scholarly journals Patient safety may be compromised if study conclusions are generalized to products that make similar claims but have no equivalent research evidence

2018 ◽  
Vol 24 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Amit Gefen ◽  
Nick Santamaria ◽  
Sue Creehan ◽  
Joyce Black

This paper addresses a fundamentally important issue in health care, namely how to make informed decisions on product selection when two products, from different manufacturers, appear to be similar and have medical claims that sound comparable. In such cases, manufacturers of competing products often use each other’s evidence. They argue that the published evidence is generally applicable even if the original bioengineering tests and clinical trials were performed on a specific product, and no equivalence was obtained for their product that has similar medical claims. In this work, we use prophylactic dressings for pressure injury prevention as a good demonstrative example on how patient safety may be compromised if study conclusions are generally projected to such unstudied products. The medical device industry is regulated differently than the pharmaceutical industry, and consequently, voids in current medical device regulation are sometimes used to promote commercial interests. This paper analyzes gaps and potential pitfalls that occur where guiding documentations (e.g. guidelines, standards) do not cope well with medical technology. We explain how that can eventually lead to potential compromises to the well-being of patients, primarily if nurses are unaware of the aforementioned pitfalls. We conclude that currently, there is no alternative to rigorousness: Clinicians and decision-makers need to scrutinize up-to-date literature, decide which products have the best portfolio of bioengineering and clinical research to support the claims made, and which products have the best cost–benefit models. This is fundamentally different from simply buying the least expensive product because of appealing sale arguments.

2017 ◽  
Vol 2 (2) ◽  
pp. e013 ◽  
Author(s):  
Gary Frank ◽  
Kathleen E. Walsh ◽  
Sharyl Wooton ◽  
Jim Bost ◽  
Wei Dong ◽  
...  

2021 ◽  
Vol 74 (2) ◽  
Author(s):  
Sabrina Guterres da Silva Galetto ◽  
Eliane Regina Pereira do Nascimento ◽  
Patrícia Madalena Vieira Hermida ◽  
Josefine Busanello ◽  
Luciana Bihain Hagemann de Malfussi ◽  
...  

ABSTRACT Objectives: to know the care implemented by the nursing team to prevent medical device-related pressure injuries in critically ill patients. Methods: this is a qualitative research conducted with 15 nursing professionals from Intensive Care Unit. Sampling was carried out by theoretical saturation. For data analysis, the Discourse of the Collective Subject technique was used. Results: six speeches emerged, whose central ideas were interventions for medical device-related pressure injury prevention: care in fixation; frequent repositioning; protection and padding of body areas in contact; preferences for flexible materials, when available; attention of professionals so that they do not comer under patients; early assessment and removal, when clinically possible. Final Considerations: nursing care was directed mainly to respiratory devices, catheters in general and monitoring equipment, indicating that professionals have the knowledge to provide safe assistance consistent with the literature.


2018 ◽  
Vol 23 (3) ◽  
pp. 123-127 ◽  
Author(s):  
William V Padula ◽  
Patricia M Davidson ◽  
Debra Jackson ◽  
Rachel Pedreira ◽  
Peter J Pronovost

Hospital-acquired conditions such as pressure injuries, falls, and infections are common, costly, and deadly. Addressing the simultaneous needs of evidence-based prevention guidelines for multiple conditions can be challenging for clinical teams. Current payment incentives created by The Centers for Medicare and Medicaid Services using the Agency for Healthcare Research and Quality Patient Safety Indicator 90 (PSI90) measure impact how clinical resources are allocated by prioritizing conditions that are simpler and less costly to prevent. Pressure injury prevention guidelines may be one of the more complex programs for hospitals to implement due to the financial investment in nursing time and technology. However, a quality improvement program focused around pressure injury prevention holds good value by tackling many of the tangential conditions caused by issues related to the decubitus patient and mobility, including fall injury, venous thromboembolism, catheter-associated urinary tract infection, and sepsis. Hospitals should reconsider their prioritization of different patient safety indicators, and The Centers for Medicare and Medicaid Services should create more focused payment incentives on harmful hospital-acquired conditions such as pressure injury that are independent of composite measures of harm, including PSI90.


2020 ◽  
Vol 29 (Sup12) ◽  
pp. S6-S15
Author(s):  
Amit Gefen

The objective of this educational article is to explain in non-technical terms how the engineering considerations in the design of prophylactic dressings for pressure ulcer (PU, also known as pressure injury) prevention eventually determine the associated clinical and cost-benefit outcomes. The article specifically describes a bioengineering algorithm for quantitative evaluation of the biomechanical efficacy of different prophylactic dressing designs, which is exemplified for two fundamentally different dressing technologies, one based on superabsorbent cellulose core versus the conventional silicone-foam dressing design. A set of three biomechanical indices is described and employed for the above comparative evaluation, namely, the protective efficacy index, the protective endurance and the prophylactic trade-off design parameter. It is demonstrated that the dressing with the superabsorbent cellulose core is at least as good as silicone-foams but, importantly, provides a good balance between its protective performance in its ‘new’ condition, as opposed to its ‘used’ condition, i.e., after being exposed to moisture. Most notably, we show that preventative dressings are never equal in their performances; the underlying structure and the dressing ingredients together determine the extent of the delivered tissue protection and its durability.


2015 ◽  
Vol 53 (4) ◽  
pp. 1033-1036

Matthew D. Adler of Duke University reviews “Happiness and the Law”, by John Bronsteen, Christopher Buccafusco, and Jonathan S. Masur. The Econlit abstract of this book begins: “Assesses how the law affects people's quality of life with a particular focus on criminal punishment and civil lawsuits. Discusses measuring happiness; well-being analysis; well-being analysis versus cost–benefit analysis; happiness and punishment; adaptation, affective forecasting, and civil litigation; some problems with preference theories and objective theories; a hedonic theory of well-being; addressing objections to the hedonic theory; and the future of happiness and the law. Bronsteen is a professor in the Loyola University Chicago School of Law. Buccafusco is an associate professor in the Chicago-Kent School of Law and Codirector of the Center for Empirical Studies of Intellectual Property at the Illinois Institute of Technology. Masur is John P. Wilson Professor of Law in the University of Chicago Law School.”


2021 ◽  
pp. oemed-2020-107314
Author(s):  
Paige M Hulls ◽  
Rebecca C Richmond ◽  
Richard M Martin ◽  
Yanaina Chavez-Ugalde ◽  
Frank de Vocht

The published evidence on whether workplace health and well-being interventions are as effective in male-dominated industries compared with mixed-gender environments has not been synthesised. We performed a systematic review of workplace interventions aimed at improving employee health and well-being in male-dominated industries. We searched Web of Knowledge, PubMed, Medline, Cochrane Database and Web of Science for articles describing workplace interventions in male-dominated industries that address employee health and well-being. The primary outcome was to determine the effectiveness of the intervention and the process evaluation (intervention delivery and adherence). To assess the quality of evidence, Cochrane Collaboration’s Risk of Bias Tool was used. Due to the heterogeneity of reported outcomes, meta-analysis was performed for only some outcomes and a narrative synthesis with albatross plots was presented. After full-text screening, 35 studies met the eligibility criteria. Thirty-two studies delivered the intervention face-to-face, while two were delivered via internet and one using postal mail. Intervention adherence ranged from 50% to 97%, dependent on mode of delivery and industry. 17 studies were considered low risk of bias. Albatross plots indicated some evidence of positive associations, particularly for interventions focusing on musculoskeletal disorders. There was little evidence of intervention effect on body mass index and systolic or diastolic blood pressure. Limited to moderate evidence of beneficial effects was found for workplace health and well-being interventions conducted within male-dominated industries. Such interventions in the workplace can be effective, despite a different culture in male-dominated compared with mixed industries, but are dependent on delivery, industry and outcome. CRD42019161283.


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