First, Do No Harm: Predictive Analytics to Reduce In-Hospital Adverse Events

2021 ◽  
Vol 38 (4) ◽  
pp. 1122-1149
Author(s):  
Yu-Kai Lin ◽  
Xiao Fang
2007 ◽  
Vol 65 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Eunice Chuang ◽  
Marilisa M. Guerreiro ◽  
Sara Y. Tsuchie ◽  
Angelica Santucci ◽  
Carlos A. M. Guerreiro ◽  
...  

BACKGROUND: Although overtreatment with antiepileptic drugs contributes to the morbidity associated with epilepsy, many children still are overtreated. OBJECTIVE: To evaluate if the withdrawal of at least one antiepileptic drug (AED) in children with refractory epilepsy using polytherapy enable a better seizure control. METHOD: This was a prospective study. Children with refractory epilepsy using at least two AEDs were included. Once the patient, or guardian, agreed to participate in the study, one or more AED were slowly tapered off. The remaining AEDs dosages could be adjusted as needed, but a new AED could not be introduced. RESULTS: Fifteen patients were evaluated, three girls; ages ranging from 3 to 18 (mean=8.7 years). After at least one AED withdrawal, two (13.5%) patients became seizure free, seizures improved >50% in 5 (33.5%) patients, did not change in 5 (33.5%), and seizure frequency became worse in 3 (20%). Adverse events improved in 12 patients (80%). CONCLUSION: The withdrawal of at least one AED is a valuable option in the treatment of selected children with refractory epilepsy.


2019 ◽  
Author(s):  
Fingki handayani

Keselamatan pasien dan mutu pelayanan kesehatan yang tinggi adalah tujuan akhir yang selalu diharapkan oleh rumah sakit, manajer, tim penyedia pelayanan kesehatan, pihak jaminan kesehatan, serta pasien, keluarga dan masyarakat. Namun demikian, prinsip “First, do no harm” tidak cukup kuat untuk mencegah berkembangnya masalah keselamatan pasien. Hal ini tercermin dari tingkat dan skala masalah keselamatan pasien sejak terbitnya publikasi “To Err is Human” pada tahun 2000.1 Hingga studi-studi terkini. Di Amerika, hasil studi keselamatan pasien pada akhir tahun 1990-an menemukan angka 3,9% dan 2,7% angka kejadian yang tidak diinginkan (KTD) pada pasien rawat inap.2,3 Dua puluh tahun kemudian, pengukuran dengan Global Trigger Tool menunjukkan bahwa KTD meningkat 10 kali lipat (menjadi 32%).4 Di Indonesia, isu keselamatan pasien mulai dibahas pada tahun 2000, diikuti dengan studi pertama di 15 rumah sakit dengan 4500 rekam medik. Hasilnya menunjukkan bahwa angka KTD sangat bervariasi, yaitu 8,0%-98,2% untuk kesalahan diagnosis dan 4,1%-91,6% untuk kesalahan pengobatan.5 Sejak itu, bukti-bukti tentang keselamatan pasien di Indonesia pun merebak, meskipun belum ada studi nasional hingga saat ini. Kita patut merasa iri dengan negara-negara di Amerika Latin yang telah mempunyai studi Iberoamerican study of adverse events (IBEAS) di 58 rumah sakit dari 5 negara.


Author(s):  
I. H. Monrad Aas

The patient safety and quality problem in health care are considerable. To err is human, but primum non nocere (first, do no harm) means work against the adverse events and work for good quality. The purpose of the chapter is to explore the potential role for patient safety of a telemedicine network organization with centralization and decentralization taken into consideration. Network organization is of importance for strengthening of professional communities and competence complementation. For the building of strong professional communities, some size can be necessary, and this can be promoted by centralization. In the telemedicine era, a new way of organizing can be network organization, combined with centralization and decentralization. Not to do anything with the significant patient safety and quality problem is fundamentally wrong and morally indefensible. To err is human, to continue to err is diabolic, and to forgive is divine.


2010 ◽  
Vol 44 (12) ◽  
pp. 16
Author(s):  
STEPHEN I. PELTON
Keyword(s):  

2012 ◽  
Vol 45 (16) ◽  
pp. 28
Author(s):  
BETSY BATES FREED
Keyword(s):  

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