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BMJ Quality & Safety Oct 2020Despite significant advances, patient safety remains a critical public health concern. Daily huddles-discussions to identify and respond to safety risks-have been...
BACKGROUND
Despite significant advances, patient safety remains a critical public health concern. Daily huddles-discussions to identify and respond to safety risks-have been credited with enhancing safety culture in operationally complex industries including aviation and nuclear power. More recently, huddles have been endorsed as a mechanism to improve patient safety in healthcare. This review synthesises the literature related to the impact of hospital-based safety huddles.
METHODS
We conducted a systematic review of peer-reviewed literature related to scheduled, multidisciplinary, hospital-based safety huddles through December 2019. We screened for studies (1) in which huddles were the primary intervention being assessed and (2) that measured the huddle programme's apparent impact using at least one quantitative metric.
RESULTS
We identified 1034 articles; 24 met our criteria for review, of which 19 reflected unit-based huddles and 5 reflected hospital-wide or multiunit huddles. Of the 24 included articles, uncontrolled pre-post comparison was the prevailing study design; we identified only two controlled studies. Among the 12 unit-based studies that provided complete measures of statistical significance for reported outcomes, 11 reported statistically significant improvement among some or all outcomes. The objectives of huddle programmes and the language used to describe them varied widely across the studies we reviewed.
CONCLUSION
While anecdotal accounts of successful huddle programmes abound and the evidence we reviewed appears favourable overall, high-quality peer-reviewed evidence regarding the effectiveness of hospital-based safety huddles, particularly at the hospital-wide level, is in its earliest stages. Additional rigorous research-especially focused on huddle programme design and implementation fidelity-would enhance the collective understanding of how huddles impact patient safety and other targeted outcomes. We propose a taxonomy and standardised reporting measures for future huddle-related studies to enhance comparability and evidence quality.
Topics: Delivery of Health Care; Humans; Patient Care Team; Patient Safety; Safety Management
PubMed: 32265256
DOI: 10.1136/bmjqs-2019-009911 -
The Journal of Forensic... Dec 2022Objective of work: The aim of this study was to determine the most frequent injuries and their relationship with gender, age and aetiology. Materials and Methods: An... (Meta-Analysis)
Meta-Analysis
Objective of work: The aim of this study was to determine the most frequent injuries and their relationship with gender, age and aetiology. Materials and Methods: An Epidemiologic Systematic Review was carried out, in the databases PUBMED and Scopus, between 2010-2020. We used Joanna Briggs Institute Checklist to access the Risk of Bias and Grading of recommendations, assessment, development, and the evaluations (GRADE) method was applied to assess the quality of the evidence of the 78 included articles. Results and Conclusions: Out of the 78 articles included, 14 were classified as moderate-risk bias and 58 as low risk. Only 20.5% had a prospective design and the male/female ratio ranged from 0.299 to 11.83. The majority of the studies described fractures (67) and only 26 reported dental injuries. The studies were distributed into five regions of countries: Asia, Africa, Latin America, Europe and Muslin regions. The results showed that road traffic accidents (55.37%) were the most frequent type of trauma, followed by assault (17.56%) and falls (10.21%). Fractures were the most prevalent injuries (84.3%). It was possible to establish an association between road traffic accidents and Asian countries. Assaults were more frequent in Africa, predominantly males, whilst falls increased with age, amongst women, in European countries. Fractures were usually observed in Muslin regions.
Topics: Humans; Female; Male; Accidents, Traffic; Maxillofacial Injuries; Fractures, Bone; Europe; Africa
PubMed: 36623294
DOI: No ID Found -
Neuroscience and Biobehavioral Reviews Jun 2021Studies have demonstrated an increased risk of accidents and injuries in children, adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). However,... (Review)
Review
Studies have demonstrated an increased risk of accidents and injuries in children, adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). However, little is known about how accident risk may alter over the lifespan. Additionally, it would be important to know if the most common types of accidents and injuries differ in ADHD patients over different age groups. Furthermore, there is increasing evidence of an ameliorating effect of ADHD medication on accident risk. Lastly, the underlying risk factors and causal mechanisms behind increased accident risk remain unclear. We therefore conducted a systematic review focusing on the above described research questions. Our results suggested that accident/injury type and overall risk changes in ADHD patients over the lifespan. ADHD medication appeared to be similarly effective at reducing accident risk in all age groups. However, studies with direct comparisons of accident/injuries and effects of medication at different age groups or in old age are still missing. Finally, comorbidities associated with ADHD such as substance abuse appear to further increase the accident/injury risk.
Topics: Accidents; Adolescent; Adult; Attention Deficit Disorder with Hyperactivity; Central Nervous System Stimulants; Child; Comorbidity; Humans; Longevity; Methylphenidate
PubMed: 33582234
DOI: 10.1016/j.neubiorev.2021.02.002 -
Dimensions of Critical Care Nursing :...Nursing practice workarounds (NPWs) are a significant problem for health care organizations. Identified NPWs serve as a catalyst for innovation to improve efficiency,...
BACKGROUND
Nursing practice workarounds (NPWs) are a significant problem for health care organizations. Identified NPWs serve as a catalyst for innovation to improve efficiency, patient safety, and system design. To date, a systematic review of NPW literature has not been performed.
OBJECTIVES
The aim of this systematic review was to synthesize evidence of NPW definitions, context, and prevention strategies, utilizing previous research to develop a framework that examines the current state of this phenomenon and implications for clinical practice, while highlighting the need for future research.
METHODS
A systematic review of the literature was conducted using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Academic Search, Ovid MEDLINE, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Google Scholar databases were reviewed for eligible studies from 2013 to 2020. Results were further screened and sorted by relevance and scored for quality.
RESULTS
Thirteen studies were included. Studies lacked the use of theory, and NPW definitions were varied. Nursing workarounds occurred most frequently when implementing new technology (46%) and when administering medications (31%). Contributing factors were workplace stressors and obstructions in workflow environment. Workaround prevention strategies include open communication and a proactive approach addressing conditions, situations, and processes. Overall study quality was low.
DISCUSSION
This systematic review provides valuable information for critical care nurses and administrators regarding NPW. Implications for practice include the need for proactive and open communication between nurses and administrators when new technology and/or patient care processes require NPW. Administrative considerations include process and environmental improvement strategies to remove perceived workflow barriers. Future research to examine causes and consequences of NPW is needed to identify interventions for NPW prevention. Specific nursing considerations include workload, staffing and time constraints, and impacts of work-related stress levels. Critical care nursing processes should be examined for common NPW challenges. Interventions developed to address these challenges should then be tested to further advance evidence-based critical care nursing care.
Topics: Evidence-Based Nursing; Humans; Patient Safety; Workload
PubMed: 36179314
DOI: 10.1097/DCC.0000000000000549 -
Injury Prevention : Journal of the... Jun 2022The prevention of dog bites is an increasingly important public health topic, as the incidence of serious injury continues to rise. (Review)
Review
BACKGROUND
The prevention of dog bites is an increasingly important public health topic, as the incidence of serious injury continues to rise.
OBJECTIVES
To evaluate the effectiveness of interventions to prevent dog bites and aggression.
METHODS
Online databases were searched (PubMed, Cochrane Library, Embase and Google Scholar), using the search terms: , for studies between 1960 and 2021. All study designs were considered. Outcomes of interest were the incidence of dog bites or dog aggression. Non-English studies, and those without full-text access were excluded.
RESULTS
Forty-three studies met the review criteria, including 15 observational and 27 interventional studies. Fifteen studies investigating dog-control legislation, including leash laws, stray dog control and infringements indicated this can reduce dog bite rates. Breed-specific legislation had less of an effect. Six studies investigating sterilisation, showed while this may reduce dog bites through a reduction in the dog population, the effect on dog aggression was unclear. An alcohol reduction programme showed a significant reduction in dog bite rates in one study. Seven studies assessing educational approaches found that intensive adult-directed education may be effective, with one study showing child-directed education was not effective. Eight studies on dog training (two police-dog related), and six evaluating dog medication or diet were generally low quality and inconclusive.
CONCLUSIONS
Multiple strategies including effective engagement with indigenous communities and organisations will be required to reduce dog-bites and other incidents involving dog aggression. This review provides some evidence that legislated dog control strategies reduce dog bite rates. Available evidence suggests greater restrictions should be made for all dogs, rather than based on breed alone. Due to a burden of child injury, protection of children should be a focus of legislation and further investigations. Prevention strategies in children require redirection away from a focus on child-directed education and future research should investigate the effectiveness of engineering barriers and reporting strategies.
Topics: Accidents; Aggression; Animals; Bites and Stings; Breeding; Dogs; Humans; Incidence
PubMed: 35393286
DOI: 10.1136/injuryprev-2021-044477 -
The Journal of Craniofacial Surgery May 2017The aim of this study was to perform a systematic review of the etiology of nasal bone fractures (NBFs).In PubMed (500 titles) and Scopus (272), the search terms "nasal... (Review)
Review
The aim of this study was to perform a systematic review of the etiology of nasal bone fractures (NBFs).In PubMed (500 titles) and Scopus (272), the search terms "nasal bone fracture" AND "etiology OR cause" were used. Among the 772 titles, 137 were duplicated and excluded. The 552 titles were excluded and 83 abstracts were read. Subsequently, 42 abstracts were excluded and 41 full articles providing data on etiologies of NBFs were reviewed. Finally, 26 papers were incorporated into this analysis.The causes of NBFs were different between adults and children. In adults, the most frequent causes were fights (36.3%), traffic accidents (20.8%), sports (15.3%), and falls (13.4%). In children, the most frequent causes were sports (59.3%), fights (10.8%), traffic accidents (8.3%), collisions (5.0%), and falls (3.3%). It is noticeable that fights, traffic accidents, and falls were more frequent in adults than in children, although sports and collisions were more frequent in children than in adults (P < 0.001). The causes of NBFs varied geographically. Fights were the most frequent cause in Asia (36.7%), South America (46.5%), and Europe (40.8%). In North America, however, traffic accidents were the most frequent cause (33.6%), followed by fights (20.7%) and sports (17.3%). Among the sports injuries, ball-related sports were the most frequent cause (84.2%). Fighting-related sports (6.4%) contributed to relatively small proportion of NBFs.In efforts to prevent NBFs in children, sports injuries should be primarily considered. Restraining devices such as seatbelts are needed to prevent NBFs caused by traffic accidents, especially in North America.
Topics: Accidental Falls; Accidents, Traffic; Athletic Injuries; Facial Bones; Global Health; Humans; Incidence; Nasal Bone; Skull Fractures
PubMed: 28468166
DOI: 10.1097/SCS.0000000000003477 -
Sensors (Basel, Switzerland) Jan 2022This paper aims to provide a review of the electrically assisted bicycles (also known as e-bikes) used for recovery of the rider's physical and physiological... (Review)
Review
This paper aims to provide a review of the electrically assisted bicycles (also known as e-bikes) used for recovery of the rider's physical and physiological information, monitoring of their health state, and adjusting the "medical" assistance accordingly. E-bikes have proven to be an excellent way to do physical activity while commuting, thus improving the user's health and reducing air pollutant emissions. Such devices can also be seen as the first step to help unhealthy sedentary people to start exercising with reduced strain. Based on this analysis, the need to have e-bikes with artificial intelligence (AI) systems that recover and processe a large amount of data is discussed in depth. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to complete the relevant papers' search and selection in this systematic review.
Topics: Accidents, Traffic; Artificial Intelligence; Bicycling; Electricity; Humans; Transportation
PubMed: 35062429
DOI: 10.3390/s22020468 -
TheScientificWorldJournal 2021Medical errors are the third leading cause of death in the United States. Reporting of all medical errors is important to better understand the problem and to implement...
BACKGROUND
Medical errors are the third leading cause of death in the United States. Reporting of all medical errors is important to better understand the problem and to implement solutions based on root causes. Underreporting of medical errors is a common and a challenging obstacle in the fight for patient safety. The goal of this study is to review common barriers to reporting medical errors.
METHODS
We systematically reviewed the literature by searching the MEDLINE and SCOPUS databases for studies on barriers to reporting medical errors. The preferred reporting items for systematic reviews and meta-analyses guideline was followed in selecting eligible studies.
RESULTS
Thirty studies were included in the final review, 8 of which were from the United States. The majority of the studies used self-administered questionnaires (75%) to collect data. Nurses were the most studied providers (87%), followed by physicians (27%). Fear of consequences is the most reported barrier (63%), followed by lack of feedback (27%) and work climate/culture (27%). Barriers to reporting were highly variable between different centers.
Topics: Medical Errors; Patient Safety; Risk Management; Surveys and Questionnaires; United States
PubMed: 34220366
DOI: 10.1155/2021/6494889 -
European Journal of Trauma and... Jun 2016The aim of this study is to establish the biomechanics, presentation and diagnosis of mesenteric avulsions following blunt abdominal trauma and reach a consensus on... (Review)
Review
PURPOSE
The aim of this study is to establish the biomechanics, presentation and diagnosis of mesenteric avulsions following blunt abdominal trauma and reach a consensus on their overall management.
MATERIALS AND METHODS
A systematic review of literature in MedLine, Embase, Scopus and CINHAL in English language from 1951 to November 2014 was performed. A total of 20 reported cases were identified. Variables including patient's demographics, signs and symptoms, mechanism of injury, investigative modality, management, length of stay, follow-up and outcomes were reviewed and analyzed.
RESULTS
The median age of the cohort was 28.5 years (range 10-58 years), with a male-to-female ratio of 3:1. The commonest mechanism of injury was road traffic accident due to seat belt restraint (n = 12, 60 %). The commonest presentation was diffuse abdominal tenderness (n = 10, 45 %) followed by ecchymosis/bruising (n = 9, 40 %). Computed tomography (CT) remained the investigative modality of choice (n = 9, 45 %). All cases had an emergency exploratory laparotomy (n = 18, 90 %) within the initial 24 h and the median length of stay was 19 days (range 4-90 days). The overall mortality was 15 % (n = 3).
CONCLUSION
Mesenteric avulsion is rare and has a complex and vague presentation. Due to its potential mortality and morbidity, emergency physicians should keep a high index of suspicion in individuals with blunt abdominal trauma from any mechanism of injury.
Topics: Abdominal Injuries; Accidents, Traffic; Biomechanical Phenomena; Early Diagnosis; Humans; Laparoscopy; Laparotomy; Mesentery; Multidetector Computed Tomography; Referral and Consultation; Seat Belts; Trauma Severity Indices; Wounds, Nonpenetrating
PubMed: 26038032
DOI: 10.1007/s00068-015-0514-z -
International Journal of Environmental... Mar 2023Legalizing medical and recreational cannabis and decriminalizing this substance may have unanticipated effects on traffic safety. The present study aimed to assess the... (Review)
Review
BACKGROUND
Legalizing medical and recreational cannabis and decriminalizing this substance may have unanticipated effects on traffic safety. The present study aimed to assess the impact of cannabis legalization on traffic accidents.
METHODS
A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration of the articles included in the Web of Science (WoS) and Scopus databases. The number of papers included in the review was 29.
RESULTS
The results show that in 15 papers, there is a relationship between the legalization of medical and/or recreational cannabis and the number of traffic accidents, while in 5 papers, no such relationship is observed. In addition, nine articles indicate a greater number of risk behaviors related to driving after consumption, identifying young, male, and alcohol consumption together with cannabis as the risk profile.
CONCLUSIONS
It can be concluded that the legalization of medical and/or recreational cannabis has negative effects on road safety when considering the number of jobs that affect the number of fatalities.
Topics: Cannabis; Legislation, Drug; Accidents, Traffic; Automobile Driving; Alcohol Drinking
PubMed: 36901669
DOI: 10.3390/ijerph20054655