scholarly journals Health Care Safety Management in Modern Health Care

2019 ◽  
pp. 18-31 ◽  
Author(s):  
Yuriy Voskanyan ◽  
Irina Shikina
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Safety ◽  
Adverse Events ◽  
Medical Care ◽  
Safety Management ◽  
Meta Analysis ◽  
Modern Health Care ◽  
Health Care Safety

The article is a systematic review of the research devoted to the study of epidemiology, mechanisms of adverse events associated with the provision of medical care, as well as the principles of patient safety management. The meta-analysis allowed to establish that cases of harm in the provision of medical care (adverse events) are recorded in 10.6% of patients. At the heart of the development of adverse events are systemic causes – latent threats, the management of which is the basis of the modern strategy of ensuring the safety of medical care.

scholarly journals Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 553 ◽  
Author(s):  
Cíntia Garcia ◽  
Luiz Abreu ◽  
José Ramos ◽  
Caroline Castro ◽  
Fabiana Smiderle ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Interpersonal Relationships ◽  
Health Professionals ◽  
Safety Management ◽  
Meta Analysis ◽  
Burn Out ◽  
High Workload ◽  
Compromise Patient Safety ◽  
The Relationship

Background and Objectives: Several factors can compromise patient safety, such as ineffective teamwork, failed organizational processes, and the physical and psychological overload of health professionals. Studies about associations between burn out and patient safety have shown different outcomes. Objective: To analyze the relationship between burnout and patient safety. Materials and Methods: A systematic review with a meta-analysis performed using PubMed and Web of Science databases during January 2018. Two searches were conducted with the following descriptors: (i) patient safety AND burnout professional safety AND organizational culture, and (ii) patient safety AND burnout professional safety AND safety management. Results: Twenty-one studies were analyzed, most of them demonstrating an association between the existence of burnout and the worsening of patient safety. High levels of burnout is more common among physicians and nurses, and it is associated with external factors such as: high workload, long journeys, and ineffective interpersonal relationships. Good patient safety practices are influenced by organized workflows that generate autonomy for health professionals. Through meta-analysis, we found a relationship between the development of burnout and patient safety actions with a probability of superiority of 66.4%. Conclusion: There is a relationship between high levels of burnout and worsening patient safety.

scholarly journals Impact of personal protective equipment use on health care workers’ physical health during the COVID-19 pandemic: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Petros Galanis ◽  
Irene Vraka ◽  
Despoina Fragkou ◽  
Angeliki Bilali ◽  
Daphne Kaitelidou
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Adverse Events ◽  
Physical Health ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Meta Analysis ◽  
Protective Equipment ◽  
Care Workers ◽  
The Impact

SummaryBackgroundDuring the COVID-19 pandemic, health care workers (HCWs) caring for patients with coronavirus disease 2019 (COVID-19) in high-risk clinical settings have been obliged to wear personal protective equipment (PPE).AimTo assess the impact of PPE use on HCWs’ physical health during the COVID-19 pandemic. Also, we examined factors related with a greater risk of adverse events among HCWs due to PPE use.MethodsWe applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the Cochrane criteria for this systematic review and meta-analysis. We searched PubMed, Medline, Scopus, ProQuest, CINAHL and pre-print services (medRxiv) from January 1, 2020 to December 27, 2020.FindingsOur review included 14 studies with 11,746 HCWs from 16 countries. The estimated overall prevalence of adverse events among HCWs was 78% (95% CI: 66.7-87.5%) with a range from 42.8% to 95.1% among studies. The prevalence of adverse events was higher for the studies with poor quality compared to those with moderate quality (83.5% vs. 67.1%), while increased sample size was related with decreased prevalence (p<0.001). The most frequent adverse events were headache (55.9%), dry skin (54.4%), dyspnoea (53.4%), pressure injuries (40.4%), itching (39.8%), hyperhidrosis (38.5%), and dermatitis (31.0%). Among others, the following factors were related with the risk of adverse events among HCWs due to PPE use: female gender, younger age, obesity, diabetes mellitus, smoking pre-existing headache, longer duration of shifts wearing PPE, increased consecutive days with PPE, and increased exposure to confirmed or suspected COVID-19 patients.ConclusionThe frequency of adverse events amongst HCWs due to PPE use is very high. Further studies should be conducted since the limitations of this review do not allow us to infer conclusive results especially in case of risk factors for the occurrence of adverse events. Healthcare facilities should take the necessary precautions and change the working conditions during the COVID-19 pandemic to prevent adverse events associated with PPE use and minimize harm to HCWs.

scholarly journals Protocol: Benefits and harms of remdesivir for COVID-19 in adults: A systematic review with meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260544
Author(s):  
Asger Sand Paludan-Müller ◽  
Andreas Lundh ◽  
Matthew J. Page ◽  
Klaus Munkholm
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Adverse Events ◽  
Meta Analysis ◽  
Severe Disease ◽  
Risk Of Bias ◽  
Bibliographic Databases ◽  
Selective Reporting ◽  
Randomised Trials ◽  
Study Results

Background Effective drug treatments for Covid-19 are needed to decrease morbidity and mortality for the individual and to alleviate pressure on health care systems. Remdesivir showed promising results in early randomised trials but subsequently a large publicly funded trial has shown less favourable results and the evidence is interpreted differently in clinical guidelines. Systematic reviews of remdesivir have been published, but none have systematically searched for unpublished data, including regulatory documents, and assessed the risk of bias due to missing evidence. Methods We will conduct a systematic review of randomised trials comparing remdesivir to placebo or standard of care in any setting. We will include trials regardless of the severity of disease and we will include trials examining remdesivir for indications other than Covid-19 for harms analyses. We will search websites of regulatory agencies, trial registries, bibliographic databases, preprint servers and contact trial sponsors to obtain all available data, including unpublished clinical data, for all eligible trials. Our primary outcomes will be all-cause mortality and serious adverse events. Our secondary outcomes will be length of hospital stay, time to death, severe disease, and adverse events. We will assess the risk of bias using the Cochranes Risk of Bias 2 tool and the risk of bias due to missing evidence (e.g. publication bias, selective reporting bias) using the ROB-ME tool. Where appropriate we will synthesise study results by conducting random-effects meta-analysis. We will present our findings in a Summary of Findings table and rate the certainty of the evidence using the GRADE approach. Discussion By conducting a comprehensive systematic review including unpublished data (where available), we expect to be able to provide valuable information for patients and clinicians about the benefits and harms of remdesivir for the treatment of Covid-19. This will help to ensure optimal treatment for individual patients and optimal utilisation of health care resources. Systematic review registration CRD42021255915.

Systematic Review and Meta-analysis of Flibanserin's Effects and Adverse Events in Women with Hypoactive Sexual Desire Disorder

2017 ◽  
Vol 18 (1) ◽  
pp. 78-85 ◽  
Author(s):  
Seyed Saadat ◽  
Yunes Panahi ◽  
Milad Hosseinialhashemi ◽  
Ali Kabir ◽  
Khaled Rahmani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Sexual Desire ◽  
Meta Analysis ◽  
Hypoactive Sexual Desire Disorder ◽  
Desire Disorder

Efficacy and Safety of Antigen-specific Immunotherapy in the Treatment of Patients with Non-small-cell Lung Cancer: A Systematic Review and Meta-analysis

2019 ◽  
Vol 19 (3) ◽  
pp. 199-209 ◽  
Author(s):  
Bing-Di Yan ◽  
Xiao-Feng Cong ◽  
Sha-Sha Zhao ◽  
Meng Ren ◽  
Zi-Ling Liu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Adverse Events ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Specific Immunotherapy ◽  
Meta Analysis ◽  
Small Cell ◽  
Efficacy And Safety ◽  
Small Cell Lung

Background and Objective: We performed this systematic review and meta-analysis to assess the efficacy and safety of antigen-specific immunotherapy (Belagenpumatucel-L, MAGE-A3, L-BLP25, and TG4010) in the treatment of patients with non-small-cell lung cancer (NSCLC). </P><P> Methods: A comprehensive literature search on PubMed, Embase, and Web of Science was conducted. Eligible studies were clinical trials of patients with NSCLC who received the antigenspecific immunotherapy. Pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) were calculated for overall survival (OS), progression-free survival (PFS). Pooled risk ratios (RRs) were calculated for overall response rate (ORR) and the incidence of adverse events. </P><P> Results: In total, six randomized controlled trials (RCTs) with 4,806 patients were included. Pooled results showed that, antigen-specific immunotherapy did not significantly prolong OS (HR=0.92, 95%CI: 0.83, 1.01; P=0.087) and PFS (HR=0.93, 95%CI: 0.85, 1.01; P=0.088), but improved ORR (RR=1.72, 95%CI: 1.11, 2.68; P=0.016). Subgroup analysis based on treatment agents showed that, tecemotide was associated with a significant improvement in OS (HR=0.85, 95%CI: 0.74, 0.99; P=0.03) and PFS (HR=0.70, 95%CI: 0.49, 0.99, P=0.044); TG4010 was associated with an improvement in PFS (HR=0.87, 95%CI: 0.75, 1.00, P=0.058). In addition, NSCLC patients who were treated with antigen-specific immunotherapy exhibited a significantly higher incidence of adverse events than those treated with other treatments (RR=1.11, 95%CI: 1.00, 1.24; P=0.046). </P><P> Conclusion: Our study demonstrated the clinical survival benefits of tecemotide and TG4010 in the treatment of NSCLC. However, these evidence might be limited by potential biases. Therefore, further well-conducted, large-scale RCTs are needed to verify our findings.

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