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Medicare & Medicaid Research Review 2014Serious adverse events that occur in hospitals rank as a leading cause of preventable death in the United States. Many states operate reporting systems to monitor and...
BACKGROUND
Serious adverse events that occur in hospitals rank as a leading cause of preventable death in the United States. Many states operate reporting systems to monitor and publicly report serious adverse events, a subset that falls under Medicare's Hospital-Acquired Conditions (HACs).
PURPOSES
Identify and describe state efforts, and the supporting role of federal initiatives, to track and report HACs and other serious adverse events.
DATA SOURCES
Document review of state and federal reports, databases, and policies for HACs and other serious adverse events; conduct semi-structured telephone interviews with state health department officials and directors of patient safety organizations.
RESULTS
Thirty-two states and the District of Columbia (D.C.) track at least one Medicare HAC. Five states collect nearly all ten Medicare HACs (9-10). Eighteen states and D.C. track events through both a state-based reporting system and the Centers for Disease Control National Healthcare Safety Network (NHSN) for health-care associated infections (HAI). For serious adverse events, most states either partially or fully adopted the National Quality Forum's Serious Reportable Events. For HAIs, thirty states and D.C. mandate reporting through NHSN. States interviewed reported that Medicare's choice of HACs for nonpayment had at least a partial influence on which serious adverse events required reporting.
CONCLUSIONS
Many states use the collected data on HACs and other events for quality improvement initiatives and to provide greater transparency through public reporting. More work and research is needed to develop a national reporting system template that has standard definitions, methodology, and reporting.
Topics: Cross Infection; Federal Government; Humans; Interviews as Topic; Mandatory Reporting; Medicare; Population Surveillance; State Government; United States
PubMed: 25584196
DOI: 10.5600/mmrr.004.04.a04 -
Neurobiology of Sexual Assault and Osteopathic Considerations for Trauma-Informed Care and Practice.The Journal of the American Osteopathic... Feb 2018Sexual assault is a traumatic event with potentially devastating lifelong effects on physical and emotional health. Sexual assault is associated with gastrointestinal,... (Review)
Review
Sexual assault is a traumatic event with potentially devastating lifelong effects on physical and emotional health. Sexual assault is associated with gastrointestinal, neurologic, and reproductive symptoms, as well as obesity, diabetes, and chronic pain. With 1 in 3 women and 1 in 6 men experiencing some form of unwanted sexual violence in their lifetime, sexual assault is a significant public health problem that necessitates attention in the medical community. This review discusses relevant literature on the neurobiologic changes that occur as a consequence of sexual assault, such as how the brain responds during a traumatic experience and the impact of trauma on memory. Osteopathic considerations for trauma-informed care and practice and how all physicians can better serve patients with a history of sexual assault are also discussed.
Topics: Female; Humans; Male; Mandatory Reporting; Nervous System Physiological Phenomena; Osteopathic Medicine; Rape; Sex Offenses; Sexual Harassment; Stress Disorders, Post-Traumatic; Wounds and Injuries
PubMed: 29227505
DOI: 10.7556/jaoa.2018.018 -
Revue Medicale de Liege 2014Elder abuse is frequent (from 4 to 6% of adults aged 65 + according to WHO). It can take various forms: psychological, financial, violation of rights, neglect and... (Review)
Review
Elder abuse is frequent (from 4 to 6% of adults aged 65 + according to WHO). It can take various forms: psychological, financial, violation of rights, neglect and physical. Due to demographic changes, it is expected that the number of cases will increase over coming years. Scientific data show the importance of a systemic analysis of elder abuse situations in order to avoid the simplistic thinking of the "horrible abuser" and the "poor victim". A multidisciplinary team, including a physician (a general practitioner, or a specialist), is necessary. Physicians can play a role in the prevention, detection and follow up of such cases. In order to detect elder abuse, active and attentive listening is mandatory. When a possibility exists that the older adult is abused, the suspicion should be documented (per example, by using the EASI tool), in order to implement an adequate follow-up. In the French part of Belgium, specialised services can be involved: Respect Seniors (www.respectseniors.be) in Wallonia and the SEPAM d'Infor-Homes in Brussels.
Topics: Aged; Aged, 80 and over; Elder Abuse; Geriatric Assessment; Humans; Mandatory Reporting; Physician's Role; Prevalence
PubMed: 25065250
DOI: No ID Found -
Lakartidningen Nov 2014
Topics: Autopsy; Case Management; Cause of Death; Clinical Competence; Critical Pathways; Death Certificates; Forensic Medicine; Humans; Mandatory Reporting; Police
PubMed: 25423340
DOI: No ID Found -
Clinical Radiology Mar 2017Recognising the skeletal manifestations of inflicted injury (II) in infants and young children is of crucial importance. There are specific fracture patterns which are... (Review)
Review
Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 1: initial considerations and appendicular skeleton.
Recognising the skeletal manifestations of inflicted injury (II) in infants and young children is of crucial importance. There are specific fracture patterns which are highly suspicious of II in addition to common differential diagnoses with which radiologists should be familiar. Our objective is to provide a non-exhaustive review of the important factors relevant to the imaging and reporting of II as a platform for further learning. Part 1 encompasses important initial considerations and fracture patterns of the appendicular skeleton.
Topics: Accidents; Child; Child Abuse; Child, Preschool; Documentation; Female; Fractures, Bone; Guideline Adherence; Humans; Infant; Infant, Newborn; Male; Mandatory Reporting; Practice Guidelines as Topic; Radiography; United Kingdom
PubMed: 28063602
DOI: 10.1016/j.crad.2016.11.016 -
Clinical Radiology Mar 2017Recognising the skeletal manifestations of inflicted injury (II) in infants and young children is of crucial importance. There are specific fracture patterns which are... (Review)
Review
Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 2: axial skeleton and differential diagnoses.
Recognising the skeletal manifestations of inflicted injury (II) in infants and young children is of crucial importance. There are specific fracture patterns which are highly suspicious of II in addition to common differential diagnoses with which radiologists should be familiar. Our objective is to provide a non-exhaustive review of the important factors relevant to the imaging and reporting of II as a platform for further learning. Part 2 encompasses fracture patterns of the axial skeleton and important differential diagnoses.
Topics: Accidents; Child; Child Abuse; Child, Preschool; Documentation; Female; Fractures, Bone; Guideline Adherence; Humans; Infant; Infant, Newborn; Male; Mandatory Reporting; Practice Guidelines as Topic; Radiography; United Kingdom
PubMed: 28027778
DOI: 10.1016/j.crad.2016.11.015 -
Deutsches Arzteblatt International Feb 2013An estimated 1 million needlestick injuries (NSIs) occur in Europe each year. The Council Directive 2010/32/EU on the prevention of NSIs describes minimum requirements...
BACKGROUND
An estimated 1 million needlestick injuries (NSIs) occur in Europe each year. The Council Directive 2010/32/EU on the prevention of NSIs describes minimum requirements for prevention and calls for the implementation of local, national and Europe-wide reporting systems. The Directive is to be implemented by all EU member states by 11 May 2013. The purpose of this study was to assess (and improve) the procedures for the reporting and treatment of needlestick injuries in a German tertiary-care hospital.
METHODS
We carried out a prospective observational study of the NSI reporting system in the hospital over a period of 18 months and determined the incidence of NSIs, the prevalence of blood-borne pathogens among index patients, the rate of initiation of post-exposure prophylaxis, and the rate of serological testing of the affected health care personnel.
RESULTS
519 instances of NSI were reported to the accident insurance doctor over the period of the study, which consisted of 547 working days. 86.5% of the index patients underwent serological study for hepatitis B and C (HBV and HCV) and for the human immune deficiency virus (HIV); this resulted in two initial diagnoses (one each of active hepatitis B and hepatitis C) in the index patient. 92 of 449 index patients, or one in five, was infected with at least one blood-borne pathogen. HIV post-exposure prophylaxis was initiated in 41 health care workers. One case of hepatitis C virus transmission arose and was successfully treated. Other than that, no infection was transmitted.
CONCLUSION
Complete reporting of NSIs is a prerequisite for the identification of risky procedures and to ensure optimal treatment of the affected health care personnel. The accident insurance doctor must possess a high degree of interdisciplinary competence in order to treat NSI effectively.
Topics: Causality; Comorbidity; Disease Notification; Germany; Humans; Mandatory Reporting; Medical Staff; Needlestick Injuries; Occupational Injuries; Prevalence; Risk Factors; Virus Diseases
PubMed: 23437024
DOI: 10.3238/arztebl.2013.0061 -
Federal Register Sep 2014OSHA is issuing a final rule to update the appendix to its Injury and Illness Recording and Reporting regulation. The appendix contains a list of industries that are...
OSHA is issuing a final rule to update the appendix to its Injury and Illness Recording and Reporting regulation. The appendix contains a list of industries that are partially exempt from requirements to keep records of work-related injuries and illnesses due to relatively low occupational injury and illness rates. The updated appendix is based on more recent injury and illness data and lists industry groups classified by the North American Industry Classification System (NAICS). The current appendix lists industries classified by Standard Industrial Classification (SIC). The final rule also revises the requirements for reporting work-related fatality, injury, and illness information to OSHA. The current regulation requires employers to report work-related fatalities and in-patient hospitalizations of three or more employees within eight hours of the event. The final rule retains the requirement for employers to report work-related fatalities to OSHA within eight hours of the event but amends the regulation to require employers to report all work-related in-patient hospitalizations, as well as amputations and losses of an eye, to OSHA within 24 hours of the event.
Topics: Forms and Records Control; Humans; Mandatory Reporting; Occupational Diseases; Occupational Health; Occupational Injuries; United States; United States Occupational Safety and Health Administration
PubMed: 25233537
DOI: No ID Found -
BMC Pediatrics May 2024Child abuse and neglect (CAN) causes enormous suffering for those affected.
BACKGROUND
Child abuse and neglect (CAN) causes enormous suffering for those affected.
OBJECTIVE
The study investigated the current state of knowledge concerning the recognition of CAN and protocols for suspected cases amongst physicians and teachers.
METHODS
In a pilot study conducted in Mecklenburg-Western Pomerania from May 2020 to June 2021, we invited teachers and physicians working with children to complete an online questionnaire containing mainly multiple-choice-questions.
RESULTS
In total, 45 physicians and 57 teachers responded. Altogether, 84% of physicians and 44% of teachers were aware of cases in which CAN had occurred in the context of their professional activity. Further, 31% of physicians and 23% of teachers stated that specific instructions on CAN did not exist in their professional institution or that they were not aware of them. All physicians and 98% of teachers were in favor of mandatory training on CAN for pediatric residents and trainee teachers. Although 13% of physicians and 49% of teachers considered a discussion of a suspected case of CAN to constitute a breach of confidentiality, 87% of physicians and 60% of teachers stated that they would discuss a suspected case with colleagues.
CONCLUSION
Despite the fact that a large proportion of respondents had already been confronted with suspected cases of CAN, further guidelines for reporting procedures and training seem necessary. There is still uncertainty in both professions on dealing with cases of suspected CAN.
Topics: Humans; Child Abuse; Child; School Teachers; Pilot Projects; Surveys and Questionnaires; Female; Male; Physicians; Adult; Health Knowledge, Attitudes, Practice; Germany; Middle Aged; Mandatory Reporting; Attitude of Health Personnel
PubMed: 38704564
DOI: 10.1186/s12887-024-04782-3 -
American Family Physician Mar 2001Child victims of sexual abuse may present with physical findings that can include anogenital problems, enuresis or encopresis. Behavioral changes may involve sexual... (Review)
Review
Child victims of sexual abuse may present with physical findings that can include anogenital problems, enuresis or encopresis. Behavioral changes may involve sexual acting out, aggression, depression, eating disturbances and regression. Because the examination findings of most child victims of sexual abuse are within normal limits or are nonspecific, the child's statements are extremely important. The child's history as obtained by the physician may be admitted as evidence in court trials; therefore, complete documentation of questions and answers is critical. A careful history should be obtained and a thorough physical examination should be performed with documentation of all findings. When examining the child's genitalia, it is important that the physician be familiar with normal variants, non-specific changes and diagnostic signs of sexual abuse. Judicious use of laboratory tests, along with appropriate therapy, should be individually tailored. Forensic evidence collection is indicated in certain cases. Referral for psychologic services is important because victims of abuse are more likely to have depression, anxiety disorders, behavioral problems and post-traumatic stress disorder.
Topics: Child; Child Abuse, Sexual; Diagnosis, Differential; Female; Humans; Male; Mandatory Reporting; Medical History Taking; Physical Examination; Practice Guidelines as Topic; Sexually Transmitted Diseases
PubMed: 11261865
DOI: No ID Found