The effect of critical care outreach on postoperative serious adverse events

The deterioration of patients in general wards could go unnoticed owing to the intermittent monitoring of vital data. The delayed or missed recognition of deteriorating patients results in serious adverse events in general wards. These challenges have resulted in the development of a critical care outreach service. Australia was the first country to establish critical care outreach services in 1990. In South Africa, critical care outreach services were implemented in 2005 at a private hospital in Pretoria. The researcher has noticed certain phenomena supported by literature such as the hesitancy of nurses working in general wards to escalate a patient to a critical care outreach service, and incorrect interpretation of modified early warning scores which could cause delays in patients being referred to outreach nurse experts. In this study, nurses’ (professional, staff and auxiliary nurses) experiences in respect of their self-leadership in critical care outreach services were explored. To this end, a qualitative phenomenological research approach was followed. Focus groups were held with the nurses (all nurse categories) working in a South African private hospital which provides critical care outreach services. It is recommended that nurses be granted access to training sessions, workshops and information to provide appropriate nursing care. Nurses should be encouraged to focus on the positive outcomes of providing nursing care and to “applaud themselves mentally” when they have successfully assisted or cared for their patients. Nurses also need to identify and correct negative assumptions about their competence.

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Clinical review: Serious adverse events associated with the use of rituximab - a critical care perspective

Critical Care ◽

10.1186/cc11304 ◽

2012 ◽

Vol 16 (4) ◽

pp. 231 ◽

Cited By ~ 69

Author(s):

Pashtoon M Kasi ◽

Hussein A Tawbi ◽

Chester V Oddis ◽

Hrishikesh S Kulkarni

Keyword(s):

Critical Care ◽

Adverse Events ◽

Clinical Review ◽

Serious Adverse Events

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Serious adverse events in academic critical care research

Canadian Medical Association Journal ◽

10.1503/cmaj.071366 ◽

2008 ◽

Vol 178 (9) ◽

pp. 1181-1184 ◽

Cited By ~ 22

Author(s):

D. Cook ◽

F. Lauzier ◽

M. G. Rocha ◽

M. J. Sayles ◽

S. Finfer

Keyword(s):

Critical Care ◽

Adverse Events ◽

Serious Adverse Events ◽

Care Research

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Statin-induced adverse effects – facts and genes

Orvosi Hetilap ◽

10.1556/oh.2013.29530 ◽

2013 ◽

Vol 154 (3) ◽

pp. 83-92

Author(s):

Mariann Harangi ◽

Noémi Zsíros ◽

Lilla Juhász ◽

György Paragh

Keyword(s):

Risk Factors ◽

Single Nucleotide Polymorphisms ◽

Adverse Effects ◽

Adverse Events ◽

Statin Therapy ◽

Significant Proportion ◽

Gene Mutations ◽

Nucleotide Polymorphisms ◽

Serious Adverse Events ◽

Single Nucleotide

Statin therapy is considered to be safe and rarely associated with serious adverse events. However, a significant proportion of patients on statin therapy show some degree of intolerance which can lead to decreased adherence to statin therapy. The authors summarize the symptoms, signs and frequencies of the most common statin-induced adverse effects and their most important risk factors including some single nucleotide polymorphisms and gene mutations. Also, they review the available approaches to detect and manage the statin-intolerant patients. Orv. Hetil., 2013, 154, 83–92.

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Adverse Events Reporting System as Experienced by Critical-Care Nurses in KwaZulu-Natal, South Africa

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/2456 ◽

2018 ◽

Vol 20 (1) ◽

Author(s):

Thusile Mabel Gqaleni ◽

Busisiwe Rosemary Bhengu

Keyword(s):

South Africa ◽

Critical Care ◽

Adverse Events ◽

Patient Care ◽

Family Involvement ◽

Reporting System ◽

Legal Framework ◽

Critical Care Nurses ◽

Kwazulu Natal ◽

Life Threatening

Critically ill patients admitted to critical-care units (CCUs) might have life-threatening or potentially life-threatening problems. Adverse events (AEs) occur frequently in CCUs, resulting in compromised quality of patient care. This study explores the experiences of critical-care nurses (CCNs) in relation to how the reported AEs were analysed and handled in CCUs. The study was conducted in the CCUs of five purposively selected hospitals in KwaZulu-Natal, South Africa. A descriptive qualitative design was used to obtain data through in-depth interviews from a purposive sample of five unit managers working in the CCUs to provide a deeper meaning of their experiences. This study was a part of a bigger study using a mixed-methods approach. The recorded qualitative data were analysed using Tesch’s content analysis. The main categories of information that emerged during the data analysis were (i) the existence of an AE reporting system, (ii) the occurrence of AEs, (iii) the promotion of and barriers to AE reporting, and (iv) the handling of AEs. The findings demonstrated that there were major gaps that affected the maximum utilisation of the reporting system. In addition, even though the system existed in other institutions, it was not utilised at all, hence affecting quality patient care. The following are recommended: (1) a non-punitive and non-confrontational system should be promoted, and (2) an organisational culture should be encouraged where support structures are formed within institutions, which consist of a legal framework, patient and family involvement, effective AE feedback, and education and training of staff.

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Phosphene perceptions and safety of chronic visual cortex stimulation in a blind subject

Journal of Neurosurgery ◽

10.3171/2019.3.jns182774 ◽

2020 ◽

Vol 132 (6) ◽

pp. 2000-2007 ◽

Cited By ~ 3

Author(s):

Soroush Niketeghad ◽

Abirami Muralidharan ◽

Uday Patel ◽

Jessy D. Dorn ◽

Laura Bonelli ◽

...

Keyword(s):

Visual Cortex ◽

Adverse Events ◽

Clinical Intervention ◽

Occipital Cortex ◽

Neuronal Population ◽

Serious Adverse Events ◽

Stimulation Parameters ◽

The Right ◽

Visual Cortical ◽

Stimulation Of

Stimulation of primary visual cortices has the potential to restore some degree of vision to blind individuals. Developing safe and reliable visual cortical prostheses requires assessment of the long-term stability, feasibility, and safety of generating stimulation-evoked perceptions.A NeuroPace responsive neurostimulation system was implanted in a blind individual with an 8-year history of bare light perception, and stimulation-evoked phosphenes were evaluated over 19 months (41 test sessions). Electrical stimulation was delivered via two four-contact subdural electrode strips implanted over the right medial occipital cortex. Current and charge thresholds for eliciting visual perception (phosphenes) were measured, as were the shape, size, location, and intensity of the phosphenes. Adverse events were also assessed.Stimulation of all contacts resulted in phosphene perception. Phosphenes appeared completely or partially in the left hemifield. Stimulation of the electrodes below the calcarine sulcus elicited phosphenes in the superior hemifield and vice versa. Changing the stimulation parameters of frequency, pulse width, and burst duration affected current thresholds for eliciting phosphenes, and increasing the amplitude or frequency of stimulation resulted in brighter perceptions. While stimulation thresholds decreased between an average of 5% and 12% after 19 months, spatial mapping of phosphenes remained consistent over time. Although no serious adverse events were observed, the subject experienced mild headaches and dizziness in three instances, symptoms that did not persist for more than a few hours and for which no clinical intervention was required.Using an off-the-shelf neurostimulator, the authors were able to reliably generate phosphenes in different areas of the visual field over 19 months with no serious adverse events, providing preliminary proof of feasibility and safety to proceed with visual epicortical prosthetic clinical trials. Moreover, they systematically explored the relationship between stimulation parameters and phosphene thresholds and discovered the direct relation of perception thresholds based on primary visual cortex (V1) neuronal population excitation thresholds.

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