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نتیجه جستجو - ایمنی بیمار

تعداد مقالات یافته شده: 8
ردیف عنوان نوع
1 Patient blood management implementation in light of new Italian laws on patients safety
اجرای مدیریت خون بیمار با توجه به قوانین جدید ایتالیایی در مورد ایمنی بیمار-2020
The present work aims to analyze the impact - from legal and medical perspective - of the recent Italian legislative provisions on the subject of healthcare safety, and how these affect current transfusion practices, also in light of the accumulation of evidence deriving from the implementation of the Patient Blood Management (PBM) program. The scientific evidence shows that PBM is a bundle of care that improves patient outcomes including mortality and morbidity, improves the quality of life of patients and the population, reduces healthcare costs and decreases consumption of blood components. These aspects should be largely sufficient to carry out an urgent implementation of PBM in Italian hospitals. However, it is now also possible to indicate a further incentive for implementation which is made up of medico-legal aspects and is characterized by the need to decrease the intrinsic risks of the use of blood products so as to protect doctors and hospitals from possible future medicolegal disputes regarding adverse transfusion events that could be effectively avoided.
Keywords: Patient blood management | Clinical risk management | Patient safety | Medical liability
مقاله انگلیسی
2 Painting a picture of nurse presenteeism: A multi-country integrative review
ترسیم تصویری از حضور پرستار: مروری یکپارچه در چند کشور-2020
Aim: To conduct a review of the impact of presenteeism as it relates to the nursing workforce. Background: Presenteeism behaviour has been researched in the broader workforce across multiple industries including business/management, public health and occupational health. Presenteeism in nursing is particularly significant because it puts patients at risk by reducing the capacity of nurses to provide high quality care. Rates of presenteeism are particularly high in the nursing workforce and the impact of nurse presenteeism needs to be further examined and explored. Design: An integrative review of the associated literature. Methods: Online databases were searched for research related to presenteeism in the nursing workforce. Original primary research investigating presenteeism in the nursing workforce, in all clinical settings, in the English language and published between 2006 and 2018 were included. Results: A total of 17 studies fit the inclusion criteria and were included in this review: 16 quantitative and 1 qualitative. Five categories emerged from the data synthesis process: 1) the prevalence of presenteeism, 2) the economic cost of presenteeism, 3) presenteeism and related health conditions, 4) presenteeism and nurse well-being, and 5) presenteeism and patient safety. Conclusion: The scale and impact of presenteeism is rarely explicitly discussed. Further research is needed to investigate the link between presenteeism, nurse well-being quality of patient care and costs in the nursing sector.
Keywords: Integrative review | Presenteeism | Productivity | revalence | Economic cost | Well-being | Patient safety | Nurse
مقاله انگلیسی
3 Medical malpractice liability and its consequences: A survey among AEU urologists
مسئولیت قصور پزشکی و پیامدهای آن: یک نظرسنجی در میان متخصصان اورولوژی AEU-2020
Introduction: Urology is a specialty of medium risk of claim. Receiving a claim for medical professional liability is a stressful experience with significant repercussions. The objective of this study was to assess the impact of these claims on Spanish urologists. Methodology: A survey on medical professional liability in urology was designed. The Spanish Association of Urology and the Urological Research Foundation approved the questionnaire, generated by the PIEM online tool. Results: The total number of responses obtained was 202 (11.6% rate), of which 25.24% reported having been claimed, 88% reported mood changes after being claimed, 100% in criminal proceedings. The level of emotional involvement reported was the highest at the beginning of the process and progressively decreasing until its resolution. An affected doctor---patient relationship was considered in 67.9% of cases and 71.4% acknowledged increased defensive medicine in their professional practice. A percentage of 6.7% considered leaving the profession. Discussion: The response rate obtained and the medical acts motivating the claims were comparable to those obtained in a similar survey conducted in the United States. The fact that claims are perceived as very stressful situations and may give rise to the phenomenon of the second victim or to the clinical judicial syndrome is clear, so efforts should be devoted to develop training in this matter and programs that address the consequences derived from these situations.
KEYWORDS : Urology | Claims | Patient safety | Standard of care | Medical professional | liability
مقاله انگلیسی
4 ورزش ترکیبی و آموزش خیره شدن بصری موجب افزایش دقت قدم برداشتن در افراد مبتلا به نوروپاتی محیطی دیابتی می شود
سال انتشار: 2019 - تعداد صفحات فایل pdf انگلیسی: 5 - تعداد صفحات فایل doc فارسی: 17
مقدمه: بیماران مبتلا به دیابت و نوروپاتی محیطی دیابتی (DPN) حین راه رفتن با دقت کمتری قدم برمی دارند، این می تواند در افزایش ریسک زمین خوردن نقش داشته باشد. این مقاله به بررسی اثرات یک مداخله ی چندوجهی بر دقت قدم برداشتن در بیماران مبتلا به دیابت و DPN می پردازد. روش ها: 40 نفر پژوهش را آغاز نمودند، از این میان 29 نفر هر دو آزمایش پیش از مداخله و پس از مداخله را انجام دادند، 8 بیمار مبتلا به DPN و 11 بیمار مبتلا به دیابت بودند اما نوروپاتی نداشتند (D) و 10 نفر هم سالم بودند. دقت قدم برداشتن پیش و پس از مداخله با حرکت شرکت کنندگان در امتداد یک پیاده رو که به صورت گام برداشتن نامنظم طراحی شده بود، سنجیده شد. شرکت کنندگان به مدت 6 هفته، یکبار در هفته، در یک جلسه ی یک ساعته، شامل تمرین مقاومتی با وزنه های سنگین و آموزش بصری-حرکتی حضور یافتند. نتایج: بیمارانی که در مداخله ی درمانی حضور یافتند، دقت قدم برداشتن خود را ارتقا بخشیدند (DPN:+45%; D: +36%; p<0.05). گروه دیابتی غیرمداخله ای (D-NI) هیچگونه تفاوت معناداری در دقت قدم برداشتن پیش و پس از مداخله از خود نشان ندارند (7-%). بحث: بهبود دقت قدم برداشتن مشاهدهشده در بیماران دیابتی و DPN به عنوان نتیجه ی این مداخله ی درمانی نوین، می تواند در کاهش ریسک زمین خوردن نقش داشته باشد. این مداخله ی چندوجهی، امر نویدبخشی برای ارتقای تحرک عمومی و ایمنی بیماران حین راه رفتن بوده و می توان آن را به عنوان بخشی از برنامه های درمانی کلینیک ها لحاظ نمود.
کلیدواژه ها: راه رفتن | زمین خوردن | ورزش | ردیابی چشمی | قدم زدن
مقاله ترجمه شده
5 Architecture and optimization of data mining modeling for visualization of knowledge extraction: Patient safety care
معماری و بهینه سازی داده کاوی و مدل سازی برای تجسم استخراج دانش: مراقبت از ایمنی بیمار-2019
Visualization of the knowledge extraction process is a front line to reveal the detail process and data structure, which is an advanced technique for the presentation of data modeling. However, the mechanisms for healthcare are challenging and dynamic processes to gain a clear insight or understanding of patient care. In this paper, we proposed a new approach of architecture and optimization of data mining modeling for visualization of knowledge extraction by analyzing clinical data sets to define the determinant attributes through modeling techniques. Therefore, architecture for the visualization of the knowledge extraction process is a systematic approach to support users to the best of their knowledge of the issues over the challenge of visualizing techniques. The proposed approach is capable and dynamic to handle and analyze large-scale data in its dimension and context. Such a variable is defined using various techniques to characterize them towards the detection of determinant variables as its influential circumstance. We focused on modeling based visualization as model representation, factor’s interaction and integration. The detection process experimented in a different approach and justification as discussed in section five. The finding showed a deep understandability for an advanced and dynamic data mining modeling techniques to integrate applications with domain contexts for the optimal and understandable decision process. The strength of this approach is the depth for visualization towards the knowledge extraction process and its understandability for users as per their background and circumstances. It is also essential to inference for architecture based modeling and visualization for large scale data. Researchers, physicians, experts, and other users are the potentials to refer to these novel ideas and findings.
Keywords: Architectures | Clinical datasets | Data mining | Decision tree | Knowledge extraction | Pattern analysis | Data visualization
مقاله انگلیسی
6 Effect of sleep deprivation after a night shift duty on simulated crisis management by residents in anaesthesia. A randomised crossover study
تأثیر محرومیت از خواب پس از یک بار تغییر شغل در مدیریت بحران شبیه سازی توسط ساکنین در بیهوشی. یک مطالعه متقاطع تصادفی-2018
Background: Sleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients’ safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology. Methods: A randomised, comparative, monocentric crossover study involving 48 residents in anaesthesia was performed on a high fidelity patient simulator. Each resident was evaluated in a sleep-deprived state (deprived group, after a night shift duty) and control state (control group, after a night of sleep). Performance was assessed through points obtained during crisis scenario 1 (oesophageal intubation followed by anaphylactic shock) and scenario 2 (anaesthesia-related bronchospasm followed by ventricular tachycardia). Sleep periods were recorded by actigraphy. Two independent observers assessed the performances. The primary endpoint of the study was the score obtained for each scenario. Results: Resident’s crisis management performance is associated with sleep deprivation (scenario 1: control = 39 [33–42] points vs. deprived = 26 [19–40] points, P = 0.02; scenario 2: control = 21 [17–24] vs. deprived = 14 [12–19], P = 0.01). The main errors observed were: error in drug administration and dose, delay in identification of hypotension, and missing communication with the surgical team about situation. Conclusions: The present study showed that sleep deprivation is associated with impairment of performance to manage crisis situations by residents in anaesthesia.
Keywords: Simulation ، Sleep deprivation ، Patient safety ، Anaesthesia
مقاله انگلیسی
7 Traditions of research into interruptions in healthcare: A conceptual review
سنت های تحقیقاتی به وقفه در مراقبت های بهداشتی: یک بررسی مفهومی-2017
Researchers from diverse theoretical backgrounds have studied workplace interruptions in healthcare, leading to a complex and conflicting body of literature. Understanding pre-existing viewpoints may advance the field more effectively than attempts to remove bias from investigations. Objective: To identify research traditions that have motivated and guided interruptions research, and to note research questions posed, gaps in approach, and possible avenues for future research. Methods: A critical review was conducted of research on interruptions in healthcare. Two researchers identified core research communities based on the community’s motivations, philosophical outlook, and methods. Among the characteristics used to categorise papers into research communities were the predominant motivation for studying interruptions, the research questions posed, and key contributions to the body of knowledge on interruptions in healthcare. In cases where a paper approached an equal number of characteristics from two traditions, it was placed in a blended research community. Results: A total of 141 papers were identified and categorised; all papers identified were published from 1994 onwards. Four principal research communities emerged: epidemiology, quality improvement, cognitive systems engineering (CSE), and applied cognitive psychology. Blends and areas of mutual influence between the research communities were identified that combine the benefits of individual traditions, but there was a notable lack of blends incorporating quality improvement initiatives. The question most commonly posed by researchers across multiple communities was: what is the impact of interruptions? Impact was measured as a function of task time or risk in the epidemiology tradition, situation awareness in the CSE tradition, or resumption lag (time to resume an interrupted task) in the applied cognitive psychology tradition. No single question about interruptions in healthcare was shared by all four of the core communities. Conclusions: Much research on workplace interruptions in healthcare can be described in terms of fundamental values of four distinct research traditions and the communities that bring the values and methods: of those research traditions to their investigations. Blends between communities indicate that mutual influence has occurred as interruptions research has progressed. It is clear from this review that there is no single or privileged perspective to study interruptions. Instead, these findings suggest that researchers investigating interruptions in healthcare would benefit from being more aware of different perspectives from their own, especially when they consider workplace interventions to reduce interruptions.
Keywords: Applied cognitive psychology | Cognitive systems engineering | Conceptual review | Distractions | Epidemiology | Interruptions | Interventions | Metanarratives | Patient safety | Quality improvement
مقاله انگلیسی
8 Implementing Major Trauma Audit in Ireland
پیاده سازی ممیزی اصلی تروما در ایرلند-2016
Background: There are 27 receiving trauma hospitals in the Republic of Ireland. There has not been an audit system in place to monitor and measure processes and outcomes of care. The National Office of Clinical Audit (NOCA) is now working to implement Major Trauma Audit (MTA) in Ireland using the wellestablished National Health Service (NHS) UK Trauma Audit and Research Network (TARN).
Aims: The aim of this report is to highlight the implementation process of MTA in Ireland to raise awareness of MTA nationally and share lessons that may be of value to other health systems undertaking the development of MTA.
Methods: The National Trauma Audit Committee of the Royal College of Surgeons in Ireland, consisting of champions and stakeholders in trauma care, in 2010 advised on the adaptation of TARN for Ireland. In 2012, the Emergency Medicine Program endorsed TARN and in setting up the National Emergency Medicine Audit chose MTA as the first audit project. A major trauma governance group was established representing stakeholders in trauma care, a national project co-ordinator was recruited and a clinical lead nominated. Using Survey Monkey, the chief executives of all trauma receiving hospitals were asked to identify their hospital’s trauma governance committee, trauma clinical lead and their local trauma data co-ordinator. Hospital Inpatient Enquiry systems were used to identify to hospitals an estimate of their anticipated trauma audit workload.
Results: There are 25 of 27 hospitals now collecting data using the TARN trauma audit platform. These hospitals have provided MTA Clinical Leads, allocated data co-ordinators and incorporated MTA reports formally into their clinical governance, quality and safety committee meetings. There has been broad acceptance of the NOCA escalation policy by hospitals in appreciation of the necessity for unexpected audit findings to stimulate action.
Conclusion: Major trauma audit measures trauma patient care processes and outcomes of care to drive quality improvement at hospital and national level. MTA will facilitate the strategic development of trauma care in Ireland by monitoring processes and outcomes and the effects of changes in trauma service provision.
Keywords: Trauma | Injury | Audit | Registry | Register | Major trauma | Ireland | Quality | Patient Safety
مقاله انگلیسی
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