a high reliability organization (HRO)-an organization in which catastrophic events are expected to occur without control measures. As health care systems transition toward high reliability, aviation practices are increasingly transferred for clinical implementation. METHODS: A PubMed search using the terms aviation, crew resource management, and patient safety was undertaken. Manuscripts authored by physician pilots and accident investigation regulations were analyzed...
May 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28417456/interventions-to-improve-adherence-to-inhaled-steroids-for-asthma
#19
REVIEW
Rebecca Normansell, Kayleigh M Kew, Elizabeth Stovold
BACKGROUND: Despite its proven efficacy in improving symptoms and reducing exacerbations, many patients with asthma are not fully adherent to their steroid inhaler. Suboptimal adherence leads to poorer clinical outcomes and increased health service utilisation, and has been identified as a contributing factor to a third of asthma deaths in the UK. Reasons for non-adherence vary, and a variety of interventions have been proposed to help people improve treatment adherence. OBJECTIVES: To assess the efficacy and safety of interventions intended to improve adherence to inhaled corticosteroids among people with asthma...
April 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28416172/epidemiology-of-ebolavirus-disease-evd-and-occupational-evd-in-health-care-workers-in-sub-saharan-africa-need-for-strengthened-public-health-preparedness
#20
REVIEW
Nlandu Roger Ngatu, Ntumba Jean-Marie Kayembe, Elayne Kornblatt Phillips, Joa Okech-Ojony, Masika Patou-Musumari, Mukunda Gaspard-Kibukusa, Ndona Madone-Mandina, Mabasi Godefroid-Mayala, Lubogo Mutaawe, Casimir Manzengo, Dimosi Roger-Wumba, Sayumi Nojima
Ebolavirus disease (EVD) is a severe contagious disease in humans, and health care workers (HCW) are at risk of infection when caring for EVD patients. This paper highlights the epidemiologic profile of EVD and its impact on the health care workforce in Africa. A documentary study was conducted which consisted of a review of available literature regarding the epidemiology of EVD, occupational EVD (OEVD), and work safety issues in Sub-Saharan Africa; the literature findings are enriched by field experiences from the authors...
April 13, 2017: Journal of Epidemiology
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