scholarly journals Are Fenestrated Tracheostomy Tubes Still Valuable?

2019 ◽  
Vol 28 (3) ◽  
pp. 1019-1028
Author(s):  
Vinciya Pandian ◽  
Sarah E. Boisen ◽  
Shifali Mathews ◽  
Therese Cole
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health Care Providers ◽  
Tracheostomy Tube ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Primary Reason ◽  
Care Providers ◽  
Airway Protection ◽  
Tracheostomy Tubes

Purpose The purpose of this clinical focus article is to describe the frequency, indications, and outcomes of fenestrated tracheostomy tube use in a large academic institution. Method A retrospective chart review was conducted to evaluate the use of fenestrated tracheostomy tubes between 2007 and 2017. Patients were included in the study if they were ≥ 18 years of age and received a fenestrated tracheostomy tube in the recent 10-year period. Results Of 2,000 patients who received a tracheostomy, 15 patients had a fenestrated tracheostomy tube; however, only 5 patients received a fenestrated tracheostomy tube at the study institution. The primary reason why the 15 patients received a tracheostomy was chronic respiratory failure (73%); other reasons included airway obstruction (20%) and airway protection (7%). Thirteen (87%) patients received a fenestrated tracheostomy tube for phonation purposes. The remaining 2 patients received it as a step to weaning. Of the 13 patients who received a fenestrated tracheostomy tube for phonation, only 1 patient was not able to phonate. Nine (60%) patients developed some type of complications: granulation only, 2 (13.3%); granulation and tracheomalacia, 2 (13.3%); granulation and stenosis, 4 (26.7%); and granulation, tracheomalacia, and stenosis, 1 (6.7%). Conclusions Fenestrated tracheostomy tubes may assist with phonation in patients who cannot tolerate a 1-way speaking valve; however, the risk of developing granulation tissue, tracheomalacia, and tracheal stenosis exists. Health care providers should be educated on the safe use of a fenestrated tracheostomy tube and other options available to improve phonation while ensuring patient safety.

Purchasing for Safety: A Human Factors-Influenced Procedure for Evaluating Medical Products

2017 ◽  
Vol 6 (1) ◽  
pp. 118-124 ◽  
Author(s):  
Helen J. A. Fuller ◽  
Nancy J. Lightner ◽  
Kyle D. Maddox ◽  
Hasan Shanawani ◽  
Tandi Bagian ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health Care Providers ◽  
The United States ◽  
Health Administration ◽  
Care Providers ◽  
Purchasing Decisions ◽  
Medical Products ◽  
Safety Concerns ◽  
Technical Requirements

Safety reports related to products and devices used in health care have demonstrated that not all items can be considered equal in terms of usability, compatibility, and functionality, which can result in patient safety concerns. Hospital systems use a wide variety of products when providing care to patients. This variability may contribute to purchasers failing to fully understand and define the needs for these products. In addition, it is necessary to define what a high-quality product is, including what minimal technical requirements it must meet. The Veteran’s Health Administration (VHA) is the largest health care system in the United States; as such, it possesses the ability to learn from a large group of health care providers as well as a great deal of purchasing power. Purchasing for Safety is a procedure for investigating medical devices or products with an end goal of improving the purchasing decision. Purchasing for Safety can help hospitals and health care systems to systematically evaluate medical products and devices for issues that may lead to patient safety concerns. By conducting careful testing and documenting methods and findings, the test team can assist stakeholders in making purchasing decisions that may ultimately result in better patient care. The greater formality introduced in Purchasing for Safety will help hospitals justify purchasing decisions, and the thoroughness of the investigation will promote patient safety.

Behavior in Klinefelter Syndrome, or Where There Is Smoke There May Not Be a Fire

PEDIATRICS ◽  
1990 ◽  
Vol 86 (6) ◽  
pp. 1001-1002
Author(s):  
MARVIN E. MILLER ◽  
STEPHEN SULKES
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Klinefelter Syndrome ◽  
Small Subset ◽  
Primary Reason ◽  
Care Providers ◽  
Fire Setting

In Reply.— Drs Hecht and Hecht smell smoke but see no fire. They also may not see the forest for the trees. When we became aware of four individuals with Klinefelter syndrome in our clinical practice who had significant fire-setting behavior, we thought this was likely more than a coincidence. Our primary reason for reporting this observation was not for counseling issues in Klinefelter syndrome, but for alerting health care providers who evaluate firesetters that Klinefelter syndrome rome may be a small subset of firesetters.

scholarly journals Patient Safety Culture and Spiritual Health in the Operating Room: A Qualitative Study

2020 ◽  
Author(s):  
Elahe mousavi ◽  
Behzad Imani
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Content Analysis ◽  
Health Care Providers ◽  
Safety Culture ◽  
Qualitative Content Analysis ◽  
Patient Safety Culture ◽  
Spiritual Health ◽  
Care Providers ◽  
Safety Skills

Abstract Background The concept of patient safety is an essential component of health care systems and is one of the key pillars of quality in health care organizations. One of the most important factors related to the safety of patients is the spiritual health of staff and patients. Accordingly, this study strived to explain the status of patient safety culture and its relationship with spiritual health from the perspective of health care providers in teaching hospitals of Hamadan.Methods This study was a qualitative content analysis study with a conventional approach using semi-structured open-ended interviews with samples selected by purposeful sampling technique to achieve data saturation. The proposed method of Granheim and Landman (2004) was also used for the qualitative content analysis of the data.Results In this study, 5 themes and 11 sub-themes were obtained from the participants' experiences. These included: continuous and dynamic training and upgrading of safety skills, attention to spirituality and conscientiousness and work commitment, effective communication and teamwork, equipping human and logistical resources based on the principle of care, accurate recognition of instructions, and error control.Conclusions The evaluation of safety culture clarifies the perceptions of safety participants in the organization and the attitude of managers and employees towards safety issue which can lead to the development of safety culture and quality improvement.

scholarly journals Is MRI Overutilized for Evaluation of Knee Pain in Veterans?

2021 ◽  
Author(s):  
Scott Koenig ◽  
George Morcos ◽  
Rohan Gopinath ◽  
Kenneth Wang ◽  
Frank Henn ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Imaging Modality ◽  
Medical Center ◽  
Retrospective Chart Review ◽  
Care Providers ◽  
Mri Imaging ◽  
Knee Arthritis ◽  
Diagnostic Strategies ◽  
Mri Scans

AbstractMRI is an essential diagnostic imaging modality for many knee conditions; however, it is not indicated in the setting of advanced knee arthritis. Inappropriate MRI imaging adds to health care costs and may delay definitive management for many patients. The primary purpose of this study was to ascertain the frequency of inappropriate MRI scans performed at one Veterans' Administration Medical Center (VAMC). We performed a retrospective chart review of all knee MRIs ordered over a 6-month period. Inappropriate MRI was defined as MRI performed prior to radiographs (XRs), or in the presence of XRs demonstrating severe osteoarthritis, without leading to a nonarthroplasty procedure of the knee. Of the 304 cases reviewed, 36.8% (112) of the MRIs were deemed inappropriate, 33 were ordered by orthopedists, and 79 were ordered by other health care providers. Of the 33 ordered by orthopedists, 25 were ordered by retired/nonsurgical orthopedists. Obtaining an MRI delayed care by an average of 29.2 days. Of the 252 cases that had XR prior to MRI, none included all four views in the standard knee XR series and only four had weightbearing images. Over a third of knee MRIs performed at this VAMC were inappropriate and delayed care. Additionally, no XRs in our study contained all the necessary views to properly assess knee arthritis. These concerning findings signify a potential opportunity for education in diagnostic strategies, to better patient care and resource utilization in the VAMC.

scholarly journals Perception of patient safety culture among health-care providers in a Tertiary Care Hospital, South India

2018 ◽  
Vol 9 (1) ◽  
pp. 14 ◽  
Author(s):  
Adhisakthi Rajalatchumi ◽  
ThanjavurS Ravikumar ◽  
Kaliaperumal Muruganandham ◽  
Mahalakshmy Thulasingam ◽  
Kalaiselvi Selvaraj ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health Care Providers ◽  
Safety Culture ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Patient Safety Culture ◽  
Care Hospital ◽  
Care Providers

scholarly journals Practice, Perceived Barriers and Motivating factors to medical-incident reporting: A cross-section survey of health care providers at Mbarara Regional Referral Hospital, Southwestern Uganda.

2020 ◽  
Author(s):  
Naome Turyahabwe ◽  
James Mwesigwa ◽  
Christine Atuhairwe ◽  
Ivan Mugisha Taremwa
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health Care Providers ◽  
Incident Reporting ◽  
Referral Hospital ◽  
Perceived Barriers ◽  
P Value ◽  
Motivating Factors ◽  
Care Providers ◽  
Regional Referral Hospital

Abstract Background : Medical-incident reporting (MIR) ensures patient safety and delivery of quality of care by minimizing unintentional harm among health care providers. We explored medical-incident reporting practices, perceived barriers and motivating factors among health care providers at Mbarara Regional Referral Hospital (MRRH). Methods : We conducted a cross-sectional descriptive study on 158 health provider at Mbarara Regional Referral Hospital (MRRH), Western Uganda. Data was gathered using a structured questionnaire and analyzed with SPSS. The chi-square was used to determine factors associated with MIR at MRRH. Results : The results showed that there was no formal incident reporting structure. However the medical-incidences identified were: medication errors (89.9%), diagnostic errors (71.5%), surgical errors (52.5%) and preventive error (47.7%). The motivating factors of MIR were: establishment of a good communication system, instituting corrective action on the reported incidents and reinforcing health workers knowledge on MIR (p-value 0.004); presence of effective organizational systems like: written guidelines, practices of open door policy, no blame approach, and team work were significantly associated with MIR (p-value 0.000). On the other hand, perceived barriers to MIR were: lack of knowledge on incidents and their reporting, non-existence of an incident reporting team and fear of being punished (p value 0.669). Conclusion : Medical Incident Reporting at MRRH was sub-optimal. Therefore setting up an incident management team and conducting routine training MIR among health care workers will increase patient safety.

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