scholarly journals Interruptions of nurses' activities and patient safety: an integrative literature review

2015 ◽  
Vol 23 (1) ◽  
pp. 169-179 ◽  
Author(s):  
Cintia Monteiro ◽  
Ariane Ferreira Machado Avelar ◽  
Mavilde da Luz Gonçalves Pedreira

OBJECTIVES: to identify characteristics related to the interruption of nurses in professional practice, as well as to assess the implications of interruptions for patient safety.METHOD: integrative literature review. The following databases were searched: Pubmed/Medline, LILACS, SciELO and Cochrane Library, using the descriptors interruptions and patient safety. An initial date was not established, but the final date was December 31, 2013. A total of 29 papers met the inclusion criteria.RESULTS: all the papers included describe interruptions as a harmful factor for patient safety. Data analysis revealed three relevant categories: characteristics of interruptions, implications for patient safety, and interventions to minimize interruptions.CONCLUSION: interruptions favor the occurrence of errors in the health field. Therefore, there is a need for further studies to understand such a phenomenon and its effects on clinical practice.

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 82
Author(s):  
Magdalena Hoffmann ◽  
Christine Maria Schwarz ◽  
Stefan Fürst ◽  
Christina Starchl ◽  
Elisabeth Lobmeyr ◽  
...  

Critically ill patients in the intensive care unit (ICU) have a high risk of developing malnutrition, and this is associated with poorer clinical outcomes. In clinical practice, nutrition, including enteral nutrition (EN), is often not prioritized. Resulting from this, risks and safety issues for patients and healthcare professionals can emerge. The aim of this literature review, inspired by the Rapid Review Guidebook by Dobbins, 2017, was to identify risks and safety issues for patient safety in the management of EN in critically ill patients in the ICU. Three databases were used to identify studies between 2009 and 2020. We assessed 3495 studies for eligibility and included 62 in our narrative synthesis. Several risks and problems were identified: No use of clinical assessment or screening nutrition assessment, inadequate tube management, missing energy target, missing a nutritionist, bad hygiene and handling, wrong time management and speed, nutritional interruptions, wrong body position, gastrointestinal complication and infections, missing or not using guidelines, understaffing, and lack of education. Raising awareness of these risks is a central aspect in patient safety in ICU. Clinical experts can use a checklist with 12 identified top risks and the recommendations drawn up to carry out their own risk analysis in clinical practice.


Author(s):  
Salvatore Gentile

Abstract Background It has been recently suggested that second-generation antipsychotic long-acting injection (SGA-LAIs) are underutilized in clinical practice, despite that their costs significantly impact on national health system budgets. Hence, an updated analysis of safety data shown by SGA-LAIs may contribute to clarify their role in clinical practice. Materials and methods English-language, peer-reviewed articles reporting updated, primary findings on the SGA-LAI safety were identified (updated through an electronic search of five databases – PubMed, EMBASE, PsycInfo, DARE and the Cochrane Library). Results The articles reviewed suggest that the most frequent treatment emergent adverse events (TEAEs) associated with aripiprazole long-acting injection (ARI-LAI) are psychotic symptoms, extrapyramidal symptoms (EPS) and weight gain. Data on olanzapine long-acting injection (OLA-LAI)-associated TEAEs highlight the risk of psychosis, metabolic disturbances and hyperprolactinemia. Four-hundred and forty cases of post-injection delirium/sedation syndrome (PDSS) have also been recorded. Although not reported in reviewed studies, the risk of impulse-control problem and drug reaction with eosinophilia and systemic symptoms (DRESS) ARI- and OLA-associated, respectively, must not be underestimated. With regards paliperidone palmitate 1-month formulation (PP1), the high incidence of clinically relevant weight gain and hyperprolactinemia are both findings of concern. Reviewed data also confirm that the leading cause of death in risperidone long-acting injection (RIS-LAI) clinical trials is suicide. The new 3-month paliperidone palmitate formulation, risperidone sustained release 1-month formulation (RIS-SR1), aripiprazole lauroxil (ARI-LXL) are still lacking exhaustive safety data. Conclusion The risk of specific TEAEs associated with all SGA-LAIs confirms SGA-LAIs do not offer advantages in safety compared with FGA-LAIs or oral antipsychotics and, especially, in early-phase schizophrenia patients. Implementing non pharmacological intervention and strategies can be effective for people with schizophrenia and bipolar disorder who adhere poorly to medication regimens.


2022 ◽  
Vol 75 (suppl 1) ◽  
Author(s):  
Cristina Tavares de Aguiar Avilar ◽  
Ítala Maria Araújo Andrade ◽  
Cawana da Silva do Nascimento ◽  
Larissa Vanessa Machado Viana ◽  
Thatiana Lameira Maciel Amaral ◽  
...  

ABSTRACT Objective: to identify the main nursing care procedures for performing bed bath in patients with COVID-19. Method: an integrative literature review. Five stages were followed for this research: research question elaboration (identification of the problem), search of studies in literature, study assessment, data analysis, and presentation of review. To search for primary studies, the VHL and SciELO databases were selected. Results: initially, 55 publications were found. After reading and analyzing the abstracts, the sample consisted of 15 studies. Conclusion: patients with the new coronavirus have specific care to perform a bed bath, oral, intimate and skin hygiene. It is important that professionals use adequate personal protective equipment, perform humanized care, continuously observing patients’ vital signs to avoid occurrence of adverse events, promoting patient safety.


2019 ◽  
Vol 02 (02) ◽  
pp. 098-099
Author(s):  
Blasco Bonora PM ◽  
Seoane Pardo R. ◽  
Sánchez Lorenzo M.

Abstract Background and Aims The use of ultrasound in physiotherapy helps to increase the precision and effectiveness of different techniques and provide a more objective assessment. Standardized clinical practice guidelines are needed to enable an appropriate reproducibility. The aims of this study were to perform a literature review to identify studies using ultrasound for the assessment of peroneal muscles. Also, to establish whether reliable and reproducible assessment protocols exist, and analyze these protocols to determine both reliability as well as methodology. Material and Methods A literature search was performed in PubMed, Cochrane Library, PEDro and ScienceDirect databases over the last 10 years (2009-2018). The descriptors "Ultrasonography" and "Peroneus Muscle" were used, restricting the search to publications in English and Spanish for studies performed in humans.The two main researchers revised the results and selected those that were most relevant. The data were then extracted individually and blindly. The third researcher shared the data obtained, verifying the exactness of the same and commenting the differences. There were no disagreements. Results Initially, 92 studies were retrieved. After the analysis of the title, abstract and full-text (when necessary), 12 studies were selected for the analysis. Seven studies used ultrasound in B mode. In total, 10 morphometric descriptors were identified. Eight descriptors presented a very good reliability (CCI >90) and two descriptors had good reliability (CCI 0.71-0.90). Of the measurements performed in the cross-sectional plane, the cross-sectional area (CSA) and circular perimeter (CP) demonstrated a CCI >90 both in the analysis of the peroneus longus as well as the peroneus brevis, jointly or individually. The measurements of the CSA and CP demonstrated a CCI between 0.71-0.90 when these were performed upon the connective tissue of these muscles. The measurement of the anterior-posterior thickness presented a CCI >90. In the longitudinal plane, the measurement of muscle thickness presented a CCI >90. Five studies employed elastography to analyze muscle stiffness using Shear Wave Elastography and providing very good CCI results (>0.90) or good results (0.71-0.90) in peroneus muscles. Only one study reported a moderate CCI (0.51-0.70) for the measurement of the peroneus brevis. Sufficient data were obtained to perform a standardized measurement protocol based on good or very good reliability criteria. Conclusions It is possible to perform a sonographic exploration with reliability and reproducibility in the peroneal muscles for descriptors in B mode. Although some studies analyzed echogenicity, the authors recognized that this technique depends on the echographer and the operator and values of reliability are not reported. Although shear wave elastography has demonstrated to be reproducible, with moderate to good reliability, further studies are required to enable an objective interpretation of these results in clinical practice.


2020 ◽  
Author(s):  
Bintang Marsondang Rambe

Latar Belakang Keselamatan pasien (patient safety) rumah sakit adalah suatu sistem dimana rumah sakit membuat asuhan pasien lebih aman yang meliputi assessment risiko, identifikasi dan pengelolaan hal yang berhubungan dengan risiko pasien, pelaporan dan analisis insiden, kemampuan belajar dari insiden dan tindak lanjutnya serta implementasi solusi untuk meminimalkan timbulnya risiko dan mencegah terjadinya cedera yang disebabkan oleh kesalahan akibat melaksanakan suatu tindakan atau tidak mengambil tindakan yang seharusnya diambil yang dilakukan oleh perawat (Kemenkes, 2011).Salah satu kesalahan yang dapat merugikan pasien adalah medication error. Menurut WHO (2016) medication error adalah setiap kejadian yang dapat dicegah yang menyebabkan penggunaan obat yang tidak tepat yang menyebabkan bahaya kepasien, dimana obat berada dalam kendali profesional perawatan kesehatan. proses terjadi medication error dimulai dari tahap prescribing, transcribing, dispensing,dan administration. Kesalahan peresepan (prescribing error), kesalahan penerjemahan resep (transcribing erorr), kesalahan menyiapkan dan meracik obat (dispensing erorr), dan kesalahan penyerahan obat kepada pasien (administration error). Medication error yang paling sering terjadi adalah pada fase administration / pemberian obat yang dilakukan oleh perawat.Administration error terjadi ketika pemberian obat kepada pasien tidak sesuai dengan prinsip enam benar yaitu benar obat, benar pasien, benar dosis, benar rute pemberian, benar waktu pemberian dan benar pendokumentasian. Secara global, kesalahan pemberian obat (medication errors) sampai saat ini masih menjadi isu keselamatan pasien dan kualitas pelayanan di beberapa rumah sakit (Depkes RI, 2015; AHRQ, 2015). Perawat sebagai bagian terbesar dari tenaga kesehatan di rumah sakit, mempunyai peranan dalam kejadian medication error. Perawat berkontribusi karena perawat banyak berperan dalam proses pemberian obat. Pemberian obat/ Medication Administration adalah salah satu intervensi keperawatan yang paling banyak dilakukan, dengan sekitar 5- 20% waktu perawat dialokasikan untuk kegiatan ini (Härkänen et al.,, 2019). Pemberian obat juga mencakup tugas-tugas lain, seperti menyiapkan dan memeriksa obat obatan, memantau efek obat-obatan, mengedukasi pasien tentang pengobatan, dan memperdalam pengetahuan perawat tentang obat – obatan sendiri (DrachZahavy et al., 2014 dalam Yulianti et al., 2019)Berdasarkan isu tersebut, penulis tertarik untuk melakukan literature review terkait faktor perawat dalam pelaksanakan keselamatan pasien terhadap kejadian medication administration error di Rumah Sakit.


Author(s):  
Sachin Bagali ◽  
Umapati Baragi ◽  
M. R. Sajjanshetti

In the present day scenario prime need of Ayurveda is practical applicability of Ayurvedic fundamental principles and research should be more focused on all aspects where scientific inputs should confirm Ayurveda’s principles and philosophy. In Ayurveda, Gunas are described as the way of presentation of action without which no Karma (action) can be possible. Ayurveda has provided significance to every Guna so that they become useful in clinical practice. Clinical practice or research is a continuous process including a series of events which need to be performed in a sequential manner. Though there are many factors on which accomplishment of treatment depends, among these Charaka has given prime importance to Paradi Gunas. In clinical practice, Guna which are to be with Bhishak are mainly the Paradi Gunas which can also be called as miscellaneous Gunas. As rightly quoted by Acarya Charaka, for getting success in the treatment Paradi Gunas are the best. The Sutra quotes "Sidhyupaya Chikitsayam" which means that Chikitsa i.e. Dhatusamya will be done mainly with the help of Paradi Gunas. Knowledge of Paradi Gunas are required to be present in pharmacists, physicians and Researchers. Acharya Charaka says that Chikitsa Siddhi i.e. successful management of disease is not possible without the knowledge of Paradi Gunas. Paradi Gunas play an important role in selection, adaption and manifestation of drug as per condition of the disease and the patient in particular Desha and Kala. The ultimate goal of any clinical activity is to contribute in the knowledge domain and to improve professional practice. Thus this literary review of Paradi Gunas serves to explore the subject of the clinical practice.


2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Huai Leng Pisaniello ◽  
Mark C. Fisher ◽  
Hamish Farquhar ◽  
Ana Beatriz Vargas-Santos ◽  
Catherine L. Hill ◽  
...  

AbstractGout flare prophylaxis and therapy use in people with underlying chronic kidney disease (CKD) is challenging, given limited treatment options and risk of worsening renal function with inappropriate treatment dosing. This literature review aimed to describe the current literature on the efficacy and safety of gout flare prophylaxis and therapy use in people with CKD stages 3–5. A literature search via PubMed, the Cochrane Library, and EMBASE was performed from 1 January 1959 to 31 January 2018. Inclusion criteria were studies with people with gout and renal impairment (i.e. estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl) < 60 ml/min/1.73 m2), and with exposure to colchicine, interleukin-1 inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), and glucocorticoids. All study designs were included. A total of 33 studies with efficacy and/or safety analysis stratified by renal function were reviewed—colchicine (n = 20), anakinra (n = 7), canakinumab (n = 1), NSAIDs (n = 3), and glucocorticoids (n = 2). A total of 58 studies reported these primary outcomes without renal function stratification—colchicine (n = 29), anakinra (n = 10), canakinumab (n = 6), rilonacept (n = 2), NSAIDs (n = 1), and glucocorticoids (n = 10). Most clinical trials excluded study participants with severe CKD (i.e. eGFR or CrCl of < 30 mL/min/1.73 m2). Information on the efficacy and safety outcomes of gout flare prophylaxis and therapy use stratified by renal function is lacking. Clinical trial results cannot be extrapolated for those with advanced CKD. Where possible, current and future gout flare studies should include patients with CKD and with study outcomes reported based on renal function and using standardised gout flare definition.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aline Bourdin ◽  
Marie Paule Schneider ◽  
Isabella Locatelli ◽  
Myriam Schluep ◽  
Olivier Bugnon ◽  
...  

AbstractThe Fingolimod Patient Support Program (F-PSP) is an interprofessional specialty pharmacy service designed to ensure responsible use of fingolimod by promoting patient safety and medication adherence. This study aims to evaluate the safety and medication adherence of patients who joined the F-PSP between 2013 and 2016. Sociodemographic and medical characteristics, patient safety data (patient-reported symptoms, discontinuations due to adverse events (AEs), repeated first-dose monitoring), and medication adherence (implementation, persistence, reasons for discontinuation, influence of covariates, barriers and facilitators) were described. Sixty-seven patients joined the F-PSP. Patients reported a high frequency of symptoms. Due to AEs, 7 patients discontinued fingolimod, 3 took therapeutic breaks, and 1 reduced the regimen temporarily. Three patients repeated the first-dose monitoring. Patients had a high medication adherence over the 18-month analysis period: implementation decreased from 98.8 to 93.7%, and fingolimod persistence was 83.2% at 18 months. The patients’ level of education, professional situation, and living with child(ren) influenced implementation. Patients reported more facilitators of medication adherence than barriers. The F-PSP seems valuable for supporting individual patients (ensuring responsible use of fingolimod and inviting patients for shared-decision making) and public health (indirectly gathering real-world evidence).


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