scholarly journals 1248 “Passing the Surgical Torch”- A Review of Appropriate Surgical Handover Protocol on The Acute Surgical Take

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Shaladi ◽  
K Marshall ◽  
R Fernandes
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Royal College ◽  
Patient Management ◽  
Management Plan ◽  
Clinical State ◽  
Time Data ◽  
Imaging Results ◽  
Resuscitation Status

Abstract Aim Effective handover between shifts is vital to protect patient safety. The Royal College of Surgeons has detailed the necessary information needed for each patient at handover. We aimed to assess compliance with this handover protocol. Method Weekday surgical handover was reviewed over an 8-week period of time. Data was collected on documentation of diagnosis, up to investigations/bloods, clinical state of patient, management plan and resuscitation status/ceiling of care and COVID status. Results 210 patients were reviewed. Of these, a clear diagnosis was documented for 152 patients. Up to date imaging results if applicable was documented in 111 of 153 patients. Up to date bloods were included in 140 of 210 patients. COVID status was only noted in 31 of 210 patients and DNAR status in only 24. After re-audit of 197 a clear diagnosis was seen in 183 patients, COVID status was documented in 170 patients and DNAR status in 169. Conclusions Surgical handover is hugely crucial for provision of patient care. Following clear guidance from the royal college of surgeons, better compliance with handover was noted, including a critical improvement in COVID and DNAR status.

859 Improving Accuracy of Admission Notes Over A Four-Year Period Within an Orthopaedic Trauma Ward: A Four-Cycle Audit

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
C McCann ◽  
S Mackenzie ◽  
T White
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Royal College ◽  
Further Education ◽  
Patient Records ◽  
Orthopaedic Trauma ◽  
Contact Number ◽  
Audit Cycle ◽  
Improving Accuracy

Abstract Background Accurate medical notes are essential for effective patient care and safety. The Royal College of Surgeons (RCS) set forth guidelines for standards of documentation. Lack of awareness of these standards can result in inaccurate documentation, compromising patient safety. Method Four prospective audits of admission documents for orthopaedic inpatients were completed, each 1 year apart. For each cycle, 50 admission documents were assessed to determine compliance with the RCS standards. Interventions were carried out between each audit cycle in the following order: educational posters, change from handwritten to online admission forms and optimisation of the online proforma. Results Initially, only two criteria showed above 95% compliance. Implementing educational posters produced significant improvement in one criterion: ‘note signed’ (60% to 96%, p < 0.05). Moving admission documents online improved ‘date stamp’ (66% to 100%, P < 0.05) and ‘contact number’ (0% to 34%, p < 0.05), but decreased documentation of ‘time recorded’ (18% to 0%, p < 0.05) and ‘name and grade’ (74% to 26%, p < 0.05). Further education and modification to the admissions proforma improved documentation of all criteria to over 95%. Conclusions Early cycles of this audit highlighted poor standards of documentation in admission records. Changing to online patient records significantly changed documentation standards. These were further improved with educational measures.

A Problem-Oriented Patient Management Scheme

1975 ◽  
Vol 14 (01) ◽  
pp. 13-19 ◽  
Author(s):  
Catherine Rhys Hearn ◽  
D. W. Young
Keyword(s):  
Patient Care ◽  
Patient Information ◽  
Patient Management ◽  
Medical Knowledge ◽  
Management Plan ◽  
Current Medical ◽  
Patient Record ◽  
Medical Opinion ◽  
Management Scheme ◽  
Management Plans

Inefficient patient care may occur not because of lack of medical skills or limitation of resources, but because of inconsistent or deficient application of current medical knowledge. Conventional recording of patient information in the traditional record makes it difficult to assess, for a group of patients with similar problems, the effectiveness of any particular management plan.The ›Problem-Oriented Patient Management Scheme‹ has been developed to overcome these two difficulties. In essence it is a method of organising management plans for handling of patient problems. As the plans are prespecified they should reflect current medical opinion, as they are written down they can be applied consistently, and as the data needed is itemized the resulting patient record should be analysable to assess the effectiveness of the particular management scheme.

Clinical Cybersecurity Training Through Novel High Fidelity Simulations (Preprint)

2018 ◽  
Author(s):  
Christian Dameff ◽  
Jordan Selzer ◽  
Jonathan Fisher ◽  
James Killeen ◽  
Jeffrey Tully
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Medical Devices ◽  
Healthcare Systems ◽  
High Fidelity ◽  
Protected Health Information ◽  
Patient Harm ◽  
Security Vulnerabilities ◽  
Clinical Simulations ◽  
Medical Infrastructure

BACKGROUND Cybersecurity risks in healthcare systems have traditionally been measured in data breaches of protected health information but compromised medical devices and critical medical infrastructure raises questions about the risks of disrupted patient care. The increasing prevalence of these connected medical devices and systems implies that these risks are growing. OBJECTIVE This paper details the development and execution of three novel high fidelity clinical simulations designed to teach clinicians to recognize, treat, and prevent patient harm from vulnerable medical devices. METHODS Clinical simulations were developed which incorporated patient care scenarios with hacked medical devices based on previously researched security vulnerabilities. RESULTS Clinician participants universally failed to recognize the etiology of their patient’s pathology as being the result of a compromised device. CONCLUSIONS Simulation can be a useful tool in educating clinicians in this new, critically important patient safety space.

scholarly journals 179 Evaluating a Clinical Pharmacist Service in a Residential Care Unit

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Claire Kavanagh ◽  
Eimear O'Dwyer ◽  
Róisín Purcell ◽  
Niamh McMahon ◽  
Morgan Crowe ◽  
...  
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Patient Outcomes ◽  
Residential Care ◽  
Clinical Pharmacist ◽  
Comparative Evaluation ◽  
Positive Impact ◽  
Standard Of Care ◽  
Pharmacist Interventions ◽  
Medication Reviews

Abstract Background This study assessed the pharmacist role in an 80 bed residential care unit by: Quantifying the number and type of pharmacist interventions made and their acceptance rate.Assessing impact of pharmacist interventions on patient care.Assessing staff attitudes towards the clinical pharmacist service. Methods This was a non-blinded, non-comparative evaluation of the existing clinical pharmacist service in the unit. All residents were included. All pharmacist interventions over a 10-week period were recorded, then graded according to the Eadon scale1 by a consultant gerontologist and an experienced pharmacist to assess their impact on patient care. Results There were 615 pharmacist interventions. The most common interventions were: Drug Therapy Review, 34% (n=209) Technical Prescription, 26.5% (n=163) Administration, 15.3% (n=94) Drug Interaction, 10.4% (n=64) Medication Reconciliation, 8.5% (n=52) 98% (n=596) of interventions were rated as having significance to patient care, of which: 48.4% (n=298) and 41.8% (n=257) of the interventions rated as ‘significant and resulting in an improvement in the standard of care’1% (n=6) and 0.5% (n=3) rated as ‘very significant and preventing harm’. There was a statistically significant agreement between the evaluators, κw = 0.231 (95% CI, 0.156 to 0.307), p < .0005. The strength of agreement was fair. Of interventions requiring acceptance by medical team (n=335), 89.9% (n=301) were accepted. 95% (n=36) of staff who responded agreed or strongly agreed that improved patient safety resulted from the pharmacist’s involvement in multidisciplinary medication reviews. Over 92% (n=35) agreed or strongly agreed that their experience of the pharmacist was positive. Conclusion The pharmacist has an important role in our residential care unit. Their involvement in the medicines optimisation process positively impacts patient outcomes and prevents harm. Staff perceived a positive impact of the clinical pharmacist service provided on patient care and patient safety.

Quality improvement in hospitals: barriers and facilitators

2017 ◽  
Vol 30 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Dick E. Zoutman ◽  
B. Douglas Ford
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Patient Care ◽  
Acute Care ◽  
Medical Staff ◽  
Acute Care Hospitals ◽  
Content Type ◽  
Active Involvement ◽  
Staff Engagement ◽  
Positive Impacts

Purpose The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety. Design/methodology/approach An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives. Findings The response rate was 37 percent, 46 surveys were completed from 125 acute care hospitals. QI initiatives had positive impacts on patient safety and care. Staff in all hospitals reported conducting past or present hand-hygiene QI projects and C. difficile and surgical site infection were the next most frequent foci. Hospital staff not having time and problems with staff prioritizing QI with other duties were identified as important QI barriers. All respondents reported hospital leadership support, data utilization and internal champions as important QI facilitators. Multiple regression models identified nurses’ active involvement and medical staff engagement in QI with improved patient care and physicians’ active involvement and medical staff engagement with greater patient safety. Practical implications There is the need to study how best to support and encourage physicians and nurses to become more engaged in QI. Originality/value QI initiatives were shown to have positive impacts on patient safety and patient care and barriers and facilitating factors were identified. The results indicated patient care and safety would benefit from increased physician and nurse engagement in QI initiatives.

scholarly journals Adjustment of oxygen use by means of pulse oximetry: an important tool for patient safety

2010 ◽  
Vol 8 (4) ◽  
pp. 449-455 ◽  
Author(s):  
Telma de Almeida Busch Mendes ◽  
Paola Bruno de Araújo Andreoli ◽  
Leny Vieira Cavalheiro ◽  
Claudia Talerman ◽  
Claudia Laselva
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Physical Therapy ◽  
Confidence Interval ◽  
Pulse Oximetry ◽  
Patient Care ◽  
Physical Therapists ◽  
Severe Damage ◽  
Margin Of Error

ABSTRACT Objective: To assess patient's level of oxygenation by means of pulse oximetry, avoiding hypoxia (that causes rapid and severe damage), hyperoxia, and waste. Methods: Calculations were made with a 7% margin of error and a 95% confidence interval. Physical therapists were instructed to check pulse oximetry of all patients with prescriptions for physical therapy, observing the scheduled number of procedures. Results: A total of 129 patients were evaluated. Hyperoxia predominated in the sectors in which the patient was constantly monitored and hypoxia in the sectors in which monitoring was not continuous. Conclusions: Professionals involved in patient care must be made aware of the importance of adjusting oxygen use and the risk that non-adjustment represents in terms of quality of care and patient safety.

scholarly journals IS PATIENT SAFETY AT THE HEART OF MEDICAL EDUCATION IN INDONESIA? REFLECTION ON THE IMPACT OF THE NATIONAL EXAMINATION

2019 ◽  
Vol 8 (3) ◽  
pp. 153
Author(s):  
Rachmadya Nur Hidayah
Keyword(s):  
Medical Education ◽  
Quality Assurance ◽  
Patient Safety ◽  
Focus Groups ◽  
Patient Care ◽  
Medical Schools ◽  
Theory Approach ◽  
High Stakes ◽  
Teachers And Students ◽  
The Impact

ABSTRACT Background: National examinations in Indonesia (UKMPPD) has been implemented since 2007 as a quality assurance method for medical graduates and medical schools. The impact of UKMPPD has been studied since then, where one of the consequences were related to how it affected medical education and curricula. This study explored the consequences of UKMPPD, focusing on how the students, teachers, and medical schools’ leaders relate the examination with patient care. This study aimed to explore the impact of UKMPPD on medical education, which focusing on the issue of patient safety. Methods: This study was part of a doctoral project, using a qualitative method with a modified grounded theory approach. The perspectives of multiple stakeholders on the impact of the UKMPPD were explored using interview and focus groups. Interviews were conducted with medical schools’ representatives (vice deans/ programme directors), while focus groups were conducted with teachers and students. A sampling framework was used by considering the characteristics of Indonesian medical schools based on region, accreditation status, and ownership (public/ private). Data was analysed using open coding and thematic framework as part of the iterative process. Results: The UKMPPD affected how the stakeholders viewed this high-stakes examination and the education delivered in their medical schools. One of the consequences revealed how stakeholders viewed the UKMPPD and its impact on patient care. Participants viewed the UKMPPD as a method of preparation for graduates’ real clinical practice. The lack of reference for patient safety as the impact of the UKMPPD in this study showed that there were missing links in how stakeholders perceived the examination as part of quality assurance in health care. Conclusion: The UKMPPD as a high-stakes examination has a powerful impact in changing educational policy and programmes in Indonesia. However, in Indonesia, the examination brought in the reflection on how the “patient” element was lacking from medical education. This research offers an insight on the concept of patient safety in Indonesia and how the stakeholders could approach the issue. Keywords: UKMPPD, national licensing examination, impact, competence, patient safety, curriculum 

A qualitative study exploring nurses' communication about patient safety

2017 ◽  
Author(s):  
◽  
Allison Brandt Anbari
Keyword(s):  
Patient Safety ◽  
Qualitative Study ◽  
Patient Care ◽  
Local Level ◽  
Advanced Degree ◽  
Degree Programs ◽  
University Of Missouri ◽  
Systemic Level ◽  
Theory Of Language ◽  
The University

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] There is a growing body of evidence suggesting that an increased number of bachelor's prepared nurses at the bedside improves patient safety and outcomes. However, these studies do not stratify their sample into four-year BSNs and ADN to BSN graduates. There must be underlying reasons why the BSN degree as an entirety (BSN, accelerated BSN, and ADN to BSN completion) improves patient care and outcomes, but a gap in the literature remains. To begin to address this gap, a qualitative study was conducted to investigate potential differences in patient safety meaning among differently educated nurses, specifically BSNs and ADN to BSNs graduates and to better understand how/if the advanced BSN education for ADNs enhanced their understanding of patient safety. Guided by the theory of Language Convergence/Meaning Divergence, interview data from 8 BSN and 8 ADN to BSN graduates were analyzed. Findings indicate there are two meaning levels, including understanding the meaning of patient safety at the local level as well as at the systemic level. The local level was where the meaning of patient safety is focused at the patient's bedside is regulated by the nurse. The systemic level encompasses the local level, but also includes the notion that health system factors such as policies and staffing are paramount to keeping patients safe. More frequently, ADN to BSN graduates' meaning of patient safety was at the local level, while BSNs' meaning centered at the systemic level. In addition, ADN to BSN graduates were asked to discuss components of their degree programs that they perceived to influence their ability to keep patients safe. The graduates pursued their degrees for career advancement purposes, and did not correlate the advanced degree with their ability to keep patients safe. Additional research is needed to further explore patient safety meaning differences among differently educated nurses and the potential impact those differences might have on patient care and outcomes.

Clinical assessments

2019 ◽  
pp. 867-872
Keyword(s):  
Patient Safety ◽  
Medical School ◽  
Clinical Evaluation ◽  
Management Plan ◽  
Multisource Feedback ◽  
Differential Diagnoses ◽  
Practical Advice ◽  
Objective Structured Clinical Examinations ◽  
Case Presentations ◽  
Case Based

This chapter focuses on a number of different assessments that occur during clinical medical years and at the end of medical school, which may be formative or summative. The chapter reviews case presentations, and how best to structure them to reach a proposed management plan and summary. It provides students with an opportunity to explore differential diagnoses. It also discusses objective structured clinical examinations including examples of stations and practical advice with a focus on patient safety. This chapter includes examples of work-based assessments such as mini clinical evaluation exercises, case-based discussions, direct observation of procedural skills, and multisource feedback. It is written for both those looking to apply for medicine, and those in medical school.

scholarly journals Embedding neuroscience in psychiatry training

2020 ◽  
Vol 26 (6) ◽  
pp. 379-380
Author(s):  
Christopher O'Loughlin
Keyword(s):  
Patient Care ◽  
Royal College ◽  
Treatment Options ◽  
Improve Patient Care ◽  
Medical Specialty ◽  
Psychiatry Training ◽  
Clinical Assessments ◽  
The Uk ◽  
Improve Patient ◽  
Scientific Fields

SUMMARYTraining in neuroscience is vital to the future of psychiatry as a medical specialty. Trainees and trainers alike demonstrate a desire to keep up to date with developments in the associated scientific fields. Neuroscience increasingly underpins clinical assessments, treatment options and patients’ expectations. Psychiatry training in the UK can embrace neuroscience at many levels, from discussing patient presentations with supervisors, to teaching programmes supported by the Royal College of Psychiatrists’ activities. Although challenges remain, neuroscience literacy enhances the specialty and will improve patient care.

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