Journal of patient safety
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Journal of patient safety · Mar 2015
TRIAD VI: how well do emergency physicians understand Physicians Orders for Life Sustaining Treatment (POLST) forms?
Physician Orders for Life-Sustaining Treatment (POLST) documents are active medical orders to be followed with intention to bridge treatment across health care systems. We hypothesized that these forms can be confusing and jeopardize patient safety. ⋯ Significant confusion exists among members of the Pennsylvania chapter of the American College of Emergency Physicians regarding the use of POLST in critically ill patients. This confusion poses risk to patient safety. Additional training and/or safeguards are needed to allow patient choice as well as protect their safety.
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Journal of patient safety · Mar 2015
Emotion and coping in the aftermath of medical error: a cross-country exploration.
Making a medical error can have serious implications for clinician well-being, affecting the quality and safety of patient care. Despite an advancing literature base, cross-country exploration of this experience is limited, and a paucity of studies has examined the coping strategies used by clinicians. A greater understanding of clinicians' responses to making an error, the factors that may influence these, and the various coping strategies used are all essential for providing effective clinician support and ensuring optimal outcomes.The objectives were therefore to investigate the following: a) the professional or personal disruption experienced after making an error, b) the emotional response and coping strategies used, c) the relationship between emotions and coping strategy selection, d) influential factors in clinicians' responses, and e) perceptions of organizational support. ⋯ Clinicians in the United Kingdom and the United States experience professional and personal disruption after an error. A number of factors may influence clinician recovery; these factors should be considered in the provision of comprehensive support programs so as to improve clinician recovery and ensure higher quality, safer patient care.
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Journal of patient safety · Dec 2014
Predicting potential postdischarge adverse drug events and 30-day unplanned hospital readmissions from medication regimen complexity.
To determine whether medication regimen complexity (MRC) could predict likelihood for occurrence of potential adverse drug events (ADEs), unplanned 30-day hospital readmission, or 30-day emergency department use in patients transitioning from hospital to home care. ⋯ MRC was predictive of patients' potential for ADEs and unplanned hospital readmission. MRC may be useful in identifying patients that would benefit from additional transitional care interventions. Results indicate that simplifying medication regimens may favorably impact postdischarge outcomes.
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Journal of patient safety · Sep 2014
Multicenter StudyThe relationship between nurse staffing and failure to rescue: where does it matter most?
This study further expands on the relationship between nurse staffing levels and patient outcomes, in particular, failure to rescue. Many studies are based on single-site hospitals or single-year data, thus limiting the generalizations of the findings. The purpose was to evaluate in a multisite multiyear study the relationship between unit-level nurse staffing and FTR mortality, for ICU and non-ICU patients. ⋯ We did not observe any of the expected associations between the nurse staffing variables and FTR for either general care unit or ICU discharges. The comprehensive risk adjustments provided adequate "leveling of the playing field" to evaluate the impact of unit-based nurse staffing levels on FTR mortality. Future studies should evaluate the influence of unit environment and patient risk.
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Journal of patient safety · Sep 2014
Observational StudyThe relationship between hospital systems load and patient harm.
The objective of this study was to describe the relationship between patient harm due to health-care errors and the stresses on the hospital systems that occur because of the patients in need of care. ⋯ The results of this analysis are highly suggestive of a relationship between Hospital Systems Load and patient harm.