scholarly journals How Safety Is Compromised When Hospital Equipment Is a Poor Fit for Patients Who Are Obese

2020 ◽  
pp. 48-56
Author(s):  
Eliabeth Kukielka
Keyword(s):  
United States ◽  
Reporting System ◽  
Healthcare Providers ◽  
The United States ◽  
Healthcare Facilities ◽  
Safety Reporting ◽  
Imaging Department ◽  
Skin Tears ◽  
Hospital Equipment ◽  
Surgical Unit

Obesity is common, serious, and costly, and according to recent data, its prevalence is on the rise in the United States. Event reports submitted to the Pennsylvania Patient Safety Reporting System (PA-PSRS) indicate that some healthcare facilities do not have the necessary equipment to monitor and care for some individuals in this patient population, leading to embarrassment for patients, delays in care, and injuries to patients. An analysis of 107 events related to monitoring and patient care for patients who are obese submitted to PA-PSRS from 2009 through 2018 showed that imaging equipment, especially MRI and CT scanners, was most often implicated in event reports (49.5%; 53 events); other equipment included stretchers (24.3%; 26 events) and wheelchairs (11.2%; 12 events). Events most often occurred in an imaging department (30.8%; 33 events) or a medical/surgical unit (21.5%; 23 events). Analysts determined that 80 events (74.8%) resulted in a delay in care and that 44 events (41.1%) resulted in temporary harm to the patient, including skin tears and abrasions. Healthcare providers may not be able to prevent delays in care resulting from the unavailability of adequate equipment for patients who are obese, but they may be able to prevent harm and embarrassment for patients through proactive assessment.

scholarly journals Accidental Choking Among Hospitalized Patients in Pennsylvania: A 15-Year Retrospective Review

2020 ◽  
pp. 42-53
Author(s):  
Elizabeth Kukielka
Keyword(s):  
United States ◽  
Risk Factors ◽  
Older Adults ◽  
Death Rate ◽  
Tooth Loss ◽  
Foreign Bodies ◽  
Reporting System ◽  
The United States ◽  
Common Cause ◽  
Safety Reporting

Choking occurs when a foreign body becomes lodged in the airway and obstructs respiration. In the United States, over 5,000 deaths were attributed to choking in 2015. Among older adults, food is the most common cause of choking, and the death rate for choking events involving food is seven times higher among older adults than young children. We queried the Pennsylvania Patient Safety Reporting System (PA-PSRS) and identified 545 events related to accidental choking on food, beverages, medications, or other foreign bodies reported from 2004 to 2019. Patients who experienced a choking event were more often female (56%; 306 of 545), and they ranged in age from 6 months to 102 years, with a median patient age of 70 years (interquartile range = 54 to 83 years). Among choking events that specified the substance involved, food was the most common (80%; 424 of 528 events). The most common foods that patients choked on were meat or fish (n=77), sandwiches (n=38), and breads or cakes (n=31). Abdominal thrusts were the most common immediate response described in event reports, attempted in more than half of events (56%; 306 of 545). Prevention of accidental choking may involve timely assessment of risk factors that predispose a patient to choking, including age older than 60 years, tooth loss and presence of dentures, and underlying psychiatric or neurologic illness.

scholarly journals 2019 Pennsylvania Patient Safety Reporting: An Analysis of Serious Events and Incidents From the Nation's Largest Event Reporting Database

2020 ◽  
Author(s):  
Shawn Kepner ◽  
Rebecca Jones ◽  
Caitlyn Allen ◽  
Daniel Glunk ◽  
Eric Weitz ◽  
...  
Keyword(s):  
Patient Safety ◽  
Acute Care ◽  
Reporting System ◽  
Safety Data ◽  
The United States ◽  
Event Reporting ◽  
Healthcare Facilities ◽  
Safety Reporting ◽  
The Past ◽  
The World

Pennsylvania is the only state that requires healthcare facilities to report all events of harm or potential for harm. Serious Events and Incidents are reported to the Pennsylvania Patient Safety Reporting System (PA-PSRS)*, which is the largest repository of patient safety data in the United States, and one of the largest in the world, with over 3.6 million acute care records. The overwhelming majority (97.1%) of all acute care event reports are Incidents. For 2019, there were 284,847 Incidents and 8,553 Serious Events for a total of 293,400 reported events. The counts of all events and the percentage that are Serious Events reported over the last eight years are provided in Figure 1. The total number of event reports has increased during the last four years. The number of reported Serious Events has increased over the past three years with the largest annual increase occurring in 2019 (+5.7%). This article will show details of the PA-PSRS acute care data along with longitudinal and categorical insights that can be used for improving patient safety.

scholarly journals Preparedness and response to an emerging health threat—Lessons learned from Candida auris outbreaks in the United States

2021 ◽  
pp. 1-6
Author(s):  
Diane Meyer ◽  
Elena K. Martin ◽  
Syra Madad ◽  
Priya Dhagat ◽  
Jennifer B. Nuzzo
Keyword(s):  
United States ◽  
New York ◽  
Qualitative Interviews ◽  
The United States ◽  
Lessons Learned ◽  
Infection Prevention And Control ◽  
Healthcare Organizations ◽  
Candida Auris ◽  
Term Care ◽  
Healthcare Facilities

Abstract Objective: Candida auris infections continue to occur across the United States and abroad, and healthcare facilities that care for vulnerable populations must improve their readiness to respond to this emerging organism. We aimed to identify and better understand challenges faced and lessons learned by those healthcare facilities who have experienced C. auris cases and outbreaks to better prepare those who have yet to experience or respond to this pathogen. Design: Semi-structured qualitative interviews. Setting: Health departments, long-term care facilities, acute-care hospitals, and healthcare organizations in New York, Illinois, and California. Participants: Infectious disease physicians and nurses, clinical and environmental services, hospital leadership, hospital epidemiology, infection preventionists, emergency management, and laboratory scientists who had experiences either preparing for or responding to C. auris cases or outbreaks. Methods: In total, 25 interviews were conducted with 84 participants. Interviews were coded using NVivo qualitative coding software by 2 separate researchers. Emergent themes were then iteratively discussed among the research team. Results: Key themes included surveillance and laboratory capacity, inter- and intrafacility communication, infection prevention and control, environmental cleaning and disinfection, clinical management of cases, and media concerns and stigma. Conclusions: Many of the operational challenges noted in this research are not unique to C. auris, and the ways in which we address future outbreaks should be informed by previous experiences and lessons learned, including the recent outbreaks of C. auris in the United States.

scholarly journals Pre-Exposure Prophylaxis Training among Medical Schools in the United States

2021 ◽  
Vol 12 ◽  
pp. 215013272110287
Author(s):  
Robert L. Cooper ◽  
Mohammad Tabatabai ◽  
Paul D. Juarez ◽  
Aramandla Ramesh ◽  
Matthew C. Morris ◽  
...  
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Injection Drug Users ◽  
Drug Users ◽  
Healthcare Providers ◽  
Medical Schools ◽  
The United States ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exposure Prophylaxis

Pre-Exposure Prophylaxis (PrEP) has been shown to be an effective method of HIV prevention for men who have sex with-men (MSM) and -transgender women (MSTGWs), serodiscordant couples, and injection drug users; however fewer than 50 000 individuals currently take this regimen. Knowledge of PrEP is low among healthcare providers and much of this lack of knowledge stems from the lack or exposure to PrEP in medical school. We conducted a cross sectional survey of medical schools in the United States to assess the degree to which PrEP for HIV prevention is taught. The survey consisted Likert scale questions assessing how well the students were prepared to perform each skill associated with PrEP delivery, as well as how PrEP education was delivered to students. We contacted 141 medical schools and 71 responded to the survey (50.4%). PrEP education was only reported to be offered at 38% of schools, and only 15.4% reported specific training for Lesbian, Gay, Bisexual, and Transgender (LGBT) patients. The most common delivery methods of PrEP content were didactic sessions with 11 schools reporting this method followed by problem-based learning, direct patient contact, workshops, and small group discussions. Students were more prepared to provide PrEP to MSM compared to other high-risk patients. Few medical schools are preparing their students to prescribe PrEP upon graduation. Further, there is a need to increase the number of direct patient contacts or simulations for students to be better prepared.

scholarly journals Evaluation of pharmacists’ awareness of illegal online pharmacies and perceived impact on safe access to medicines

2021 ◽  
Vol 5 ◽  
pp. 239920262110056
Author(s):  
John B Hertig ◽  
Shannon M James ◽  
Connor J Hummel ◽  
Matthew J Rubin
Keyword(s):  
United States ◽  
Healthcare Providers ◽  
Access To Medicines ◽  
The United States ◽  
Pharmacy Education ◽  
Electronic Survey ◽  
Medication Therapy ◽  
Online Pharmacies ◽  
Effective Medication ◽  
Selection Of

Background: An estimated 95% of all online pharmacies operate unlawfully. Illegal online pharmacies distribute substandard and falsified medical products that may result in patient harm and suboptimal treatment, leading to an overall mistrust of medications, healthcare providers, and health systems. As medication experts, pharmacists are trusted to guide patients in selection of safe and effective medication therapy. Objective: The objective of this study was to determine gaps in knowledge and recognition of the negative clinical and safety impacts associated with illegal Internet pharmacies by licensed pharmacists. Methods: A 37-question electronic survey was developed and distributed to pharmacists across the United States by email via a database from the American Pharmacists Association. Descriptive statistics was utilized to analyze data. Results: A total of 347 pharmacists from across the United States responded to at least one question in the survey. In all, 58% of pharmacists reported a lack of confidence in their ability to counsel patients on the identification of illegal pharmacy websites. Fewer than 60% of pharmacists were able to accurately identify the legitimacy of a webpage based on visual characteristics. In addition, 75% of pharmacists reported being unfamiliar with resources available to help consumers identify safe and legitimate online pharmacies. Conclusion: Integration of the topic into pharmacy education curricula, training on available resources, and additional research into the prevalence and impact of illegal pharmacy websites are necessary to ensure that pharmacists and other healthcare professionals are adequately prepared to protect their communities from the threat of illegal online pharmacies.

scholarly journals Energy Consumption Analysis and Characterization of Healthcare Facilities in the United States

Energies ◽  
2019 ◽  
Vol 12 (19) ◽  
pp. 3775 ◽  
Author(s):  
Khaled Bawaneh ◽  
Farnaz Ghazi Nezami ◽  
Md. Rasheduzzaman ◽  
Brad Deken
Keyword(s):  
United States ◽  
Energy Consumption ◽  
Energy Intensity ◽  
The United States ◽  
High Energy ◽  
Total Energy Consumption ◽  
Healthcare Facilities ◽  
Energy Consumption Analysis ◽  
Consumption Data ◽  
End Use

Healthcare facilities in the United States account for 4.8% of the total area in the commercial sector and are responsible for 10.3% of total energy consumption in this sector. The number of healthcare facilities increased by 22% since 2003, leading to a 21% rise in energy consumption and an 8% reduction in energy intensity per unit of area (544.8 kWh/m2). This study provides an analytical overview of the end-use energy consumption data in healthcare systems for hospitals in the United States. The energy intensity of the U.S. hospitals ranges from 640.7 kWh/m2 in Zone 5 (very hot) to 781.1 kWh/m2 in Zone 1 (very cold), with an average of 738.5 kWh/m2. This is approximately 2.6 times higher than that of other commercial buildings. High energy intensity in the healthcare facilities, particularly in hospitals, along with energy costs and associated environmental concerns make energy analysis crucial for this type of facility. The proposed analysis shows that U.S. healthcare facilities have higher energy intensity than those of most other countries, especially the European ones. This necessitates the adoption of more energy-efficient approaches to the infrastructure and the management of healthcare facilities in the United States.

Managing Our Microbial Mark

2016 ◽  
Vol 42 (2-3) ◽  
pp. 393-428
Author(s):  
Ann Marie Marciarille
Keyword(s):  
United States ◽  
Infection Control ◽  
The United States ◽  
West African ◽  
Healthcare Associated Infections ◽  
Healthcare Facilities ◽  
Quality Reporting ◽  
Reporting Systems ◽  
Control Procedures ◽  
Healthcare Associated

The narrative of Ebola's arrival in the United States has been overwhelmed by our fear of a West African-style epidemic. The real story of Ebola's arrival is about our healthcare system's failure to identify, treat, and contain healthcare associated infections. Having long been willfully ignorant of the path of fatal infectious diseases through our healthcare facilities, this paper considers why our reimbursement and quality reporting systems made it easy for this to be so. West Africa's challenges in controlling Ebola resonate with our own struggles to standardize, centralize, and enforce infection control procedures in American healthcare facilities.

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