scholarly journals Transfers of Care Around Medicine

2020 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
Dr Bernard Crotty ◽  
Christopher Learoyd
Keyword(s):  
Patient Safety ◽  
Care Setting ◽  
Financial Economic ◽  
Social Benefits ◽  
Significant Cost ◽  
Safety Issues ◽  
Health Community ◽  
Increased Risk ◽  
National Initiative ◽  
Transfers Of Care

This article covers both patient safety issues and optimising medicine use, this national initiative is known as Transfers of Care around Medicine (TCAM). When a patient moves from one care setting to another, this is known as a transfer of care. When transfers of care occur there is an increased risk of adverse effects due, in part, to medication errors arising. This article asserts that a relatively small investment can generate significant cost avoidances; thereby delivering significant financial, economic and social benefits to the health community as well as enhancing patient safety.

scholarly journals PATIENT SAFETY ISSUES: THE ROLE OF ORGANIZATIONAL BEHAVIORAL APPROACH (OBA) IN ADDRESSING ISSUES RELATED TO MEDICAL ERROR AND SAFETY CULTURE

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Fatmawati Fatmawati ◽  
Muhammad Taufik
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Medical Error ◽  
Care Setting ◽  
Health Sciences ◽  
Behavioral Approach ◽  
Safety Issues ◽  
Behavioral Theories ◽  
Main Target

During these recent years, patient safety has become a prominent issue in the medical atmosphere and appeared to be the main target for improvement (Leroy et al., 2012). As one of the disciplines in health sciences, psychology might play an important role in addressing the problems occurred in patient safety. There are broad aspects where psychology may contribute (Nash, McKay, Vogel, & Masters, 2012), but the involvement of psychology in changing the safety within health care setting has been underestimated and its role has been partially described (Øvretveit, 2009).Therefore, this paper is proposed in order to demonstrate one of the behavioral theories in psychology, named the Organizational Behavioral Approach (OBA) to give a wider understanding on how psychologist may contribute to address the issues in patient safety, especially the problems related to medical error and safety culture.

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.

Outbreak of Escherichia coli O157:H7 Infections Associated with Nonintact Blade-Tenderized Frozen Steaks Sold by Door-to-Door Vendors

2005 ◽  
Vol 68 (6) ◽  
pp. 1198-1202 ◽  
Author(s):  
ELLEN SWANSON LAINE ◽  
JONI M. SCHEFTEL ◽  
DAVID J. BOXRUD ◽  
KEVIN J. VOUGHT ◽  
RICHARD N. DANILA ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Single Case ◽  
Escherichia Coli O157 ◽  
Processing Methods ◽  
Safety Issues ◽  
The Public ◽  
Department Of Health ◽  
Increased Risk ◽  
Beef Products ◽  
Uremic Syndrome

Steaks have not been recognized as an important vehicle of Escherichia coli O157:H7 infection. During 11 to 27 June 2003, the Minnesota Department of Health (MDH) identified four O157 infection cases with the same pulsed-field gel electrophoresis (PFGE) subtype. All four case patients consumed brand A vacuum packed frozen steaks sold by door-to-door vendors. The steaks were blade tenderized and injected with marinade (i.e., nonintact). Information from single case patients in Michigan and Kansas identified through PulseNet confirmed the outbreak. The MDH issued a press release on 27 June to warn consumers, prompting a nationwide recall of 739,000 lb (335,506 kg) of frozen beef products. The outbreak resulted in six culture-confirmed cases (including one with hemolytic uremic syndrome) and two probable cases in Minnesota and single confirmed cases in four other states. The outbreak PFGE subtype of O157 was isolated from unopened brand A bacon-wrapped fillets from five affected Minnesota households. A fillet from one affected household was partially cooked in the laboratory, and the same O157 subtype was isolated from the uncooked interior. The tenderizing and injection processes likely transferred O157 from the surface to the interior of the steaks. These processing methods create new challenges for prevention of O157 infection. Food regulatory officials should reevaluate safety issues presented by nonintact steak products, such as microbiologic hazards of processing methods, possible labeling to distinguish intact from nonintact steaks, and education of the public and commercial food establishments on the increased risk associated with undercooked nonintact steaks. Information on single cases of O157 infection in individual states identified through PulseNet can be critical in solving multistate outbreaks in a timely manner.

scholarly journals Nighthawk: Making Night Float Education and Patient Safety Soar

2017 ◽  
Vol 9 (6) ◽  
pp. 755-758 ◽  
Author(s):  
Brett W. Sadowski ◽  
Hector A. Medina ◽  
Joshua D. Hartzell ◽  
William T. Shimeall
Keyword(s):  
Patient Safety ◽  
Online Education ◽  
Senior Resident ◽  
Resident Satisfaction ◽  
Educational Materials ◽  
Team Members ◽  
Safety Issues ◽  
Night Float ◽  
Satisfaction With Supervision ◽  
The Impact

ABSTRACT Background  Some residency programs responded to duty hour restrictions by implementing night rotations. Night supervision models can vary, resulting in potential patient safety issues and educational voids for residents. Objective  We evaluated the impact of multiple evidence-based interventions on resident satisfaction with supervision, perception of the education value of night rotations, and residents' use of online educational materials. Methods  The night team was augmented with an intern to assist with admissions and a senior resident (the “nighthawk”) to supervise inpatient care and deliver a night medicine curriculum. We instituted a “must-call” list, with specific clinical events requiring mandatory attending notification, and reduced conflict in the role of the night float team. We studied patient contact, online curriculum use, residents' perceptions of nighthawk involvement, exposure to educational materials, and satisfaction with supervision. Results  During the first half of academic year 2016–2017, 51% (64 of 126) of trainees were on the night medicine rotation. The nighthawk reviewed 1007 intern plans (15 per night; range, 6–36) and supervised 215 hands-on evaluations, including codes and rapid responses (3 per night; range, 0–12). The number of users of the online education materials increased by 85% (13 to 24), and instances of use increased 35% (85 to 115). The majority of residents (79%, 27 of 34) favored the new system. Conclusions  A nighthawk rotation, a must-call list, and reducing conflict in night team members' roles improved resident satisfaction with supervision and the night medicine rotation, resulting in increased communication.

The Development and Implementation of Patient Safety Information Systems (PSIS)

2011 ◽  
pp. 2054-2072
Author(s):  
Jeongeun Kim
Keyword(s):  
Patient Safety ◽  
Developmental Stages ◽  
Safety Information ◽  
Clinical Decision ◽  
Quality Of Healthcare ◽  
Essential Elements ◽  
Current Status ◽  
General Description ◽  
Safety Issues ◽  
Future Goals

This chapter presents the overview of the current status and developmental stages of the PSIS technology and consensus around the patient safety issues as they emerge, grow, and mature globally. The first section gives the general description of the patient safety reporting system (PSRS), and then provides the brief summary of 23 patient safety information classifications and terminologies to date. In the next section, the development of the international classification of patient safety (ICPS) is overviewed, which evolved from the local to an international level by the joint initiatives of WHO. The essential elements of the PSIS and the clinical decision support system (CDSS) functionalities are explained to make the future goals of PSIS clearer. The patient safety indicator (PSI) is explained in a separate section, which provides the opportunity to assess the incidence of adverse events and in-hospital complications using administrative data found in the typical discharge record. The ultimate goals of PSIS and PSI are to improve the quality of healthcare and ensure patient safety.

scholarly journals Residents' Perspectives on Patient Safety in University and Community Teaching Hospitals

2014 ◽  
Vol 6 (3) ◽  
pp. 603-607 ◽  
Author(s):  
Deborah L. Jones
Keyword(s):  
Internal Medicine ◽  
Patient Safety ◽  
General Surgery ◽  
Health Care Professionals ◽  
Diagnostic Radiology ◽  
Transitions Of Care ◽  
Teaching Hospitals ◽  
Safety Issues ◽  
Communication Problems ◽  
Community Teaching

Abstract Background Patient safety is an important concept in resident education. To date, few studies have assessed resident perceptions of patient safety across different specialties. Objective The study explored residents' views on patient safety across the specialties of internal medicine, general surgery, and diagnostic radiology, focusing on common themes and differences. Methods In fall 2012, interviews of small groups of senior residents in internal medicine, general surgery, and diagnostic radiology were conducted at 3 academic medical centers and 3 community teaching hospitals in 3 major US metropolitan areas. In total, 33 residents were interviewed. Interviews used interactive discussion to explore multiple facets of patient safety. Results Residents identified lack of information, common errors, volume and acuity of patients, and inadequate supervision as major risks to patient safety. Specific threats to patient safety included communication problems, transitions of care, information technology interface issues, time constraints, and work flow. Residents disclosed that reporting safety issues was viewed as burdensome and carrying some degree of risk. There was variability as to whether residents would report safety threats they encountered. Conclusions Residents are aware of threats to patient safety and have a unique perspective compared with other health care professionals. Transitions of care and communication problems were the most common safety threats identified by the residents interviewed.

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