BMJ quality & safety
-
Hospitalised patients whose inpatient teams rotate off service experience increased mortality related to end-of-rotation care transitions, yet standardised handoff practices are lacking. ⋯ In this controlled pilot study, a structured ICU end-of-rotation care transition strategy was feasible to implement with high fidelity. While mortality and LOS were not affected in a pilot study with limited power, the pragmatic strategy of this intervention holds promise for future trials.
-
summary"...I encourage all patient safety stakeholders to resist an overemphasis on absolute safety, and instead draw on the strengths of both the safety I and safety II approaches. We should be clear about what types of harms can or cannot be prevented and anticipated, work to eliminate those where there is good evidence for preventability by adopting evidence-based practices, improve the ability of everyone responsible for safety to identify risks, conduct better risk analyses to anticipate and reduce unintended harms, measure and celebrate the routine adaptations that prevent harm, and reward organisational learning and improvement." – Thomas, 2020.
-
BMJ quality & safety · Jan 2020
ReviewManaging risk in hazardous conditions: improvisation is not enough.
To improve overall safety and reduce harm, focus should be on reducing risk instead of eliminating harm.
pearl -
BMJ quality & safety · Jan 2020
Interventions for improving teamwork in intrapartem care: a systematic review of randomised controlled trials.
The labour and delivery environment relies heavily on interdisciplinary collaboration from anaesthesiologists, obstetricians and nurses or midwives to deliver optimal patient care. A large number of adverse events in obstetrics are associated with failure in communication and teamwork among team members, with substantive consequences. The objective of this study is to perform a systematic review of interventions aimed at improving teamwork in obstetrics. ⋯ CRD42018090452.
-
BMJ quality & safety · Nov 2019
Comparative StudyNursing roles for in-hospital cardiac arrest response: higher versus lower performing hospitals.
Good outcomes for in-hospital cardiac arrest (IHCA) depend on a skilled resuscitation team, prompt initiation of high-quality cardiopulmonary resuscitation and defibrillation, and organisational structures to support IHCA response. We examined the role of nurses in resuscitation, contrasting higher versus lower performing hospitals in IHCA survival. ⋯ Hospitals that excelled in IHCA survival emphasised mentoring and empowering front-line nurses and ensured clinical competency and adequate nursing training for IHCA care. Though not proof of causation, nurses appear to be critical to effective IHCA response, and how to support their role to optimise outcomes warrants further investigation.