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Heart Rhythm Aug 2023
Topics: Humans; Patient Safety; Defibrillators, Implantable; Ventricular Fibrillation
PubMed: 37119994
DOI: 10.1016/j.hrthm.2023.04.020 -
Revista Gaucha de Enfermagem Nov 2023
Topics: Humans; Patient Safety; Nursing Staff, Hospital
PubMed: 37971112
DOI: 10.1590/1983-1447.2023.20230194.en -
Worldviews on Evidence-based Nursing Dec 2023Elopement jeopardizes patient safety, affects the hospital's reputation, and results in financial ramifications. In an academic community hospital, executive leadership...
BACKGROUND
Elopement jeopardizes patient safety, affects the hospital's reputation, and results in financial ramifications. In an academic community hospital, executive leadership approached a team of nurse leaders for expertise following the elopement of a vulnerable patient.
AIM OF THE INITIATIVE
The team's goal was to identify evidence-based strategies to mitigate future elopement events. Following an extensive literature review and gap analysis, the organization recognized opportunities pertaining to elopement management, including patient assessment, prevention strategies, and facility-wide response when events occur. The nurse leader team thoroughly searched current literature to answer the Population, Intervention, Comparison, and Outcome (i.e., PICO) questions of interest. Following a critical appraisal of 55 articles, 26 were utilized to make practice change recommendations. The body of evidence included a variety of age groups and diagnoses.
IMPLEMENTATION PLAN
After the synthesis of the literature, the team provided recommendations to the organization. These recommendations included the assessment of patient-specific risks and the implementation of elopement prevention measures as fundamental elements for incidence reduction. The team partnered with multidisciplinary stakeholders for the revision of policies, processes, and electronic medical record documentation.
OUTCOMES
The organization monitored elopement events and the duration of each event throughout the phases of implementation. Pre-implementation data, collected from January to June 2021, demonstrated 34 individual elopement cases lasting an average of 118 min each. In comparison, post-implementation data collected during the same time frame in 2022 found only 12 events lasting an average of 24 min each.
IMPLICATIONS FOR PRACTICE
The organization implemented evidence-based recommendations to standardize the facility's approach to elopement. With structured assessment, precautions, and response, the organization demonstrated a notable decline in the number and duration of elopement events. Hardwiring processes, analyzing data, and adjusting expectations within an evidence-based framework should assist the organization's drive to further enhance patient safety surrounding elopement events.
Topics: Humans; Patient Safety; Evidence-Based Nursing
PubMed: 37776169
DOI: 10.1111/wvn.12683 -
Journal of Pediatric Urology Apr 2024
Topics: Humans; Reading; Quality Improvement; Patient Safety
PubMed: 38453617
DOI: 10.1016/j.jpurol.2024.01.039 -
Journal of Patient Safety Oct 2023This study mainly examines the effects of patient safety culture dimensions on 4 outcomes (self-reported errors, witnessing errors, incident reporting, and patient...
OBJECTIVES
This study mainly examines the effects of patient safety culture dimensions on 4 outcomes (self-reported errors, witnessing errors, incident reporting, and patient safety grade).
METHODS
The data were collected using the Turkish version of the Safety Attitudes Questionnaire, which consists of 6 dimensions (teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions). Of 1679 personnel working in 6 hospitals in Ankara, 860 were randomly selected. The data were analyzed using descriptive statistics, the Spearman correlation coefficient, and binary logistic regression analyses.
RESULTS
The response rate was 62.7%. When the overall patient safety culture score increased by 1 point; the probability of witnessing an error was 2 times lower (P < 0.001), the probability of incident reporting was 4.22 times higher (P < 0.001), and the probability of assessing the patient safety grade as excellent was 29.86 times higher (P < 0.001). The teamwork climate was negatively related to making errors and witnessing errors (P < 0.001). The safety climate and working conditions were positively related to incident reporting and patient safety grade (P < 0.001). Job satisfaction was negatively related to incident reporting (P < 0.001). Perceptions of management were positively related to making errors and patient safety grade (P < 0.001).
CONCLUSIONS
The patient safety culture scores were positively correlated with incident reporting and patient safety grade but negatively correlated with the occurrence of errors. Each dimension of the patient safety culture, except stress recognition, affected different outcomes. Therefore, managers should focus on different dimensions of patient safety culture to improve different outcomes.
Topics: Humans; Patient Safety; Risk Management; Hospitals; Job Satisfaction; Safety Management
PubMed: 37729641
DOI: 10.1097/PTS.0000000000001152 -
Joint Commission Journal on Quality and... Dec 2023
Topics: Humans; United States; Patient Safety; Joint Commission on Accreditation of Healthcare Organizations; Safety Management
PubMed: 37748940
DOI: 10.1016/j.jcjq.2023.09.005 -
British Journal of Anaesthesia Aug 2023We review the development of technology in anaesthesia over the course of the past century, from the invention of the Boyle apparatus to the modern anaesthetic... (Review)
Review
We review the development of technology in anaesthesia over the course of the past century, from the invention of the Boyle apparatus to the modern anaesthetic workstation with artificial intelligence assistance. We define the operating theatre as a socio-technical system, being necessarily comprised of human and technological parts, the ongoing development of which has led to a reduction in mortality during anaesthesia by an order of four magnitudes over a century. The remarkable technological advances in anaesthesia have been accompanied by important paradigm shifts in the approach to patient safety, and we describe the inter-relationship between technology and the human work environment in the development of such paradigm shifts, including the systems approach and organisational resilience. A better understanding of emerging technological advances and their effects on patient safety will allow anaesthesia to continue to be a leader in both patient safety and in the design of equipment and workspaces.
Topics: Humans; Artificial Intelligence; Patient Safety; Anesthesia; Anesthesiology; Operating Rooms
PubMed: 37208283
DOI: 10.1016/j.bja.2023.04.023 -
Anesthesia and Analgesia Feb 2024Over the last few decades, the field of anesthesia has advanced far beyond its humble beginnings. Today's anesthetics are better and safer than ever, thanks to...
Over the last few decades, the field of anesthesia has advanced far beyond its humble beginnings. Today's anesthetics are better and safer than ever, thanks to innovations in drugs, monitors, equipment, and patient safety.1-4 At the same time, we remain limited by our herd approach to medicine. Each of our patients is unique, but health care today is based on a one-size-fits-all approach, while our patients grow older and more medically complex every year. By 2050, we believe that precision medicine will play a central role across all medical specialties, including anesthesia. In addition, we expect that health care and consumer technology will continually evolve to improve and simplify the interactions between patients, providers, and the health care system. As demonstrated by 2 hypothetical patient experiences, these advancements will enable more efficient and safe care, earlier and more accurate diagnoses, and truly personalized treatment plans.
Topics: Humans; Anesthesia; Delivery of Health Care; Anesthetics; Patient Safety
PubMed: 38215711
DOI: 10.1213/ANE.0000000000006688 -
International Journal of Medical... Dec 2023Identifying patient safety events using electronic health records (EHRs) and automated machine learning-based detection methods can help improve the efficiency and... (Review)
Review
INTRODUCTION
Identifying patient safety events using electronic health records (EHRs) and automated machine learning-based detection methods can help improve the efficiency and quality of healthcare service provision.
OBJECTIVE
This study aimed to systematically review machine learning-based methods and techniques, as well as their results for patient safety event management using EHRs.
METHODS
We reviewed the studies that focused on machine learning techniques, including automatic prediction and detection of patient safety events and medical errors through EHR analysis to manage patient safety events. The data were collected by searching Scopus, PubMed (Medline), Web of Science, EMBASE, and IEEE Xplore databases.
RESULTS
After screening, 41 papers were reviewed. Support vector machine (SVM), random forest, conditional random field (CRF), and bidirectional long short-term memory with conditional random field (BiLSTM-CRF) algorithms were mostly applied to predict, identify, and classify patient safety events using EHRs; however, they had different performances. BiLSTM-CRF was employed in most of the studies to extract and identify concepts, e.g., adverse drug events (ADEs) and adverse drug reactions (ADRs), as well as relationships between drug and severity, drug and ADEs, drug and ADRs. Recurrent neural networks (RNN) and BiLSTM-CRF had the best results in detecting ADEs compared to other patient safety events. Linear classifiers and Naive Bayes (NB) had the highest performance for ADR detection. Logistic regression had the best results in detecting surgical site infections. According to the findings, the quality of articles has non-significantly improved in recent years, but they had low average scores.
CONCLUSIONS
Machine learning can be useful in automatic detection and prediction of patient safety events. However, most of these algorithms have not yet been externally validated or prospectively tested. Therefore, further studies are required to improve the performance of these automated systems.
Topics: Humans; Electronic Health Records; Bayes Theorem; Patient Safety; Machine Learning; Algorithms
PubMed: 37837710
DOI: 10.1016/j.ijmedinf.2023.105246 -
Journal of Endourology Feb 2024The journey of minimally invasive (MI) urology is one of quality improvement (QI) and patient safety. New techniques have been progressively studied for adoption and... (Review)
Review
The journey of minimally invasive (MI) urology is one of quality improvement (QI) and patient safety. New techniques have been progressively studied for adoption and growth. As more advanced methods of data collection and analysis are developed, a review of the patterns and history of these principles in the development of MI urology can inform future urologic QI and patient safety initiatives. To perform a scoping review identifying patterns of QI and patient safety in MI urology. PubMed and the American Urological Association (AUA) journal search page were screened on December 2022 for publications using the search parameters "quality improvement" and "minimally invasive." Articles were screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR). The initial literature search identified 471 articles from PubMed and 57 from the AUA journal search page. After screening, 528 articles were relevant to the topic and reviewed. Four hundred eighty-two articles were duplicates or did not meet inclusion criteria. Forty-six are included in this review. Urology has developed a pattern of assessing MI surgery the open counterpart. This includes analyzing the newest approach to understand complications, examining the factors contributing to complications, and lastly designing projects to mitigate future risk. This information, as well as advanced methods of data collection, has identified areas of improvement for new QI projects. The stage is set for a promising future with the adoption of advanced QI in daily urologic practice to improve patient safety and minimize errors.
Topics: Humans; Quality Improvement; Patient Safety; Urology; Minimally Invasive Surgical Procedures
PubMed: 37950717
DOI: 10.1089/end.2022.0733