Can patient and family education prevent medical errors? A descriptive study.

BACKGROUND: This study aims to increase understanding of how patient and family education affects the prevention of medical errors, thereby providing basic data for developing educational contents. METHODS: This descriptive study surveyed patients, families, and Patient Safety Officers to investigate the relationship between educational contents and medical error prevention. The Chi-square test and ANOVA were used to derive the results of this study. The educational contents used in this study consisted of health information (1. current medicines, 2. allergies, 3. health history, 4. previous treatments/tests and complications associated with them) and Speak Up (1. handwashing, 2. patient identification, 3. asking about medical conditions, 4. asking about test results, 5. asking about behaviour and changes in lifestyle, 6. asking about the care plan, 7. asking about medicines, and 8. asking about medicine interactions). RESULTS: In this study, the first criterion for choosing a hospital for treatment in Korea was 'Hospital with a famous doctor' (58.6% patient; 57.7% families). Of the patients and their families surveyed, 82.2% responded that hospitals in Korea were safe. The most common education in hospitals is 'Describe your medical condition', given to 69.0% of patients, and 'Hospitalisation orientation', given to 63.4% of families. The most important factors in preventing patient safety events were statistically significant differences among patients, family members, and Patient Safety Officers (p = 0.001). Patients and families had the highest 'Patient and family participation' (31.0% of patients; 39.4% of families) and Patient Safety Officers had the highest 'Patient safety culture' (47.8%). CONCLUSIONS: Participants thought that educational contents developed through this study could prevent medical errors. The results of this study are expected to provide basic data for national patient safety campaigns and standardised educational content development to prevent medical errors.

[An Analysis of Tasks of Nurses Caring for Patients with COVID-19 in a Nationally-Designated Inpatient Treatment Unit].

PURPOSE: The purpose of this study was to provide foundational knowledge on nursing tasks performed on patients with COVID-19 in a nationally-designated inpatient treatment unit. METHODS: This study employs both quantitative and qualitative approaches. The quantitative method investigated the content and frequency of nursing tasks for 460 patients (age ≥ 18 y, 57.4% men) from January 20, 2020, to September 30, 2021, by analyzing hospital information system records. Qualitative data were collected via focus group interviews. The study involved interviews with three focus groups comprising 18 nurses overall to assess their experiences and perspectives on nursing care during the pandemic from February 3, 2022, to February 15, 2022. The data were examined with thematic analysis. RESULTS: Overall, 49 different areas of nursing tasks (n = 130,687) were identified based on the Korean Patient Classification System for nurses during the study period. Among the performed tasks, monitoring of oxygen saturation and measuring of vital signs were considered high-priority. From the focus group interview, three main themes and eleven sub-themes were generated. The three main themes are "Experiencing eventfulness in isolated settings," "All-around player," and "Reflections for solutions." CONCLUSION: During the COVID-19 pandemic, it is imperative to ensure adequate staffing levels, compensation, and educational support for nurses. The study further propose improving guidelines for emerging infectious diseases and patient classification systems to improve the overall quality of patient care.

The Effect of a Non-Invasive Positive Pressure Ventilation Simulation Program on General Ward Nurses' Knowledge and Self-Efficacy.

The purpose of this study is to develop a simulation-based ventilator training program for general ward nurses and identify its effects. Quantitative data were collected from 29 nurses (intervention group: 15, control group: 14), of which seven were interviewed with focus groups to collect qualitative data. The quantitative results revealed significant differences in ventilator-related knowledge (p = 0.029) and self-efficacy (p = 0.026) between the intervention and control groups. Moreover, three themes were derived from meaningful statements in the qualitative data: understanding psychophysical discomfort of the patient while applying the ventilator; helping in ventilator care; and establishing a future ventilator training strategy. The findings confirmed that the non-invasive positive pressure ventilation (NPPV) simulation program is an effective method for improving the knowledge of ventilator nursing and self-efficacy and will be helpful in developing educational methods and strategies related to ventilator nursing for general ward nurses.

Risk Factors for Fall-Related Serious Injury among Korean Adults: A Cross-Sectional Retrospective Analysis.

The purpose of this study was to identify the risk factors of serious fall-related injuries by analyzing the differences between two fall groups: one with serious fall-related injuries and one without such injuries. Applying a retrospective, descriptive investigation study design, we analyzed the degree of fall-related injury and the risk factors related to serious falls by conducting a complete survey of the medical records of fall patients reported throughout one full year, 2017, at a tertiary hospital in Seoul, Korea. Among the patients with reported falls, 188 sustained no injury (63.1%), 72 sustained minor injury (24.2%), and 38 patients sustained serious injury (12.8%). The serious fall-related injuries included eight lacerations requiring suture (2.7%), 23 fractures (7.7%), five brain injuries (1.7%), and two deaths (0.7%). Analysis results indicated that taking anticoagulants/antiplatelet drugs (p = 0.016) and having a fall history (p = 0.038) were statistically significant in the differences between the group with serious injury related to falls and the group without serious injury. Logistic regression revealed that taking anticoagulant/antiplatelet drugs was the factor most significantly correlated with serious injuries related to falls (OR = 2.299, p = 0.022). Results show that it is necessary to develop a patient-tailored fall prevention activity program.

How to Improve Patient Safety Literacy?

The aim of this comparative study involving pre- and post-tests was to analyze the effectiveness of patient safety educational materials developed for the Comprehensive Plans for Patient Safety in Korea (2018-2022), and to suggest how to improve patient safety literacy. A face-to-face survey interview comprising items related to general information and patient safety literacy was completed by 217 patients and their families who visited three general hospitals in Seoul and one general hospital in Gyeonggi-do for treatment between 25 October and 15 November 2019. In the interview, the patients were asked questions about whether the patient safety educational materials were "easy to understand," provided "help in safe hospitalization," and enabled patients to practice patient safety independently ("do it yourself"). The literacy of the patient safety educational materials was analyzed using a paired t-test with a p value of 0.05. The comparison between patient safety literacy on pre- and post-tests revealed that among all participants, there were significant differences in "easy to understand," "help in safe hospitalization," and "do it yourself" scores. To improve patient safety literacy, patient education materials need to optimize communication by improving patients' knowledge, skills, and attitudes for maintaining and promoting healthy living.

Identification of synaptic pattern of kainate glutamate receptor subtypes on direction-selective retinal ganglion cells.

In this article we investigate the distributions of kainate glutamate receptor subtypes GluR5-7 and KA1, 2 on the dendritic arbors of direction-selective (DS) retinal ganglion cells (RGCs) of the rabbit retina to search for anisotropies, which might contribute to a directional preference of DS RGCs. The distribution of the kainate receptor subunits on the DS RGCs was determined using antibody immunocytochemistry. DS RGCs were injected with Lucifer yellow and the cells were identified by their characteristic morphology. The double-labeled images of dendrites and receptors were visualized using confocal microscopy and were reconstructed from high-resolution confocal images. We found no evidence of asymmetry in any of the kainate receptor subunits examined on the dendritic arbors of both On and Off layers of DS RGCs. Our results indicate that direction selectivity appears to lie in the neuronal circuitry afferent to the ganglion cell.

A protein tyrosine phosphatase inhibitor, pervanadate, inhibits angiotensin II-Induced beta-arrestin cleavage.

Beta-arrestins turn off G protein-mediated signals and initiate distinct G protein-independent signaling pathways. We previously demonstrated that angiotensin AT(1) receptor-bound beta-arrestin 1 is cleaved after Phe(388) upon angiotensin II stimulation. The mechanism and signaling pathway of angiotensin II-induced beta-arrestin cleavage remain largely unknown. Here, we show that protein Tyr phosphatase activity is involved in the regulation of beta-arrestin 1 cleavage. Tagging of green fluorescent protein (GFP) either to the N-terminus or C-terminus of beta-arrestin 1 induced conformational changes and the cleavage of beta-arrestin 1 without angiotensin AT(1) receptor activation. Orthovanadate and molybdate, inhibitors of protein Tyr phosphatase, attenuated the cleavage of C-terminal GFP-tagged beta-arrestin 1 in vitro. The inhibitory effects of okadaic acid and pyrophosphate, which are inhibitors of protein Ser/Thr phosphatase, were less than those of protein Tyr phosphatase inhibitors. Cell-permeable pervanadate inhibited angiotensin II-induced cleavage of beta-arrestin 1 in COS-1 cells. Our findings suggest that Tyr phosphorylation signaling is involved in the regulation of angiotensin II-induced beta-arrestin cleavage.

Ionotropic glutamate receptor GluR1 in the visual cortex of hamster: distribution and co-localization with calcium-binding proteins and GABA.

The subunit composition of the AMPA receptor is critical to its function. AMPA receptors that display very low calcium permeability include the GluR2 subunit, while AMPA receptors that contain other subunits, such as GluR1, display high calcium permeability. We have studied the distribution and morphology of neurons containing GluR1 in the hamster visual cortex with antibody immunocytochemistry. We compared this labeling to that for calbindin D28K, parvalbumin, and GABA. Anti-GluR1-immunoreactive (IR) neurons were located in all layers. The highest density of GluR1-IR neurons was found in layers II/III. The labeled neurons were non-pyramidal neurons, but were varied in morphology. The majority of the labeled neurons were round or oval cells. However, stellate, vertical fusiform, pyriform, and horizontal neurons were also labeled with the anti-GluR1 antibody. Two-color immunofluorescence revealed that many of the GluR1-IR neurons in the hamster visual cortex were double-labeled with either calbindin D28K (31.50%), or parvalbumin (22.91%), or GABA (63.89%). These results indicate that neurons in the hamster visual cortex express GluR1 differently according to different layers and selective cell types, and that many of the GluR1-IR neurons are limited to neurons that express calbindin D28K, parvalbumin, or GABA. The present study elucidates the neurochemical structure of GluR1, a useful clue in understanding the differential vulnerability of GluR1-containing neurons with regard to calcium-dependent excitotoxic mechanisms.