scholarly journals Implementing an intervention to improve adverse incident reporting in the hospital setting: A pilot study

2020 ◽  
Author(s):  
Naomi Akiyama ◽  
Keisuke Koeda ◽  
Ryuji Uozumi ◽  
Fumiaki Takahashi ◽  
Kuniaki Ogasawara
Keyword(s):  
Pilot Study ◽  
Hospital Setting ◽  
Incident Reporting ◽  
University Hospital ◽  
Exact Test ◽  
Hospital Administrators ◽  
Staff Members ◽  
Adverse Incident ◽  
Incident Reports ◽  
Reporting Rates

Abstract Objective: This pilot study evaluated an intervention designed to increase error reporting among physicians. Research was conducted at University Hospital A, where data were collected from April 2017 to March 2019. The intervention began in April 2018 and consisted of the four following steps: define reporting standards, improve the incident reporting system, have the hospital administrators set clear goals and begin a visualized feedback process, and achieve support and appropriate feedback from the hospital administrator. Results: Physicians’ reporting rates were higher in FY 2018 than 2017. Particularly, differences began to occur in November of FY 2018 (p < 0.05, analysed using Fisher’s exact test). Further, the number of reports submitted by non-physicians increased by 900 in FY 2018 compared to those in FY 2017. Based on these results, the intervention effectively increased incident reporting rates among not only physicians, but also other staff members. In this regard, reporting barriers were broken when hospital administrators encouraged employees to submit incident reports.

scholarly journals Implementing an Intervention to Improve Adverse Incident Reporting in the Hospital Setting: A Pilot Study

2020 ◽  
Author(s):  
Naomi Akiyama ◽  
Keisuke Koeda ◽  
Ryuji Uozumi ◽  
Fumiaki Takahashi ◽  
Kuniaki Ogasawara
Keyword(s):  
Pilot Study ◽  
Improve Patient Safety ◽  
Hospital Setting ◽  
Incident Reporting ◽  
Near Miss ◽  
University Hospital ◽  
Reporting Standards ◽  
Exact Test ◽  
Hospital Administrators ◽  
Reporting Rates

Abstract BackgroundTo improve patient safety, it is needed to collect information related to adverse events and near-miss reports. This practice constitutes one of the strategies hospital managers use to understand the kinds of errors that occur at their hospitals. This pilot study aimed to evaluate an intervention designed to improve error reporting rates among physicians. MethodsThe study was conducted at University Hospital A, where data were collected from April 2017 to March 2019. The intervention began in April 2018 and consisted of the four following steps: defining reporting standards, improving the incident reporting system, having the hospital administrators set clear goals and beginning a visualized feedback process, and achieving support and appropriate feedback as a leadership resource from the hospital administrator. ResultsPhysicians’ reporting rates were higher in FY 2018 than 2017. Particularly, differences began to occur in November of FY 2018 (p < 0.05, analyzed using Fisher’s exact test). Further, the number of reports submitted by non-physicians increased by 900 in FY 2018 compared to those in FY 2017. Physicians tend to underreport minor incidents, but reports of near-miss events increased from 16 in FY 2017 to 106 in FY 2018. Reporting standards were focused on severe cases, but they had related treatment/procedure and drug, so that not only error cases but also near-miss cases were reported. Based on these results, the intervention effectively increased incident reporting rates among not only physicians, but also other staff members. In this regard, reporting barriers were broken when hospital administrators encouraged employees to submit incident reports.ConclusionsActive intervention of hospital administrators, the executive class of the hospital, may encourage employees to submit incident reports, thus effectively removing reporting barriers.

scholarly journals Drivers of healthy eating in a workplace in Nepal: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e031404
Author(s):  
Dipesh Tamrakar ◽  
Archana Shrestha ◽  
Anjana Rai ◽  
Biraj Man Karmacharya ◽  
Vasanti Malik ◽  
...  
Keyword(s):  
Focus Group ◽  
Qualitative Study ◽  
Healthy Eating ◽  
Health Personnel ◽  
Hospital Setting ◽  
Food Preferences ◽  
University Hospital ◽  
Local Market ◽  
Healthy Foods ◽  
Hospital Administrators

ObjectiveTo explore the perceptions, enablers and barriers to employees’ healthy eating in a hospital site.DesignA qualitative study including focus group discussion and in-depth interview, data were analysed using thematic analysis method.SettingThe study was carried out among employees of Dhulikhel Hospital-Kathmandu University Hospital, located about 30 km east of Nepal's capital Kathmandu.ParticipantsFocus group discussions were conducted among the 33 participants, who were divided into four groups: (a) support staff (drivers, cook, laundry, gardeners and ward boys), (b) hospital administrators and managers, (c) health personnel (doctors, nurses and assistants) who work 8–12 hours shifts and (d) health personnel who work during office hours. Nine in-depth interviews were conducted among six canteen operators and three managers.ResultsThe major factors for promoting healthy eating were identified as the availability of affordable healthy food options in the cafeterias, a commitment to such promotion by the cafeteria manager, operators, staff and hospital administration and the level of education of the employees. The most commonly reported barriers for healthy eating were the unavailability of healthy options, including the lack of food supply from local market, the higher cost of healthy foods, individual food preferences and limited human resources in the cafeteria.ConclusionThe availability of affordable healthy foods, supply of healthy foods from the market, commitment from cafeteria managers, hospital administrators and health awareness among cafeteria operators may promote healthy eating among employees in a Nepali hospital setting.

scholarly journals Anaesthetic Adverse Incident Reports: An Australian Study of 1,231 Outcomes

2005 ◽  
Vol 33 (3) ◽  
pp. 336-344 ◽  
Author(s):  
A. Aders ◽  
H. Aders
Keyword(s):  
Risk Management ◽  
Side Effects ◽  
Patient Outcomes ◽  
Drug Side Effects ◽  
Australian Study ◽  
Nerve Injuries ◽  
Respiratory Complications ◽  
Adverse Incident ◽  
Incident Reports ◽  
Reporting Rates

While there have been previous studies looking at patterns of litigation against anaesthetists overseas, there is little reported on the trends in Australia. This study was performed to ascertain current reporting rates of anaesthetic incidents, and from what areas these reports arise. Over the five years spanning January 1999 until December 2003, 1,231 adverse anaesthetic outcomes were reported to United Medical Protection by Australian anaesthetists. As in other studies, damage relating to airway instrumentation was the most frequently reported, comprising 261 incidents (21.8%). Complications related to epidural blockade were the next most common, accounting for 182 outcomes (15.2%). Other common areas generating incident reports included nerve injuries, respiratory complications, drug side-effects and death. To date 147 claims (12.3%) have arisen from these incident reports. Knowledge of these areas of risk should translate into more effective risk management with reduction in claims and adverse patient outcomes.

scholarly journals Characteristics of Inpatient Falls not Reported in an Incident Reporting System

2015 ◽  
Vol 8 (3) ◽  
pp. 17 ◽  
Author(s):  
Shin-ichi Toyabe
Keyword(s):  
Acute Care ◽  
Reporting System ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Incident Reporting ◽  
Care Hospital ◽  
Incident Reporting System ◽  
Inpatient Falls ◽  
Male Patients ◽  
Incident Reports

An incident reporting system is the most commonly used method to identify patient safety incidents in a hospital. However, non-reporting of incidents for various reasons is a serious problem. We studied the rate of inpatient falls that were not reported in an incident reporting system but were recorded in medical charts and we evaluated characteristics of those falls by comparing with the falls reported in incident reports in a Japanese acute care hospital setting. Falls recorded in medical charts were detected by using a text mining method followed by a manual chart review. About 25% of the recorded falls were not reported in incident reports. Male patients, first fall, long lag time until recording, no witness at the time of the fall and physician profession were shown to be significant factors associated with non-reporting. Our results show that the rate of non-reporting of inpatient falls in a Japanese acute care hospital is compable to that shown in previous studies in other conutries and that the same barriers to incident reporting as those found in previous studies exist in the medical staff.

scholarly journals 520 AN EVALUATION OF VIRTUAL MUSIC THERAPY TO PATIENTS ON AN ACUTE HEALTH CARE OF OLDER PEOPLE WARD DURING THE COVID-19 PANDEMIC

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
J McAulay ◽  
M Block ◽  
V Booth ◽  
A Cowley
Keyword(s):  
Health Care ◽  
Older People ◽  
Music Therapy ◽  
Hospital Setting ◽  
University Hospital ◽  
Hospital Environment ◽  
Ward Staff ◽  
Face To Face ◽  
Staff Members ◽  
Acute Health Care

Abstract Introduction Music therapy has been shown to reduce anxiety and social isolation for elderly patients in the acute hospital setting. At Nottingham University Hospital NHS Trust a programme of live, face-to-face music has been delivered by Wellspring Music on Healthcare of Older Peoples wards since 2015. In response to COVID-19, face-to-face delivery was stopped and a virtual method was proposed. This project investigated feasibility of virtual live music delivery. Method Twelve, two-hour music therapy sessions were delivered by Wellspring Music to 41 patients over six weeks. The validated Arts-obs tool was used by staff members facilitating the sessions to record observations of patient mood, relaxation, and distraction from the ward setting on Likert scales. Patient, ward staff, and facilitator feedback were also recorded. Qualitative and quantitative analyses were conducted by an Occupational Therapist. Results Data from the Arts-obs tool showed that thirty-two patients had an observable improvement in mood, seven had no mood change, and two presented a slightly worsened mood. Fourteen patients were fully engaged with the music therapy, sixteen were partially engaged, and eleven were focussed on the hospital environment. Thirty-four patients were visibly more relaxed, and seven showed no change. Patient feedback ranged from gratitude and expressions of enjoyment of the session to finding it too loud. Ward staff feedback ranged from appreciation to finding the music too distracting. The Wellspring musician and staff facilitators reported occasional loss of internet connection, and patients sometimes focusing on the facilitator rather than the musician. Conclusion It is feasible to deliver virtual music therapy to inpatients on Health Care of Older People wards. Feedback shows that this was largely acceptable to staff and patients. Improvements in mood, relaxation and distraction were found.

STUDYING SOME CLINICAL AND PARACLINICAL CHARACTERISTICS OF POSMATURE BABIES CARED IN NICU AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 74-84
Author(s):  
Thi Kieu Nhi Nguyen
Keyword(s):  
Respiratory Rate ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
University Hospital ◽  
Maternal Characteristics ◽  
Exact Test ◽  
Menstrual Cycles ◽  
Term Newborns ◽  
Student’S T ◽  
The Individual

Objectives: 1. Estimating the ratios of clinical and paraclinical signs of post-term newborns hospitalized at Pediatric Department of Hue University Hospital. 2. Identifying the relation between clinical signs and paraclinical signs. Materials and Method: 72 post- term babies < 7 days of life hospitalized at NICU from 2010/5 to 2011/4. Classification of post - term newborn was based on WHO 2003: gestational age ≥ 42 weeks with clinical manifestations: desquamation on press with fingers or natural desquamation, withered or meconial umbilicus, meconial long finger nails (*) or geatational age still < 42 weeks with theses clinical manifestations (*). Data were recorded on a clinical record form. Per-protocol analysis of clinical outcomes was performed by using Medcalc 11.5 and Excell 2007. Analyses used the χ2 test or Fisher's exact test for categorical data; Student's t test was used for continuous data and the Mann-Whitney U test for nonparametric data. Data were presented as means or proportions with 95% CIs. Results: Clinical characteristics: Tachypnea and grasp were main reasons of hospitalisation (48.61%). Poor feeding, vomitting (16.67%). Asphyxia (8.34%). Jawndice (6.94%). Hypothermia < 36.50C (13.89%), fever (13.89%). Tachypnea (59.72%). Bradycardia (1.39%). Poor feeding (11.11%). Hypertonia (9.72%). Paraclinical characteristics: Erythrocytes < 4.5.1012/l (51.39%), Leucocytes 5 – 25.103/mm3 (81.94%), Thrombocytes 100- 400.103/mm3 (94.44%). Hemoglobinemia < 10mg/l (67.61%). Maternal characteristics: Menstrual cycles regular (75%). Primiparity (75%). Amniotic volume average (70.42%), little (29.58%). Aminiotic liquid clair (62.5%), aminiotic liquid yellow (4.17%), aminiotic meconial liquid (33.33%). Maternal manifestation of one of many risk factors consist of genital infection; urinary infection; fever before, during, after 3 days of birth; prolonged delivery; medical diseases influence the foetus (75%). The relation between clinical signs and paraclinical signs: There was significantly statistical difference: between gestationnal age based on obstetrical criteria and amniotic volume on ultrasound (p < 0.05); between birth weight and glucosemia p < 0.02). There was conversional correlation of average level between erythroctes number and respiratory rate (r = - 0.5158; p < 0,0001), concordance correlation of weak level betwwen leucocytes number and respiratory rate r = 0.3045; p = 0.0093). Conclusion: It should made diagnosis of postterm baby based on degree of desquamation. The mother who has menstrual cycles regular is still delivered of a postterm baby. A postterm baby has the individual clinical and paraclinical signs.

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

scholarly journals Mycoplasma pneumoniae may cause dyspnoea and hospitalisations in young healthy adults

2021 ◽  
Author(s):  
Riku Metsälä ◽  
Solja Ala-Korpi ◽  
Juha Rannikko ◽  
Merja Helminen ◽  
Marjo Renko
Keyword(s):  
Respiratory Tract ◽  
Mycoplasma Pneumoniae ◽  
Hospital Setting ◽  
Health Condition ◽  
Clinical Findings ◽  
Antimicrobial Treatment ◽  
University Hospital ◽  
Upper Respiratory Tract ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics

AbstractPolymerase chain reaction (PCR)-based diagnostics for Mycoplasma pneumoniae (M. pneumoniae) from the respiratory tract has become widely available, but the interpretation of the results remains unclear. M. pneumoniae has been suggested to cause mainly mild and self-limiting infections or asymptomatic carriage. However, systematic analyses of the association between PCR results and clinical findings are scarce. This study aimed to clarify the clinical features of PCR-positive M. pneumoniae infections in a hospital setting. We reviewed 103 PCR-positive patients cared for in a university hospital during a 3-year period. Data on age, sex, health condition, acute symptoms, other pathogens found, laboratory and X-ray results and treatments were collected. Over 85% of the patients had a triad of typical symptoms: fever, cough and shortness of breath. Symptoms in the upper respiratory tract were rare. In 91% of the cases, M. pneumoniae was the only pathogen found. The highest incidence was found in the age group of 30–40 years, and 68% of the patients did not have any underlying diseases. Most patients were initially empirically treated with beta-lactam antibiotics and needed 2–4 changes in their treatment. Only 6% were discharged without an antibiotic effective against M. pneumoniae. This study shows that M. pneumoniae often led to hospitalisation and that patients needed appropriate antimicrobial treatment to recover. Mixed infections were rare, and situations that could be interpreted as carriage did not occur.

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