SciCombinator

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Concept: Patient safety

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OBJECTIVE: /st>To study the psychometric properties of a translated version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPSC) in the Slovenian setting. DESIGN: /st>A cross-sectional psychometric study including principal component and confirmatory factor analysis. The percentage of positive responses for the 12 dimensions (42 items) of patient safety culture and differences at unit and hospital-level were calculated. SETTING: /st>Three acute general hospitals. PARTICIPANTS: /st>Census of clinical and non-clinical staff (n = 976). MAIN OUTCOME MEASURES: /st>Model fit, internal consistency and scale score correlations. RESULTS: /st>Principal component analysis showed a 9-factor model with 39 items would be appropriate for a Slovene sample, but a Satorra-Bentler scaled χ(2) difference test demonstrated that the 12-factor model fitted Slovene data significantly better. Internal consistency was found to be at an acceptable level. Most of the relationships between patient safety culture dimensions were strong to moderate. The relationship between all 12 dimensions and the patient safety grade was negative. The unit-level dimensions of patient safety were perceived better than the dimensions at the hospital-level. CONCLUSION: /st>The original 12-factor model for the HSOPSC was a good fit for a translated version of the instrument for use in the Slovene setting.

Concepts: Hospital, Psychometrics, Factor analysis, Principal component analysis, Confirmatory factor analysis, Safety, Patient safety, Slovenia

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In 2015, the Institute of Medicine Vital Signs report called for a new patient safety composite measure to lessen the reporting burden of patient harm. Before this report, two patient safety organizations had developed an electronic all-cause harm measurement system leveraging data from the electronic health record, which identified and grouped harms into five broad categories and consolidated them into one all-cause harm outcome measure.

Concepts: Measurement, Psychometrics, Test method, Electronic health record, Systems of measurement, Safety, Patient safety

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Medication computerised provider order entry (CPOE) has been shown to decrease errors and is being widely adopted. However, CPOE also has potential for introducing or contributing to errors.

Concepts: Patient safety, Computer physician order entry

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Surgical innovations disseminate in the absence of coordinated systems to ensure their safe integration into clinical practice, potentially exposing patients to increased risk for medical error.

Concepts: Medical terms, Hospital, Surgery, Physician, Minimally invasive, Safety, Patient safety, Surgical oncology

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Adopting the milliliter as the preferred unit of measurement has been suggested as a strategy to improve the clarity of medication instructions; teaspoon and tablespoon units may inadvertently endorse nonstandard kitchen spoon use. We examined the association between unit used and parent medication errors and whether nonstandard instruments mediate this relationship.METHODS: Cross-sectional analysis of baseline data from a larger study of provider communication and medication errors. English- or Spanish-speaking parents (n = 287) whose children were prescribed liquid medications in 2 emergency departments were enrolled. Medication error defined as: error in knowledge of prescribed dose, error in observed dose measurement (compared to intended or prescribed dose); >20% deviation threshold for error. Multiple logistic regression performed adjusting for parent age, language, country, race/ethnicity, socioeconomic status, education, health literacy (Short Test of Functional Health Literacy in Adults); child age, chronic disease; site.RESULTS: Medication errors were common: 39.4% of parents made an error in measurement of the intended dose, 41.1% made an error in the prescribed dose. Furthermore, 16.7% used a nonstandard instrument. Compared with parents who used milliliter-only, parents who used teaspoon or tablespoon units had twice the odds of making an error with the intended (42.5% vs 27.6%, P = .02; adjusted odds ratio=2.3; 95% confidence interval, 1.2-4.4) and prescribed (45.1% vs 31.4%, P = .04; adjusted odds ratio=1.9; 95% confidence interval, 1.03-3.5) dose; associations greater for parents with low health literacy and non-English speakers. Nonstandard instrument use partially mediated teaspoon and tablespoon-associated measurement errors.CONCLUSIONS: Findings support a milliliter-only standard to reduce medication errors.

Concepts: Regression analysis, Medicine, Measurement, Health literacy, Normal distribution, Units of measurement, Deviation, Patient safety

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: The Agency for Healthcare Research and Quality has defined pressure ulcers (PUs) an important patient safety indicator (#3). Despite the existence of evidence-based guidelines for PU prevention and treatment from the United States Department of Health and Human Services, the sustained success in reducing the development of PUs is elusive in many acute care hospitals.

Concepts: Health care, Medicine, Health insurance, Hospital, United States, Healthcare quality, Massachusetts, Patient safety

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Office-based anesthesia is a new and growing subspecialty within ambulatory anesthesia. We examine major developments in office-based anesthesia and how patient safety can be maintained.

Concepts: Safety, Patient safety

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Medication errors can lead to significant morbidity and mortality for patients. Children are particularly vulnerable to medication errors. A strategy for reducing medication errors and the harm resulting from these errors is use of computerized provider order entry (CPOE). This article examines the frequency and nature of prescribing errors for pediatric patients. Also discussed are the proposed benefits from CPOE use, including elimination of eligibility errors, ensuring completeness in prescribing fields, reduction in transcription errors, and improved prescribing practices through the use of clinical decision support. The literature on the effect of CPOE in actual use is explored, as are policy implications and directions for future research.

Concepts: Medicine, Medical terms, Physician, Decision theory, Decision support system, Patient safety, Medical informatics, Computer physician order entry

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The National Quality Forum (NQF) is a nonprofit consensus organization that recently endorsed a measure focused on CT radiation doses. To comply, facilities must summarize the doses from consecutive scans within age and anatomic area strata and report the data in the medical record. Our purpose was to assess the time needed to assemble the data and to demonstrate how review of such data permits a facility to understand doses.

Concepts: Ionizing radiation, Radiobiology, Sievert, Safety, Patient safety, Gray, Absorbed dose, Equivalent dose