scholarly journals Systematic evidence review of rates and burden of harm of intravenous admixture drug preparation errors in healthcare settings

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e015912 ◽  
Author(s):  
Nancy Hedlund ◽  
Idal Beer ◽  
Torsten Hoppe-Tichy ◽  
Patricia Trbovich
Keyword(s):  
Dose Calculation ◽  
Poor Quality ◽  
Future Research ◽  
Drug Preparation ◽  
Aseptic Technique ◽  
Healthcare Settings ◽  
Published Evidence ◽  
Preparation Errors ◽  
Consistent Error ◽  
Error Types

ObjectiveTo examine published evidence on intravenous admixture preparation errors (IAPEs) in healthcare settings.MethodsSearches were conducted in three electronic databases (January 2005 to April 2017). Publications reporting rates of IAPEs and error types were reviewed and categorised into the following groups: component errors, dose/calculation errors, aseptic technique errors and composite errors. The methodological rigour of each study was assessed using the Hawker method.ResultsOf the 34 articles that met inclusion criteria, 28 reported the site of IAPEs: central pharmacies (n=8), nursing wards (n=14), both settings (n=4) and other sites (n=3). Using the Hawker criteria, 14% of the articles were of good quality, 74% were of fair quality and 12% were of poor quality. Error types and reported rates varied substantially, including wrong drug (~0% to 4.7%), wrong diluent solution (0% to 49.0%), wrong label (0% to 99.0%), wrong dose (0% to 32.6%), wrong concentration (0.3% to 88.6%), wrong diluent volume (0.06% to 49.0%) and inadequate aseptic technique (0% to 92.7%)%). Four studies directly compared incidence by preparation site and/or method, finding error incidence to be lower for doses prepared within a central pharmacy versus the nursing ward and lower for automated preparation versus manual preparation. Although eight studies (24%) reported ≥1 errors with the potential to cause patient harm, no study directly linked IAPE occurrences to specific adverse patient outcomes.ConclusionsThe available data suggest a need to continue to optimise the intravenous preparation process, focus on improving preparation workflow, design and implement preventive strategies, train staff on optimal admixture protocols and implement standardisation. Future research should focus on the development of consistent error subtype definitions, standardised reporting methodology and reliable, reproducible methods to track and link risk factors with the burden of harm associated with these errors.

Couples Facing Cancer

2021 ◽  
pp. 729-736
Author(s):  
Hoda Badr ◽  
Courtney Bitz
Keyword(s):  
Routine Care ◽  
Poor Quality ◽  
Psychosocial Adaptation ◽  
Future Research ◽  
Great Promise ◽  
Clinical Implications ◽  
Social Challenges ◽  
Healthcare Settings ◽  
Care And Support

Cancer survivors experience significant physical, psychological, and social challenges that contribute to poor quality of life. Intimate partners provide critical care and support across the cancer continuum, but they report psychological distress, lack basic healthcare knowledge and skills, and experience increased tension and conflict in their relationships with survivors. Couple-based interventions hold great promise in cancer because they can simultaneously address survivor, partner, and relationship concerns. However, they are seldom implemented in healthcare settings as part of routine care. This chapter will therefore integrate what research has taught us about couples and cancer and what we have learned from couples in the clinical setting. We begin with an overview of challenges faced by couples across the cancer continuum, including biopsychosocial stressors. Next, we describe different perspectives that have shaped descriptive and intervention research on couples’ psychosocial adaptation to cancer. We conclude with clinical implications and directions for future research.

Parasite defense mechanisms in bees: behavior, immunity, antimicrobials, and symbionts

2019 ◽  
Vol 4 (1) ◽  
pp. 59-76 ◽  
Author(s):  
Alison E. Fowler ◽  
Rebecca E. Irwin ◽  
Lynn S. Adler
Keyword(s):  
Defense Mechanisms ◽  
Poor Quality ◽  
Future Research ◽  
Immune Priming ◽  
Social Bees ◽  
Bee Health ◽  
Landscape Scales ◽  
And Function ◽  
Solitary Species

Parasites are linked to the decline of some bee populations; thus, understanding defense mechanisms has important implications for bee health. Recent advances have improved our understanding of factors mediating bee health ranging from molecular to landscape scales, but often as disparate literatures. Here, we bring together these fields and summarize our current understanding of bee defense mechanisms including immunity, immunization, and transgenerational immune priming in social and solitary species. Additionally, the characterization of microbial diversity and function in some bee taxa has shed light on the importance of microbes for bee health, but we lack information that links microbial communities to parasite infection in most bee species. Studies are beginning to identify how bee defense mechanisms are affected by stressors such as poor-quality diets and pesticides, but further research on this topic is needed. We discuss how integrating research on host traits, microbial partners, and nutrition, as well as improving our knowledge base on wild and semi-social bees, will help inform future research, conservation efforts, and management.

scholarly journals An Overview of Ecosystem Service Studies in a Tropical Biodiversity Hotspot, Sri Lanka: Key Perspectives for Future Research

Forests ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 540
Author(s):  
Chaya Sarathchandra ◽  
Yirga Alemu Abebe ◽  
Iresha Lakmali Wijerathne ◽  
Sasith Tharanga Aluthwattha ◽  
Sriyani Wickramasinghe ◽  
...  
Keyword(s):  
Ecosystem Services ◽  
Sri Lanka ◽  
Ecosystem Service ◽  
Future Research ◽  
Species Introduction ◽  
Related Research ◽  
Management Actions ◽  
Service Category ◽  
Tropical Biodiversity ◽  
Published Evidence

Tropical island countries are often highly populated and deliver immense ecosystem service benefits. As human wellbeing depends on these ecosystems, proper management is crucial in the resource-rich tropical lands where there is less related research. Though ecosystem service and biodiversity studies are a promising path to inform the ecosystem management for these mostly developing countries, published evidence of using ecosystem service studies in decision making is lacking. The purpose of this study is to provide an overview of ecosystem services and related research in Sri Lanka, examining trends and gaps in how these studies are conceptualized. Out of the considered 220 peer-reviewed articles, the majority of articles (48.2%) were terrestrial and forest related while coastal ecosystems were considered in 33.2% of studies. In most studies, the ecosystem service category studied was provisioning (31.5%) followed by regulatory service (28.7%). Studies investigating and quantifying ecosystem services, pressures on ecosystems, and their management were fewer compared to studies related to biodiversity or species introduction. Moreover, studies investigating the value of ecosystem services and biodiversity to the communities or involvement of stakeholders in the development of management actions regarding the ecosystem services were rare in Sri Lanka, and an intense focus from future studies in these aspects is timely and necessary.

In the Moment: Fostering Mindfulness and Reducing Stressors in the Healthcare Workplace

2021 ◽  
pp. 193758672098824
Author(s):  
Shabboo Valipoor ◽  
Sheila J. Bosch
Keyword(s):  
Design Research ◽  
Healthcare Professionals ◽  
Well Being ◽  
Job Dissatisfaction ◽  
Future Research ◽  
Design Strategies ◽  
Environmental Interventions ◽  
Work Related ◽  
Healthcare Settings ◽  
The Moment

While healthcare design research has primarily focused on patient outcomes, there is a growing recognition that environmental interventions could do more by promoting the overall quality of care, and this requires expanding the focus to the health and well-being of those who deliver care to patients. Healthcare professionals are under high levels of stress, leading to burnout, job dissatisfaction, and poor patient care. Among other tools, mindfulness is recommended as a way of decreasing stress and helping workers function at higher levels. This article aims to identify potential environmental strategies for reducing work-related stressors and facilitating mindfulness in healthcare settings. By examining existing evidence on workplace mindfulness and stress-reducing design strategies, we highlight the power of the physical environment in not only alleviating stressful conditions but intentionally encouraging a mindful perspective. Strategies like minimizing distractions or avoiding overstimulation in the healthcare environment can be more effective if implemented along with the provision of designated spaces for mindfulness-based programs. Future research may explore optimal methods and hospital workers’ preferences for environments that support mindfulness and stress management. The long-term goal of all these efforts is to enhance healthcare professionals’ well-being, reignite their professional enthusiasm, and help them be resilient in times of stress.

All aboard!: Involvement of medical and pharmacy trainees in antimicrobial stewardship

2018 ◽  
Vol 40 (2) ◽  
pp. 200-205 ◽  
Author(s):  
Lindsey M. Childs-Kean ◽  
Heather L. Briggs ◽  
Jonathan C. Cho
Keyword(s):  
Antimicrobial Stewardship ◽  
Pharmacy Students ◽  
Future Research ◽  
Published Evidence ◽  
Selection Of

AbstractAntimicrobial stewardship (AS) involves the appropriate selection of antimicrobials. Antimicrobial stewardship programs are mandated in hospitals and are expanding to involve outpatient arenas. Multiple articles have been published describing the need for AS education for medical and pharmacy students, beginning early in the students’ career to develop into competent AS practitioners. Additionally, publications have described the role and impact of medical and pharmacy trainees on AS programs. Here, we review the published evidence describing medical and pharmacy trainees’ involvement in AS and call for future research in this area.

scholarly journals Physical monitoring and advice: absence of evidence is not evidence of absence

2015 ◽  
Vol 21 (2) ◽  
pp. 75-77
Author(s):  
Katharine Smith
Keyword(s):  
Mental Illness ◽  
Physical Health ◽  
Health Monitoring ◽  
Poor Quality ◽  
Future Research ◽  
Cost Benefits ◽  
Cochrane Reviews ◽  
Different Types ◽  
Physical Health Problems ◽  
General Physical

SummaryIndividuals with severe mental illness have increased rates of physical health problems and reduced life expectancy. As a vulnerable population, they have been identified as needing increased physical health monitoring and treatment. The first of two Cochrane reviews considered here assessed the evidence for the benefit of monitoring but found no studies that could be included. The second reviewed the evidence for provision of general physical healthcare advice. Although the results were suggestive of benefit, the evidence, where available, was of poor quality. These reviews highlight an important area for future research to evaluate the relative health and cost benefits of different types of intervention.

Interpersonal Perspectives on Depression

2016 ◽  
pp. 166-178
Author(s):  
Mark A. Whisman
Keyword(s):  
Interpersonal Relationships ◽  
Family Relationships ◽  
Poor Quality ◽  
Stress Generation ◽  
Future Research ◽  
Reassurance Seeking ◽  
Interpersonal Behaviors ◽  
Avoidant Attachment ◽  
Interpersonal Characteristics ◽  
Social Skills Deficits

Humans have an intrinsic need to form and maintain interpersonal relationships. Therefore, difficulties and problems in interpersonal functioning are likely to influence and be influenced by mental health outcomes such as depression. In this chapter, key theories and empirical findings regarding interpersonal perspectives on depression are reviewed. Specifically, the review focuses on problematic interpersonal characteristics and processes (i.e., excessive reassurance seeking and rejection, circumplex models of problematic interpersonal behaviors, interpersonal stress and stress generation, anxious and avoidant attachment, social skills deficits) and poor quality interpersonal relationships (i.e., marriage and intimate relationships, family relationships) that are associated with the onset, severity, and course of depression. Implications of these interpersonal perspectives for the treatment of depression are also reviewed, and suggestions for future research are advanced.

Caring for Patients with Service Dogs: Information for Healthcare Providers

2016 ◽  
Vol 22 (1) ◽  
Author(s):  
Michelle Krawczyk
Keyword(s):  
Emotional Support ◽  
Healthcare Providers ◽  
Background Information ◽  
Future Research ◽  
Service Dogs ◽  
Patient Centered ◽  
Service Dog ◽  
Healthcare Settings ◽  
Centered Care

People with disabilities use various assistance devices to improve their capacity to lead independent and fulfilling lives. Service dogs can be crucial lifesaving companions for their owners. As the use of service dogs increases, nurses are more likely to encounter them in healthcare settings. Service dogs are often confused with therapy or emotional support dogs. While some of their roles overlap, service dogs have distinct protection under the American Disabilities Act (ADA). Knowing the laws and proper procedures regarding service dogs strengthens the abilities of healthcare providers to deliver holistic, patient-centered care. This article provides background information about use of dogs, and discusses benefits to patients and access challenges for providers. The author reviews ADA laws applicable to service dog use and potential challenges and risks in acute care settings. The role of the healthcare professional is illustrated with an exemplar, along with recommendations for future research and nursing implications related to care of patients with service dogs.

scholarly journals Social exclusion in primary healthcare settings: the time for measurement has come

2019 ◽  
Vol 29 (1) ◽  
pp. 10-13
Author(s):  
Patrick O’Donnell ◽  
Khalifa Elmusharaf
Keyword(s):  
Social Exclusion ◽  
Primary Healthcare ◽  
Knowledge Network ◽  
Individual Level ◽  
Healthcare Settings ◽  
Published Evidence ◽  
Measurement Tools ◽  
Definition Of ◽  
The Individual

Social exclusion is a concept that has been discussed and debated in many disciplines in recent decades. In 2006 the WHO Social Exclusion Knowledge Network published a report detailing their work explaining the relevance of social exclusion to the domain of health. As part of that work, the authors formulated a complex definition of social exclusion that has proven difficult to adapt or operationalize in healthcare settings. We looked at this WHO work, and at other published evidence, and decided that social exclusion is a concept that is worth measuring at the individual level in healthcare settings. We suggest that the primary healthcare space, in particular, is an ideal setting in which to do that measurement. We have examined existing social exclusion measurement tools, and scrutinised the approaches taken by their authors, and the various domains they measured. We now propose to develop and validate such a tool for use in primary healthcare settings.

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