Aust Crit Care
-
The high numbers of patients suffering from adverse incidents has resulted in wide spread commitment to improving patient safety. While a lack of technical skill can play a part, there is growing evidence that poor non-technical skills can be a major cause of error in healthcare. Non-technical skills, or human factors, play an important role in improving team function and improving these skills can drive improvements in patient safety and outcome. This editorial challenges traditional role stereo-types, and argues that fundamental changes in the behaviour of professionals need to be made, and sustained, in order that the whole team can make a valuable contribution to the patient safety agenda.
-
The use of the sepsis bundles in patients with severe sepsis and septic shock has been controversial in the last decade. Clinical studies have reported beneficial, as well as negative results. We conducted a meta-analysis to assess the clinical evidence and to evaluate survival effects. ⋯ The Resuscitation 6 hour bundle in the context of the patient population at hand is unlikely to do harm and is yet to be established in primary research in Australia. The Management 24 hour Bundle could not establish a strong enough survival benefit above current routine practice. The sepsis guidelines and bundles have demanded more credible process measurements and debate to induce positive changes in the intervention and treatment care of patients with severe sepsis.
-
Elements of evidence based practice (EBP) are well described in the literature and achievement of EBP is frequently being cited as an organisational goal. Despite this, the practical processes and resources for achieving EBP are often not readily apparent, available or successful. ⋯ A multi-dimensional program of practice change has been implemented in one setting and is providing a forum for discussion of practice-related issues and improvements. Adaptation of these strategies to multiple different health care settings is possible, with the potential for sustained practice change and improvement.