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Healthcare Safety

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https://www.readbyqxmd.com/read/28549369/safety-analysis-of-occupational-exposure-of-healthcare-workers-to-residual-contaminations-of-cytotoxic-drugs-using-fmeca-security-approach
#1
Laetitia Minh Mai Le, Delphine Reitter, Sophie He, Franck Té Bonle, Amélie Launois, Diane Martinez, Patrice Prognon, Eric Caudron
Handling cytotoxic drugs is associated with chemical contamination of workplace surfaces. The potential mutagenic, teratogenic and oncogenic properties of those drugs create a risk of occupational exposure for healthcare workers, from reception of starting materials to the preparation and administration of cytotoxic therapies. The Security Failure Mode Effects and Criticality Analysis (FMECA) was used as a proactive method to assess the risks involved in the chemotherapy compounding process. FMECA was carried out by a multidisciplinary team from 2011 to 2016...
May 22, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28549051/pressure-injuries-in-inpatient-care-facilities-in-the-czech-republic-analysis-of-a-national-electronic-database
#2
Andrea Pokorná, Klára Benešová, Jiří Jarkovský, Jan Mužík, Dimitri Beeckman
PURPOSE: The purpose of this study was to analyze pressure injury (PI) occurrence upon admission and at any time during the hospital course inpatients care facilities in the Czech Republic. Secondary aims were to evaluate demographic and clinical data of patients with PI and the impact of a PI on length of stay (LOS) in the hospital. DESIGN: Retrospective, cross-sectional analysis. SETTING AND SUBJECTS: The sample comprised data of hospitalized patients entered into the National Register of Hospitalized Patients (NRHOSP) database of the Czech Republic between 2007 and 2014 with a diagnosis L89 (pressure ulcer of unspecified site based on the International Classification of Diseases, Tenth Revision, ICD-10)...
May 25, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28546510/towards-high-reliability-organising-in-healthcare-a-strategy-for-building-organisational-capacity
#3
Hanan J Aboumatar, Sallie J Weaver, Dianne Rees, Michael A Rosen, Melinda D Sawyer, Peter J Pronovost
In a high-reliability organisation (HRO), safety and quality (SQ) is an organisational priority, and all workforce members are engaged, continuously learning and improving their work. To build organisational capacity for SQ work, we have developed a role-tailored capacity-building framework that we are currently employing at the Johns Hopkins Armstrong Institute for Patient Safety and Quality as part of an organisational strategy towards HRO. This framework considers organisation-wide competencies for SQ that includes all staff and faculty and is integrated into a broader organisation-wide operating management system for improving quality...
May 25, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28546090/safety-and-tolerability-of-long-acting-cabotegravir-injections-in-hiv-uninfected-men-eclair-a-multicentre-double-blind-randomised-placebo-controlled-phase-2a-trial
#4
Martin Markowitz, Ian Frank, Robert M Grant, Kenneth H Mayer, Richard Elion, Deborah Goldstein, Chester Fisher, Magdalena E Sobieszczyk, Joel E Gallant, Hong Van Tieu, Winkler Weinberg, David A Margolis, Krischan J Hudson, Britt S Stancil, Susan L Ford, Parul Patel, Elizabeth Gould, Alex R Rinehart, Kimberly Y Smith, William R Spreen
BACKGROUND: Cabotegravir (GSK1265744) is an HIV-1 integrase strand transfer inhibitor with potent antiviral activity and a long half-life when administered by injection that prevented simian-HIV infection upon repeat intrarectal challenge in male macaques. We aimed to assess the safety, tolerability, and pharmacokinetics of long-acting cabotegravir injections in healthy men not at high risk of HIV-1 infection. METHODS: We did this multicentre, double-blind, randomised, placebo-controlled, phase 2a trial at ten sites in the USA...
May 22, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28545491/treatment-of-acute-sciatica-with-transforaminal-epidural-corticosteroids-and-local-anesthetic-design-of-a-randomized-controlled-trial
#5
Bastiaan C Ter Meulen, Esther T Maas, Amrita Vyas, Marinus van der Vegt, Koo de Priester, Michiel R de Boer, Maurits W van Tulder, Henry C Weinstein, Raymond W J G Ostelo
BACKGROUND: Transforaminal epidural injections with steroids (TESI) are used increasingly for patients with sciatica. However there is much debate about their safety and effectiveness. It is important to identify patients that benefit most from TESI and only few trials have yet evaluated the effects in patients with acute sciatica. METHODS: We describe a prospective, randomized controlled trial (RCT), with the aim to evaluate the hypothesis that TESI plus Levobupivacaine (TESI-plus) added to oral pain medication is more effective compared to pain medication alone or compared to transforaminal injection with a local anesthetic of short duration among patients with acute sciatica...
May 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28544919/risk-factors-for-patient-reported-errors-during-cancer-follow-up-results-from-a-national-survey-in-denmark
#6
Anne Hjøllund Christiansen, Henriette Lipczak, Janne Lehmann Knudsen, Anne Mette Tranberg Kejs
Due to an increased cancer survival, more cancer patients are referred to follow-up after primary treatment. Knowledge of patient safety during follow-up is sparse. OBJECTIVE: To examine patient-reported errors during cancer follow-up and identify factors associated with errors. DESIGN: A national survey on cancer patients' experiences of treatment and aftercare was conducted in 2012, about two years following cancer diagnosis (N=6914). Associations between patient-reported errors during follow-up and covariates were examined using multiple logistic regression...
May 22, 2017: Cancer Epidemiology
https://www.readbyqxmd.com/read/28543427/conservation-of-resources-theory-in-nurse-burnout-and-patient-safety
#7
Aoyjai Prapanjaroensin, Patricia A Patrician, David E Vance
AIMS: To examine how the Conservation of Resources theory explains burnout in the nursing profession. BACKGROUND: Burnout, which is an accumulation of work-related mental stress in people-oriented occupations, has been an issue of concern for decades for healthcare workers, especially nurses. Yet, few studies have examined a unified theory that explains the etiology, progression and consequences of nurse burnout. DESIGN: This discussion article integrates current knowledge on nurse burnout using Conservation of Resources theory, which focuses on four resources (i...
May 24, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28541515/recalmin-the-association-between-management-of-spanish-national-health-service-internal-medical-units-and-health-outcomes
#8
Antonio Zapatero-Gaviria, Francisco Javier Elola-Somoza, Emilio Casariego-Vales, Cristina Fernandez-Perez, Ricardo Gomez-Huelgas, José Luis Bernal, Raquel Barba-Martín
Objective: To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Design: Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Setting: Spanish National Health Service...
May 24, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28541430/implementation-and-evaluation-of-a-prototype-consumer-reporting-system-for-patient-safety-events
#9
Saul N Weingart, Joel S Weissman, Karen P Zimmer, Robert C Giannini, Denise D Quigley, Lauren E Hunter, M Susan Ridgely, Eric C Schneider
Objective: No methodologically robust system exists for capturing consumer-generated patient safety reports. To address this challenge, we developed and pilot-tested a prototype consumer reporting system for patient safety, the Health Care Safety Hotline. Design: Mixed methods evaluation. Setting: The Hotline was implemented in two US healthcare systems from 1 February 2014 through 30 June 2015. Participants: Patients, family members and caregivers associated with two US healthcare systems...
May 24, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28540672/communication-on-safety-of-medicines-in-europe-current-practices-and-general-practitioners-awareness-and-preferences
#10
Sieta T de Vries, Maartje J M van der Sar, Amelia Cupelli, Ilaria Baldelli, Anna Marie Coleman, Dolores Montero, Ivana Šipić, Adriana Andrić, Annika Wennberg, Jane Ahlqvist-Rastad, Petra Denig, Peter G M Mol
INTRODUCTION: National competent authorities (NCAs) for medicines coordinate communication relating to the safety of medicines in Europe. The effectiveness of current communication practices has been questioned, particularly with regard to reaching general practitioners (GPs). OBJECTIVE: The aim of this study was to assess current European NCA safety communication practices and to investigate European GPs' awareness of and preferences for safety communications on medicines...
May 24, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28540465/technology-induced-errors-associated-with-computerized-provider-order-entry-software-for-older-patients
#11
Manuel Vélez-Díaz-Pallarés, Ana María Álvarez Díaz, Teresa Gramage Caro, Noelia Vicente Oliveros, Eva Delgado-Silveira, María Muñoz García, Alfonso José Cruz-Jentoft, Teresa Bermejo-Vicedo
Background The introduction of new technologies in the prescribing process has seen the emergence of new types of medication errors. Objective To determine the prevalence and consequences of technology-induced prescription errors associated with a computerized provider order entry (CPOE) system in hospitalized older patients. Setting Patients 65 years or older admitted to the Departments of Internal Medicine, General Surgery, and Vascular Surgery of a tertiary hospital. Method Prospective observational 6-month study...
May 24, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28539084/creating-safer-health-systems-lessons-from-other-sectors-and-an-account-of-an-application-in-the-safer-clinical-systems-programme
#12
Peter Spurgeon, Hugh Flanagan, Matthew Cooke, Mark Sujan, Stephen Cross, Rose Jarvis
Despite well meaning initiatives over decades, the percentage of inpatients suffering adverse events remains constant in most advanced health systems. The notion of incident reporting as used in other safety critical industries has proved far less effective in healthcare. This article describes a new patient safety paradigm in the search for improved patient safety in healthcare. Underpinned by a holistic use of human factors the Safer Clinical Systems programme involves a proactive, risk-based approach seeking to eliminate or control risk before it is converted to patient harm...
May 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28538499/expectations-and-experiences-of-follow-up-and-self-care-after-living-kidney-donation-a-focus-group-study
#13
Karine E Manera, Camilla S Hanson, Jeremy R Chapman, John Kanellis, John Gill, Jonathan C Craig, Steve J Chadban, Germaine Wong, Angelique F Ralph, Allison Tong
BACKGROUND: Ensuring donor wellbeing warrants ongoing monitoring following living kidney donation. However, there is considerable variability in donor follow up processes, including information provided to donors regarding self-care. Loss to follow up is common, suggesting that the aims and benefits of monitoring and follow up may not be apparent. We aimed to describe the experiences and expectations of living kidney donors regarding follow up and self-care after donation. METHODS: Participants from 3 transplant centers in Australia and Canada participated in 14 focus groups (n=123)...
May 24, 2017: Transplantation
https://www.readbyqxmd.com/read/28538169/racial-differences-in-colorectal-cancer-survival-at-a-safety-net-hospital
#14
Umit Tapan, Shin Yin Lee, Janice Weinberg, Vijaya B Kolachalama, Jean Francis, Marjory Charlot, Kevan Hartshorn, Vipul Chitalia
BACKGROUND: While racial disparity in colorectal cancer survival have previously been studied, whether this disparity exists in patients with metastatic colorectal cancer receiving care at safety net hospitals (and therefore of similar socioeconomic status) is poorly understood. METHODS: We examined racial differences in survival in a cohort of patients with stage IV colorectal cancer treated at the largest safety net hospital in the New England region, which serves a population with a majority (65%) of non-Caucasian patients...
May 21, 2017: Cancer Epidemiology
https://www.readbyqxmd.com/read/28538057/an-airway-risk-assessment-score-for-unplanned-extubation-in-intensive-care-pediatric-patients
#15
Atul Vats, Clara Hopkins, Kelly M Hatfield, Jia Yan, Robert Palmer, Pinar Keskinocak
OBJECTIVE: As a result of a workshop to identify common causes of unplanned extubation, Children's Healthcare of Atlanta developed a scoring tool (Risk Assessment Score) to stratify patients into groups of low, moderate, high, and extreme risk. This tool could be used to institute appropriate monitoring or interventions for patients with high risks of unplanned extubation to enhance safety. The objective of this study is to test the hypothesis that the Risk Assessment Score will correlate with the occurrence rate of unplanned extubation in pediatric patients...
May 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28538056/engaging-all-employees-in-efforts-to-achieve-high-reliability
#16
Anne Marie Benedicto
DRAMATIC AND NUMEROUS advances in science, technology, and medicine provide new opportunities to keep people healthy as well as to diagnose, treat, and cure disease. Unfortunately, increasing complexity increases opportunities for mistakes and errors, particularly in healthcare organizations as they struggle to prevent patient harm (). Safety problems persist and harm to patients continues despite widespread attention to the need for improvement ().An engaged and empowered workforce is critical to improving the patient experience, improving health outcomes, and correcting unsafe conditions ()...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28538054/achieving-high-reliability-with-people-processes-and-technology
#17
Candice L Saunders, John A Brennan
High reliability as a corporate value in healthcare can be achieved by meeting the "Quadruple Aim" of improving population health, reducing per capita costs, enhancing the patient experience, and improving provider wellness. This drive starts with the board of trustees, CEO, and other senior leaders who ingrain high reliability throughout the organization. At WellStar Health System, the board developed an ambitious goal to become a top-decile health system in safety and quality metrics. To achieve this goal, WellStar has embarked on a journey toward high reliability and has committed to Lean management practices consistent with the Institute for Healthcare Improvement's definition of a high-reliability organization (HRO): one that is committed to the prevention of failure, early identification and mitigation of failure, and redesign of processes based on identifiable failures...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28538053/achieving-high-reliability-through-cultural-mindfulness
#18
Patrick J Cawley, Danielle B Scheurer
Healthcare has enthusiastically embraced quality and safety improvement. Yet, more radical transformation is clearly needed to make a more significant impact on error reduction and to ensure consistent quality. This need for transformation is leading healthcare to examine how other industries, such as nuclear power and aviation, improve safety to achieve a high degree of reliability and avoid potential catastrophes. Research has shown that successful organizations in high-risk industries achieve high reliability by maintaining a cultural mindfulness that allows them to continually reinvent themselves in complex environments...
July 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28536845/bariatric-surgery-in-septuagenarians-a-comparison-with-60%C3%A2-year-olds
#19
Chetan Parmar, Kamal K Mahawar, William R J Carr, Norbert Schroeder, Shlok Balupuri, Peter K Small
INTRODUCTION: There is reluctance amongst many healthcare professionals to offer bariatric surgery to septuagenarians. There is only one study in the scientific literature specifically describing any experience with this group of patients and none that compares the outcomes in this group with younger patients. METHODS: We retrospectively examined our prospective database to identify all those who were >70 years old at the time of bariatric surgery. This group was then compared with a matched (for sex, body mass index, surgical procedure, and time of surgery) cohort of younger (<60 year old) patients...
May 23, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28535398/nurses-occupational-physical-activity-levels-a-systematic-review
#20
REVIEW
Stephanie E Chappel, Simone J J M Verswijveren, Brad Aisbett, Julie Considine, Nicola D Ridgers
BACKGROUND: Nurses' physical performance at work has implications both for nurses' occupational health and patient care. Although nurses are the largest healthcare workforce, are present 24-hours a day, and engage in many physically demanding tasks, nurses' occupational physical activity levels are poorly understood. OBJECTIVES: The aim of this systematic review was to examine nurses' occupational physical activity levels, and explore how nurses accumulate their physical activity during a shift...
May 10, 2017: International Journal of Nursing Studies
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