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1.
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
2.
Appl Ergon ; 81: 102904, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31422264

RESUMO

To date, vehicle manufacturers have largely been left to their own initiatives when it comes to the design, development and implementation of automated driving features. Whilst this has enabled developments within the field to accelerate at a rapid pace, we are also now beginning to see the negative aspects of automated design (e.g., driver complacency, automation misuse and ethical dilemmas). It is therefore becoming increasingly important to identify systemic aspects that can address some of these Human Factors challenges. This paper applies the principles of the Risk Management Framework to explore the wider systemic issues associated with automated driving in the United Kingdom through the novel application of network metrics. The authors propose a number of recommendations targeted at each level of the Risk Management Framework that seek to shift the power of influence away from vehicle manufacturers and back into the hands of governing bodies.


Assuntos
Automação/ética , Automóveis/ética , Ergonomia/ética , Gestão de Riscos/ética , Análise de Sistemas , Condução de Veículo/legislação & jurisprudência , Condução de Veículo/psicologia , Automóveis/legislação & jurisprudência , Humanos , Gestão de Riscos/legislação & jurisprudência , Rede Social , Reino Unido
3.
Am J Nurs ; 119(5): 12, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31033534
4.
Radiol Med ; 124(8): 783-793, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30972532

RESUMO

AIMS AND OBJECTIVES: The aim of this study was to properly define the information regarding patient exposure to Ionizing Radiations in the radiological report, according to the European Directive 2013/59/EURATOM (EU 2013/59 art.58(b)). For this purpose, we evaluated the results from other Member States EU 2013/59 transpositions and from Guidelines recommendation published by International Organizations involved in diagnostic radiology. A practical way for implementing art.58 is also traced. MATERIALS AND METHODS: Dosimetric quantities, such as exposure, absorbed dose and effective dose which may be included in radiological report, were first analyzed; then, in order to define international state of art of Member States EU 2013/59 transposition, a Web research using French, English, Spanish and German key words was performed. RESULTS: EU 2013/59 transposition for 5 Member States was reported. Especially regarding art.58, a European project reports that few European countries (11 of 28) have identified the dose metrics to be used in radiological report. Scientific organizations supporting clinical radiologists and medical physicists have published Guidelines reporting parameters useful to quantify the radiation output and to assess patient dose. CONCLUSIONS: Our research revealed that there is not a shared interpretation of patient exposure information to be included in radiological report. Nevertheless, according to scientific community, authors believe that the exposure is the most appropriate information that could be included in radiological report. Alternatively, but with more expensiveness, a risk index based on effective dose could be used. Moreover, the systematic exposure information recorded could be useful for dose estimates of population from medical exposure.


Assuntos
Registros Médicos/legislação & jurisprudência , Educação de Pacientes como Assunto/legislação & jurisprudência , Doses de Radiação , Exposição à Radiação/legislação & jurisprudência , Radiologia/legislação & jurisprudência , Gestão de Riscos/legislação & jurisprudência , Adulto , Fatores Etários , Criança , União Europeia , Humanos , Radiação Ionizante , Radiometria , Valores de Referência , Eficiência Biológica Relativa
5.
Stanford Law Rev ; 71(2): 341-409, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30883076

RESUMO

Based on case studies indicating that apologies from physicians to patients can promote healing, understanding, and dispute resolution, thirty-nine states (and the District of Columbia) have sought to reduce litigation and medical malpractice liability by enacting apology laws. Apology laws facilitate apologies by making them inadmissible as evidence in subsequent malpractice trials. The underlying assumption of these laws is that after receiving an apology, patients will be less likely to pursue malpractice claims and will be more likely to settle claims that are filed. However, once a patient has been made aware that the physician has committed a medical error, the patient's incentive to pursue a claim may increase even though the apology itself cannot be introduced as evidence. Thus, apology laws could lead to either increases or decreases in overall medical malpractice liability risk. Despite apology laws' status as one of the most widespread tort reforms in the country, there is little evidence that they achieve their goal of reducing litigation. This Article provides critical new evidence on the role of apology laws by examining a dataset of malpractice claims obtained directly from a large national malpractice insurer. This dataset includes substantially more information than is publicly available, and thus presents a unique opportunity to understand the effect of apology laws on the entire litigation landscape in ways that are not possible using only publicly available data. Decomposing medical malpractice liability risk into the frequency of claims and the magnitude of those claims, we examine the malpractice claims against 90% of physicians in the country who practice within a particular specialty over an eight-year period.


Assuntos
Responsabilidade Legal , Imperícia/legislação & jurisprudência , Gestão de Riscos/legislação & jurisprudência , Humanos , Erros Médicos/legislação & jurisprudência , Governo Estadual , Estados Unidos
6.
BMC Health Serv Res ; 19(1): 85, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30709359

RESUMO

BACKGROUND: In advanced health services, a main objective is to promote the culture of safety and clinical risk management. In this regard, the reporting of sentinel events fits within a perspective of error analysis, attempting to propose solutions aimed at preventing a new occurrence of the harmful event. The purpose of this study is to analyze the contribution of medico-legal litigation in the management of clinical risk and to propose an organizational model so as to coordinate the intervention of clinical risk management and medico-legal services. METHODS: Retrospective review of 206 cases of medico-legal litigation, settled against a Hospital of a North-eastern city in Italy from January 1, 2014 and December 31, 2015. RESULTS: Approximately 20% of cases, that are classifiable as "sentinel events", were not reported due to various factors. The reason that these events are under-reported is mainly due to the latency between the event itself and its manifestation as a serious damage to health as well as the discomfort in reporting the events of this kind, which is still widespread among healthcare workers. The systematic research of the available documentation for medico-legal purposes permits the acquisition of more information concerning the clinical event, thereby increasing the number and accuracy of the reports to the clinical risk unit. CONCLUSION: The analysis of medico-legal litigation is a valid tool to enhance the reporting of "sentinel events". One possible proposal is the implementation of an organizational model to establish a rapid procedure for the reporting of sentinel events during the evaluation of medico-legal litigations.


Assuntos
Medicina Legal/legislação & jurisprudência , Gestão de Riscos/legislação & jurisprudência , Pessoal de Saúde , Humanos , Itália , Erros Médicos/legislação & jurisprudência , Segurança do Paciente/legislação & jurisprudência , Projetos de Pesquisa , Estudos Retrospectivos
8.
Z Med Phys ; 29(1): 66-76, 2019 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-30563737

RESUMO

The increasing frequency and complexity of medical radiation exposures to humans inevitably result in higher risks of harmful unintended or accidental radiation exposures. To ensure a high level of protection and its continuous improvement, the Directive 2013/59/Euratom thus requires to systematically record and analyze both events and near-miss events as well as, in the case of their significance, to disseminate information regarding lessons learned from these events promptly and nationwide to improve radiation protection in medicine. These requirements have been transposed into German legislation by the new radiation protection law and radiation protection ordinance that entered into force simultaneously on December 31th, 2018. The reporting and information system as provided by these regulations as well as the tasks, duties and powers of the parties involved are presented in the first part of this review article. In the second part, the established application-specified criteria for the significance - and thus the notification requirement - of (near-miss) events are itemized and explicated.


Assuntos
Sistemas de Informação em Saúde/organização & administração , Exposição à Radiação/efeitos adversos , Proteção Radiológica/legislação & jurisprudência , Gestão de Riscos/organização & administração , União Europeia , Sistemas de Informação em Saúde/legislação & jurisprudência , Humanos , Garantia da Qualidade dos Cuidados de Saúde , Exposição à Radiação/normas , Gestão de Riscos/legislação & jurisprudência
10.
Ann N Y Acad Sci ; 1427(1): 1-90, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30230554

RESUMO

Los Angeles (LA) County's coastal areas are highly valued for their natural benefits and their economic contributions to the region. While LA County already has a high level of exposure to flooding (e.g. people, ports, and harbors), climate change and sea level rise will increase flood risk; anticipating this risk requires adaptation planning to mitigate social, economic, and physical damage. This study provides an overview of the potential effects of sea level rise on coastal LA County and describes adaptation pathways and estimates associated costs in order to cope with sea level rise. An adaptation pathway in this study is defined as the collection of measures (e.g., beach nourishment, dune restoration, flood-proofing buildings, and levees) required to lower flood risk. The aim of using different adaptation pathways is to enable a transition from one methodology to another over time. These pathways address uncertainty in future projections, allowing for flexibility among policies and potentially spreading the costs over time. Maintaining beaches, dunes, and their natural dynamics is the foundation of each of the three adaptation pathways, which address the importance of beaches for recreation, environmental value, and flood protection. In some scenarios, owing to high projections of sea level rise, additional technical engineering options such as levees and sluices may be needed to reduce flood risk. The research suggests three adaptation pathways, anticipating a +1 ft (0.3 m) to +7 ft (+2 m) sea level rise by year 2100. Total adaptation costs vary between $4.3 and $6.4 bn, depending on measures included in the adaptation pathway.


Assuntos
Aclimatação , Mudança Climática , Inundações , Mudança Climática/economia , Mudança Climática/estatística & dados numéricos , Simulação por Computador , Custos e Análise de Custo , Inundações/economia , Inundações/prevenção & controle , Inundações/estatística & dados numéricos , Humanos , Los Angeles , Oceano Pacífico , Medição de Risco , Gestão de Riscos/economia , Gestão de Riscos/legislação & jurisprudência , Incerteza , Áreas Alagadas
11.
Pharmacoepidemiol Drug Saf ; 27(11): 1231-1238, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30187590

RESUMO

PURPOSE: The purposes of the study are to compare safety specifications between Japan and the European Union (EU) and to identify the factors affecting categorization of important identified or potential risks. METHODS: Safety specifications were collected from orphan and nonorphan drugs approved in Japan between 2014 and 2016, and in the EU as of October 2017. Outcome was defined dichotomously as listed as important identified risks or potential risks. A mixed-effects logistic regression was performed to estimate odds ratios of being listed as important identified risks. RESULTS: This study included 20 orphan and 33 nonorphan drugs. The number of safety specifications per drug and the distribution of risk categories were significantly different between Japan and the EU regardless of orphan status. In orphan drugs, the occurrence of serious adverse events (AEs) during clinical trials for new drug applications was associated with a higher probability of being listed as important identified risks in Japan, while AE rate (%) was positively associated with being listed as important identified risks in the EU. For nonorphan drugs in Japan, AE occurring at a high rate, adverse drug reactions (ADRs) listed as important identified risks in EU risk management plans, and clinically significant ADRs known in similar drugs were likely to be listed as important identified risks, whereas a ≥1.4 risk ratio was associated with a higher probability of being listed as important identified risks in the EU. CONCLUSIONS: Factors affecting risk categories were different between Japan and the EU, which might contribute to the difference in safety specifications between these 2 regions.


Assuntos
Rotulagem de Medicamentos/normas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , União Europeia/organização & administração , Produção de Droga sem Interesse Comercial/legislação & jurisprudência , Gestão de Riscos/métodos , Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Rotulagem de Medicamentos/legislação & jurisprudência , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Humanos , Japão , Medição de Risco/métodos , Gestão de Riscos/legislação & jurisprudência
12.
Expert Opin Drug Saf ; 17(10): 975-982, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30107752

RESUMO

AIMS: Additional risk minimization measures (aRMMs) may be needed to ensure that the benefits continue to outweigh the risks for medicines associated with serious risks. Prior research showed an increasing trend in medicines with aRMMs. We assessed whether the European pharmacovigilance legislation may have impacted the number and type of aRMMs. METHODS: We included new active substances approved between 1 January 2010 and 31 December 2015. Information extracted from the summary of the Risk Management Plan at the time of licensing included date and type of marketing authorization, presence and type of aRMMs. We tested for differences using Pearson's Χ2 test and segmented Poisson regression. RESULTS: We identified 231 medicines approved during the study period, of which 30% had aRMMs at the time of licensing. ARMMs were in place for 38% of medicines before July 2012 and for 28% after (p = 0.16). Segmented Poisson regression did not show changes in trend or level of medicines with aRMMs. DISCUSSION AND CONCLUSION: During the study period, no significant differences in the proportion or trend of products with aRMMs at the time of licensing before and after the pharmacovigilance legislation were identified.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos/legislação & jurisprudência , Legislação de Medicamentos , Farmacovigilância , Gestão de Riscos/legislação & jurisprudência , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , União Europeia , Humanos , Distribuição de Poisson , Medição de Risco/legislação & jurisprudência
14.
Rev Esp Salud Publica ; 922018 Jul 04.
Artigo em Espanhol | MEDLINE | ID: mdl-29961752

RESUMO

OBJECTIVE: Risk-sharing contracts (RSC) present a novel management tool, which link the payment to the pharmaceutical company to health outcomes. The objective of this work was to know the perception of health professionals about the utility of these agreements in the Spanish National Health System. METHODS: A questionnaire was designed to conduct a series of semi-structured interviews with hospital pharmacy, laboratory and oncology professionals from Spanish hospitals in Madrid, Aragón, Castilla-La Mancha, Castilla y León, Cataluña, La Rioja, País Vasco and Navarra. The selection criteria was for convenience. The interview period was from April to November 2017. A qualitative analysis was performed based on the responses from 14 interviews. RESULTS: All the surveyed affirmed that the CRCs allow to improve the economic and administrative management of the hospital, emphasizing as main advantages the budgetary control, the obtaining of funding and the savings possibilities. CRCs are perceived (13 of 14 respondents) as agreements with positive health implications because they increased the portfolio of treatments and had greater efficacy. The need for CRCs to register patients, involved monitoring and control, also contributed to the improvement of their health. In addition, CRCs were believed (8 out of 14 respondents) to facilitate the introduction of personalized medicine (MP) as both depend on diagnostic tests, one for screening reasons (MP) and the other for obtain clinical evidences that improve economic outcomes (CRC). However, it was considered that signing the CRCs entails the need to modify certain regulations (5 out of 14 respondents) as well as to increase the number of staff to handle bureaucratic tasks and to increase laboratory tests, which can complicate health management. CONCLUSIONS: Qualitative social research techniques have proven to be useful for gathering information on a new topic and understanding the perception of the advantages and disadvantages of CRCs, as well as their association with the MP. In addition, synergies were detected between the CRCs and the MP. Respondents had positive opinions on CRCs about its application, although work must be done in order to improve the normative and organizational context so that the additional complexity that they incorporate does not constitute an obstacle to extend its use.


Assuntos
Atitude do Pessoal de Saúde , Assistência à Saúde/economia , Gastos em Saúde , Gestão de Riscos/legislação & jurisprudência , Orçamentos , Indústria Farmacêutica/legislação & jurisprudência , Pessoal de Saúde , Humanos , Espanha , Inquéritos e Questionários
16.
Orthopade ; 47(3): 205-211, 2018 03.
Artigo em Alemão | MEDLINE | ID: mdl-29396611

RESUMO

BACKGROUND: Although investigations of retrieved medical implants can provide valuable information about the cause of the revision, there is a lack of information, which could be avoided by consequent failure analyses. In the framework of the EndoCert certification system it is obligatory to record and report incidents. OBJECTIVES: The present work examines how the willingness to report has developed in certified arthroplasty centers and which method of handling retrievals is preferred and actually used. MATERIALS AND METHODS: On the basis of a questionnaire for handling retrievals, all 508 arthroplasty centers that were certified till June 1, 2016, were included (return rate = 97.2%). RESULTS: A total of 93.3% of the centers have established an algorithm for handling of retrievals and 83.0% of the centers prefer to hand out the retrieval to the patient, while only 25.7% wish to store it in the center for research purposes. In the case of a potential incident as the cause of revision, centers prefer to forward the retrieval to damage analysis, whereby the centers act in different ways, depending on the case. An implant fracture is, e.g., considered a reportable event in most cases without temporal limitation. On the other hand, breakage or failure of surgical instruments is considered not to be reported in the case of more than half of the centers. In 2014 and 2015, approximately 71% of EPZs reported no incidents. CONCLUSIONS: According to our survey, many certified arthroplasty centers are sensitized to careful handling of retrievals. The treatment of the explanted components is conducted in different ways. The assessment of whether an incident is to be reported shows large differences. In view of the relatively high number of revision surgeries, the number of reports to the authorities appears to be low.


Assuntos
Algoritmos , Artroplastia de Substituição/instrumentação , Remoção de Dispositivo/legislação & jurisprudência , Falha de Prótese , Artroplastia de Substituição/legislação & jurisprudência , Aprovação de Equipamentos/legislação & jurisprudência , Prova Pericial/legislação & jurisprudência , Alemanha , Humanos , Programas Nacionais de Saúde/legislação & jurisprudência , Falha de Prótese/etiologia , Reoperação/legislação & jurisprudência , Gestão de Riscos/legislação & jurisprudência , Inquéritos e Questionários
17.
Transfus Clin Biol ; 25(1): 19-25, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29223725

RESUMO

OBJECTIVES: Transfusion-associated circulatory overload (TACO) is a severe pulmonary transfusion reaction and leading cause of transfusion-related morbidity and mortality in Europe. TACO is of particular importance in critically ill patients, since they often receive blood transfusions and have multiple risk factors for TACO. This study investigates transfusion practices in patients at risk of developing TACO, and furthermore knowledge concerning risk factors, diagnoses and treatment strategies among Dutch intensive care unit (ICU) fellows. MATERIAL AND METHODS: An unannounced paper-based survey was conducted among Dutch ICU fellows during an educational conference. The survey consisted of 16 multiple and open choice questions. RESULTS: Of all 65 Dutch ICU fellows 56.8% completed the survey; of respondents 88.9% identified the correct constellation of symptoms for TACO. In total, 29.7% of the respondents are aware they are obligated to report TACO cases to the blood bank. Major risk factors for TACO that respondents identified were reduced left ventricular function, infusion volume and infusion rate. In a non-emergency setting, 45.9% of fellows start red blood cell transfusion with 2 units or more. Transfusion rates exceeded national guidelines in 15.4% of fictitious cases. TACO is treated with furosemide by 94.5% of the fellows, however goals of the therapy varied greatly. CONCLUSION: Dutch ICU fellows are knowledgeable of TACO symptoms, risk factors and treatment, however knowledge on reporting and transfusion practice in the setting of at risk patients for TACO should be improved.


Assuntos
Cuidados Críticos , Conhecimentos, Atitudes e Prática em Saúde , Corpo Clínico Hospitalar/psicologia , Reação Transfusional , Segurança do Sangue , Transfusão de Sangue/métodos , Competência Clínica , Educação Médica Continuada , Feminino , Humanos , Masculino , Medicina , Países Baixos , Fatores de Risco , Gestão de Riscos/legislação & jurisprudência , Inquéritos e Questionários , Reação Transfusional/diagnóstico , Reação Transfusional/fisiopatologia , Reação Transfusional/prevenção & controle , Reação Transfusional/terapia
18.
Crit Rev Food Sci Nutr ; 58(2): 297-317, 2018 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-27052385

RESUMO

Nanotechnology has seen exponential growth in last decade due to its unique physicochemical properties; however, the risk associated with this emerging technology has withdrawn ample attention in the past decade. Nanotoxicity is majorly contributed to the small size and large surface area of nanomaterials, which allow easy dispersion and invasion of anatomical barriers in human body. Unique physio-chemical properties of nanoparticles make the investigation of their toxic consequences intricate and challenging. This makes it important to have an in-depth knowledge of different mechanisms involved in nanomaterials's action and toxicity. Nano-toxicity has various effects on human health and diseases as they can easily enter into the humans via different routes, mainly respiratory, dermal, and gastrointestinal routes. This also limits the use of nanomaterials as therapeutic and diagnostic tools. This review focuses on the nanomaterial-cell interactions leading to toxicological responses. Different mechanisms involved in nanoparticle-mediated toxicity with the main focus on oxidative stress, genotoxic, and carcinogenic potential has also been discussed. Different methods and techniques used for the characterization of nanomaterials in food and other biological matrices have also been discussed in detail. Nano-toxicity on different organs-with the major focus on the cardiac and respiratory system-have been discussed. Conclusively, the risk management of nanotoxicity is also summarized. This review provides a better understanding of the current scenario of the nanotoxicology, disease progression due to nanomaterials, and their use in the food industry and medical therapeutics. Briefly, the required rules, regulations, and the need of policy makers has been discussed critically.


Assuntos
Agroquímicos/toxicidade , Poluentes Ambientais/toxicidade , Aditivos Alimentares/efeitos adversos , Contaminação de Alimentos , Nanoestruturas/toxicidade , Gestão de Riscos , Agroquímicos/normas , Animais , Carcinógenos Ambientais/toxicidade , Aditivos Alimentares/normas , Contaminação de Alimentos/legislação & jurisprudência , Contaminação de Alimentos/prevenção & controle , Humanos , Legislação de Medicamentos , Legislação sobre Alimentos , Mutagênicos/toxicidade , Nanoestruturas/efeitos adversos , Nanoestruturas/normas , Oxidantes/efeitos adversos , Oxidantes/normas , Oxidantes/toxicidade , Gestão de Riscos/legislação & jurisprudência , Gestão de Riscos/normas , Gestão de Riscos/tendências , Testes de Toxicidade/normas
19.
Environ Sci Pollut Res Int ; 25(4): 3120-3126, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28752303

RESUMO

Daily fish intake is a key parameter of water quality criteria for protecting human health. Daily fish intake values should be representative of consumption patterns and must be practical for regulatory purposes. Thus, values must be scientifically verified and regularly updated for inclusion in water quality criteria. In Korea, four different fish intake values have been identified from food balance sheets (KREI 2000), the Korea National Health and Nutrition Examination Survey (KNHANES) II (Ministry of Health and Welfare 2002), Korean Exposure Factors Handbook (MOE 2007a), and KNHANES IV-V (CDC 2008; 2009; 2010), which have been applied to water quality standards and related national projects and regulations. This paper reviews the estimation methodologies of previous daily fish intake values from multiple sources and improvements in these values between 2000 and 2012. Finally, limitations associated with each value were examined to assist future research and regulatory management. This review provides information on changes in the daily fish intake values and their application in water quality standards in Korea.


Assuntos
Exposição Dietética/normas , Produtos Pesqueiros/normas , Avaliação do Impacto na Saúde/métodos , Avaliação do Impacto na Saúde/normas , Gestão de Riscos/normas , Qualidade da Água/normas , Animais , Inquéritos sobre Dietas/estatística & dados numéricos , Avaliação do Impacto na Saúde/estatística & dados numéricos , Humanos , República da Coreia , Gestão de Riscos/legislação & jurisprudência
20.
Australas Psychiatry ; 26(5): 474-477, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26530349

RESUMO

OBJECTIVES: Our aim was to develop a framework for clinical decision-making that can be used to take into account risk in an era of recovery and rights. CONCLUSION: We developed a framework influenced by civil liability law to develop a guide for clinical decision-making which emphasises collaboration, clarification of the available information and communication of decisions as essential components of recovery-oriented risk management.


Assuntos
Tomada de Decisão Clínica , Transtornos Mentais/terapia , Saúde Mental , Pessoas Mentalmente Doentes , Psiquiatria , Gestão de Riscos , Humanos , Saúde Mental/legislação & jurisprudência , Pessoas Mentalmente Doentes/legislação & jurisprudência , Psiquiatria/legislação & jurisprudência , Psiquiatria/métodos , Gestão de Riscos/legislação & jurisprudência , Gestão de Riscos/métodos
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