scholarly journals PATIENT SAFETY IN THE ADMINISTRATION OF ANTINEOPLASTIC CHEMOTHERAPY AND OF IMMUNOTHERAPICS FOR ONCOLOGICAL TREATMENT: SCOPING REVIEW

2019 ◽  
Vol 28 ◽  
Author(s):  
Patrícia Peres de Oliveira ◽  
Viviane Euzébia Pereira Santos ◽  
Manacés dos Santos Bezerril ◽  
Fernanda Belmiro de Andrade ◽  
Renilly de Melo Paiva ◽  
...  

ABSTRACT Objective: to identify and synthesize the scientific evidence on cancer patient safety in the administration of antineoplastic and immunotherapeutic chemotherapeutic agents. Method: a scoping review, according to the Joanna Briggs Institute and to the recommendations of the PRISMA-ScR international guide. The research was conducted in five electronic databases, the Cochrane Library and eight catalogs of theses and dissertations. The inclusion criteria were the following: studies related to patient safety in the administration of antineoplastic and immunotherapeutic chemotherapy by nurses in places where cancer care occurs, published entirely in Portuguese, Spanish and/or English, with no time limit. The extracted data were analyzed and synthesized in narrative form. Results: a total of 14,444 records were retrieved and 47 studies were kept for review. Most publications (44.7%) had a qualitative approach, while 40.4% were quantitative and 14.9%, mixed. When summarizing the findings, the following themes emerged: Safety standards in parenteral administration of antineoplastic chemotherapy; Good practices for patient safety using oral antineoplastic therapy; Administration and safe handling of immunotherapies; Prevention and management of errors related to the administration of antineoplastic and immunotherapeutic chemotherapeutic agents. Conclusion: patients safety with cancer in the administration of antineoplastic therapy occurs when there is implementation of evidence-based protocols, continuing education of nurses and implementation of safety standards and processes, as a strategy to prevent errors in drug administration.

2020 ◽  
Vol 73 (4) ◽  
Author(s):  
João Marcos Alves Melo ◽  
Patrícia Peres de Oliveira ◽  
Raíssa Silva Souza ◽  
Deborah Franscielle da Fonseca ◽  
Thaís Fonseca Gontijo ◽  
...  

ABSTRACT Objectives: to identify and synthesize scientific evidence on prevention and management of extravasation of antineoplastic agents in adult patients by nurses. Methods: scoping review, according to Joanna Briggs Institute and PRISMA-ScR. Research was conducted in five electronic databases, Cochrane Library and eight catalogs of theses and dissertations. Data collection occurred from April to July 2018, with no time limit. The extracted data were analyzed and synthesized in a narrative way. Results: a total of 3,110 records were retrieved and 18 studies were kept for review. Most publications (66.6%) had a qualitative approach and addressed both aspects, i.e., prevention and management of extravasation of chemotherapy in adult patients. Conclusions: the implementation of protocols based on scientific evidence on prevention and management of extravasation of antineoplastic agents is paramount in order to provide patient safety and support to the nursing staff.


2020 ◽  
Author(s):  
E Blix ◽  
Robyn Maude ◽  
E Hals ◽  
S Kisa ◽  
E Karlsen ◽  
...  

© 2019 Blix et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Intermittent auscultation (IA) is the technique of listening to and counting the fetal heart rate (FHR) for short periods during active labour and continuous cardiotocography (CTC) implies FHR monitoring for longer periods. Although the evidence suggests that IA is the best way to monitor healthy women at low risk of complications, there is no scientific evidence for the ideal device, timing, frequency and duration for IA. We aimed to give an overview of the field, identify and describe methods and practices for performing IA, map the evidence and accuracy for different methods of IA, and identify research gaps. Methods We conducted a systematic scoping review following the Joanna Briggs methodology. Med-line, EMBASE, Cinahl, Maternity & Infant Care, Cochrane Library, SveMed+, Web of Science, Scopus, Lilacs and African Journals Online were searched for publications up to January 2019. We did hand searches in relevant articles and databases. Studies from all countries, international guidelines and national guidelines from Denmark, United Kingdom, United States, New Zealand, Australia, The Netherlands, Sweden, Denmark, and Norway were included. We did quality assessment of the guidelines according to the AGREEMENT tool. We performed a meta-analysis assessing the effects of IA with a Doppler device vs. Pinard device using methods described in The Cochrane Handbook, and we performed an overall assessment of the summary of evidence using the GRADE approach. Results The searches generated 6408 hits of which 26 studies and 11 guidelines were included in the review. The studies described slightly different techniques for performing IA, and some did not provide detailed descriptions. Few of the studies provided details of normal and abnormal IA findings. All 11 guidelines recommended IA for low risk women, although they had slightly different recommendations on the frequency, timing, and duration for IA, and the FHR characteristics that should be observed. Four of the included studies, comprising 8436 women and their babies, were randomised controlled trials that evaluated the effect of IA with a Doppler device vs. a Pinard device. Abnormal FHRs were detected more often using the Doppler device than in those using the Pinard device (risk ratio 1.77; 95% confidence interval 1.29–2.43). There were no significant differences in any of the other maternal or neonatal outcomes. Four studies assessed the accuracy of IA findings. Normal FHR was easiest to identify correctly, whereas identifying periodic FHR patterns such as decelerations and saltatory patterns were more difficult. Conclusion Although IA is the recommended method, no trials have been published that evaluate protocols on how to perform it. Nor has any study assessed interrater agreements regarding interpretations of IA findings, and few have assessed to what degree clinicians can describe FHR patterns detected by IA. We found no evidence to recommend Doppler device instead of the Pinard for IA, or vice versa.


2019 ◽  
Author(s):  
Aislinn Conway ◽  
Jessica Reszel ◽  
Mark C Walker ◽  
Jeremy M Grimshaw ◽  
Sandra I Dunn

Introduction: Optimizing the safety of obstetric patient care is a primary concern for many hospitals. Identifying performance indicators that measure aspects of patient care processes related to preventable harms can present opportunities to improve health systems. In this paper, we present our protocol for a scoping review to identify performance indicators for obstetric safety. We aim to identify a comprehensive list of obstetric safety indicators which may help reduce the number of preventable patient harms, to summarize the data and to synthesize the results. Methods and analysis: We will use the methodological framework described by Arksey and O Malley and further expanded by Levac. We will search multiple electronic databases such as Medline, Embase, CINAHL and the Cochrane Library as well as websites from professional bodies and other organisations, using an iterative search strategy. We will include indicators that relate to preventable harms in the process of obstetric care. Two reviewers will independently screen titles and abstracts of search results to determine eligibility for inclusion. For records where eligibility is not clear, the reviewers will screen the full text version. If reviewers decisions regarding eligibility differ, a third reviewer will review the full text record. Two reviewers will independently extract data from records that meet our inclusion criteria using a standardized data collection form. We will narratively describe quantitative data, such as the frequency with which indicators are identified, and conduct a thematic analysis of the qualitative data. We will compile a comprehensive list of patient safety indicators identified during our scoping review and organise them according to concepts that best suit the data such as the Donabedian model or the Hospital Harm Framework. We will discuss the implications of the indicators for future research, clinical practice and policy making. We will report the conduct of the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA ScR) Checklist. Ethics and Dissemination: The sources of information included in this scoping review will be available to the public. Therefore, ethical review for this research is not warranted. We will disseminate our research results using multiple modes of delivery such as a peer-reviewed publication, conference presentations and stakeholder communications. Keywords: Obstetrics, patient safety, performance indicators, prevention, hospital harms, scoping review, protocol.


2020 ◽  
Vol 19 (4) ◽  
pp. 525-572
Author(s):  
Madalena Canellas ◽  
Isabel Palma ◽  
Patrícia Pontífice-Sousa ◽  
Isabel Rabiais

Transportar a un paciente crítico conlleva una serie de riesgos que pueden poner en peligro su seguridad. Conocer los riesgos asociados con el transporte intrahospitalario es esencial para mejorar su seguridad. Elegimos estudiar la lista de verificación de transporte intrahospitalario, ya que la literatura los describe como una forma práctica y simple de aumentar la seguridad.Objetivo: Mapear la envidencia científica existente sobre los aspectos del check list o lista de verificación garantizando la seguridad del paciente crítico en el transporte intrahospitalario. Material y método: Se realizó un scoping review através de la metodologia The Joanna Briggs Institute, utilizando los motores de búsqueda EBSCOhost y B-on. La investigación fue realizada en portugués, inglés y español. Fueron seleccionados artículos con texto libre, sin límite de tiempo. Los criterios incluídos: el paciente crítico adulto/anciano, transporte intrahospitalario, la lista de verificación y la seguridad del paciente.Resultados: Se incluyeron 7 artículos. La mayoría de los aspectos de la lista de verificación se enfoca en la preparación del transporte, el aspecto que más se menciona es la monitorización del paciente. La parte después del transporte, aspectos de la lista de verificación solo es mencionada en 3 de los 7 artículos.Conclusión: Todos los estudios constatan aspectos que pueden incluírse en una lista de verificación y que mejoran la seguridad de los pacientes críticos en el transporte intrahospitalario. No hay unanimidad en cuanto a qué aspectos incluir en la lista de verificación. Transporting critically ill patients is has a set of risks that may jeopardize their safety. Knowing the risks associated with intrahospitalar transport of critically ill patients is essential to improving patient safety. For the sake of improving patient safety, was chosen to approach it as an intrahospitalar transport checklist, as the literature describes it as a practical and simple way to increase safety.Objective: Map available scientific evidence regarding aspects of a checklist that ensure the safety of critically ill patients in intrahospitalar transport.Material and Method: A scoping review was performed following the methodology proposed by The Joanna Briggs Institute in databases using the EBSCOhost and B-on search engines. Conducted research in Portuguese, English, and Spanish. Selected free full text articles, with no time limit. Inclusion criteria: adult/elderly critically ill patient, intrahospital transport, a checklist and patient safety.Results: Included 7 articles for analysis. Most verification requests that ensure the safety of critical patients on intrahospitalar transport concern the transport preparation phase, in which patient is monitored was the most mentioned aspect. From the post-transportation phase, checklist aspects are only available in 3 of 7 articles Conclusion: All studies address aspects that improve the safety of critically ill patients in intrahospitalar transport and are likely to be included in the checklist. There is no unanimity as to which aspects to include in the checklist. O transporte do doente crítico acarreta um conjunto de riscos para a sua segurança. Conhecer os riscos associados ao transporte intra-hospitalar do doente crítico é essencial para melhorar a segurança do mesmo. Optou-se por abordar a checklist de transporte intra-hospitalar, uma vez que a literatura a descreve como uma forma prática e simples de aumentar a segurança.Objetivo: Mapear a evidência científica disponível referente aos aspetos de uma checklist que garantem a segurança do doente crítico no transporte intra-hospitalar.Material e Método: Realizou-se uma scoping review recorrendo à metodologia do The Joanna Briggs Institute, nas bases de dados utilizando os motores de busca EBSCOhost e B-on. Realizada pesquisa em Português, Inglês e Espanhol. Selecionados artigos free full text, sem limite temporal. Critérios de inclusão: o doente crítico adulto/idoso, o transporte intra-hospitalar, a checklist e a segurança do doente.Resultados: Foram incluídos 7 artigos. A maioria dos aspetos da checklist que garantem a segurança do doente crítico no transporte intra-hospitalar, dizem respeito à fase da preparação do transporte, na qual o aspeto mais mencionado é a monitorização do doente. Da fase posterior ao transporte, aspetos da checklist apenas são mencionados em 3 dos 7 artigos.Conclusão: Todos os estudos abordam aspetos que são passíveis de incluir em checklist e melhoram a segurança do doente. Não existe unanimidade quanto aos aspetos a incluir na checklist do transporte intra-hospitalar.


2020 ◽  
Author(s):  
E Blix ◽  
Robyn Maude ◽  
E Hals ◽  
S Kisa ◽  
E Karlsen ◽  
...  

© 2019 Blix et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Intermittent auscultation (IA) is the technique of listening to and counting the fetal heart rate (FHR) for short periods during active labour and continuous cardiotocography (CTC) implies FHR monitoring for longer periods. Although the evidence suggests that IA is the best way to monitor healthy women at low risk of complications, there is no scientific evidence for the ideal device, timing, frequency and duration for IA. We aimed to give an overview of the field, identify and describe methods and practices for performing IA, map the evidence and accuracy for different methods of IA, and identify research gaps. Methods We conducted a systematic scoping review following the Joanna Briggs methodology. Med-line, EMBASE, Cinahl, Maternity & Infant Care, Cochrane Library, SveMed+, Web of Science, Scopus, Lilacs and African Journals Online were searched for publications up to January 2019. We did hand searches in relevant articles and databases. Studies from all countries, international guidelines and national guidelines from Denmark, United Kingdom, United States, New Zealand, Australia, The Netherlands, Sweden, Denmark, and Norway were included. We did quality assessment of the guidelines according to the AGREEMENT tool. We performed a meta-analysis assessing the effects of IA with a Doppler device vs. Pinard device using methods described in The Cochrane Handbook, and we performed an overall assessment of the summary of evidence using the GRADE approach. Results The searches generated 6408 hits of which 26 studies and 11 guidelines were included in the review. The studies described slightly different techniques for performing IA, and some did not provide detailed descriptions. Few of the studies provided details of normal and abnormal IA findings. All 11 guidelines recommended IA for low risk women, although they had slightly different recommendations on the frequency, timing, and duration for IA, and the FHR characteristics that should be observed. Four of the included studies, comprising 8436 women and their babies, were randomised controlled trials that evaluated the effect of IA with a Doppler device vs. a Pinard device. Abnormal FHRs were detected more often using the Doppler device than in those using the Pinard device (risk ratio 1.77; 95% confidence interval 1.29–2.43). There were no significant differences in any of the other maternal or neonatal outcomes. Four studies assessed the accuracy of IA findings. Normal FHR was easiest to identify correctly, whereas identifying periodic FHR patterns such as decelerations and saltatory patterns were more difficult. Conclusion Although IA is the recommended method, no trials have been published that evaluate protocols on how to perform it. Nor has any study assessed interrater agreements regarding interpretations of IA findings, and few have assessed to what degree clinicians can describe FHR patterns detected by IA. We found no evidence to recommend Doppler device instead of the Pinard for IA, or vice versa.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Doris Yimgang ◽  
Georges Danhoundo ◽  
Elizabeth Kusi-Appiah ◽  
Vijit Sunder ◽  
Sandra Campbell ◽  
...  

Abstract Background Improving evidence-informed policy dialogue to support the development and implementation of national health policies is vital, but there is limited evidence on researchers’ roles in policy dialogue processes in Africa. The objective of this study is to examine researchers’ involvement in health policy dialogue in Africa. Methods The database search of this scoping review was conducted from inception to January 24, 2021, by an expert searcher/librarian to determine the extent of evidence, barriers, and facilitators of researchers’ involvement in health policy dialogues in Africa. PROSPERO, Wiley Cochrane Library, OVID Medline, OVID EMBASE, OVID PsycINFO, OVID Global Health, EBSCO CINAHL, BASE (Bielefeld Academic Search Engine), and Google/Google Scholar were searched using key words representing the concepts “policy dialogue”, “health”, and “Africa”. No limits were applied. A narrative summary of results was presented. Results There were 26 eligible studies representing 21 African countries. Significant discrepancies in researchers’ involvement existed across countries. In 62% of the countries, there was suboptimal involvement of researchers in policy dialogues due to no or partial participation in policy dialogues. Major barriers included limited funding, lack of evidence in the public health field of interest, and skepticism of policymakers. The presence of an interface for exchange, demand for scientific evidence, and donors’ funding were the most reported facilitators. Conclusions To improve the uptake of evidence in health policy-making processes, an environment of trust and communication between policymakers and researchers must be established. Policymakers need to demonstrate that they value research, by providing adequate funding, promoting knowledge translation activities, and supporting personal and professional development opportunities for researchers.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049873
Author(s):  
Adel Alabdaly ◽  
Deborah Debono ◽  
Reece Hinchcliff ◽  
Su-yin Hor

IntroductionHospitals commonly examine patient safety culture and other quality indicators to evaluate and improve performance in relation to quality and safety. A growing body of research has separately examined relationships between patient safety culture and patient experience on clinical outcomes and other quality indicators. However, there is a knowledge gap regarding the relationship between these two important domains. This article describes the protocol for a scoping review of published literature examining the relationship between patient safety culture and patient experience in hospital settings. The scoping review will provide an overview of research into the relationship between patient safety culture and patient experience in hospital contexts, map key concepts underpinning these domains and identify research gaps for further study.Methods and analysisThe scoping review will be conducted using the five stages of Arksey and O’Malley’s framework: identify the research question; identify relevant studies; study selection; chart data; and collate, summarise and report the results. The inclusion criteria will be applied using the Population, Concept and Context Framework. Searches will be conducted in the CINAHL, Cochrane Library, ProQuest, MEDLINE, PsycINFO, Scopus and SciELO databases, without applying date range limits. Hand-searching of grey literature will also be performed to find relevant, non-indexed literature. Data will be extracted using a standardised data extraction form developed by the Joanna Briggs Institute. Both descriptive and thematic analyses will be undertaken to scope key concepts within the body of reviewed literature.Ethics and disseminationThis type of study does not require an ethics review. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.


Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 429
Author(s):  
Julian Hipp ◽  
Blin Nagavci ◽  
Claudia Schmoor ◽  
Joerg Meerpohl ◽  
Jens Hoeppner ◽  
...  

Background: A substantial fraction of patients with esophageal cancer show post-neoadjuvant pathological complete response (pCR). Principal esophagectomy after neoadjuvant treatment is the standard of care for all patients, although surveillance and surgery as needed in case of local recurrence may be a treatment alternative for patients with complete response (CR). Methods: We performed a scoping review to describe key characteristics of relevant clinical studies including adults with non-metastatic esophageal cancer receiving multimodal treatment. Until September 2020, relevant studies were identified through systematic searches in the bibliographic databases Medline, Web of Science, Cochrane Library, Science Direct, ClinicalTrials, the German study register, and the WHO registry platform. Results: In total, three completed randomized controlled trials (RCTs, with 468 participants), three planned/ongoing RCTs (with a planned sample size of 752 participants), one non-randomized controlled study (NRS, with 53 participants), ten retrospective cohort studies (with 2228 participants), and one survey on patients’ preferences (with 100 participants) were identified. All studies applied neoadjuvant chemoradiation protocols. None of the studies examined neoadjuvant chemotherapeutic protocols. Studies investigated patient populations with esophageal squamous cell carcinoma, adenocarcinoma, and mixed cohorts. Important outcomes reported were overall, disease-free and local recurrence-free survival. Limitations of the currently available study pool include heterogeneous chemoradiation protocols, a lack of modern neoadjuvant treatment protocols in RCTs, short follow-up times, the use of heterogeneous diagnostic methods, and different definitions of clinical CR. Conclusion: Although post-neoadjuvant surveillance and surgery as needed compared with post-neoadjuvant surgery on principle has been investigated within different study designs, the currently available results are based on a wide variation of diagnostic tools to identify patients with pCR, short follow-up times, small sample sizes, and variations in therapeutic procedures. A thoroughly planned RCT considering the limitations in the currently available literature will be of great importance to provide patients with CR with the best and less harmful treatment.


Pain Medicine ◽  
2021 ◽  
Author(s):  
Daly Geagea ◽  
Zephanie Tyack ◽  
Roy Kimble ◽  
Lars Eriksson ◽  
Vince Polito ◽  
...  

Abstract Objective Inadequately treated pain and distress elicited by medical procedures can put children at higher risks of acute and chronic biopsychosocial sequelae. Children can benefit from hypnotherapy, a psychological tailored intervention, as an adjunct to pharmacological agents to address the multiple components of pain and distress. Despite providing evidence on the effectiveness and potential superiority of hypnotherapy to other psychological interventions, research on hypnotherapy for paediatric procedural pain and distress has been predominantly limited to oncology and needle procedures. Plus, there is a lack of reporting of intervention manuals, factors influencing hypnotic responding, pain unpleasantness outcomes, theoretical frameworks, adverse events, as well as barriers and facilitators to the feasibility of delivering the intervention and study procedures. The proposed review aims to map the range and nature of the evidence on hypnotherapy for procedural pain and distress in children to identify gaps in literature and areas requiring further investigation. Methods This review will follow the Arksey and O'Malley (2005) methodology and incorporate additional scoping review recommendations by The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses. Relevant studies will be identified through searching published literature databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus and Web of Science) and grey literature in addition to hand-searching of reference lists and key journals. Two authors will independently screen titles and abstracts of search results followed by full-texts review against eligibility criteria. Conclusion Findings are anticipated to guide future research and inform the development of tailored hypnotic interventions in children.


2021 ◽  
Vol 10 (1) ◽  
Author(s):  
M. F. Van den Bosch ◽  
C. M. Wiepjes ◽  
M. Den Heijer ◽  
L. J. Schoonmade ◽  
R. E. G. Jonkman ◽  
...  

Abstract Background Gender-affirming hormone (GAH) therapy aims to support the transition of transgender people to their gender identity. GAHs can induce changes in their secondary sex characteristics such as the development of breasts in transgender females and increased muscle mass in transgender males. The face and its surrounding tissues also have an important role in gender confirmation. The aim of this scoping review is to systematically map the available evidence in order to provide an overview of the effects of GAH therapy on the hard and soft tissues of the craniofacial complex in transgender people. Methods/design The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) extension for Scoping Reviews was consulted for reporting this protocol. The methods were based on the Arksey and O’Malley’s framework and the Reviewer’s Manual of the Joanna Briggs Institute for conducting scoping reviews. Ten transgender people were involved in the development of the primary research question through short interviews. The eligibility criteria were defined for transgender people undergoing GAH therapy and for quantitative and qualitative outcomes on the hard and soft tissues of the craniofacial complex. Eligible sources of evidence include observational, experimental, qualitative, and mixed method studies. No exclusion criteria will be applied for the language of publication and the setting. To identify eligible sources of evidence, we will conduct searches from inception onwards in PubMed, Embase.com, the Cochrane Library, Web of Science Core Collection, Scopus, CINAHL, LIVIVO, and various grey literature sources such as Google Scholar. Two reviewers will independently select eligible studies in these information sources and will subsequently conduct data extraction. The same operators will chart, categorize, and summarize the extracted data. A narrative summary of findings will be conducted. Frequency counts of quantitative and qualitative data on items such as concepts, populations, interventions, and other characteristics of the eligible sources will be given. Where possible, these items will be mapped descriptively. Discussion We chose the scoping review over the systematic review approach, because the research questions are broad-spectrum and the literature is expected to be widely scattered. No systematic review has previously assessed this topic. Identifying knowledge gaps in this area and summarizing and disseminating research findings are important for a wide spectrum of stakeholders, in particular, for transgender people who want to undergo additional interventions such as plastic or orthognathic surgery or orthodontics. Systematic review registration This protocol was registered in the Open Science Framework: https://osf.io/e3qj6


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