Staying Well in a Sea of Harm

2018 ◽  
Vol 158 (6) ◽  
pp. 983-984
Author(s):  
Ellen S. Deutsch
Keyword(s):  
Patient Safety ◽  
Positive Impact ◽  
Dynamic Interactions ◽  
Psychological Wellness ◽  
Physician Wellness ◽  
Complementary Approach ◽  
Human Creativity

Physician psychological wellness is an emergent outcome resulting from dynamic interactions among complex conditions. We may enhance opportunities for physician wellness by applying principles developed to improve another emergent outcome: patient safety. The Safety I approach to patient safety focuses on “what went wrong” and considers humans a liability. Safety II is a powerful complementary approach that focuses on “what went right” and values human creativity. These contrasting perspectives are described in the context of patient safety, but the underlying principles have relevance for physician psychological wellness. We can create conditions that interfere with wellness and conditions that support wellness. We can learn from exploring and reinforcing successes and improving routine processes; together, these approaches may have a greater cumulative positive impact than just addressing problems. In addition to learning from failures, there is much we can learn from success.

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.

scholarly journals Innovative Development in the Context of Complementarity

2021 ◽  
Vol 2 (48) ◽  
pp. 181-186
Author(s):  
H. I. Rybak ◽  
Keyword(s):  
Economic Development ◽  
Social Justice ◽  
Positive Impact ◽  
High Rate ◽  
Favourable Result ◽  
Ripple Effect ◽  
Innovative Development ◽  
Institutional Complementarity ◽  
Complementary Approach ◽  
The Impact

The peculiarities of innovative development in the interaction of economic and social components of the external and internal environment are studied on the basis of a complementary approach, namely the relationship between economic efficiency and social justice, their negative and positive impact on the quality of life and socio-economic development opportunities. As for complementary development, the idea of justice, which currently is an important factor in achieving European living standards and guaranteeing social-economic rights of a person and citizen, plays an important role in reforming all the spheres of public life, democratization of Ukrainian society, and providing Ukraine's integration into the European political and legal space. Complementarity research is becoming relevant at the present stage of global economic development, when the market situation is characterized by a fairly high rate of transformation, and innovation becomes the main competitive factor. The author considers the emergence of the complementarity concept in research works made in various areas (e.g., the concept of institutional complementarity), and also highlights the features of compensatory and supplemental complementarity. Unconditional following global examples without taking into account the state of real socio-economic and institutional structures in a certain state will not give a favourable result from implementing reforms and introducing innovations due to the lack of complementary connections. Therefore, the conditions for the emergence of new institutional changes and the impact of "social elevators" on social development in the long run are analyzed. The presence of complex unresolved problems in the development of our state actualizes the study of the complementary context of innovative development, aimed at rethinking the role of social justice in solving major economic problems. Due to a complementary approach, the economic system will be able to increase such features as adaptability and continuity by developing mechanisms of self-preservation, and will acquire systematic innovative development with a ripple effect.

scholarly journals The Positive Impact of Registered Nurse Sedation Teams

2019 ◽  
pp. 21-24
Author(s):  
Marlea A Judd ◽  
Mary Ellen Warner
Keyword(s):  
Patient Safety ◽  
Registered Nurse ◽  
Positive Impact ◽  
Retrospective Chart Review ◽  
Outcome Data ◽  
Moderate Sedation ◽  
The Impact ◽  
Team Model ◽  
General Care ◽  
Care Nursing

Background: Sedation care documentation and patient safety on general care nursing units need improvement. Purpose: To assess the impact of implementation of a registered nurse sedation team model on patient safety and thoroughness of documentation in patients receiving moderate sedation on general care units. Methods: In 2010 a 3-month retrospective chart review determined adverse patient outcomes and incompleteness of documentation for patients receiving sedation on general care units. After implementation of the registered nurse sedation team model for 3 months, patient’s sedation documentation and outcomes were assessed. The registered nurse sedation team model was implemented into practice and further outcome data from implementation through 2017 also were assessed. Results: There was clear improvement in both required documentation during moderate sedation and patient safety (P<0.001). Conclusion: The registered nurse sedation team model in this study improved both completeness of required sedation documentation and patient safety.

Adsorption Kinetics of Oxytetracycline onto Activated Carbon in a Closed-Loop Fixed Bed Reactor

2013 ◽  
Vol 11 (1) ◽  
pp. 569-576 ◽  
Author(s):  
Djamila Djedouani ◽  
Malika Chabani ◽  
Abdeltif Amrane ◽  
Aicha Bensmaili
Keyword(s):  
Mass Transfer ◽  
Activated Carbon ◽  
Closed Loop ◽  
Solid Phase ◽  
Positive Impact ◽  
Fixed Bed ◽  
Sorption Process ◽  
Fixed Bed Reactor ◽  
Dynamic Interactions ◽  
Initial Concentration

Abstract Batch experiments were carried out for the adsorption of oxytetracycline (OTC) onto powdered activated carbon (PAC). The operating variables examined were the initial concentration (20–150 mg L−1) and the adsorbent concentration (0.75–1.75 g L−1). As observed increasing the initial concentration, while decreasing the adsorbent dosage, had a positive impact on the amount of OTC uptake (mg g−1). The kinetics was examined in a closed-loop fixed bed adsorber to propose an adsorption mechanism, to understand the dynamic interactions of OTC with ECA08 activated carbon and to predict its fate with time. The sorption results were analyzed using chemical and physical kinetics models. For concentrations lower than 70 mg L−1, the sorption process was found to be controlled by both surface reactions and mass transfer. The average external mass transfer coefficient and intraparticle diffusion coefficient were found to be 0.0051 min−1 and 1.97 mg g−1 min−0.5, respectively. For concentrations higher than 70 mg L−1, mass transfer became rapid and the chemical reaction at the surface of the solid phase was the rate-limiting step. The results showed that the adsorption reaction was accurately described by the pseudo-second-order model.

scholarly journals Competency In Critical Care Nursing With Approach Methods Journal Sharing of Critical Care (JSCC) In Nursing Profession Students

2020 ◽  
Vol 9 (2) ◽  
pp. 686-693
Author(s):  
Heru Suwardianto ◽  
Vitaria Wahyu Astuti
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Exposure Assessment ◽  
Clinical Reasoning ◽  
Nursing Care ◽  
Positive Impact ◽  
Exam Score ◽  
Reasoning Process ◽  
Airway Assessment ◽  
Primary Assessment

The results showed that most respondents had good critical nursing competency scores including primary assessment: airway assessment (53.8%); breathing assessment  (56.4%); Circulation assessment (61.5%); Disability assessment (56.4%); and Exposure assessment (59%), professionalism (56.4%), critical nursing care competencies (79.5%), Clinical reasoning process (71.8%), Patient safety (61.5%) and critical care exam score (46.2%). The result of statistical test with Pearson test obtained that the primary assessment: airway assessment (ρ = 0.038); circulation assessment (ρ = 0.029); Exposure assessment (ρ = 0.023), competence of critical nursing care (ρ = 0.049), clinical reasoning process (ρ = 0.028) and patient safety (ρ = 0.001) have a significant relationship to the critical care exam score. The implementation of learning methods for journal sharing of critical care has a positive impact on competencies and results in good student competencies.   

scholarly journals Do We Feel Safe About the Surgical Safety Checklist? A Cross-Sectional Study Between Two Periods

2021 ◽  
Author(s):  
Danah Alsadun ◽  
Hassan Arishi ◽  
Abdullah Alhaqbani ◽  
Reema Alzighaibi ◽  
Emad Masuadi ◽  
...  
Keyword(s):  
Patient Safety ◽  
Positive Impact ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
World Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Significant Difference

ABSTRACT Introduction The aim of this study was to evaluate the change in the healthcare providers' perceptions regarding the World Health Organization Surgical Safety Checklist (WHO SSC) and patient safety in the operating room (OR) at a tertiary hospital in Riyadh, Saudi Arabia. Methods This cross-sectional study was conducted at King Abdulaziz Medical City. Data were collected from two years (2011 and 2019) for comparison. The co-investigators distributed a self-administered Likert scale questionnaire in the various operating areas (35 ORs). Results The total sample was 461. Number of participants enrolled from both years was 235 (51%) and 226 (49%), respectively. The results indicated a statistically significant difference in the attitude of the participants regarding all aspects of patient safety in the OR when the two periods were compared (p &lt; 0.001). Similarly, healthcare providers' perceptions regarding the importance of the WHO SSC increased from 50% (2011) excellent to 68% excellent (2019) (p &lt; 0.001). Conclusions Currently, more healthcare providers recognize the importance of the WHO SSC, and more have a positive attitude toward teamwork, communication, and feeling free to speak out when surgical safety is compromised. All of these cultural changes have positive impact on the overall safety of the OR; however, there are still aspects requiring improvement to provide a safer OR and surgery. Educational interventions regarding the importance of communication and teamwork would improve the safety of surgical care in the OR.

scholarly journals Hospital Information Systems (HIS) in the Examination Rooms and Wards: Doctors Perceived Positive Impact on Quality of Care and Patient Safety

2018 ◽  
Vol 7 (2.29) ◽  
pp. 871 ◽  
Author(s):  
Lizawati Salahuddin ◽  
Zuraini Ismail ◽  
. .
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Information Systems ◽  
Positive Impact ◽  
Healthcare Services ◽  
Hospital Information Systems ◽  
Structured Interviews ◽  
Healthcare Organizations ◽  
The Impact

Hospital Information Systems [HIS] is developed to support healthcare organizations in providing efficient, quality, and safe healthcare services. The objective of this study is to identify and describe doctors’ perspective on the impact of HIS use in the examination rooms and wards on quality of care and patient safety. Semi-structured interviews were carried out with thirty one doctors from three Malaysian government hospitals. Thematic qualitative analysis was performed by using ATLAS.ti to deduce the relevant themes. HIS were commonly believed to improve quality of care and patient safety in terms of : [1] accessibility of patients’ record, [2] efficient patient-care, [3] well-structured report viewing, [4] less missing patients’ records, [5] legibility of patients’ records, and [6] safety features. In conclusion, the use of HIS in examination rooms and wards suggests to improve the quality of care and patient safety.  

Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project

2018 ◽  
Vol 23 (2) ◽  
Author(s):  
Edward McAllen ◽  
Kimberly Stephens ◽  
Brenda Swanson-Biearman ◽  
Kimberly Kerr ◽  
Kimberly Whiteman
Keyword(s):  
Patient Safety ◽  
Positive Impact ◽  
Practice Change ◽  
Evidence Based ◽  
Project Implementation ◽  
Nurse Satisfaction ◽  
Improvement Project ◽  
Fall Rates ◽  
Bedside Report ◽  
Strongly Agree

A Midwestern, 532-bed, acute care, tertiary, Magnet® designated teaching hospital identified concerns about fall rates and patient and nurse satisfaction scores. Research has shown that the implementation of bedside report has increased patient safety and patient and nurse satisfaction. An evidence-based practice change incorporating bedside report into standard nursing care was implemented and evaluated over a four-month time period on three nursing units. Fall rates, HCAHPS and Press Ganey® scores, and nurses’ response to a satisfaction survey were measured before and after the project implementation. This article begins with the background of the problem and literature review, and then presents the project methods, measures, and data analysis. Results demonstrated that patient fall rates decreased by 24%, and nurse satisfaction improved with four of six nurse survey questions (67%) having percentage gains in the strongly agree or agree responses following implementation of bedside report. HCAHPS and Press Ganey® results demonstrated improvement in Press Ganey® scores on two of the three nursing units. In this project, implementation of bedside report had a positive impact on patient safety, patient satisfaction, and nurse satisfaction. The authors conclude with discussion of findings and implications for nursing management.

Physician Wellness and Patient Safety

2010 ◽  
Vol 251 (6) ◽  
pp. 1001-1002 ◽  
Author(s):  
Darrell A. Campbell
Keyword(s):  
Patient Safety ◽  
Physician Wellness

scholarly journals The impact of accreditation on healthcare quality improvement: a qualitative case study

2016 ◽  
Vol 30 (8) ◽  
pp. 1242-1258 ◽  
Author(s):  
Sara Melo
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Large Scale ◽  
Positive Impact ◽  
Healthcare Quality ◽  
Healthcare Services ◽  
Content Type ◽  
Healthcare Quality Improvement ◽  
The Impact

Purpose Research on accreditation has mostly focused on assessing its impact using large scale quantitative studies, yet little is known on how quality is improved in practice through an accreditation process. Using a case study of an acute teaching hospital in Portugal, the purpose of this paper is to explore the dynamics through which accreditation can lead to an improvement in the quality of healthcare services provided. Design/methodology/approach Data for the case study was collected through 46 in-depth semi-structured interviews with 49 clinical and non-clinical members of staff. Data were analyzed using a framework thematic analysis. Findings Interviewees felt that hospital accreditation contributed to the improvement of healthcare quality in general, and more specifically to patient safety, as it fostered staff reflection, a higher standardization of practices, and a greater focus on quality improvement. However, findings also suggest that the positive impact of accreditation resulted from the approach the hospital adopted in its implementation as well as the fact that several of the procedures and practices required by accreditation were already in place at the hospital, albeit often in an informal way. Research limitations/implications The study was conducted in only one hospital. The design of an accreditation implementation plan tailored to the hospital’s context can significantly contribute to positive outcomes in terms of quality and patient safety improvements. Originality/value This study provides a better understanding of how accreditation can contribute to healthcare quality improvement. It offers important lessons on the factors and processes that potentiate quality improvements through accreditation.

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