Journal of patient safety
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Journal of patient safety · Jun 2011
Modeling for the decision process to implement an educational intervention: an example of a central venous catheter insertion course.
The Center for Medicare and Medicaid Services recently declared that central venous catheter-associated bloodstream infections (CLABs) are preventable and no longer reimbursable. The new penalty paradigm creates substantial economic incentives for hospitals to eliminate infections. Modeling exercises offer the opportunity to justify expenditures for the prevention of rare patient safety events. ⋯ These results suggest that if the educational intervention is effective, a small increase in cost can reduce complications. Our analysis does not consider increased revenue generated by virtual bed capacity increases or dynamic changes in practice. This model serves as a template for other health care institutions to estimate the costs and benefits of their own proposed educational interventions.
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Journal of patient safety · Jun 2011
ReviewAre sequential compression devices commonly associated with in-hospital falls? A myth-busters review using the patient safety net database.
Sequential compression devices (SCDs) help prevent deep venous thrombosis and pulmonary embolism in hospitalized patients; however, clinicians often decline to use this therapy because of a perceived increased risk for patient falls. There is limited information regarding the association between the use of SCDs and patient falls. In this study, we analyze if SCD use is a common risk factor for in-hospital falls. ⋯ Sequential compression device use is rarely associated with in-hospital patient falls, and SCD-related falls are not more harmful than other types of falls.
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Journal of patient safety · Jun 2011
Consensus building for development of outpatient adverse drug event triggers.
Adverse drug event (ADE) detection is an important priority of patient safety research. Trigger tools have been developed to help identify ADEs. As part of a larger study, we developed complex and specific trigger algorithms intended for concurrent use with clinical care to detect outpatient ADEs. This article assesses the use of a modified Delphi process to obtain expert consensus on the value of these triggers. ⋯ The efficiency of the modified Delphi method could be improved by allowing participants to produce an overall summary score that incorporates both the clinical value and the general logic of the trigger. Revising and improving trigger design should be conducted in a separate process limited only to trigger experts.
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Journal of patient safety · Mar 2011
Improving vital sign documentation at triage: an emergency department quality improvement project.
Improving the quality and safety of patients seen in an emergency department (ED) has become a priority in Italy. The Tuscan Regional Health Ministry has supported quality improvement projects in several Tuscan EDs in cooperation with Harvard Medical International and Harvard Medical School. ⋯ Creating a multidisciplinary team and implementing a formal quality improvement project improved vital sign documentation at triage for a group of patients seen during ED triage in 1 Italian hospital.
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Journal of patient safety · Mar 2011
ReviewLeading clinical handover improvement: a change strategy to implement best practices in the acute care setting.
Many contemporary acute care facilities lack safe and effective clinical handover practices resulting in patient transitions that are vulnerable to discontinuities in care, medical errors, and adverse patient safety events. This article is intended to supplement existing handover improvement literature by providing practical guidance for leaders and managers who are seeking to improve the safety and the effectiveness of clinical handovers in the acute care setting. ⋯ Although gaps in handover process and function knowledge remain, efforts to improve handover safety and effectiveness are still possible. Continued evaluation is critical in building this understanding and to ensure that practice changes lead to improvements in patient safety, organizational effectiveness, and patient and provider satisfaction. Through handover knowledge building, fundamental changes in handover policies and practices may be possible.