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Rehabilitation Nursing : the Official... 2018Falls are a major safety issue in rehabilitation settings. Patients receive mixed messages-try to be as independent as possible, but don't do anything in your room...
PURPOSE
Falls are a major safety issue in rehabilitation settings. Patients receive mixed messages-try to be as independent as possible, but don't do anything in your room without calling for assistance. Despite the use of multiple falls interventions at this facility, the fall rate remained high. To impact this rate, the facility implemented a video monitoring system. This system allows for patients at risk for falling to be monitored from a remote location. The monitor technician is able to speak to the patient directly and/or contact staff members to respond to the room, preventing a fall.
DESIGN
Sequential cohort design.
METHOD
Fifteen video monitoring units were installed on high-risk units in a 115-bed inpatient rehabilitation facility. Total falls and falls rates were tracked and reported pre- and postimplementation.
FINDINGS
Over a 21-month period prior to implementing the video monitoring system, the average hospital-wide rate of falls was 6.34 per 1,000 patient-days (SD = 1.7488). After a year of usage, that average has decreased to 5.099 falls per 1,000 patient-days (SD = 1.524). The reduction in falls was statistically significant. In addition, there have been significant cost savings by reducing sitter usage.
CONCLUSIONS
Video monitoring can improve patient safety by decreasing falls; decreasing sitter usage and cost; and improving patient, family, and staff satisfaction.
CLINICAL RELEVANCE
Falls are a significant issue in rehabilitation settings, and current fall prevention strategies fall short of reducing fall rates. Implementation of new video monitoring technology can help reduce fall rates in inpatient rehabilitation settings.
Topics: Accidental Falls; Cohort Studies; Computer Terminals; Humans; Monitoring, Physiologic; New York; Patient Safety; Rehabilitation Nursing
PubMed: 29499009
DOI: 10.1097/RNJ.0000000000000089 -
GMS Journal For Medical Education 2019
Topics: Competency-Based Education; Humans; Interprofessional Relations; Patient Safety; Quality of Health Care
PubMed: 31211227
DOI: 10.3205/zma001240 -
Current Opinion in Anaesthesiology Jun 2024
Topics: Humans; Pregnancy; Female; Patient Safety; Anesthesia, Obstetrical
PubMed: 38654544
DOI: 10.1097/ACO.0000000000001369 -
BMJ Open Jan 2016To systematically review interventions that aim to improve the governance of patient safety within emergency care on effectiveness, reliability, validity and feasibility. (Review)
Review
OBJECTIVES
To systematically review interventions that aim to improve the governance of patient safety within emergency care on effectiveness, reliability, validity and feasibility.
DESIGN
A systematic review of the literature.
METHODS
PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Database of Systematic Reviews and PsychInfo were searched for studies published between January 1990 and July 2014. We included studies evaluating interventions relevant for higher management to oversee and manage patient safety, in prehospital emergency medical service (EMS) organisations and hospital-based emergency departments (EDs). Two reviewers independently selected candidate studies, extracted data and assessed study quality. Studies were categorised according to study quality, setting, sample, intervention characteristics and findings.
RESULTS
Of the 18 included studies, 13 (72%) were non-experimental. Nine studies (50%) reported data on the reliability and/or validity of the intervention. Eight studies (44%) reported on the feasibility of the intervention. Only 4 studies (22%) reported statistically significant effects. The use of a simulation-based training programme and well-designed incident reporting systems led to a statistically significant improvement of safety knowledge and attitudes by ED staff and an increase of incident reports within EDs, respectively.
CONCLUSIONS
Characteristics of the interventions included in this review (eg, anonymous incident reporting and validation of incident reports by an independent party) could provide useful input for the design of an effective tool to govern patient safety in EMS organisations and EDs. However, executives cannot rely on a robust set of evidence-based and feasible tools to govern patient safety within their emergency care organisation and in the chain of emergency care. Established strategies from other high-risk sectors need to be evaluated in emergency care settings, using an experimental design with valid outcome measures to strengthen the evidence base.
Topics: Emergency Medical Services; Feasibility Studies; Humans; Patient Safety; Reproducibility of Results
PubMed: 26826151
DOI: 10.1136/bmjopen-2015-009837 -
Orthopedic Nursing 2020This quality improvement project's purpose was to define and provide best practices in surgical patient positioning and transfer processes with the surgical spine table...
This quality improvement project's purpose was to define and provide best practices in surgical patient positioning and transfer processes with the surgical spine table to increase patient safety. Using the Define, Measure, Analyze, Improve, and Control quality improvement framework, a multidisciplinary team analyzed surveys, qualitative interviews, ergonomics, near-miss sentinel events and skin integrity data to standardize this process. Results reinforced the need to develop and standardize the process of patient positioning and transfer from cart to table. Findings resulted in practice changes, including a standardized best practice for transfer of patients, educational tools, and checklists for continued monitoring of patient safety issues. Metrics for intervention effectiveness include reduced patient skin integrity, increased staff satisfaction, and improved comfort level with use of spine table accessories and equipment. This practice improvement has a patient safety focus in the perioperative nursing practice.
Topics: Humans; Operating Tables; Patient Positioning; Patient Safety; Practice Guidelines as Topic; Quality Improvement; Spinal Cord Injuries
PubMed: 31977736
DOI: 10.1097/NOR.0000000000000622 -
The Medical Journal of Australia Dec 2014Attention was drawn to the safety of patients in acute care hospitals in the early 1990s when studies found large numbers of potentially preventable deaths. Errors were...
Attention was drawn to the safety of patients in acute care hospitals in the early 1990s when studies found large numbers of potentially preventable deaths. Errors were initially ascribed to individual doctors and nurses, but later it was recognised that errors were mainly related to failure of systems rather than individuals. Mortality is not necessarily a good measure of hospital safety. It depends more on the nature of the patient's underlying clinical state and the type of intervention than on the safety of the hospital, and its prevention (as a measure of patient safety) contributes to the failure of hospitals to recognise and appropriately manage patients who are naturally at the end of life. It is difficult to find agreement on the best ways to measure patient safety in hospitals and, as a result of the enormous resources devoted to improving and studying safety, it is difficult to show that patient safety has improved. However, the concept of safety is beginning to include post-hospital outcomes, such as quality of life. A rapid response system is an organisation-wide patient safety system which recognises the deterioration of a patient's condition and provides urgent and appropriate care. Evaluating the impact of a rapid response system can provide information on hospital safety, including potentially preventable deaths and cardiac arrests.
Topics: Hospital Mortality; Hospital Rapid Response Team; Hospitals; Humans; Outcome and Process Assessment, Health Care; Patient Safety; Quality Indicators, Health Care
PubMed: 25495310
DOI: 10.5694/mja14.01260 -
Journal of Patient Safety Sep 2018Developing a workforce skilled in improving the safety of medical care has often been cited as an important means to achieve safer care. Although some educational...
OBJECTIVES
Developing a workforce skilled in improving the safety of medical care has often been cited as an important means to achieve safer care. Although some educational programs geared toward patient safety have been developed, few advanced training programs have been described in the literature. We describe the development of a patient safety fellowship program.
METHODS
We describe the development and curriculum of an Interprofessional Fellowship in Patient Safety. The 1-year in residence fellowship focuses on domains such as leadership, spreading innovations, medical improvement, patient safety culture, reliability science, and understanding errors.
RESULTS
Specific training in patient safety is available and has been delivered to 48 fellows from a wide range of backgrounds. Fellows have accomplished much in terms of improvement projects, educational innovations, and publications. After completing the fellowship program, fellows are obtaining positions within health-care quality and safety and are likely to make long-term contributions.
CONCLUSIONS
We offer a curriculum and fellowship design for the topic of patient safety. Available evidence suggests that the fellowship results in the development of patient safety professionals.
Topics: Curriculum; Fellowships and Scholarships; Humans; Patient Safety; Quality of Health Care
PubMed: 29913462
DOI: 10.1097/PTS.0b013e3182905e9c -
BMC Health Services Research Mar 2016There is widespread recognition of the problem of unsafe care and extensive efforts have been made over the last 15 years to improve patient safety. In Sweden, a new...
BACKGROUND
There is widespread recognition of the problem of unsafe care and extensive efforts have been made over the last 15 years to improve patient safety. In Sweden, a new patient safety law obliges the 21 county councils to assemble a yearly patient safety report (PSR). The aim of this study was to describe the patient safety work carried out in Sweden by analysing the PSRs with regard to the structure, process and result elements reported, and to investigate the perceived usefulness of the PSRs as a tool to achieve improved patient safety.
METHODS
The study was based on two sources of data: patient safety reports obtained from county councils in Sweden published in 2014 and a survey of health care practitioners with strategic positions in patient safety work, acting as key informants for their county councils. Answers to open-ended questions were analysed using conventional content analysis.
RESULTS
A total of 14 structure elements, 31 process elements and 23 outcome elements were identified. The most frequently reported structure elements were groups devoted to working with antibiotics issues and electronic incident reporting systems. The PSRs were perceived to provide a structure for patient safety work, enhance the focus on patient safety and contribute to learning about patient safety.
CONCLUSION
Patient safety work carried out in Sweden, as described in annual PSRs, features a wide range of structure, process and result elements. According to health care practitioners with strategic positions in the county councils' patient safety work, the PSRs are perceived as useful at various system levels.
Topics: Documentation; Humans; Patient Safety; Qualitative Research; Quality Improvement; Risk Management; Surveys and Questionnaires; Sweden
PubMed: 27001079
DOI: 10.1186/s12913-016-1350-5 -
International Emergency Nursing Sep 2019Patients who call for an ambulance but only have primary care needs do not always get appropriate care. The starting point in this study is that such patients should be... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Patients who call for an ambulance but only have primary care needs do not always get appropriate care. The starting point in this study is that such patients should be assigned to as basic of care as possible, while maintaining high levels of patient trust and patient safety.
AIM
To evaluate patient trust and patient safety among low-priority ambulance patients referred to care at either the Community Health Centre (CHC) or the Emergency Department (ED).
METHODS
This randomized controlled trial pilot study compared the level of patient trust and patient safety among low-priority ambulance patients who were randomized into two groups: CHC (n = 105) or ED (n = 83).
RESULTS
There was a high level of trust in the care received, regardless of whether the patient received care at CHC or ED. Overall 31% fulfilled one or more of the given criteria for potentially jeopardizing patient safety.
CONCLUSION
Patient selection for the trial indicated a potential limit in patient safety. There was a high level of trust in the care received regardless of whether the patient received care. The accuracy of patient selection for the new care model needs to be further improved with the intention to enhance patient safety even further.
Topics: Adult; Aged; Aged, 80 and over; Emergency Medical Services; Female; Humans; Male; Middle Aged; Patient Acuity; Patient Safety; Pilot Projects; Psychometrics; Surveys and Questionnaires; Sweden; Trust
PubMed: 31331836
DOI: 10.1016/j.ienj.2019.06.001 -
Indian Journal of Pharmacology 2015
Topics: Curriculum; Education, Medical; Patient Safety
PubMed: 25878369
DOI: 10.4103/0253-7613.153417