Qual Saf Health Care
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Qual Saf Health Care · Dec 2010
ReviewCoping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals' psychological well-being.
Previous research has established health professionals as secondary victims of medical error, with the identification of a range of emotional and psychological repercussions that may occur as a result of involvement in error.2 3 Due to the vast range of emotional and psychological outcomes, research to date has been inconsistent in the variables measured and tools used. Therefore, differing conclusions have been drawn as to the nature of the impact of error on professionals and the subsequent repercussions for their team, patients and healthcare institution. A systematic review was conducted. ⋯ It is evident that involvement in a medical error can elicit a significant psychological response from the health professional involved. However, a lack of literature around coping and support, coupled with inconsistencies and weaknesses in methodology, may need be addressed in future work.
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Qual Saf Health Care · Dec 2010
Medication reconciliation in the emergency department: opportunities for workflow redesign.
To examine the role of workflow redesign to improve medication reconciliation at four Washington State community hospital emergency departments. ⋯ Ideas for an optimal workflow to generate a medication list include involving patients and utilising clerical staff to a greater extent in medication information gathering, identifying and flagging patients with missing medication information, and gathering only the medication information needed to make clinical decisions in the emergency department.
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Qual Saf Health Care · Dec 2010
Randomized Controlled TrialTeamwork training with nursing and medical students: does the method matter? Results of an interinstitutional, interdisciplinary collaboration.
The authors conducted a randomised controlled trial of four pedagogical methods commonly used to deliver teamwork training and measured the effects of each method on the acquisition of student teamwork knowledge, skills, and attitudes. ⋯ Each of the four modalities demonstrated significantly improved teamwork knowledge and attitudes, but no modality was demonstrated to be superior. Institutions should feel free to utilise educational modalities, which are best supported by their resources to deliver interdisciplinary teamwork training.
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Qual Saf Health Care · Dec 2010
Pneumococcal vaccination process improvement in an acute care setting.
Despite the availability of the pneumococcal vaccine since 1977, the vaccine is greatly underutilised. Centers for Medicare and Medicaid Services, The Joint Commission and Healthy People 2010 have all listed the administration of the pneumococcal vaccine before hospital discharge as a standard of care and a quality initiative in the 21st century. SSM St Mary's Health Center chartered a multidisciplinary team to address a disappointing pneumococcal vaccination rate of 34.7% in the first quarter of 2005. ⋯ Utilising Plan-Do-Study-Act allows for continual improvement of the vaccination process. Multiple cycles are necessary to achieve standardisation and optimal process flow.
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Although acknowledged to be an ethical imperative for providers, disclosure following patient safety incidents remains the exception. The appropriate response to a patient safety incident and the disclosure of medical errors are neither easy nor obvious. An inadequate response to patient harm or an inappropriate disclosure may frustrate practitioners, dent their professional reputation, and alienate patients. ⋯ Adopting a policy of transparency represents a major shift in organisational focus and may take several years to implement. In our experience, the ability to rapidly learn from, respond to, and modify practices based on investigation to improve the safety and quality of patient care is grounded in transparency.