scholarly journals Analysis of Medication-Related Deaths in Denmark

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Lars Dahlgaard Hove ◽  
Johannes Bock ◽  
Jens Krogh Christoffersen
Keyword(s):  
Internal Medicine ◽  
Adverse Event ◽  
Patient Safety ◽  
Retrospective Study ◽  
Orthopaedic Surgery ◽  
Safety Measures ◽  
Danish Patient ◽  
Wrong Drug ◽  
Closed Claims ◽  
Future Patient

Objective. To investigate the circumstances associated with medication-related deaths. Design and Setting. This retrospective study investigated closed claims concerning medication-related deaths from 1996 to 2008 registered by the Danish Patient Insurance Association (DPIA). Results. A total of 80 were patients registered as having died because of an adverse event or error associated with a medication, and 37 of these cases were considered to have been preventable. The circumstances of the 37 deaths are described in detail in this report. Orthopaedic surgery, anaesthesiology, and internal medicine were the specialties involved in the majority of the deaths. Incorrect dosing was the cause of 17 deaths, and the use of the wrong drug caused 11 deaths. The administration of a drug despite a known allergy/intolerance or contraindication caused 6 deaths. Other 5 deaths were caused by anticoagulation medications. Methotrexate given daily by mistake caused 2 deaths. Conclusion. This study describes the circumstances of 37 preventable deaths caused by medication. Drug administration despite a known allergy, opioids, sedative, anticonvulsive medicine, and incorrect dosing and incorrect use of anticoagulants are the most important areas to be addressed in the development of future patient safety measures to reduce patient deaths caused by or related to medications.

scholarly journals Adverse Events in Home-Care Nursing Agencies and Related Factors: A Nationwide Survey in Japan

2021 ◽  
Vol 18 (5) ◽  
pp. 2546
Author(s):  
Noriko Morioka ◽  
Masayo Kashiwagi
Keyword(s):  
Adverse Event ◽  
Patient Safety ◽  
Adverse Events ◽  
Home Care ◽  
Process Of Care ◽  
Related Factors ◽  
Cross Sectional ◽  
Home Care Nursing ◽  
Number Of Patients ◽  
Care Nursing

Despite the importance of patient safety in home-care nursing provided by licensed nurses in patients’ homes, little is known about the nationwide incidence of adverse events in Japan. This article describes the incidence of adverse events among home-care nursing agencies in Japan and investigates the characteristics of agencies that were associated with adverse events. A cross-sectional nationwide self-administrative questionnaire survey was conducted in March 2020. The questionnaire included the number of adverse event occurrences in three months, the process of care for patient safety, and other agency characteristics. Of 9979 agencies, 580 questionnaires were returned and 400 were included in the analysis. The number of adverse events in each agency ranged from 0 to 47, and 26.5% of the agencies did not report any adverse event cases. The median occurrence of adverse events was three. In total, 1937 adverse events occurred over three months, of which pressure ulcers were the most frequent (80.5%). Adjusting for the number of patients in a month, the percentage of patients with care-need level 3 or higher was statistically significant. Adverse events occurring in home-care nursing agencies were rare and varied widely across agencies. The patients’ higher care-need levels affected the higher number of adverse events in home-care nursing agencies.

scholarly journals 905 How to prioritise patients and safely resume elective surgery during the Covid-19 pandemic

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Subbiah Ponniah ◽  
M Ahmed ◽  
T Edwards ◽  
J Cobb ◽  
E Dean ◽  
...  
Keyword(s):  
Patient Safety ◽  
High Risk ◽  
Orthopaedic Surgery ◽  
Elective Surgery ◽  
Paediatric Patients ◽  
Level 3 ◽  
Level 1 ◽  
Surgical Unit

Abstract Introduction There are now over 2.5 million NHS patients awaiting elective surgery, with the most in orthopaedics. We present an algorithm and results for safely and equitably restarting surgery at COVID-light sites. Method An MDT applied the COVID-19 Algorithm for Resuming Elective Surgery (CARES) on 1169 patients awaiting elective orthopaedic surgery. It assessed safety, procedural efficacy, and biopsychosocial factors, to prioritise patients. They were assigned to five categories and underwent surgery at one of three COVID-light sites (1. access to HDU/ITU/Paediatrics/specialist equipment, 2. an NHS elective surgical unit and 3. a private elective surgical unit). Results 21 ‘Urgent’ patients received expedited care; 118 were Level 1/2; 222 were Level 3; 808 were Level 4. In 6 weeks, 355 surgeries were performed, with Urgent and Level 1/2 cases performed soonest (mean 18 days, p < 0.001). 33 high-risk/complex/paediatric patients had surgery at Site 1 and the rest at Sites 2 and 3. No patients contracted COVID-19 within 2 weeks of surgery. Conclusions We validated a widely generalisable model to facilitate resumption of elective surgery in COVID-light sites. It enabled surgery for patients in most suffering, undergoing the most efficacious procedures and/or at highest risk of deterioration, without compromising patient-safety.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

scholarly journals Application of electronic trigger tools to identify targets for improving diagnostic safety

2018 ◽  
Vol 28 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Daniel R Murphy ◽  
Ashley ND Meyer ◽  
Dean F Sittig ◽  
Derek W Meeks ◽  
Eric J Thomas ◽  
...  
Keyword(s):  
Adverse Event ◽  
Patient Safety ◽  
High Risk ◽  
Health Systems ◽  
Language Processing ◽  
Diagnostic Errors ◽  
Diagnostic Process ◽  
Future Research ◽  
Implementation Challenges ◽  
Preventable Harm

Progress in reducing diagnostic errors remains slow partly due to poorly defined methods to identify errors, high-risk situations, and adverse events. Electronic trigger (e-trigger) tools, which mine vast amounts of patient data to identify signals indicative of a likely error or adverse event, offer a promising method to efficiently identify errors. The increasing amounts of longitudinal electronic data and maturing data warehousing techniques and infrastructure offer an unprecedented opportunity to implement new types of e-trigger tools that use algorithms to identify risks and events related to the diagnostic process. We present a knowledge discovery framework, the Safer Dx Trigger Tools Framework, that enables health systems to develop and implement e-trigger tools to identify and measure diagnostic errors using comprehensive electronic health record (EHR) data. Safer Dx e-trigger tools detect potential diagnostic events, allowing health systems to monitor event rates, study contributory factors and identify targets for improving diagnostic safety. In addition to promoting organisational learning, some e-triggers can monitor data prospectively and help identify patients at high-risk for a future adverse event, enabling clinicians, patients or safety personnel to take preventive actions proactively. Successful application of electronic algorithms requires health systems to invest in clinical informaticists, information technology professionals, patient safety professionals and clinicians, all of who work closely together to overcome development and implementation challenges. We outline key future research, including advances in natural language processing and machine learning, needed to improve effectiveness of e-triggers. Integrating diagnostic safety e-triggers in institutional patient safety strategies can accelerate progress in reducing preventable harm from diagnostic errors.

scholarly journals Adverse Event Reporting: Harnessing Residents to Improve Patient Safety

2017 ◽  
Vol 16 (4) ◽  
pp. 294-298 ◽  
Author(s):  
Sarah E. Tevis ◽  
Ryan K. Schmocker ◽  
Tosha B. Wetterneck
Keyword(s):  
Adverse Event ◽  
Patient Safety ◽  
Improve Patient Safety ◽  
Adverse Event Reporting ◽  
Event Reporting ◽  
Improve Patient

Tumour markers in internal medicine: a low-cost test or an unnecessary expense? A retrospective study based on appropriateness

2007 ◽  
Vol 2 (2) ◽  
pp. 88-94 ◽  
Author(s):  
D. Arioli ◽  
M. Pipino ◽  
E. Boldrini ◽  
E. Amateis ◽  
A. Cristani ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Retrospective Study ◽  
Low Cost ◽  
Tumour Markers

scholarly journals COST-EFFICIENCY ANALYSIS OF A MULTI-PAVILION HOSPITAL IN CLUJ COUNTY

2016 ◽  
Vol 89 (1) ◽  
pp. 110-116
Author(s):  
Mihai Mleșnițe ◽  
Ioan Stelian Bocșan
Keyword(s):  
Internal Medicine ◽  
Retrospective Study ◽  
Cost Efficiency ◽  
Time Frame ◽  
Healthcare Systems ◽  
Efficiency Analysis ◽  
Financial Indicators ◽  
Target Groups ◽  
Hospital Administrators ◽  
Clinical Hospital

Background and aim: Multi-hospital health systems have become the most popular administrative structure in healthcare, leading to both opportunities and challenges for hospital administrators. In government-funded healthcare systems, there is a balance between costs and the provision of health services.The aim of the present study is to assess the efficiency in terms of costs of a multi-pavilion hospital from Cluj County, Romania.Methods: The institution analyzed in this article is the Adults’ Clinical Hospital in Cluj-Napoca. A descriptive retrospective study collected data from January 2004 to December 2010. A set of indicators were compiled, divided into three main categories: personnel, statistics, and financial.Results: Twenty-one financial indicators were investigated. Heterogeneity between different years was observed for the continuous hospitalization indicator and the wage budget indicator. The highest variability was observed between the budget and expenses indicators, while a smaller variability was observed at the average costs per patient. The costs per patient have increased at all pavilions in the studied time frame, the higher costs being at the Internal Medicine and Surgery pavilions: 10,203 RON in 2010 (1 euro ~ 4.4 RON)Conclusion: The pavilions included in the Adults’ Clinical Hospital Cluj-Napoca have different expenses patterns, as each pavilion is focused on different specialties. Each pavilion serves different target groups, requiring different procedures. This in turn results in different expense patterns across each pavilion.

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