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Abolishment of 24-hour continuous medical call duty in quebec: a quality of life survey of general surgical residents following implementation of the new work-hour restrictions.

https://arctichealth.org/en/permalink/ahliterature114387
Source
J Surg Educ. 2013 May-Jun;70(3):296-303
Publication Type
Article
Author
Fadi T Hamadani
Dan Deckelbaum
Alexandre Sauve
Kosar Khwaja
Tarek Razek
Paola Fata
Author Affiliation
McGill University Health Centre, Division of Trauma Surgery, Montreal, Quebec, Canada.
Source
J Surg Educ. 2013 May-Jun;70(3):296-303
Language
English
Publication Type
Article
Keywords
Adult
Education, Medical, Graduate - standards
Female
General Surgery - education
Humans
Internship and Residency
Male
Patient Safety
Quality of Life
Quebec
Questionnaires
Work Schedule Tolerance
Workload - standards - statistics & numerical data
Abstract
The implementation of work hour restrictions across North America have resulted in decreased levels of self injury and medical errors for Residents. An arbitration ruling in Quebec has led to further curtailment of work hours beyond that proposed by the ACGME. This may threaten Resident quality of life and in turn decrease the educational quality of surgical residency training.
We administered a quality of life questionnaire with an integrated education quality assessment tool to all General Surgery residents training at McGill 6 months after the work hour restrictions.
Across several strata respondents reveal a decreased sense of educational quality and quality of life.
The arbitration argued that work- hour restrictions would be necessary to improve quality of life for trainees and hence improve patient safety. Results from this study demonstrate the exact opposite in a large majority of respondents, who report a poorer quality of life and a self-reported inability on their part to provide continuous and safe patient care.
PubMed ID
23618437 View in PubMed
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Achieving optimal prescribing: what can physicians do?

https://arctichealth.org/en/permalink/ahliterature121612
Source
Can Fam Physician. 2012 Aug;58(8):820-1
Publication Type
Article
Date
Aug-2012
Author
Samuel Shortt
Ingrid Sketris
Author Affiliation
Office for Knowledge Transfer, Canadian Medical Association, Ottawa ON. sam.shortt@cma.ca
Source
Can Fam Physician. 2012 Aug;58(8):820-1
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Canada
Drug Costs
Humans
Inappropriate Prescribing - adverse effects - economics - prevention & control
Medication Errors - adverse effects - economics - prevention & control
Patient Safety
Physician's Practice Patterns - economics - standards
Physician's Role
Quality Improvement
Notes
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Cites: Can J Cardiol. 2004 Jan;20(1):61-714968144
PubMed ID
22893327 View in PubMed
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Acute general surgery in Canada: a survey of current handover practices.

https://arctichealth.org/en/permalink/ahliterature113607
Source
Can J Surg. 2013 Jun;56(3):E24-8
Publication Type
Article
Date
Jun-2013
Author
Amanda M Johner
Shaila Merchant
Nava Aslani
Anneke Planting
Chad G Ball
Sandy Widder
Giuseppe Pagliarello
Neil G Parry
Dennis Klassen
S Morad Hameed
Author Affiliation
Department of Surgery, University of British Columbia, 3669 Commercial St., Vancouver BC V5N 4G1, Canada. amanda.johner@gmail.com
Source
Can J Surg. 2013 Jun;56(3):E24-8
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Communication
General Surgery - education - organization & administration
Hospitalization
Humans
Internship and Residency
Patient Handoff - organization & administration
Patient Safety
Physician's Practice Patterns - organization & administration
Abstract
Today's acute care surgery (ACS) service model requires multiple handovers to incoming attending surgeons and residents. Our objectives were to investigate current handover practices in Canadian hospitals that have an ACS service and assess the quality of handover practices in place.
We administered an electronic survey among ACS residents in 6 Canadian general surgery programs.
Resident handover of patient care occurs frequently and often not under ideal circumstances. Most residents spend less than 5 minutes preparing handovers. Clinical uncertainty owing to inadequate handover is most likely to occur during overnight and weekend coverage. Almost one-third of surveyed residents rate the overall quality of the handovers they received as poor.
Handover skills must be taught in a systematic fashion. Improved resident communication will likely decrease loss of patient information and therefore improve ACS patient safety.
Notes
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PubMed ID
23706854 View in PubMed
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Adapting and remodelling the US Institute for Safe Medication Practices' Medication Safety Self-Assessment tool for hospitals to be used to support national medication safety initiatives in Finland.

https://arctichealth.org/en/permalink/ahliterature281586
Source
Int J Pharm Pract. 2016 Aug;24(4):262-70
Publication Type
Article
Date
Aug-2016
Author
Ercan Celikkayalar
Minna Myllyntausta
Matthew Grissinger
Marja Airaksinen
Source
Int J Pharm Pract. 2016 Aug;24(4):262-70
Date
Aug-2016
Language
English
Publication Type
Article
Keywords
Delphi Technique
Drug-Related Side Effects and Adverse Reactions - prevention & control
Finland
Hospitals - standards
Humans
Medication Errors - prevention & control
Patient Safety
Pharmacy Service, Hospital - standards
Pilot Projects
Risk Assessment - methods
Self-Assessment
Abstract
The US Institute for Safe Medication Practices' (ISMP) Medication Safety Self-Assessment (MSSA) tool for hospitals is a comprehensive tool for assessing safe medication practices in hospitals.
To adapt and remodel the ISMP MSSA tool for hospitals so that it can be used in individual wards in order to support long-term medication safety initiatives in Finland.
The MSSA tool was first adapted for Finnish hospital settings by a four-round (applicability, desirability and feasibility were evaluated) Delphi consensus method (14 panellists), and then remodelled by organizing the items into a new order which is consistent with the order of the ward-based pharmacotherapy plan recommended by the Ministry of Social Affairs and Health. The adapted and remodelled tool was pilot tested in eight central hospital wards.
The original MSSA tool (231 items under ten key elements) was modified preliminarily before the Delphi rounds and 117 items were discarded, leaving 114 items for Delphi evaluation. The panel suggested 36 new items of which 23 were accepted. A total of 114 items (including 91 original and 23 new items) were accepted and remodelled under six new components that were pilot tested. The pilot test found the tool time-consuming but useful.
It was possible to adapt the ISMP's MSSA tool for another hospital setting. The modified tool can be used for a hospital pharmacy coordinated audit which supports long-term medication safety initiatives, particularly the establishment of ward-based pharmacotherapy plans as guided by the Ministry of Social Affairs and Health.
PubMed ID
26811257 View in PubMed
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Adverse events associated with hospitalization or detected through the RAI-HC assessment among Canadian home care clients.

https://arctichealth.org/en/permalink/ahliterature107858
Source
Healthc Policy. 2013 Aug;9(1):76-88
Publication Type
Article
Date
Aug-2013
Author
Diane Doran
John P Hirdes
Régis Blais
G Ross Baker
Jeff W Poss
Xiaoqiang Li
Donna Dill
Andrea Gruneir
George Heckman
Hélène Lacroix
Lori Mitchell
Maeve O'Beirne
Andrea Foebel
Nancy White
Gan Qian
Sang-Myong Nahm
Odilia Yim
Lisa Droppo
Corrine McIsaac
Author Affiliation
Professor Emeritus, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON.
Source
Healthc Policy. 2013 Aug;9(1):76-88
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Age Factors
Aged
Aged, 80 and over
Canada - epidemiology
Female
Home Care Services - standards - statistics & numerical data
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Medical Errors - statistics & numerical data
Medication Errors - statistics & numerical data
Patient Safety - statistics & numerical data
Retrospective Moral Judgment
Risk
Sex
Abstract
The occurrence of adverse events (AEs) in care settings is a patient safety concern that has significant consequences across healthcare systems. Patient safety problems have been well documented in acute care settings; however, similar data for clients in home care (HC) settings in Canada are limited. The purpose of this Canadian study was to investigate AEs in HC, specifically those associated with hospitalization or detected through the Resident Assessment Instrument for Home Care (RAI-HC).
A retrospective cohort design was used. The cohort consisted of HC clients from the provinces of Nova Scotia, Ontario, British Columbia and the Winnipeg Regional Health Authority.
The overall incidence rate of AEs associated with hospitalization ranged from 6% to 9%. The incidence rate of AEs determined from the RAI-HC was 4%. Injurious falls, injuries from other than fall and medication-related events were the most frequent AEs associated with hospitalization, whereas new caregiver distress was the most frequent AE identified through the RAI-HC.
The incidence of AEs from all sources of data ranged from 4% to 9%. More resources are needed to target strategies for addressing safety risks in HC in a broader context. Tools such as the RAI-HC and its Clinical Assessment Protocols, already available in Canada, could be very useful in the assessment and management of HC clients who are at safety risk.
Notes
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Cites: Int J Qual Health Care. 2013 Feb;25(1):16-2823283731
PubMed ID
23968676 View in PubMed
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Adverse events during air and ground neonatal transport: 13 years' experience from a neonatal transport team in Northern Sweden.

https://arctichealth.org/en/permalink/ahliterature275292
Source
J Matern Fetal Neonatal Med. 2015 Jul;28(10):1231-7
Publication Type
Article
Date
Jul-2015
Author
Johannes van den Berg
Linn Olsson
Amelie Svensson
Stellan Håkansson
Source
J Matern Fetal Neonatal Med. 2015 Jul;28(10):1231-7
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Emergency Medical Services - statistics & numerical data
Female
Humans
Infant, Newborn
Male
Organization and Administration
Patient Safety - statistics & numerical data
Risk assessment
Sweden
Transportation of Patients - methods - statistics & numerical data
Abstract
To study the prevalence of adverse events (AEs) associated with neonatal transport, and to categorize, classify and assess the risk estimation of these events.
Written comments in 1082 transport records during the period 1999-2011 were reviewed. Comments related to events that infringed on patient and staff safety were included as AEs, and categorized and further classified as complaint, imminent risk of incident/negative event, actual incident or actual negative event. AEs were also grouped into emergency or planned transports, and risk estimation was calculated according to a risk assessment tool and defined as low, intermediate, high or extreme risk.
AEs (N = 883) were divided into five categories: logistics (n = 337), organization (n = 177), equipment (n = 165), vehicle (n = 129) and medical/nursing care (n = 75). Eighty-five percent of AEs were classified as incidents or negative events. The majority of AEs were estimated to be of low or intermediate risk in both planned and emergency transports. AEs estimated to be of high or extreme risk were significantly more frequent in emergency transports (OR = 10.1; 95% CI: 5.0-20.9; p
PubMed ID
25102938 View in PubMed
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Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care.

https://arctichealth.org/en/permalink/ahliterature305729
Source
BMC Palliat Care. 2020 Jun 01; 19(1):76
Publication Type
Journal Article
Date
Jun-01-2020
Author
Ellinor Christin Haukland
Christian von Plessen
Carsten Nieder
Barthold Vonen
Author Affiliation
Department of Oncology and Palliative Medicine, Nordland Hospital Trust, PO Box 1480, 8092, Bodø, Norway. ellinor.haukland@nlsh.no.
Source
BMC Palliat Care. 2020 Jun 01; 19(1):76
Date
Jun-01-2020
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Neoplasms - psychology - therapy
Norway
Patient Safety - standards - statistics & numerical data
Quality of Health Care - standards - statistics & numerical data
Retrospective Studies
Terminal Care - standards - statistics & numerical data
Abstract
Anticancer treatment exposes patients to negative consequences such as increased toxicity and decreased quality of life, and there are clear guidelines recommending limiting use of aggressive anticancer treatments for patients near end of life. The aim of this study is to investigate the association between anticancer treatment given during the last 30?days of life and adverse events contributing to death and elucidate how adverse events can be used as a measure of quality and safety in end-of-life cancer care.
Retrospective cohort study of 247 deceased hospitalised cancer patients at three hospitals in Norway in 2012 and 2013. The Global Trigger Tool method were used to identify adverse events. We used Poisson regression and binary logistic regression to compare adverse events and association with use of anticancer treatment given during the last 30?days of life.
30% of deceased hospitalised cancer patients received some kind of anticancer treatment during the last 30?days of life, mainly systemic anticancer treatment. These patients had 62% more adverse events compared to patients not being treated last 30?days, 39 vs. 24 adverse events per 1000 patient days (p?
PubMed ID
32482172 View in PubMed
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Adverse events in nursing: A retrospective study of reports of patient and relative experiences.

https://arctichealth.org/en/permalink/ahliterature273385
Source
Int Nurs Rev. 2015 Sep;62(3):377-85
Publication Type
Article
Date
Sep-2015
Author
Å. Andersson
C. Frank
A M L Willman
P-O Sandman
G. Hansebo
Source
Int Nurs Rev. 2015 Sep;62(3):377-85
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Clinical Competence
Female
Humans
Male
Medical Errors - statistics & numerical data
Middle Aged
Nursing Care - standards
Patient Safety
Quality of Health Care
Retrospective Studies
Sweden
Abstract
Patient safety is an important global issue. While it is well known that patients can suffer from adverse events in nursing care, there is a lack of knowledge as to how they experience them.
To examine adverse events in nursing care as they are experienced by patients and relatives.
This was a retrospective study taking both a qualitative and a quantitative approach. It was based on data regarding 242 adverse events in nursing care, as reported by patients and relatives to Sweden's Medical Responsibility Board, content analysis was used to analyse the reports.
Patients' and relatives' experiences were analysed into four categories of adverse events, as concerning participation, clinical judgement, nursing intervention and the essentials of care.
The reports were classified by the Medical Responsibility Board, without a standardized system. The adverse events reported were few in number and were reported by patients and relatives only.
Lack of participation has negative consequences and contributes to adverse events. Adverse events occur through missed care as well as through carer errors.
Nurses need to improve their skills that support patient participation. Patient participation needs to be incorporated into nurses' duties.
Resources for patients to participate in their own care needs to be a priority underpinning policy-making in health systems. Nursing education systems need to teach students about the value and benefits of involving patients in their care.
PubMed ID
26109381 View in PubMed
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Adverse events in psychiatry: a national cohort study in Sweden with a unique psychiatric trigger tool.

https://arctichealth.org/en/permalink/ahliterature307049
Source
BMC Psychiatry. 2020 02 04; 20(1):44
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
02-04-2020
Author
Lena Nilsson
Madeleine Borgstedt-Risberg
Charlotta Brunner
Ullakarin Nyberg
Urban Nylén
Carina Ålenius
Hans Rutberg
Author Affiliation
Department of Anaesthesiology and Intensive Care, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. lena.nilsson@regionostergotland.se.
Source
BMC Psychiatry. 2020 02 04; 20(1):44
Date
02-04-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Cohort Studies
Female
Humans
Male
Medical Errors
Patient Safety
Psychiatry
Retrospective Studies
Sweden
Abstract
The vast majority of patient safety research has focused on somatic health care. Although specific adverse events (AEs) within psychiatric healthcare have been explored, the overall level and nature of AEs is sparsely investigated.
Cohort study using a retrospective record review based on a two-step trigger tool methodology in the charts of randomly selected patients 18?years or older admitted to the psychiatric acute care departments in all Swedish regions from January 1 to June 30, 2017. Hospital care together with corresponding outpatient care were reviewed as a continuum, over a maximum of 3?months. The AEs were categorised according to type, severity and preventability.
In total, the medical records of 2552 patients were reviewed. Among the patients, 50.4% were women and 49.6% were men. The median (range) age was 44 (18-97) years for women and 44.5 (18-93) years for men. In 438 of the reviewed records, 720 AEs were identified, corresponding to the AEs identified in 17.2% [95% confidence interval, 15.7-18.6] of the records. The majority of AEs resulted in less or moderate harm, and 46.2% were considered preventable. Prolonged disease progression and deliberate self-harm were the most common types of AEs. AEs were significantly more common in women (21.5%) than in men (12.7%) but showed no difference between age groups. Severe or catastrophic harm was found in 2.3% of the records, and the majority affected were women (61%). Triggers pointing at deficient quality of care were found in 78% of the records, with the absence of a treatment plan being the most common.
AEs are common in psychiatric care. Aside from further patient safety work, systematic interventions are also warranted to improve the quality of psychiatric care.
PubMed ID
32019518 View in PubMed
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Adverse events in Public Dental Service in a Swedish county--a survey of reported cases over two years.

https://arctichealth.org/en/permalink/ahliterature262236
Source
Swed Dent J. 2014;38(3):151-60
Publication Type
Article
Date
2014
Author
Lena Jonsson
Pia Gabre
Source
Swed Dent J. 2014;38(3):151-60
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Child
Databases, Factual
Delayed Diagnosis
Dental Auxiliaries - statistics & numerical data
Dental Care - adverse effects - statistics & numerical data
Dental Records - statistics & numerical data
Dentists - statistics & numerical data
Documentation - statistics & numerical data
Female
Humans
Insurance, Health - statistics & numerical data
Male
Medical Errors - adverse effects - statistics & numerical data
Middle Aged
Patient Advocacy - statistics & numerical data
Patient Safety - statistics & numerical data
Public Health Dentistry - statistics & numerical data
Sex Factors
Sweden
Time Factors
Young Adult
Abstract
Adverse events cause suffering and increased costs in health care. The main way of registering adverse event is through dental personnel's reports, but reports from patients can also contribute to the knowledge of such occurrences. This study aimed to analyse the adverse events reported by dental personnel and patients in public dental service (PDS) in a Swedish county. The PDS has an electronic system for reporting and processing adverse events and, in addition, patients can report shortcomings, as regards to reception and treatment, to a patient committee or to an insurance company. The study material consisted of all adverse events reported in 2010 and 2011, including 273 events reported by dental personnel, 53 events reported by patients to the insurance company and 53 events reported by patients to the patient committee. Data concerning patients' age and gender, the nature, severity and cause of the event and the dental personnel's age gender and profession were collected and analysed. Furthermore the records describing the dental personnel's reports from 2011 were studied to investigate if the event had been documented and the patient informed. Age groups 0 to 9 and 20 to 39 years were underrepresented while those between the ages 10 to 19 and 60 to 69 years were overrepresented in dental personnel's reports. Among young patients delayed diagnosis and therapy dominated and among patients over 20 years the most frequent reports dealt with inadequate treatments, especially endodontic treatments. In 29% of the events there was no documentation of the adverse event in the records and 49% of cases had no report about patient information. The majority of the reports from dental personnel were made by dentists (69%). Reporting adverse events can be seen as a reactive way of working with patient safety, but knowledge about frequencies and causes of incidents is the basis of proactive patient safety work.
PubMed ID
25796809 View in PubMed
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406 records – page 1 of 41.