scholarly journals Nurses’ Experiences of Adverse Events Management at a Public Hospital, Gauteng Province

2020 ◽  
Vol 12 (12) ◽  
pp. 80
Author(s):  
Elizabeth Malefu Nkosi
Keyword(s):  
Adverse Events ◽  
Public Hospital ◽  
Negative Impact ◽  
Traumatic Experience ◽  
Sampled Data ◽  
Job Rotation ◽  
Individual Interviews ◽  
Managerial Support ◽  
Audio Tape Recorder ◽  
Qualitative Phenomenological

BACKGROUND: Involvement in adverse events can be a traumatic experience that leaves the nurses with professional and personal distress. Some feel as though they have failed the patient doubting their nursing skills. While the effects of the event can be distinctively evident on the patient and hospital, the nurses in question often suffer in silence. The purpose of this study was to explore and describe the nurses’ experiences of adverse events management at a public hospital, and to develop recommendations to address them. METHODS: A qualitative, phenomenological and contextual research design was used to explore and describe the nurse’s experiences of management of adverse events at this public hospital in Gauteng, South Africa. A total of 18 professional nurses who met the inclusion criteria were purposively sampled. Data was collected by means of in-depth semi structured individual interviews and documented field notes. An audio tape recorder was used with the participants’ consent to capture the participant’s responses. Data was analyzed using Tesch’s open coding method. Ethical principles to protect the rights of the participants were adhered to, and the criteria of trustworthiness was ensured. RESULTS: Findings of the study revealed that participants experienced negative management of adverse events. Three sub- themes emerged namely: inconsistency in the reporting and recording of adverse events, lack of managerial support and unplanned job rotation used as punishment following the events. CONCLUSION: Involvement in adverse events has a negative impact on the nurses’ wellbeing as well as patient care. Management should make efforts to promote awareness, implement positive management of adverse events, ensure consistency in the reporting and recording of adverse events including the provision of managerial support, and planned job rotation.

scholarly journals Scale of adverse events associated to nursing practices: a psychometric study in Portuguese hospital context

2018 ◽  
Vol 26 ◽  
Author(s):  
Teresa Neves ◽  
Vitor Rodrigues ◽  
João Graveto ◽  
Pedro Parreira
Keyword(s):  
Adverse Events ◽  
Public Hospital ◽  
Hospital Setting ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Stable Factor ◽  
Hospital Units ◽  
Northern Regions ◽  
Structural Invariance ◽  
The Stability

Objective to contribute to the validation study of the Scale of Adverse Events associated with Nursing Practices in the hospital context. Method cross-sectional study, in public hospital units, in the central and northern regions of Portugal. The exploratory factor analysis of the Scale of Adverse Events associated to Nursing Practices was conducted with a sample of 165 nurses and the confirmatory factorial analysis was made with a sample of 685 nurses. Reliability, internal consistency and construct validity were estimated. The invariance of the model was evaluated in two subsamples to confirm the stability of the factorial solution. Results the global sample consisted of 850 nurses aged between 22 and 59, mostly licensed professionals. The model had a good overall fit in the subscales (Nursing Practices: χ2/df = 2.88, CFI = 0.90, GFI = 0.86, RMSEA = 0.05, MECVI = 3.30; Adverse Events: χ2/df = 4.62, CFI = 0.93, GFI = 0.95, RMSEA = 0.07, MECVI = 0.39). There was a stable factor structure, indicating strong invariance in the subscale Nursing Practices and structural invariance in the subscale Adverse Events. Conclusion the refined model of the Scale of Adverse Events associated with Nursing Practices revealed good fit and stability of the factorial solution. The instrument was adjusted to evaluate the perception of nurses about adverse events associated with health care, precisely nursing care, in the hospital setting.

scholarly journals Psychological prevention of injuries of the musculoskeletal system in elite athletes

2021 ◽  
Vol 11 (3) ◽  
pp. 51-56
Author(s):  
E. I. Razumets
Keyword(s):  
Musculoskeletal System ◽  
Negative Impact ◽  
Elite Athletes ◽  
Sports Injury ◽  
Traumatic Experience ◽  
Traumatic Experiences ◽  
Professional Activity ◽  
Return To Sports ◽  
Traumatic Episode ◽  
Elite Sports

The article presents a study of traumatic experiences by high-class athletes (members of the Russian national teams). Data on the subjective sensations of athletes who have suffered from injury of the musculoskeletal system are obtained, patterns in the perception of the consequences of an injury event are revealed. Also we present data on the attitude of athletes to injury in the aspect of professional activity. The analyzed information is an important component in the development of personalized programs for the prevention of reinjury in elite sports.Objective: to assess the psychoemotional experiences of sports trauma by elite athletes in the process of rehabilitation treatment after the musculoskeletal system injury.Materials and methods: a specially developed medical and psychological interview was conducted with athletes-members of the sports national Russian Federation teams, who are inpatient treatment in the sports traumatology department, in order to obtain primary subjective information from the athlete about his presentation of his own experiences of a traumatic episode. Further, the information obtained from the interviews was analyzed and grouped for further evaluation.Results: we state the significant influence exerted by the previous traumatic experience on the future life and professional activity of an athlete. Moreover, the influence can be both negative (fear, anxiety, kinesiophobia, uncertainty in sports-specific movements) and positive (acquired skills of coping with traumatic experiences, gaining new knowledge about one’s physical and psychological capabilities).Conclusions: thus, despite the diversity of individual reactions of athletes to injury, different life situations, sports and traumatic events, it is possible to identify general patterns in the perception of elite athletes of the injury itself, as well as the entire process of recovery and return to sports. This information is very important both for minimizing the negative impact of a sports injury on the psychological recovery of an athlete by switching his attention to identifying the “positive” consequences of the injury, and for the prevention of repeated injuries in elite sports.

scholarly journals Comparison of Efficacy in Patients with Metastatic Melanoma Treated with Ipilimumab and Nivolumab Who Did or Did Not Discontinue Treatment Due to Immune-Related Adverse Events: A Real-World Data Study

Cancers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 5550
Author(s):  
Morten Fink ◽  
Anders Schwartz Vittrup ◽  
Lars Bastholt ◽  
Inge Marie Svane ◽  
Marco Donia ◽  
...  
Keyword(s):  
Adverse Events ◽  
Metastatic Melanoma ◽  
Real World ◽  
Negative Impact ◽  
Cox Proportional Hazards Model ◽  
Induction Phase ◽  
Discontinue Treatment ◽  
Real World Data ◽  
World Data ◽  
Significant Difference

Immune-related adverse events (irAEs) are very prevalent when treating patients with ipilimumab and nivolumab in combination, and 30–40% of patients discontinue the treatment for this reason. It is of high clinical relevance to investigate the consequences of discontinuing the treatment early since combination therapy with ipilimumab and nivolumab is the first line of treatment for many patients with metastatic melanoma. In this follow-up study, with real-world data from the nationwide DAMMED database, we investigated whether there was a difference in progression-free survival (PFS) and overall survival (OS) for patients who discontinued or did not discontinue treatment within the first four doses of treatment due to irAEs. In total, 448 patients were treated with ipilimumab and nivolumab. Of these, 133 patients discontinued due to irAEs in the induction phase. Using the Cox proportional hazards model, there was no significant difference in PFS when comparing the group that discontinued with the group that did not discontinue. The group that discontinued had a significantly longer OS than the group that received the full length of treatment. Therefore, we conclude that there is no significant negative impact on efficacy for patients who discontinue due to irAEs in the induction phase of combination immunotherapy for metastatic melanoma.

scholarly journals Nurturing Grandchildren With Down Syndrome: A Qualitative Study on Grandparents’ Needs Using Digital Tools†

2021 ◽  
Vol 12 ◽  
Author(s):  
María C. Sánchez Gómez ◽  
Rocío Martín-Sevillano ◽  
María V. Martín-Cilleros ◽  
J. J. Mena Marcos ◽  
Francisco J. García-Peñalvo
Keyword(s):  
Down Syndrome ◽  
General Purpose ◽  
Future Research ◽  
Personal Perspective ◽  
Social Emotional ◽  
Individual Interviews ◽  
Open Questions ◽  
Future Research Directions ◽  
Qualitative Phenomenological ◽  
Negative Feelings

Grandparents who have grandchildren with disabilities are an underrepresented group in existing research related to the field. This qualitative phenomenological study’s general purpose is to analyze, from a personal perspective, the situations and needs of grandparents who have grandchildren with Down syndrome. The participants’ ages range from 65 to 85, and the ages of their grandchildren with Down syndrome range from 3 to 21 years. All participants had one grandchild with a disability, except for two, who each had two. A sociodemographic questionnaire was administered, and individual interviews were conducted, using open questions, through phone and/or video calls. An analysis of the participants’ speech was carried out, which implied the development of a system of meta-categories and categories. This analysis was developed manually, given the COVID-19 environment. The results indicate a substantial change from negative feelings caused by the knowledge of the diagnosis to feelings related to positive experiences expressed currently. The participants see themselves as a fundamental source of support (informal, instrumental, practical, social, emotional, and economic) for their families and, mainly, for their grandchildren with Down syndrome. A need for information and training was observed when the grandparents talked about first being informed of the diagnosis and their concerns about the future of these grandchildren and their siblings. They made social demands, such as greater government involvement or more significant opportunities to access resources and rights for their grandchildren. The results are discussed, as are possible future research directions.

scholarly journals Diversity Challenges and Organizational Cynicism: A study on Egyptian Physicians

2017 ◽  
Vol 9 (1) ◽  
pp. 41-74 ◽  
Author(s):  
Mohamed Mousa
Keyword(s):  
Regression Analysis ◽  
Cultural Diversity ◽  
Public Hospital ◽  
Negative Impact ◽  
Vital Role ◽  
Correlation And Regression Analysis ◽  
Organizational Cynicism ◽  
Academic Management ◽  
Management Literature ◽  
Race Ethnicity

Abstract As a result of globalization and interactions of people with various identities, cultural diversity has become a noticeable norm in today’s business life. Accordingly, managing such cultural diversity requires a dependence on a much more tolerant culture in which employees seek to attain both career and organizational objectives without being hurdled by irrelevant factors of religion, race, ethnicity and so on. During the last two decades, organizational cynicism has found a place in academic management literature. It has a vital role in interpreting many organizational unwanted behaviors such as: absenteeism, day dreaming and the state of being careless when doing work. This study investigates the association between cultural diversity challenges and organizational cynicism dimensions by conducting a quantitative study of physicians in Kasr El Eini public hospital in Egypt. Upon using correlation and regression analysis for the collected data, it appears that not all cultural diversity challenges have a negative impact on organizational cynicism dimensions.

scholarly journals Mortality is not increased with Diabetes in Hospitalised Very Old Adults: A multi-site review.

2020 ◽  
Author(s):  
Peter Smerdely
Keyword(s):  
Length Of Stay ◽  
Adverse Events ◽  
Negative Binomial ◽  
Negative Impact ◽  
Outcome Data ◽  
Teaching Hospitals ◽  
Very Old ◽  
Old Adults ◽  
Lengths Of Stay ◽  
Hospital Acquired

Abstract Background: Few data exist regarding hospital outcomes in people with diabetes aged beyond 75 years. This study aimed to explore the association of diabetes with hospital outcome in the very old patient.Methods: A retrospective review was conducted of all presentations of patients aged 65 years or more admitted to three Sydney teaching hospitals over six years (2012-2018), exploring primarily the outcomes of in-hospital mortality, and secondarily the outcomes of length of stay, the development of hospital-acquired adverse events and unplanned re-admission to hospital within 28 days of discharge. Demographic and outcome data, the presence of diabetes and comorbidities were determined from ICD10 coding within the hospital's electronic medical record. Logistic and negative binomial regression models were used to assess the association of diabetes with outcome. Results: A total of 139130 separations (mean age 80 years, range 65 to 107 years; 51% female) were included, with 49% having documented comorbidities and 26.1% a diagnosis of diabetes. When compared to people without diabetes, diabetes was not associated with increased odds of mortality (OR: 0.89 SE (0.02), p<0.001). Further, because of a significant interaction with age, diabetes was associated with decreased odds of mortality beyond 80 years of age. While people with diabetes overall had longer lengths of stay (10.2 days SD (13.4) v 9.4 days SD (12.3), p<0.001), increasing age was associated with shorter lengths of stay in people aged more than 90 years. Diabetes was associated with increased odds of hospital-acquired adverse events (OR: 1.09 SE (0.02), p<0.001) and but not 28-day re-admission (OR: 0.88 SE (0.18), p=0.523).Conclusion: Diabetes has not been shown to have a negative impact on mortality or length of stay in hospitalised very old adults from data derived from hospital administrative records. This may allow a more measured application of diabetic guidelines in the very old hospitalised patient.

scholarly journals Toitū te Mana Rangatahi: Marae-Based Youth Courts: Negotiating Pathways for Rangatahi Offending

2021 ◽  
Author(s):  
◽  
Haimona Hone Hiki-Tia-Te-Rangi Waititi
Keyword(s):  
Restorative Justice ◽  
Justice System ◽  
Negative Impact ◽  
Court System ◽  
Youth Justice ◽  
Demographic Groups ◽  
Individual Interviews ◽  
Kaupapa Māori ◽  
Disproportionate Number ◽  
Group Interviews

<p>The Aotearoa/New Zealand Government has a disposition to spend tax payer's money on prisons. The way in which our current legal system is structured, subsequent Governments are going to have to do the same. Māori make up a disproportionate number of those in prison. Recent times have seen the establishment of an initiative aimed at reducing youth crime rates such as Restorative Justice and Marae-Based Youth Courts (MBYC). This study explores how well these new initiatives offered by the youth justice system provide for the needs of youth and community. The specific aim of this study is to analyse the MBYC from the perspective of rangatahi, lay advocates and Kaumātua (honoured elders). The purpose of this is to better understand the processes that rangatahi (Māori youth) went through when they came into contact with the criminal justice system and how cultural philosophies may better inform this process, so that improved outcomes may be achieved for these rangatahi. This research was conducted under a Kaupapa Māori methodology. A series of 3 individual interviews and 3 focus group interviews were conducted (participant total 11) with the three demographic groups. Interviews were later transcribed and analysed using thematic analysis. Four major themes were identified from the analysis. These were; Tā te ture ki te Rangatahi (law as it pertains to the rangatahi), whakamā, Te Wairuatanga o te Marae (the spirituality of the Marae) and Potentiality of the Lay Advocate Role. All four major themes had a set of subordinate themes directly related to them. It was found that the adversarial nature of the youth justice system was having a negative impact on rangatahi and was inhibiting their ability to experience the feelings of remorse and accountability that the process is designed to induce. The restorative justice parts of the system showed more promise but were also falling short of the outcomes they set for themselves. Encouraging results were seen in relation to the MBYC. However, the transplanting of the adversarial court system on to the marae warranted concerns over the domination of this institution over the marae.</p>

scholarly journals Innovative Approach for the Prevention of Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients: A Pilot Study With the Hilotherm Device, the Poliambulanza Hospital Experience

2020 ◽  
Vol 19 ◽  
pp. 153473542094328
Author(s):  
Ester Oneda ◽  
Fausto Meriggi ◽  
Laura Zanotti ◽  
Elisabetta Zaina ◽  
Sara Bighè ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peripheral Neuropathy ◽  
Adverse Events ◽  
Negative Impact ◽  
Life Questionnaire ◽  
European Organization ◽  
Effective Prevention ◽  
The Common ◽  
Hands And Feet

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse event of taxanes, with no effective prevention or treatment available and a highly negative impact on patient quality of life. The aim of this study is to asses that the constant application of cooled cuffs on the hands and feet prevent and mitigate CIPN. Methods: Patients with breast, gynecologic, and pancreatic cancer who received weekly paclitaxel (PTX), PTX/carboplatin, and nab-paclitaxel (nab-PTX)/gemcitabine for any indication at the therapeutic scheduled dosage were included in this prospective study. Hilotherm Chemo care device forms a closed-loop system with cuffs and tubes through which a coolant flows at a temperature of 10 °C. CIPN was monitored using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (edition 3.0), and the tolerability and side effects were scored by using the Common Terminology Criteria for Adverse Events (T4.03 2017). Results: To date, we have enrolled 64 patients. Of these, 54 (84%) completed all cooling cycles. Continuous cooling was well tolerated by all patients. No patients had grade >2 CIPN or had serious or lasting adverse events as a result of Hilotherapy. The median time to CIPN onset was 77 days for the entire population. Conclusion: Hilotherapy has good effectiveness and tolerability and seems to be able to prevent or reduce the symptoms of CIPN. We are still recruiting patients to obtain more data and to collect data at 3 months after the end of chemotherapy. Prospective studies seem to be warranted.

scholarly journals CORRECT PATIENT IDENTIFICATION: EXPERIENCE WITH THE IMPLEMENTATION OF A PATIENT SAFETY CORE

2019 ◽  
Vol 5 ◽  
Author(s):  
Paula Eduarda Oliveira Honorato ◽  
Tania Monteiro Teixeira
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Adverse Events ◽  
Lower Risk ◽  
Public Hospital ◽  
Experience Report ◽  
Patient Identification ◽  
Multiprofessional Team ◽  
Identification Process

Objective: to report and evaluate the implementation of the Patient Safety Center, with emphasis on the identification of patients in a public hospital in Piauí. Method: experience report, in which the activities were performed from January to April 2019. The information for analysis came from the situations experienced by the authors in the implementation of the NSP and the patient identification process. Results: There was an improvement and facilitation in the work of the multiprofessional team enabling lower risk of patient exchange, and consequent avoidable adverse events. Conclusion: the implementation of the NSP was reported and analyzed, with a significant improvement in the organization of services, suggesting improvement with the team, highlighting the importance of protocols for better health care.

scholarly journals Feasibility and Safety of 3-Weekly Carboplatin/Paclitaxel Regimen in Advanced Squamous cell Carcinoma of the Anal Canal

2021 ◽  
pp. 1-5
Author(s):  
Abraão Dornellas ◽  
Abraão Dornellas ◽  
Renata C. Bonadio ◽  
Priscila M. G. Moraes ◽  
Maria I. Braghiroli ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cox Regression ◽  
Negative Impact ◽  
Multivariable Analysis ◽  
Treatment Strategies ◽  
Complete Response ◽  
Median Number ◽  
Rank Test ◽  
Hiv Positive ◽  
Serious Adverse Events

Introduction: Anal cancer is a rare disease, and there is a lack of phase 3 studies in the advanced setting. Currently, the standard treatment is based on interAACT phase 2 study using Carboplatin (C) (AUC 5, D1q28) plus Paclitaxel (P) (80 mg/m2, D1,8,15q28). This study demonstrated a median OS of 20m, a response rate of 59% and serious adverse events in 36% of patients (pts). However, this regimen requires more infusions and hospital visits than a 3-weekly CP regimen, resulting in high social and financial cost. Objective: To retrospectively access safety and efficacy of treatment with 3-weekly CP in advanced SCCA. Methods: We performed a single-center retrospective analysis of patients (pts) who received first-line treatment with 3-weekly CP for inoperable locally recurrent or metastatic SCCA between Jun/2011 and Jun/2018. Study data were collected using REDCap®. Survival analyses were estimated with the Kaplan-Meier method and compared by log-rank test. Prognostic factors were evaluated by Cox regression. Results: 47 patients were included. Median age was 57 years, 60% (n=28) were female and 21% (n=10) HIV positive.16% (n=7) had metastatic disease at diagnosis. The majority of pts (n=42) were treated with paclitaxel (P) 175 mg/m2 plus carboplatin (C) AUC 5 every 3 weeks. The median number of cycles was 4 and dose reduction by toxicity was necessary for 30% (n=14). Grade 3/4 adverse events were neutropenia 19% (n=9), anemia 4% (n=2), fatigue 4% (n=2), neuropathy 2% (n=1). Two pts had interruption due to toxicity and no treatment-related death. 64% of patients benefited from treatment, 4% with complete response. The median overall survival (OS) was 10 months(m). In a multivariable analysis, HIV-positive (HIV+) status (HR 3.1; 95%CI 1.8-8.4; p 0.001) and ECOG 2/3 (HR 3.9; 95%CI 1.2-8.1; p 0.01) showed a negative impact on OS. Median OS was 16m for HIV- vs 4m for HIV+ group; and 20m for ECOG 0/1 vs 4m for ECOG 2/3. Conclusion: The present study suggests that 3-weekly CP has similar outcomes to the InterAACT regimen. Nevertheless, pts who are HIV+ or have ECOG 2/3 had poor outcomes and other treatment strategies should be studied for these pts.

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