Journal of patient safety
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Journal of patient safety · Mar 2010
Check a Box. Save a Life: How student leadership is shaking up health care and driving a revolution in patient safety.
The objective was to engage health professions students as leaders in spreading the World Health Organization Surgical Checklist. The published impact of the checklist in reducing surgical complications and deaths, combined with its ease of use, offers an ideal target for students to save lives and prevent suffering. As members of the "Check a Box. Save a Life." campaign, students can speed the pace of patient safety improvement. ⋯ As an independent, self-organized, decentralized effort and an application of student social organizing to the cause of patient safety, "Check a Box." is a landmark achievement. Leveraging social media and disrupting the traditional model of safety leadership, the campaign offers hope for the future of patient safety.
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Journal of patient safety · Mar 2010
The impact of integrative medicine on pain management in a tertiary care hospital.
Optimal inpatient pain management remains a major institutional and therapeutic challenge. Nontoxic, nonpharmacological approaches to treating pain show promise but have not been widely implemented, nor has their effectiveness been evaluated. ⋯ The formal provision of inpatient integrative medicine had a significant impact on pain scores for hospitalized patients, reducing self-reported pain by more than 50%, without placing patients at increased risk of adverse effects. This was true in all 6 settings. Age, previous use of complementary therapies, and sex did not affect results. Future research must define the appropriate dose of the intervention, the duration of the relief, and the identification of patients most likely to respond to these nonpharmacological treatments. Additionally, future research using the electronic health record will allow quantification of any reduction in total costs, pain medication usage, and adverse events.
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Journal of patient safety · Dec 2009
Admission handoff communications: clinician's shared understanding of patient severity of illness and problems.
Communication errors are a leading cause of medical mistakes. Handoff communications during the admission of a patient are a critical point of communication during which patient care is transferred from one clinician to another. The transmission of the patient's current severity of illness and active problems is integral to this communication. Our objective was to determine if this information is conveyed by the current handoff process between resident physicians. ⋯ We conclude that information needed to assess the patient's severity of illness and problems may have been present in the handoff communications but may not have been fully received and integrated by the residents. In addition, attending physicians may have an additional capacity to "infer" information, perhaps because of prior clinical experience or expertise. This study implies that residents may need more formal education, training, and evaluation of their handoffs to improve patient safety.
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Journal of patient safety · Sep 2009
The role of advice in medication administration errors in the pediatric ambulatory setting.
In the pediatric setting, adverse events occurring at the administration stage are the most common type of preventable adverse drug events. Few data are available on the effect of advice from medical professionals on medication safety. ⋯ Inadequate advice was provided. The current approach for delivering advice does not prevent against medication administration errors. Those at highest risk of such errors are the youngest children and those on multiple medications.
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Journal of patient safety · Sep 2009
Comparative StudyComparison of differing sedation practice for upper endoscopic ultrasound using expert observational analysis of the procedural sedation.
To compare the quality between 2 commonly used sedation practices for upper endoscopic ultrasound (EUS) by using expert observational analysis of the sedation practice. ⋯ Expert videotape analysis of the patient state during procedural sedation allows direct comparison of sedation methodologies using small numbers of patients. In our institution, endoscopist-directed sedation using a midazolam/narcotic combination for EUS proved inferior to sedation using propofol given by an anesthesiologist. Specifically, a midazolam/narcotic combination provided less effective intraprocedural conditions, was less efficient both before and after the procedure, and was less satisfactory to patients as compared with propofol. Results of this type of analysis can be used to drive appropriate system redesign and improve patient care.