Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.285
Filtrar
1.
Bone Joint J ; 102-B(2): 148-154, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32009438

RESUMO

Cell therapies hold significant promise for the treatment of injured or diseased musculoskeletal tissues. However, despite advances in research, there is growing concern about the increasing number of clinical centres around the world that are making unwarranted claims or are performing risky biological procedures. Such providers have been known to recommend, prescribe, or deliver so called 'stem cell' preparations without sufficient data to support their true content and efficacy. In this annotation, we outline the current environment of stem cell-based treatments and the strategies of marketing directly to consumers. We also outline the difficulties in the regulation of these clinics and make recommendations for best practice and the identification and reporting of illegitimate providers. Cite this article: Bone Joint J 2020;102-B(2):148-154.


Assuntos
Instituições de Assistência Ambulatorial/normas , Publicidade Direta ao Consumidor/normas , Marketing de Serviços de Saúde/normas , Doenças Musculoesqueléticas/cirurgia , Segurança do Paciente/normas , Transplante de Células-Tronco/normas , Instituições de Assistência Ambulatorial/legislação & jurisprudência , Qualidade de Produtos para o Consumidor/legislação & jurisprudência , Qualidade de Produtos para o Consumidor/normas , Publicidade Direta ao Consumidor/legislação & jurisprudência , Publicidade Direta ao Consumidor/tendências , Humanos , Marketing de Serviços de Saúde/legislação & jurisprudência , Marketing de Serviços de Saúde/tendências , Segurança do Paciente/legislação & jurisprudência , Guias de Prática Clínica como Assunto/normas , Transplante de Células-Tronco/legislação & jurisprudência , Transplante de Células-Tronco/tendências , Reino Unido , Estados Unidos
5.
Nursing ; 50(2): 24-29, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31904617

RESUMO

Historically, MRI was contraindicated in patients with cardiovascular implantable electronic devices because the devices' metallic components made this imaging study unsafe. Advances over the last decade have now made MRI safe for many of these patients. This article examines the risks of MRI technology for this patient population and reviews recent guidelines from the Heart Rhythm Society.


Assuntos
Desfibriladores Implantáveis , Imagem por Ressonância Magnética/normas , Marca-Passo Artificial , Segurança do Paciente/normas , Desfibriladores Implantáveis/efeitos adversos , Humanos , Imagem por Ressonância Magnética/efeitos adversos , Imagem por Ressonância Magnética/enfermagem , Marca-Passo Artificial/efeitos adversos
6.
Br J Nurs ; 28(22): 1492-1493, 2019 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-31835946

RESUMO

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent patient safety crises, litigation claims and a new patient safety publication from NHS Resolution.


Assuntos
Segurança do Paciente/normas , Medicina Estatal/normas , Saúde Global , Humanos , Liderança , Imperícia/legislação & jurisprudência , Medicina Estatal/legislação & jurisprudência , Reino Unido
7.
Rev. bras. cir. plást ; 34(4): 458-467, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047901

RESUMO

Introdução: A lipoaspiração tem sido submetida à evolução constante desde a sua consolidação e emprego sistemático. O auxílio de tecnologia ultrassônica de terceira geração, VASER® (Vibration Amplification of Sound Energy at Resonance), se destina a facilitar a execução da lipoaspiração e trazer maior segurança e resultados satisfatórios, especialmente na busca por maior definição e lipoaspiração superficial. Métodos: No período de 2015 a 2017, 76 pacientes foram submetidas à lipoaspiração para melhora de contorno corporal no Centro Hospitalar Santa Mônica em Erechim. Foram avaliados os resultados obtidos, as possíveis complicações e a segurança do emprego do VASER®. Resultados: A utilização rotineira do VASER® gera aperfeiçoamento de resultados em contorno corporal. A emulsificação gerada pelo dispositivo associada à lipoaspiração em diversos níveis permite uma maior definição e evidenciação dos marcos anatômicos. Conclusão: Lipoaspiração associada ao VASER® permite ao cirurgião plástico o refinamento de seus resultados com a preservação da segurança do paciente.


Introduction: Liposuction has been improved continuously since it was first introduced. The third-generation ultrasound technology VASERTM (Vibration Amplification of Sound Energy at Resonance) facilitates liposuction, providing improved safety and satisfactory results, especially in the search for greater definition and superficial liposuction. Methods: From 2015 to 2017, 76 patients underwent liposuction to improve their body contour at the Santa Monica Hospital Center in Erechim, Rio Grande do Sul, Brazil. The results, complications, and the safety of VASERTM were evaluated. Results: The routine use of VASERTM improves body contour. The emulsification generated by the device, along with liposuction, resulted in greater definition and revelation of the anatomical landmarks. Conclusion: Liposuction associated with VASERTM allows plastic surgeons to refine the results better while ensuring patient safety is maintained.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , História do Século XXI , Complicações Pós-Operatórias/cirurgia , Procedimentos Cirúrgicos Operatórios , Lipectomia , Tecido Adiposo , Gordura Subcutânea/cirurgia , Segurança do Paciente/normas , Contorno Corporal , Lipodistrofia , Complicações Pós-Operatórias , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/métodos , Lipectomia/métodos , Tecido Adiposo/cirurgia , Gordura Subcutânea , Segurança do Paciente , Contorno Corporal/efeitos adversos , Contorno Corporal/métodos , Lipodistrofia/cirurgia , Lipodistrofia/complicações
9.
J R Soc Med ; 112(11): 462-471, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31710823

RESUMO

Locum doctors are often perceived to present greater risks of causing harm to patients than permanent doctors. After eligibility and quality assessment, eight empirical and 34 non-empirical papers were included in a narrative synthesis to establish what was known about the quality and safety of locum medical practice. Empirical literature was limited and weak methodologically. Locums enabled healthcare organisations to maintain appropriate staffing levels and allowed staffing flexibility, but they also gave rise to concerns about continuity of care, patient safety, team function and cost. There was some evidence to suggest that the way locum doctors are recruited, employed and used by organisations, may result in a higher risk of harm to patients. A better understanding of the quality and safety of locum working is needed to improve the use of locum doctors and the quality and safety of patient care that they provide.


Assuntos
Escolha da Profissão , Medicina de Família e Comunidade/organização & administração , Satisfação no Emprego , Segurança do Paciente/normas , Admissão e Escalonamento de Pessoal/organização & administração , Médicos/provisão & distribução , Humanos
11.
Medicine (Baltimore) ; 98(41): e17569, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593143

RESUMO

Near misses and unsafe conditions have become more serious for patients in emergency departments (EDs). We aimed to search the near misses and unsafe conditions that occurred in an ED to improve patient safety.This was a retrospective analysis of a 10-year observational period from January 1, 2007 to December 31, 2016. We gained access to the adverse event notification forms (AENFs) sent to the hospital quality department from the ED. Patient age, sex, and date of presentation were recorded. The near misses and unsafe conditions were classified into 7 types: medication errors, falls, management errors, penetrative-sharp tool injuries, incidents due to institution security, incidents due to medical equipment, and forensic events. The outcome of these events was recorded.A total of 220 AENF were reported from 294,673 ED visits. The median age of the 166 patients was 60 (21-95) years. Of these, 57.1% of the patients were females and 47.9% were males. The most commonly reported events were medication errors (32.7%) and management errors (27.3%). The median age of falling patients was 67.5 years. The nurse-patient ratio between 2007 to 2011 and 2011 to 2016 were 1/10 and 1/7, respectively. We found that when this ratio increased, the adverse events results were less significant (P < .003).This was the 1st study investigating the adverse events in ED in Turkey. The reporting ratio of 0.07% for the total ED visits was too low. This showed that adverse events were under-reported.


Assuntos
Serviço Hospitalar de Emergência/normas , Erros de Medicação/estatística & dados numéricos , Segurança do Paciente/normas , Acidentes por Quedas/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Programas de Assistência Gerenciada/estatística & dados numéricos , Erros Médicos/classificação , Erros Médicos/estatística & dados numéricos , Erros de Medicação/classificação , Pessoa de Meia-Idade , Ferimentos Penetrantes Produzidos por Agulha/classificação , Segurança do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Medidas de Segurança/classificação , Turquia/epidemiologia
12.
Medicine (Baltimore) ; 98(37): e17112, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517846

RESUMO

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory disease with increasing morbidity and mortality that cause huge social and economic loss. Although recommended by guidelines, pulmonary rehabilitation has not been widely applied in clinics because of its inherent limitations. Acupuncture therapy (AT) as one of the most popular treatments in traditional Chinese medicine has been used to treat COPD. We aim to evaluate the safety and efficacy of acupuncture in the treatment of COPD. METHODS: Web of science, PubMed, Springer, Medline, Cochrane Library, EBASE, WHO International Clinical Trials Registry Platform (ICTRP), China National Knowledge Infrastructure Database (CNKI), Wan Fang Database, Chinese Scientific Journal Database (VIP), and Chinese Biomedical Literature Database will be searched from their inception to May 10, 2019. Randomized controlled trials that evaluated the safety and efficacy of acupuncture for the treatment on patients with COPD will be included. The primary outcome measures will include Dyspnea scores, lung function and blood eosinophils. The secondary outcome measures will include St George's Respiratory Questionnaire and 6-minute walk distance. Study selection, data extraction, and risk of bias assessment will be independently undertaken, respectively. Statistical analysis will be conducted by RevMan software (version 5.3). RESULTS: This study will provide high-quality synthesis based on current evidence of acupuncture treatment for COPD in several aspects, including symptom score, quality of life score, side effects and laboratory examination, such as lung function text, blood eosinophils (EOS) etc. CONCLUSION:: The results of this study will provide updated evidence for weather acupuncture is an effective and safe intervention for COPD. ETHICS AND DISSEMINATION: It is not necessary for this systematic review to acquire an ethical approval. This review will be disseminated in a peer-reviewed journal or conference presentation. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019136087.


Assuntos
Terapia por Acupuntura/normas , Doença Pulmonar Obstrutiva Crônica/terapia , Terapia por Acupuntura/métodos , Humanos , Segurança do Paciente/normas , Qualidade de Vida/psicologia , Inquéritos e Questionários
13.
BMC Health Serv Res ; 19(1): 674, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533786

RESUMO

BACKGROUND: Little research exists on patient safety climate in the prehospital context. The purpose of this article is to test and validate a safety climate measurement model for the prehospital environment, and to explore and develop a theoretical model measuring associations between safety climate factors and the outcome variable transitions and handoffs. METHODS: A web-based survey design was utilized. An adjusted short version of the instrument Hospital Survey on Patient Safety Culture (HSOPSC) was developed into a hypothetical structural model. Three samples were obtained. Two from air ambulance workers in 2012 and 2016, with respectively 83 and 55% response rate, and the third from the ground ambulance workers in 2016, with 26% response rate. Confirmatory factor analysis (CFA) was applied to test validity and psychometric properties. Internal consistency was estimated and descriptive data analysis was performed. Structural equation modelling (SEM) was applied to assess the theoretical model developed for the prehospital setting. RESULTS: A post-hoc modified instrument consisting of six dimensions and 17 items provided overall acceptable psychometric properties for all samples, i.e. acceptable Chronbach's alphas (.68-.86) and construct validity (model fit values: SRMR; .026-.056, TLI; .95-.98, RMSEA; .031-.052, CFI; .96-.98). A common structural model could also be established. CONCLUSIONS: The results provided a validated instrument, the Prehospital Survey on Patient Safety Culture short version (PreHSOPSC-S), for measuring patient safety climate in a prehospital context. We also demonstrated a positive relation between safety climate dimensions from leadership to unit level, from unit to individual level, and from individual level on the outcome dimension related to transitions and handoffs. Safe patient transitions and handoffs are considered an important outcome of prehospital deliveries; hence, new theory and a validated model will constitute an important contribution to the prehospital safety climate research.


Assuntos
Serviços Médicos de Emergência/normas , Segurança do Paciente/normas , Gestão da Segurança/normas , Estudos Transversais , Análise Fatorial , Hospitais/normas , Humanos , Liderança , Cultura Organizacional , Estudos Prospectivos , Psicometria , Inquéritos e Questionários
16.
BMC Health Serv Res ; 19(1): 613, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31470853

RESUMO

BACKGROUND: The aim was to determine the feasibility of implementing a patient safety survey which measures patients' experiences of their own safety relating to a care transition. This included limited-efficacy testing, determining acceptability (to patients and staff), and investigating integration with existing systems and practices from the staff perspective. METHODS: Mixed methods study in 16 wards across four hospitals, from two English NHS Trusts and four clinical areas; cardiology, care of older people, orthopaedics, stroke. Limited-efficacy testing of a previously validated survey was conducted through collection of patient reports of safety experiences, and thematic comparison with staff safety incident reports. Patient acceptability was determined through analysis of survey response rates and semi-structured interviews. Staff acceptability and integration were investigated through analysis of survey distribution rates, semi-structured interviews and focus groups. RESULTS: Patients returned 366 valid surveys (16.4% response rate) from 2824 distributed surveys (25.1% distribution rate). Older age was a contributing factor to lower responses. Delays were the largest safety concern for patients. Staff incident report themes included five not present in the safety survey data (documentation, pressure ulcers, devices or equipment, staffing shortages, and patient actions). Patient interviews (n = 28) identified that providing feedback was acceptable, subject to certain conditions being met; cognitive-cultural (patient understanding and prioritisation of safety), structural-procedural (opportunities, means and ease of providing feedback without fear of reprisals), and learning and change (closure of the feedback loop). Staff (n = 21) valued patient feedback but barriers to collecting and using the feedback included resource limitations, staff turnover and reluctance to over-burden patients. CONCLUSIONS: Patients can provide meaningful feedback on their experiences and perceptions of safety in the context of care transitions. Providing this feedback was acceptable to some patients, subject to certain conditions being met. Safety experience feedback from patients was also acceptable to staff; quantitative data was perceived as useful to identify potential risks, and qualitative data informed types of changes required to improve care. However, patient feedback was not integrated into any quality improvement initiatives, suggesting there are still significant challenges to healthcare teams or organisations utilising patient feedback, particularly in relation to care transitions.


Assuntos
Segurança do Paciente/normas , Transferência de Pacientes/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Inglaterra , Estudos de Viabilidade , Retroalimentação , Feminino , Grupos Focais , Hospitais/normas , Humanos , Aprendizagem , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Equipe de Assistência ao Paciente/normas , Participação do Paciente , Pacientes , Melhoria de Qualidade , Gestão de Riscos , Medicina Estatal/normas , Inquéritos e Questionários , Adulto Jovem
17.
Am Surg ; 85(7): 747-751, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31405421

RESUMO

The ACGME work hour restrictions facilitated increased utilization of service-based advanced practice providers (APPs) to offset reduced general surgery resident work hours. Information regarding attending surgeon perceptions of APP impact is limited. The aim of this survey was to gauge these perceptions with respect to workload, length of stay (LOS), safety, best practice, level of function, and clinical judgment. Attending surgeons on surgical teams that employ service-based APPs at an urban tertiary referral center responded to a survey at the completion of academic year 2016. Perceptions regarding APP impact on workload, LOS, safety, best practice, level of function, and clinical judgment were examined. Twenty-two attending surgeons (40%) responded. Respondents agreed that APPs always/usually decrease their workload (77%), decrease LOS (64%), improve safety (68%), contribute to best practice (82%), and decrease near misses (71%). They also agreed that APPs decrease resident workload (87%), but fewer agreed that APPs contribute to resident education (68%). The majority perceived APPs function at the PGY1/2 (43%) or PGY3 (39%) level and always/usually trust their clinical judgment (72%), and felt there was variability in level of function among APPs (56%). This single-center study illustrates that attending surgeons perceive a positive impact on patient care by service-based APPs.


Assuntos
Atitude do Pessoal de Saúde , Internato e Residência , Admissão e Escalonamento de Pessoal/organização & administração , Adulto , Feminino , Cirurgia Geral/educação , Pesquisas sobre Serviços de Saúde , Humanos , Tempo de Internação , Masculino , Profissionais de Enfermagem , Segurança do Paciente/normas , Qualidade da Assistência à Saúde , Carga de Trabalho
18.
Rev Lat Am Enfermagem ; 27: e3167, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432920

RESUMO

OBJECTIVE: analyze the safety culture of multidisciplinary teams from three neonatal intensive care units of public hospitals in Minas Gerais, Brazil. METHOD: a cross-sectional survey conducted with 514 health professionals, using the Hospital Survey on Patient Safety Culture; data were subjected to a descriptive statistical analysis in software R-3.3.2. RESULTS: the findings showed that none of the dimensions had a positive response score above 75% to be considered as a strength area. The dimension 'Nonpunitive response to error' was classified as a critical area of the patient safety culture, present in 55.45% of the responses. However, areas with potential for improvements were identified, such as 'Teamwork within units' (59.44%) and 'Supervisor/manager's expectations and actions to promote patient safety' (49.90%). CONCLUSION: none of the dimensions was considered as a strength area, which indicates safety culture has not been fully implemented in the evaluated units. A critical look at the weaknesses of the patient safety process is recommended in order to seek strategies for the adoption of a positive safety culture to benefit patients, family members and health professionals.


Assuntos
Hospitais Públicos/estatística & dados numéricos , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Gestão da Segurança/estatística & dados numéricos , Adulto , Brasil , Estudos Transversais , Feminino , Hospitais Públicos/normas , Humanos , Unidades de Terapia Intensiva Neonatal/normas , Masculino , Cultura Organizacional , Equipe de Assistência ao Paciente/normas , Segurança do Paciente/normas , Qualidade da Assistência à Saúde/normas , Qualidade da Assistência à Saúde/estatística & dados numéricos , Gestão da Segurança/normas , Estatísticas não Paramétricas , Inquéritos e Questionários , Fatores de Tempo , Carga de Trabalho/estatística & dados numéricos , Adulto Jovem
19.
J Nurs Adm ; 49(9): 436-440, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31436742

RESUMO

OBJECTIVE: The purpose of this study was to describe current practices for onboarding travel nurses (TRNs) and identify TRNs' specific onboarding needs. BACKGROUND: Onboarding must be streamlined and organized for TRNs to provide safe patient care. METHODS: Cross-sectional descriptive survey was used with 306 TRNs throughout United States who were recruited electronically from a closed social media group page. RESULTS: The TRNs identified critical information, including unit patient ratios, onboarding schedule 7 to 14 days before travel assignment start, and login IDs/accesses on day 1. Travel nurse onboarding and competency assessment checklists should be specific to the unit/facility where they will work. CONCLUSION: Findings from this study have the potential to support hospitals in the development of streamlined and tailored TRN onboarding to support regulatory compliance and patient safety as well as realize significant cost savings for TRN onboarding.


Assuntos
Capacitação em Serviço/organização & administração , Recursos Humanos de Enfermagem no Hospital/normas , Segurança do Paciente/normas , Seleção de Pessoal/normas , Admissão e Escalonamento de Pessoal/normas , Enfermagem de Viagem/estatística & dados numéricos , Enfermagem de Viagem/normas , Adulto , Estudos Transversais , Feminino , Previsões , Humanos , Capacitação em Serviço/tendências , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/tendências , Segurança do Paciente/estatística & dados numéricos , Seleção de Pessoal/tendências , Admissão e Escalonamento de Pessoal/tendências , Enfermagem de Viagem/tendências , Estados Unidos
20.
J Nurs Adm ; 49(9): 441-446, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31436743

RESUMO

OBJECTIVE: This study uses Leader-Member Exchange theory to explore the associations between contact frequency (CF) of nurse leaders and their team members, leader-member relationship, and patient safety culture. BACKGROUND: Leader-member relationships are an important part of patient safety culture development. The behaviors of leaders to achieve these relationships are unknown. This study explores CF as a leader behavior to improve patient safety culture. METHODS: Cross-sectional survey of bedside nurses (N = 746) from an 8-hospital system. RESULTS: A significant association was found between relationship strength and patient safety culture; CF's effect on relationship and patient safety culture was demonstrated. CONCLUSION: Contact frequency may support relationships between leaders and members and improve patient safety culture on nursing units. Future studies should explore factors that could be enhancing and limiting CF.


Assuntos
Atitude do Pessoal de Saúde , Relações Interprofissionais , Enfermeiras Administradoras/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Segurança do Paciente/normas , Gestão da Segurança/métodos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA