Report From a Virtual Care Task Force

2021 ◽  
Vol 1 (1) ◽  
pp. 50-54
Author(s):  
Patricia H. Folcarelli
Keyword(s):  
Patient Safety ◽  
Task Force ◽  
Daily Practice ◽  
Delivery Of Care ◽  
Safety Issues ◽  
Virtual Care ◽  
Safety Risks ◽  
Limited Experience ◽  
Practice Of Medicine ◽  
Rapid Shift

While telehealth has been available for decades, as a result of the COVID-19 pandemic, an unprecedented demand arose for the remote delivery of safe and reliable assessments and treatment recommendations via computers, smart phones, and tablets. Institutions and individual providers needed to accelerate their adoption of virtual care. This ability to provide remote evaluations has helped to protect patients and providers at this time when physical distancing is a priority. This rapid shift to telemedicine has also meant that many providers, with limited experience or training in the virtual delivery of care, were required to adapt to new and unfamiliar technologies as part of their daily practice of medicine. Institutions and individuals have recognized that this sudden and unexpected expansion of virtual care had the potential to increase patient safety risks. Given that telemedicine will remain a mainstay after the COVID-19 pandemic, it will be important to focus on quality and safety issues that are likely to arise but as yet remain to be appreciated. This chapter explores patient safety guidance.

scholarly journals Pros and cons of eHealth: A systematic review of the literature and observations in Denmark

2021 ◽  
Vol 9 ◽  
pp. 205031212110161
Author(s):  
Mathias T Svendsen ◽  
Sylvia N Tiedemann ◽  
Klaus Ejner Andersen
Keyword(s):  
Patient Safety ◽  
English Language ◽  
Intervention Studies ◽  
Healthcare Providers ◽  
Legal Rights ◽  
Safety Issues ◽  
It Systems ◽  
Safety Risks ◽  
Pros And Cons ◽  
Governmental Control

Objectives: The main objectives of this article are to systematically review the recent literature on patient safety in relation to the use of eHealth and to investigate how the Danish authorities supervise private eHealth clinics with regard to patient safety. Methods: Original studies reporting the association between patient safety and the use of eHealth as a means of communication between patients and healthcare providers were included. Four literature databases were searched for English-language articles reporting results from cohort studies and clinical trials, published from 2015 until March 2021. Moreover, registered private eHealth clinics in Denmark were evaluated with reference to a recent national audit of patient safety issues in eHealth. Results: The literature search retrieved four intervention studies. The studies did not identify any particular patient safety risks associated with the use of eHealth. Many different authorized healthcare providers (preferably, doctors) apply eHealth in various contexts. eHealth is being used as the only form of contact between the healthcare provider and the patient, as a supplement to patient visitations in an outpatient clinic, or as a tool for communicating between two or more healthcare providers. The regulation of eHealth involves patient safety issues but also has interfaces to marketing, IT systems, and infrastructure. Supervision of eHealth includes the organization of clinics, handling patient charts, prescription medicine, patient legal rights, and patient transition. However, there are many interfaces in the division of responsibilities among the various governmental players. Conclusion: eHealth is being used increasingly and in many settings, although recently published intervention studies investigating patient safety issues by the use of eHealth are limited. A structured and continuous governmental control and regulation of patient safety in relation to the use of eHealth is warranted.

Notes on the Prognosis in Mental Disease

1859 ◽  
Vol 5 (28) ◽  
pp. 257-285 ◽  
Author(s):  
C. Lockhart Robertson
Keyword(s):  
General Practice ◽  
Mental Disease ◽  
Daily Practice ◽  
Results Of Treatment ◽  
Limited Experience ◽  
Practice Of Medicine ◽  
The Many ◽  
Made In

[This paper was intended to have been read at the December Meeting of the Brighton anil Sussex Meclico-Chirurgic.il Society, of which the writer is a member. His aim was to present a brief outline of the data on which the physician basto form his prognosis in cases of mental disease, and he makes here no pretensions to add any new facts to those already familiar to the Psychologist; his object was rather to put together a few observations on this important subject which might interest his professional brethren—members of the society—engaged in the more general practice of medicine, and to serve to raise, during that evening, an interest in the probable results of treatment in his own specialty. Circumstances having arisen to prevent the communication being made in the proposed form, it is here printed in the hope of directing the attention of the members of the Association of Medical Officers of Asylums and Hospitals for the Insane to the many important questions in the general prognosis of mental disease, which their daily practice enables them to observe and to solve with a fulness and accuracy which the writer cannot hope from his own limited experience to have here attained.]

Error Reduction in Specimen Processing of Irretrievable Body Fluids

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S130-S131
Author(s):  
V Gannon ◽  
T Albright ◽  
T Wells ◽  
C Cahak ◽  
A M Harrington ◽  
...  
Keyword(s):  
Patient Safety ◽  
Task Force ◽  
Post Intervention ◽  
Sample Distribution ◽  
Safety Issues ◽  
Staff Members ◽  
Chain Of Custody ◽  
Specimen Processing ◽  
Proper Training ◽  
A Chain

Abstract Introduction/Objective A lack of standardized processes for laboratory handling of irretrievable body fluid specimens, such as cerebrospinal fluid, serous fluids, synovial fluids, and aspirates, can result in failures that put the patient at risk by delaying testing results and/or requiring specimen recollection. We noted increased patient safety issues with irretrievable specimens in our laboratory and implemented a process improvement plan to mitigate patient harm. Herein, we report our findings of this intervention. Methods A task force was organized with wide representation across the laboratory to design a new workflow for irretrievable specimens. Hospital Patient Safety Reporting data was used to identify flaws in the pre-analytical processes pre-intervention and to monitor effectiveness of process change, post-intervention. Our intervention consisted of developing a standardized pre-analytical process for both technical and non-technical staff that could be enforced through consistent and proper training, with well-defined responsibilities for each department involved including specimen processing, microbiology, hematology, and chemistry. Our process included a centralized sterile processing location within the Micro department as well as a standardized sample log in and sample distribution process that incorporated a chain of custody form. Results Pre-intervention, we had 23 patient safety reports during a 3-month period (5-10/month; average 8/month) on irretrievable specimens; post-intervention, we had 9 patient safety reports over a 5-month period (0-4/month; average 2/month). Pre-intervention, failures identified included inconsistent workflows and training among staff, the absence of established protocols, and inadequate communication. Post-intervention, failures were noted due to improper and inconsistent training (n=4) or deviation from the established procedure by staff members. These failures were investigated and addressed through retraining or corrective actions as needed. Conclusion Our data shows that the implementation of a standardized process within the laboratory significantly decreases patient safety events by improving testing turn-around-times and quality of results and by preventing the need for specimen recollections.

scholarly journals Active Offer: Nurses’ Power and Privilege Influencing Francophone and Acadian Patient Safety

2019 ◽  
Vol 1 (2) ◽  
pp. 49-63
Author(s):  
Lisa Doucet ◽  
Danielle Byrne-Surette ◽  
Gisele Thibodeau
Keyword(s):  
Patient Safety ◽  
Reflective Practice ◽  
Language Translation ◽  
Healthcare Delivery ◽  
Primary Language ◽  
Healthcare Delivery System ◽  
Safety Issues ◽  
Safety Risks ◽  
Provision Of Care ◽  
The Impact

Nurses must communicate effectively with patients of a minority language to mitigate the risks of significant and costly patient safety issues. Within Canada’s predominant English healthcare delivery system, inadequate language translation during the provision of care between nurses fluent in English and patients whose primary language is Francophone or Acadian increases the risk of health inequities. This discussion explores the impact of nurses’ power and privilege related to Francophone and Acadian patient safety within an English-dominated healthcare system and their role to affect change. Through reflective practice, critical inquiry and activating the ‘Active offer’, nurses will be empowered to reduce safety risks for this population.  

Identifying Health and Safety Risks for Childcare Workers

AAOHN Journal ◽  
2007 ◽  
Vol 55 (8) ◽  
pp. 321-325 ◽  
Author(s):  
Belinda J. McGrath
Keyword(s):  
Health Promotion ◽  
Occupational Health ◽  
Workplace Health Promotion ◽  
Health And Safety ◽  
Workplace Health ◽  
Safety Issues ◽  
Safety Risks ◽  
Health Promotion Programs ◽  
Childcare Workers ◽  
Health And Safety Risks

Childcare workers are exposed to several health and safety risks in their work environment, the most common being infectious diseases, musculoskeletal injuries, accidents, and occupational stress. Pregnant childcare workers have an additional risk of potential harm to the fetus. Occupational health nurses can work collaboratively with childcare workers to reduce these risks and provide workplace health promotion programs. This article explores the occupational health and safety issues for childcare workers and suggests health promotion strategies that could be implemented by occupational health nurses working in this arena.

scholarly journals Risks in Management of Enteral Nutrition in Intensive Care Units: A Literature Review and Narrative Synthesis

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 82
Author(s):  
Magdalena Hoffmann ◽  
Christine Maria Schwarz ◽  
Stefan Fürst ◽  
Christina Starchl ◽  
Elisabeth Lobmeyr ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Clinical Practice ◽  
Literature Review ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Rapid Review ◽  
Narrative Synthesis ◽  
Safety Issues

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.

scholarly journals Acceptance of mHealth among Health Professionals: A Case Study on Anesthesia Practitioners

2020 ◽  
Author(s):  
Hugo Carvalho ◽  
Michael Verdonck ◽  
Patrice Forget ◽  
Jan Poelaert
Keyword(s):  
Mobile Apps ◽  
Daily Practice ◽  
Anesthesia Care ◽  
Smartphone Apps ◽  
Belgian Society ◽  
Anonymous Questionnaire ◽  
Digital Books ◽  
Practice Of Medicine ◽  
Perioperative Monitoring

Abstract Background: mHealth, the practice of medicine aided by mobile devices is a growing market. Although the offer on Anesthesia applications (Apps) is quite prolific, representative formal assessments on the views of anesthesia practitioners on its use and potential place in daily practice is lacking. This survey aimed thus to cross-assess the Belgian anesthesia population on the use of smartphone Apps and peripherals.Methods: The survey was exclusively distributed as an online anonymous questionnaire. Sharing took place via hyperlink forwarding by the Belgian Society for Anesthesia and Reanimation (BSAR) and by the Belgian Association for Regional Anesthesia (BARA) to all registered members. The first answer took place on 5 September 2018, the last on 22 January 2019. Results: 349 answers were obtained (26.9% corresponding to trainees, 73.1% to specialists). Anesthesiologists were positively confident that Apps and peripherals could help improve anesthesia care (57.0% and 47.9%, respectively, scored 4 or 5, in a scale from 0 - 5). Trainees were significantly more confident than specialists on both mobile Apps (71.2% and 51.8%, respectively; p = 0.001) and peripherals (77.7% and 45.1%, respectively; p = 0.09).The usefulness of Apps and Peripherals was rated 1 or below (on a 0 to 5 scale), respectively, by 9.5% and 14.6% of the total surveyed population, being specialists proportionally less confident in Smartphone peripherals than trainees (p = 0.008). Mobile apps are actively used by a significantly higher proportional number of trainees (67.0% vs. 37.3%, respectively; p = 0.000001).The preferred category of mobile Apps was dose-calculating applications (39.15%), followed by digital books (21.1%) and Apps for active perioperative monitoring (20.0%).Conclusions: Belgian Anesthesia practitioners show a global positive attitude towards smartphone Apps and Peripherals, with trainees trending to be more confident than specialists.

scholarly journals SEGURANÇA DO PACIENTE NA VISÃO DE ENFERMEIROS: UMA QUESTÃO MULTIPROFISSIONAL

2017 ◽  
Vol 8 (1) ◽  
pp. 52
Author(s):  
Marcos Antonio Nunes De Araujo ◽  
Wilson Danilo Lunardi Filho ◽  
Rosemary Silva Da Silveira ◽  
Jose Carlos Souza ◽  
Edison Luiz Devos Barlem ◽  
...  
Keyword(s):  
Patient Safety ◽  
Descriptive Study ◽  
Hospital Nurses ◽  
Cross Sectional ◽  
Mato Grosso ◽  
Safety Risks ◽  
City State ◽  
Promote Patient Safety ◽  
Mato Grosso Do Sul

Objetivo: identificar como o enfermeiro percebe a segurança do paciente na instituição de saúde em que atua. Metodologia: estudo descritivo, de corte transversal, realizado entre janeiro e fevereiro de 2016, em Dourados/MS, com 52,58% da população de 310 enfermeiros hospitalares. Aplicou-se questionário sociodemográfico com questões vinculadas à segurança do paciente, cujos dados foram submetidos à análise descritiva. Resultados: parte dos enfermeiros apontou menor segurança quanto aos procedimentos, cuidados e administração de medicamentos. Conclusão: compete à equipe multiprofissional atuar na promoção da segurança do paciente, sendo o enfermeiro o profissional apto a identificar e comunicar riscos iminentes, prevenindo a ocorrência de danos e promovendo saúde na sua integralidade, devido à assistência de enfermagem ocorrer ao longo das 24 horas do dia.Descritores: Segurança do paciente, Gerenciamento de risco, Papel do enfermeiro, Raciocínio clínico.PATIENT SAFETY IN THE PERPECTIVE OF NURSES: A MULTI PROFESSIONAL ISSUEObjective: to highlight how the institutional safety is in the perspective of nurses. Methodology: a cross-sectional descriptive study conducted between January and February 2016, in Dourados City, State of Mato Grosso do Sul, Brazil, with 52.58% of 310 hospital nurses. A sociodemographic questionnaire with questions about “patient safety” was used. A descriptive and statistical analysis was performed. Results: some of the nurses indicated less safety regarding procedures, care and administration of medication. Conclusion: It is the role of multi professional team to promote patient safety. Nurses are capable of identifying and communicating imminent risks, due to their 24 hours assistance, preventing injuries and promoting health in its entirety.Descriptors: Patient Safety, Risks Management, Nurse’s Role, Clinical reasoning.SEGURIDAD DE LOS PACIENTES EN LA PERCEPCIÓN DE ENFERMEROS: UNA CUESTIÓN MULTIPROFESIONALObjetivo: identificar cómo la enfermera percibe la seguridad del paciente en la institución de salud en que actúa. Metodologia: estudio descriptivo de corte trasversal hecho de enero a febrero de 2016, en Dourados/MS, con 52,58% de la población de enfermeros hospitalarias. Se utilizó encuesta sociodemografica respecto la “seguridad del paciente” Se hizo el análisis descriptivo y estadístico. Resultados: parte considerable de los enfermeros indicó menor seguridad cuanto a procedimientos, cuidados y administración medicamentosa. Conclusión: el equipo multiprofesional debe promover la seguridad del paciente, considerando el enfermero como el más apto a identificar y comunicar riesgos inminentes en las 24h de su asistencia, evitando danos e promocionando salud en su integralidad.Descriptores: Seguridad del paciente, Administración de riesgos, Función de los enfermeros, Raciocinio clínico.

scholarly journals Quality Indicators of the Pre-Analytical Phase

2012 ◽  
Vol 31 (3) ◽  
pp. 174-183 ◽  
Author(s):  
Nada Majkić-Singh ◽  
Zorica Šumarac
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Quality Indicators ◽  
Task Force ◽  
Improve Patient Safety ◽  
Laboratory Data ◽  
Sample Collection ◽  
Laboratory Errors ◽  
Analytical Phase ◽  
Total Testing Process

Quality Indicators of the Pre-Analytical PhaseQuality indicatorsare tools that allow the quantification of quality in each of the segments of health care in comparison with selected criteria. They can be defined as an objective measure used to assess the critical health care segments such as, for instance, patient safety, effectiveness, impartiality, timeliness, efficiency, etc. In laboratory medicine it is possible to develop quality indicators or the measure of feasibility for any stage of the total testing process. The total process or cycle of investigation has traditionally been separated into three phases, the pre-analytical, analytical and post-analytical phase. Some authors also include a »pre-pre« and a »post-post« analytical phase, in a manner that allows to separate them from the activities of sample collection and transportation (pre-analytical phase) and reporting (post-analytical phase). In the year 2008 the IFCC formed within its Education and Management Division (EMD) a task force calledLaboratory Errors and Patient Safety (WG-LEPS)with the aim of promoting the investigation of errors in laboratory data, collecting data and developing a strategy to improve patient safety. This task force came up with the Model of Quality Indicators (MQI) for the total testing process (TTP) including the pre-, intra- and post-analytical phases of work. The pre-analytical phase includes a set of procedures that are difficult to define because they take place at different locations and at different times. Errors that occur at this stage often become obvious later in the analytical and post-analytical phases. For these reasons the identification of quality indicators is necessary in order to avoid potential errors in all the steps of the pre-analytical phase.

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