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1.
Unfallchirurg ; 123(1): 16-21, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31940058

RESUMO

Damage to health caused by complications and errors is part of the reality of medical treatment. In order to avoid further negative consequences in the event of legal claims as a result of excessive processing times or unjustified refusals, a good cooperation between the physician and claims management in the clinic and the legal processor in liability insurance is required. In order to avoid false assumptions in claims processing, a critical analysis of the facts of the case is necessary. In addition, findings from claims management must be recorded and effectively implemented in the clinical practice.


Assuntos
Imperícia , Médicos , Gestão de Riscos , Humanos , Seguro de Responsabilidade Civil , Responsabilidade Legal
2.
Br J Nurs ; 29(1): 10, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31917942

RESUMO

Neesha Ridley, Senior Lecturer, University of Central Lancashire, discusses the importance of hand hygiene in preventing healthcare-associated infections.


Assuntos
Infecção Hospitalar/prevenção & controle , Higiene das Mãos/normas , Gestão de Riscos/métodos , Humanos
6.
Br J Anaesth ; 124(2): 197-205, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31780140

RESUMO

BACKGROUND: Medication-related adverse events (MRE) in anaesthesia care are frequent and require a deeper understanding if we are to prevent medication harm. METHODS: We searched for reported MRE from the Spanish Anaesthesia Incident Reporting System (SENSAR) database over a 10-yr period. SENSAR is a cross-national, multicentre system focused on perioperative and critical care. A descriptive analysis of independent variables, phase of medication process, type of MRE, and medication group involved, and their relationships with morbidity was conducted. RESULTS: A total of 1970 MRE were identified from 7072 reported incidents. Patient harm was reported in 31% of the MRE. The administration phase was more frequent (42%) and showed the highest harm rate (44%) compared with other medication process phases. The most frequent types of MRE were wrong treatment regimen and wrong medication (55% of cases). The medication groups most commonly reported were those that alter haemostasis (18%), vasoconstrictor agents (13%), and opioids (10%). Vasoconstrictor agents, benzodiazepines, and neuromuscular blocking agents were the medication groups involved in patient harm four-fold more, and opioids three-fold more, than medications that alter haemostasis. The 1970 incidents were investigated and led to implementation of 4223 local corrective patient safety and quality improvement measures. CONCLUSIONS: Patient harm in the perioperative setting from medications remains a major issue for patients, hospital leaders, and clinicians. We found patterns and specific causes that can be mitigated through proven systems solutions, and should be taken into consideration in designing sustainable solutions for safe perioperative care. CLINICAL TRIAL REGISTRATION: NCT03615898.


Assuntos
Anestesia/efeitos adversos , Segurança do Paciente/estatística & dados numéricos , Gestão de Riscos/estatística & dados numéricos , Bases de Dados Factuais/estatística & dados numéricos , Humanos , Melhoria de Qualidade , Estudos Retrospectivos , Espanha
7.
Exp Parasitol ; 208: 107808, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31765613

RESUMO

There is a plethora of meat-borne hazards - including parasites - for which there may be a need for surveillance. However, veterinary services worldwide need to decide how to use their scarce resources and prioritise among the perceived hazards. Moreover, to remain competitive, food business operators - irrespective of whether they are farmers or abattoir operators - are preoccupied with maintaining a profit and minimizing costs. Still, customers and trade partners expect that meat products placed on the market are safe to consume and should not bear any risks of causing disease. Risk-based surveillance systems may offer a solution to this challenge by applying risk analysis principles; first to set priorities, and secondly to allocate resources effectively and efficiently. The latter is done through a focus on the cost-effectiveness ratio in sampling and prioritisation. Risk-based surveillance was originally introduced into veterinary public health in 2006. Since then, experience has been gathered, and the methodology has been further developed. Guidelines and tools have been developed, which can be used to set up appropriate surveillance programmes. In this paper, the basic principles are described, and by use of a surveillance design tool called SURVTOOLS (https://survtools.org/), examples are given covering three meat-borne parasites for which risk-based surveillance is 1) either in place in the European Union (EU) (Trichinella spp.), 2) to be officially implemented in December 2019 (Taenia saginata) or 3) only carried out by one abattoir company in the EU as there is no official EU requirement (Toxoplasma gondii). Moreover, advantages, requirements and limitations of risk-based surveillance for meat-borne parasites are discussed.


Assuntos
Carne/parasitologia , Doenças Parasitárias/prevenção & controle , Gestão de Riscos/métodos , Animais , Prioridades em Saúde/classificação , Prioridades em Saúde/organização & administração , Humanos , Doenças Parasitárias/transmissão , Fatores de Risco , Gestão de Riscos/organização & administração , Gestão de Riscos/normas , Gestão de Riscos/tendências , Taenia saginata/isolamento & purificação , Teníase/prevenção & controle , Teníase/transmissão , Toxoplasma/isolamento & purificação , Toxoplasmose/prevenção & controle , Toxoplasmose/transmissão , Trichinella/isolamento & purificação , Triquinelose/prevenção & controle , Triquinelose/transmissão
8.
Unfallchirurg ; 123(1): 22-28, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31728555

RESUMO

An error-resistant safety culture can only be achieved through proactive clinical risk management. In April 2019 the Federal Joint Committee once again increased the pressure on hospitals by means of the Quality Promotion and Enforcement Directive (QFD Directive) to take measures within the framework of clinical risk management in order to reduce the error and harm rate and therefore to significantly improve patient safety. In the long term this can only be achieved by positively influencing the safety culture and thus the attitudes and motives of all employees. Clinical risk management should focus on the prevention of so-called sentinel events on the one hand and on the reduction of frequent and avoidable complications on the other hand. This not only improves patient safety but also protects employees from negative consequences. Effective clinical risk management always follows a systemic approach, the 10 fields of action of which are discussed in this article. Large meta-analyses have also confirmed the substantial economic benefit of a clinical risk management.


Assuntos
Cultura Organizacional , Segurança do Paciente , Gestão de Riscos , Gestão da Segurança , Humanos
9.
Emerg Med Clin North Am ; 38(1): 193-206, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31757250

RESUMO

Many orthopedic injuries can have hidden risks that result in increased liability for the emergency medicine practitioner. It is imperative that emergency medicine practitioners consider the diagnoses of compartment syndrome, high-pressure injury, spinal epidural abscess, and tendon lacerations in the right patient. Consideration of the diagnosis and prompt referrals can help to minimize the complications these patients often develop.


Assuntos
Emergências , Tratamento de Emergência/métodos , Responsabilidade Legal , Imperícia/legislação & jurisprudência , Procedimentos Ortopédicos/legislação & jurisprudência , Gestão de Riscos/legislação & jurisprudência , Ferimentos e Lesões/terapia , Humanos , Procedimentos Ortopédicos/métodos
10.
Nursing ; 50(1): 32-37, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31855984

RESUMO

Hospital-acquired delirium often goes unnoticed because the signs and symptoms resemble those of dementia and depression, making diagnosis difficult. This article explores the differences between delirium, dementia, and depression and discusses the role of nursing in patient assessment and education.


Assuntos
Delírio/enfermagem , Doença Iatrogênica/prevenção & controle , Delírio/complicações , Delírio/etiologia , Diagnóstico Diferencial , Humanos , Diagnóstico de Enfermagem , Educação de Pacientes como Assunto , Gestão de Riscos/métodos
11.
Environ Health Prev Med ; 24(1): 68, 2019 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-31785611

RESUMO

BACKGROUND: Food safety in the food market is one of the key areas of focus in public health, because it affects people of every age, race, gender, and income level around the world. The local and international food marketing continues to have significant impacts on food safety and health of the public. Food supply chains now cross multiple national borders which increase the internationalization of health risks. This systematic review of literature was, therefore, conducted to identify common public health risks related to food safety issues in the food market. METHODS: All published and unpublished quantitative, qualitative, and mixed method studies were searched from electronic databases using a three step searching. Analytical framework was developed using the PICo (population, phenomena of interest, and context) method. The methodological quality of the included studies was assessed using mixed methods appraisal tool (MMAT) version 2018. The included full-text articles were qualitatively analyzed using emergent thematic analysis approach to identify key concepts and coded them into related non-mutually exclusive themes. We then synthesized each theme by comparing the discussion and conclusion of the included articles. Emergent themes were identified based on meticulous and systematic reading. Coding and interpreting the data were refined during analysis. RESULTS: The analysis of 81 full-text articles resulted in seven common public health risks related with food safety in the food market. Microbial contamination of foods, chemical contamination of foods, food adulteration, misuse of food additives, mislabeling, genetically modified foods (GM foods), and outdated foods or foods past their use-by dates were the identified food safety-related public health risks in the food market. CONCLUSION: This systematic literature review identified common food safety-related public health risks in the food market. The results imply that the local and international food marketing continues to have significant impacts on health of the public. The food market increases internationalization of health risks as the food supply chains cross multiple national borders. Therefore, effective national risk-based food control systems are essential to protect the health and safety of the public. Countries need also assure the safety and quality of their foods entering international trade and ensure that imported foods conform to national requirements.


Assuntos
Inocuidade dos Alimentos , Saúde Pública , Qualidade de Produtos para o Consumidor , Contaminação de Alimentos/análise , Qualidade dos Alimentos , Abastecimento de Alimentos , Humanos , Internacionalidade , Fatores de Risco , Gestão de Riscos
12.
J Water Health ; 17(6): 989-1001, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31850905

RESUMO

Unsafe drinking water is a recognized health threat in Ethiopia, and climate change, rapid population growth, urbanization and agricultural practices put intense pressure on availability and quality of water. Climate change-related health problems due to floods and waterborne diseases are increasing. With increasing insight into impacts of climate change and urbanization on water availability and quality and of required adaptations, a shift towards climate-resilient water safety planning was introduced into an Ethiopian strategy and guidance document to guarantee safe drinking water. Climate-resilient water safety planning was implemented in the urban water supplies of Addis Ababa and Adama, providing drinking water to 5 million and 500,000 people, respectively. Based on the risks identified with climate-resilient water safety planning, water quality monitoring can be optimized by prioritizing parameters and events which pose a higher risk for contaminating the drinking water. Water quality monitoring was improved at both drinking water utilities and at the Public Health Institute to provide relevant data used as input for climate-resilient water safety planning. By continuously linking water quality monitoring and climate-resilient water safety planning, utilization of information was optimized, and both approaches benefit from linking these activities.


Assuntos
Mudança Climática , Água Potável , Qualidade da Água , Abastecimento de Água/normas , Etiópia , Humanos , Medição de Risco , Gestão de Riscos
13.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 793-797, 2019 Dec 09.
Artigo em Chinês | MEDLINE | ID: mdl-31874476

RESUMO

With the improvement of people's living standards and oral health education, the demand for orthodontic treatment is increasing. The comprehensive goal of orthodontic treatment is not only to obtain esthetic dentition and appearance, but also to obtain oral health, general health and mental and psychological health. Therefore, how to effectively prevent the risks in orthodontic treatment is particularly important, and it is also an important content that orthodontists must master. In this paper, the prevention of related risks in orthodontic treatment was discussed.


Assuntos
Assistência Odontológica , Ortodontia Corretiva , Gestão de Riscos , Estética Dentária , Humanos , Má Oclusão/terapia
14.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 803-807, 2019 Dec 09.
Artigo em Chinês | MEDLINE | ID: mdl-31874478

RESUMO

Facial aesthetic defect is obviously different from facial aesthetic standard. Orthodontic treatment may expose or even magnify other facial aesthetic defects while solving patients' main problems. There are many aesthetic traps in facial bone structure, soft tissue and teeth. Orthodontists should comprehensively recognize patients' dentofacial aesthetic defects. When solving major problems, we should keep an eye on the changes of minor problems and other uncontrollable factors. Potential risks should be clearly recognized and prevented.


Assuntos
Estética Dentária , Má Oclusão/terapia , Ortodontia Corretiva , Gestão de Riscos , Assistência Odontológica , Humanos
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 808-814, 2019 Dec 09.
Artigo em Chinês | MEDLINE | ID: mdl-31874479

RESUMO

Temporomandibular joint (TMJ) related signs and symptoms are frequently found in adolescent and adult orthodontic patients. TMJ health has long been considered important in orthodontic treatment for many decades, and routine screening and management of TMJ problems should be emphasized in orthodontic population. This paper was to review the TMJ problems in orthodontic patients and to set the strategy in clinical orthodontics.


Assuntos
Má Oclusão/terapia , Ortodontia Corretiva , Transtornos da Articulação Temporomandibular/etiologia , Humanos , Gestão de Riscos , Articulação Temporomandibular/fisiopatologia
16.
Wiad Lek ; 72(11 cz 1): 2155-2160, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31860864

RESUMO

This paper summarizes the scientific discussion on the issue of public-private partnership in healthcare sector. The main purpose of research is to analyze the public-private partnership as the progressive form of innovative and investment mechanism in Ukrainian healthcare sector, taking into the consideration international experience in this sphere. The key methods used in the conducted research are data analysis, summarization and comparison. The data synthesis and analysis are the basic value-added elements of this research, which could help to find out the main prospective of PPP-model use in Ukrainian healthcare sector. The object of research is the group of countries such as USA, UK, Canada, and BRIC countries, because namely they are the most progressive in public-private partnership in health care. Practical importance of the scientific research results lies in defining the general principles of public-private partnerships and a set of criterion for its efficiency estimation. Also, the worldwide experience was analyzed in this research and main challenges for its implementation in Ukrainian healthcare practice were considered. It is important for the further development of the healthcare sphere, and improvement of the healthcare facilities' activity in Ukraine. Further research directions are aimed at study of the specific issue of public-private partnership, such as circumstances for creating alliances between private and public actors from a strategy perspective, explore the impact of incentive mechanisms and risk management procedures on health service performance throughout the extended project life-cycle, and to create conducive environments to foster inter-project learning.


Assuntos
Assistência à Saúde , Parcerias Público-Privadas , Estudos Prospectivos , Gestão de Riscos , Ucrânia
17.
Huan Jing Ke Xue ; 40(12): 5570-5580, 2019 Dec 08.
Artigo em Chinês | MEDLINE | ID: mdl-31854630

RESUMO

Preventing the environmental risks linked to contaminated sites and guaranteeing the safety of human settlements are some of the challenges and tasks involved in the construction of world-class city clusters in the Guangdong-Hong Kong-Macao Greater Bay Area. Due to differences in the political systems and land property rights between Guangdong, Hong Kong, and Macao, as well as in the levels of urbanization, industrial structures, and environmental management capabilities of the nine cities in the Pearl River Delta, the risk management and control mode of contaminated sites varies considerably within the Greater Bay Area. In this context, an analysis of the features of risk management and control in the contaminated sites of typical cities can help strengthening technical communication and cooperation, optimizing risk management and control systems. This article briefly describes the risk management and control systems adopted for polluted sites in China; in particular it elaborates on the features of these systems in Guangzhou, Shenzhen, Dongguan, Hong Kong, and Macao, which have been subjected to monitoring, contamination assessments, and renovation procedures. During our study, the risk management and control systems adopted in different cities have been analyzed and compared; moreover, we elaborated thoughts and suggestions for land planning, policy feedback, information disclosure, and alliance mechanisms. We conclude that, overall, Hong Kong and several cities of the Pearl River Delta have established effective risk management and control systems for the polluted sites, which take into account certain local characteristics. However, with the further development and reuse of contaminated sites, the building of a world-class urban agglomeration in the Guangdong-Hong Kong-Macao Greater Bay Area will require safer, more refined, and more efficient risk management and control strategies. We highlight the need to exchange information among researchers in order to promote technical exchange and cooperation. This is particularly important for the risk management and control of polluted sites distributed within the two regions and nine cities of the Guangdong-Hong Kong-Macao Greater Bay Area, sine it would allow their safe reuse and efficient development.


Assuntos
Monitoramento Ambiental , Poluentes Ambientais , Gestão de Riscos , China , Cidades , Hong Kong , Humanos , Macau
18.
Br Dent J ; 227(12): 1035-1040, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31873258

RESUMO

Complex oral surgery procedures are occurring more commonly in primary care, performed by both specialist oral surgeons and non-specialists/tier 2 providers. Practitioners in the UK are working in an increasingly litigious environment which is often at the forefront of a practitioner's mind and prevention of complaints and claims of negligence is vital in maintaining confidence in our practise. In this ever-increasing litigious environment practitioners need to be aware of the risks associated with oral surgery procedures and have to be able to assess and treatment plan patients effectively and safely. Consent is critical to all procedures, and the recent Montgomery case reinforces the importance of this process which must be individual to each patient. It is vital that as practitioners we are aware of our scope of practice and are able to fully inform patients of the risks and benefits of treatment. Practitioners must know their limits and when to refer on to secondary care. This paper discusses the essentials of risk management in oral surgery and describes key stages in the management of patients undergoing an oral surgery procedure. Initial assessment of the patient, which includes medical and dental history will be discussed followed by investigations to support the clinical diagnosis. Once diagnosis has been confirmed, the process of obtaining consent and the legal implications of this are discussed. Finally, a discussion on the appropriate evidence-based management of common complications which may arise when performing oral surgery will complete the paper.


Assuntos
Imperícia , Procedimentos Cirúrgicos Bucais , Cirurgia Bucal , Humanos , Atenção Primária à Saúde , Gestão de Riscos
19.
J Water Health ; 17(6): 870-883, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31850895

RESUMO

The World Health Organization (WHO) promotes water safety plans (WSPs) - a risk-based management approach - for premise plumbing systems in buildings to prevent deterioration of drinking-water quality. Experience with the implementation of WSPs in buildings were gathered within a pilot project in Germany. The project included an evaluation of the feasibility and advantages of WSPs by all stakeholders who share responsibility in drinking-water safety. While the feasibility of the concept was demonstrated for all buildings, benefits reported by building operators varied. The more technical standards were complied with before implementing WSP, the less pronounced were the resulting improvements. In most cases, WSPs yielded an increased system knowledge and awareness for drinking-water quality issues. WSPs also led to improved operation of the premise plumbing system and provided benefits for surveillance authorities. A survey among the European Network of Drinking-Water Regulators on the existing legal framework regarding drinking-water safety in buildings exhibited that countries are aware of the need to manage risks in buildings' installations, but experience with WSP is rare. Based on the successful implementation and the positive effects of WSPs on drinking-water quality, we recommend the establishment of legal frameworks that require WSPs for priority buildings whilst accounting for differing conditions in buildings and countries.


Assuntos
Água Potável/normas , Qualidade da Água , Abastecimento de Água/normas , Alemanha , Humanos , Projetos Piloto , Medição de Risco , Gestão de Riscos
20.
N Z Med J ; 132(1488): 7-10, 2019 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-31851656

RESUMO

At the present time there are continuing debates on the legal status of cannabis in New Zealand. Many of these debates have not given sufficient consideration to evidence concerning cannabis-related harm, much of which has been gathered here in New Zealand by the Christchurch Health and Development Study (CHDS) and the Dunedin Multidisciplinary Health and Development Study (DMHDS). We present a summary of this evidence, and recommendations for a cautious path forward for changing cannabis laws in New Zealand that aims at reducing cannabis-related harm.


Assuntos
Uso da Maconha/efeitos adversos , Uso da Maconha/legislação & jurisprudência , Acidentes , Cannabis , Depressão , Humanos , Nova Zelândia , Gestão de Riscos
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