Adverse events in health care: a literature review.

AIM: This paper aims to develop understanding of the nature, costs and strategies to reduce or prevent a range of adverse events experienced by people within the health care system. BACKGROUND: Care interventions are not always based on safe practice and adverse events can and do occur that cause or place at risk patients lives and well-being. The nature of adverse events is diverse and can be attributed to a multitude of individual and system contributory factors and causes. EVALUATION: A review of the literature was undertaken in 2006 and 2007 using the following databases: Pubmed, CINAHL, Biomed Ovid, Synergy and the British Nursing Index. This paper evaluates the literature that pertains to adverse events and seeks understanding of this complex issue. KEY ISSUES: Published statistics confirm that globally, professional errors in clinical practice and care delivery occur at an unacceptably high level and result in considerable human and financial consequences. CONCLUSION: Reaching understanding of the multiple factors that contribute to unsafe clinical practice situations requires a cultural shift in organizations. IMPLICATION FOR NURSING MANAGEMENT: Reasons for adverse events are complex and require healthcare managers to evaluate the system issues which impact on the delivery and organization of care.

Focus groups: principles and process.

Richard Redmond and Elizabeth Curtis describe the process of conducting focus groups. It is specifically aimed at students undertaking research methods modules and those planning to use focus groups as a means of collecting data. It begins with a discussion of the uses of focus groups before moving on to discuss some of the many activities associated with the planning, organising and conducting of focus groups.

Survey postal questionnaire: optimising response and dealing with non-response.

Non-response is a major concern for users of surveys as it threatens the validity of the findings and consequently any conclusions drawn, and trend studies indicate that participation in surveys is declining. This paper by Elizabeth Curtis and Richard Redmond aims to raise awareness about non-response in survey research and to suggest strategies researchers can use for increasing response rates.

Focus groups in nursing research.

The literature suggests that prior to the 1950s, focus groups were almost unknown within the social sciences. Today research studies using focus groups are gaining appeal in academic journals. Likewise, they are being used quite extensively outside academic environments. The aim of this paper by Elizabeth Ann Curtis and Richard Redmond is threefold. Firstly, it introduces the background and main characteristics of focus groups, outlines their uses, and discusses the planning and preparation of focus groups. Secondly it discusses the benefits and limitations associated with the use of focus groups. Thirdly it provides an example of how one of the authors applied focus groups in their own research studies.

Reasons for secondary surgical intervention after phacoemulsification with posterior chamber lens implantation.

PURPOSE: To determine the indications for secondary surgical intervention in patients who had primary phacoemulsification with posterior chamber intraocular lens (IOL) implantation and to assess the final visual outcomes. SETTING: Department of Ophthalmology, Scarborough Hospital, Scarborough, United Kingdom. METHODS: The case notes of 17 patients (18 eyes) were reviewed to determine the reasons for secondary surgical intervention. From September 1997 to December 2000 (40 months), 4388 primary phacoemulsification procedures with posterior chamber IOL implantation were performed. RESULTS: Fifteen eyes required secondary surgical interventions for lens-related factors and 3, for surgeon-related factors. All patients had satisfactory visual outcomes after the secondary intervention. CONCLUSIONS: The indications for secondary intervention included unsatisfactory refractive outcome, posterior settlement of the IOL, unwanted imagery, inappropriate IOL power, and IOL dislocation. Secondary intervention can be performed safely and provides satisfactory final visual outcomes.

Is there a place for reflective practice in the nursing curriculum?

Within this paper a review of the literature on the area of reflection and reflective practice is presented. Lecturers at Trinity College Dublin currently face a dilemma with regard to including these concepts in the nursing curricula. They are faced on the one hand with national recommendations for the use of reflection and reflective practice, and on the other with personal and professional concerns about the practical, legal, ethical and moral implications raised in teaching and assessing this subj ect. The literature reveals that there is little consensus of opinion regarding the exact nature of reflection. There is also little empirical evidence to support the benefits of teaching and assessing of reflection or reflective practice from either an educational or clinical perspective. This, together with the practical difficulties of teaching and assessing reflection, may negate against the incorporation of reflection and reflective practice into the nursing curriculum. It is suggested that, rathe r than isolate reflection as a distinct topic, that the skills of critical thinking, problem solving, self-awareness and analysis be developed within the curriculum.