scholarly journals Insomnia management; don't sleep on it

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S20-S21
Author(s):  
Maria Donnelly ◽  
Nieves Mercadillo ◽  
Stuart Davidson

AimsIn this project our aim was to improve patient safety and care by reducing hypnotic prescription medication administration. We also wanted to reduce over-prescribing/unnecessary prescribing which has a negative pharmaceutical impact on the environment and is a huge expenditure issue for the NHS. NICE guidance for Insomnia management states “After consideration of the use of non-pharmacological measures, hypnotic drug therapy is considered appropriate for the management of severe insomnia interfering with normal daily life; it is recommended that hypnotics should be prescribed for short periods of time only, in strict accordance with their licensed indications” Side effects are common with hypnotic usage including, most importantly, the development of tolerance and rebound insomnia.MethodThe interventions we implemented included the development of an educational presentation about insomnia, the development of an “Insomnia Management Flow chart” to be used at admission point, training sessions for ward staff, shared teaching programmes with patients at their sleep management sessions, face to face and email correspondence to inform medical trainees about this project and gathering feedback from patients and staff before and after this project.ResultThe results of this project demonstrated a total reduction in hypnotic tablet administration was very significant with a 44.5% reduction post intervention.ConclusionThis demonstrates the positive change in our clinical practice that has resulted from our interventions. This will improve patient safety and reduce cost of hypnotic medications for the NHS. Following on from this initial intervention, we feel that we can continue to make further changes and expand the changes we made on this ward, to other similar wards in our hospital, trust and to other inpatient psychiatric wards further afield.

Author(s):  
Seham Sahal Aloufi

Patient safety is considered as an essential feature of healthcare system. Many trials have been conducted in order to find ways to improve patient safety, and many reports indicate that medication errors pose a threat to patient safety. Thus, some studies have investigated the impact of bar code medication administration (BCMA) system on medication error reduction during the medication administration procedure. This systematic review (SR) reports the impact of BCMA system on reducing medication errors to improve patient safety; it also compares traditional medication administration with the BCMA system. The review concentrates on the effectiveness of BCMA technology on medication administration errors, and on the accuracy of medication administration. This review also focused on different designs of quantitative studies, as they are more effective at investigating the impact of the intervention than qualitative studies. The findings from this systematic review show various results depending on the nature of the hospital setting. Most of the studies agree that the BCMA system enhances compliance with the 'five rights’' requirement (right drug, right patient, right dose, right time and right route) of medication administration. In addition, BCMA technology identified medication error types that could not be identified with the traditional approach which is applying the 'five rights' of medication administration. The findings of this systematic review also confirm the impact of BCMA system in reducing medication error, preventing adverse events and increasing the accuracy of the medication administration rate. However, BCMA technology did not consistently reduce the overall errors of medication administration. Keyword: Patient Safety, Impact, BCMA, eMAR


2019 ◽  
Vol 4 (2) ◽  
pp. 802-807
Author(s):  
Yetty Machrina ◽  
Kamal Basri Siregar ◽  
Nuraiza Meutia ◽  
Gema Nazri Yanni ◽  
Yunita Sari Pane

The technique of providing basic and quick life support (BHD) and transportation to patients with cardiac and pulmonary arrest can save a patient's life. An ambulance driver as one of the ambulance personnel should be equipped with the two forms of skills above. The aim of community service is to increase the capacity of ambulance drivers in terms of providing basic life support skills and patient transportation to improve patient safety. This training was held in September 2019, at the H. Adam Malik General Hospital Training Center Installation Medan, with 24 participants. The training is carried out with 2 methods, namely exposure to BHD theory and BHD skills training. The knowledge and skills of participants before and after the training were assessed. Pre and post assessment results were analyzed using paired t-test with a significance level of p <0.05 Ambulance drivers in the Medan Tuntung and Medan Sunggal area are mostly over 30 years old, with most working as ambulance drivers for more than 5 years. The most recent level of education is high school graduation or equivalent. The results of statistical analysis using paired t-test, obtained a significant difference in the knowledge of ambulance drivers about basic life support theory before and after training (p = 0.000). Likewise, ambulance driver skills in providing basic life support for adult patients, infants and children were significantly different before and after training (p = 0.000). Training in basic life support skills and patient transportation can increase the capacity of ambulance drivers in providing basic life support..


2021 ◽  
Author(s):  
Maria J Serrano-Ripoll ◽  
Maria A. Fiol-DeRoque ◽  
José M. Valderas ◽  
Rocío Zamanillo-Campos ◽  
Joan Llobera ◽  
...  

BACKGROUND Developing new strategies to support the provision of safer primary care (PC) is a major priority both internationally and in Spain, where around 3 million adverse events occur each year in the PC setting. OBJECTIVE The primary aims of this mixed-methods feasibility study were to examine the feasibility and to explore the acceptability and perceived utility of the SinergiAPS intervention, a novel low-cost and scalable theory-based online intervention to improve patient safety in PC centres, based on the use of patient feedback. The secondary aim was to examine the potential impact of the intervention to improve patient safety culture and avoidable hospitalizations in PC centres. METHODS We conducted a three-month, one-arm, feasibility trial in ten PC centres in Spain. Centres were fed back information regarding patients' experiences of safety (collected through PREOS-PC questionnaire) and were instructed to plan safety improvement actions based on it. We measured recruitment and follow-up rates, and intervention uptake (number of centres registering improvement plans). We explored the impact of the intervention on patient safety culture (MOSPSC questionnaire), and avoidable hospital admissions rate. We conducted semi-structured interviews with nine professionals to explore the acceptability and perceived utility of the intervention. RESULTS Of 256 professionals invited, 120 (47%) accepted to participate and 97 completed baseline and post-intervention measures. Of 780 patients invited, 585 (77%) completed the PREOS-PC questionnaire. Five centres designed 27 improvement actions. Most of the actions addressed treatment-related safety problems and consisted in the provision of training to PC providers. Compared to baseline, post-intervention MOSPSC scores were significantly higher (indicating a higher level of culture) for the safety culture synthetic index (3.36/5 at baseline vs. 3.44/5 at post-intervention (2% increase); p=0.01). No differences (p=0.11) were observed in avoidable admissions rate before (median (IQR)=0.78 (0.7 to 0.9) vs. after the intervention (0.45 (0.33 to 0.83)). The interviews revealed that the intervention was perceived as a novel strategy that could produce long-term safety improvements by raising their awareness and improving their technical knowledge about patient safety. CONCLUSIONS The proposed intervention is feasible to deliver and perceived as acceptable and useful by PC professionals if the barriers identified are addressed. The effectiveness of the refined intervention will be assessed in a trial involving 59 centres. CLINICALTRIAL clinicaltrials.gov NCT03837912


2021 ◽  
Vol 10 (1) ◽  
pp. e001086
Author(s):  
Claire Cushley ◽  
Tom Knight ◽  
Helen Murray ◽  
Lawrence Kidd

Background and problemThe WHO Surgical Safety Checklist has been shown to improve patient safety as well as improving teamwork and communication in theatres. In 2009, it was made a mandatory requirement for all NHS hospitals in England and Wales. The WHO checklist is intended to be adapted to suit local settings and was modified for use in Gloucestershire Hospitals NHS Foundation Trust. In 2018, it was decided to review the use of the adapted WHO checklist and determine whether improvements in compliance and engagement could be achieved.AimThe aim was to achieve 90% compliance and engagement with the WHO Surgical Safety Checklist by April 2019.MethodsIn April 2018, a prospective observational audit and online survey took place. The results showed compliance for the ‘Sign In’ section of the checklist was 55% and for the ‘Time Out’ section was 91%. Engagement by the entire theatre team was measured at 58%. It was proposed to move from a paper checklist to a wall-mounted checklist, to review and refine the items in the checklist and to change the timing of ‘Time Out’ to ensure it was done immediately prior to knife-to-skin.ResultsFollowing its introduction in September 2018, the new wall-mounted checklist was reaudited. Compliance improved to 91% for ‘Sign In’ and to 94% for ‘Time Out’. Engagement by the entire theatre team was achieved 100% of the time. Feedback was collected, adjustments made and the new checklist was rolled out in stages across all theatres. A reaudit in December 2018 showed compliance improved further, to 99% with ‘Sign In’ and to 100% with ‘Time Out’. Engagement was maintained at 100%.ConclusionsThe aim of the project was met and exceeded. Since April 2019, the new checklist is being used across all theatres in the Trust.


2013 ◽  
Vol 2 (3) ◽  
pp. 25 ◽  
Author(s):  
Jane Carthey

The paper summarises previous theories of accident causation, human error, foresight, resilience and system migration. Five lessons from these theories are used as the foundation for a new model which describes how patient safety emerges in complex systems like healthcare: the System Evolution Erosion and Enhancement model. It is concluded that to improve patient safety, healthcare organisations need to understand how system evolution both enhances and erodes patient safety.


2017 ◽  
Vol 22 (03) ◽  
pp. 124-125
Author(s):  
Maria Weiß

Hatch LD. et al. Intervention To Improve Patient Safety During Intubation in the Neonatal Intensive Care Unit. Pediatrics 2016; 138: e20160069 Kinder auf der Neugeborenen-Intensivstation sind besonders durch Komplikationen während des Krankenhausaufenthaltes gefährdet. Dies gilt auch für die Intubation, die relativ häufig mit unerwünschten Ereignissen einhergeht. US-amerikanische Neonatologen haben jetzt untersucht, durch welche Maßnahmen sich die Komplikationsrate bei Intubationen in ihrem Perinatal- Zentrum senken lässt.


2021 ◽  
Author(s):  
Hady Eltayeby ◽  
Catherine Brown ◽  
Brendan T. Campbell ◽  
Craig Bonanni ◽  
Mark Indelicato ◽  
...  

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