Seguridad del paciente / Patient safety

Enero 9, 2017. No. 2564

Seguridad de los pacientes ambulatorios Patient Safety in Ambulatory Settings Editors Shekelle PG, Sarkar U, Shojania K, Wachter RM, McDonald K, Motala A, Smith P, Zipperer L, Shanman R. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Oct. Report No.: 16(17)-EHC033-EF. BACKGROUND: Even though most medical care occurs in ambulatory settings, the patient safety movement originated in, and has been mainly focused on, adverse events in hospitalized patients. However, it is increasingly clear that the ambulatory setting is critically important. Ambulatory care differs substantially from inpatient care in ways that affect patient safety hazards and interventions. To better understand the scope of ambulatory care safety issues and the types of evaluations that have been reported for ambulatory patient safety practice (PSP), we have been tasked by AHRQ to provide an overview of key issues relating to the interventions. PURPOSE: This Technical Brief had the following guiding questions: What are the evidence-based hospital patient safety practices that may be applicable to the ambulatory care setting? What are the ambulatory care patient safety practices that have been studied in the literature? Which ones have not been broadly implemented or studied beyond a single ambulatory care center? What tools, settings, and other factors (such as implementation of Patient-Centered Medical Home and team-based care) may influence the implementation and spread of ambulatory care patient safety practices? METHODS: We integrated insights from discussions with eight Key Informants (KIs) with a literature scan of 28 safety topics/strategies. FINDINGS: KIs identified medication safety, diagnosis, transitions, referrals, and testing as important ambulatory care safety topics, and strategies that addressed communications, health IT, teams, patient engagement, organizational approaches, and safety culture as the most important strategies. The literature search found a moderate number of published intervention evaluations for e-prescribing, medication errors and adverse events, pharmacist-based interventions, and transitions from hospital to ambulatory care. There were few published evaluations of interventions for other targets/strategies. These results will assist AHRQ in developing a research agenda in ambulatory patient safety. SUMMARY AND IMPLICATIONS: Both key informant interviews and the literature scan reveal important differences between inpatient and ambulatory safety. There are significant gaps in ambulatory safety research, including a notable lack of studies on patient engagement and timely and accurate diagnosis. Key informants recommend prospective, large-scale studies in diverse ambulatory settings to develop and test ambulatory safety interventions. PDF Sistemas de informe de incidentes: estudio comparativo de dos hospitales Incident reporting systems: a comparative study of two hospital divisions. Hewitt T1, Chreim S2, Forster A3. Arch Public Health. 2016 Aug 15;74:34. doi: 10.1186/s13690-016-0146-8. eCollection 2016. Abstract BACKGROUND: Previous studies of incident reporting in health care organizations have largely focused on single cases, and have usually attended to earlier stages of reporting. This is a comparative case study of two hospital divisions' use of an incident reporting system, and considers the different stages in the process and the factors that help shape the process. METHOD: The data was comprised of 85 semi-structured interviews of health care practitioners in general internal medicine, obstetrics and neonatology; thematic analysis of the transcribed interviews was undertaken. Inductive and deductive themes are reported. This work is part of a larger qualitative study found elsewhere in the literature. RESULTS: The findings showed that there were major differences between the two divisions in terms of: a) what comprised a typical report (outcome based vs communication and near-miss based); b) how the reports were investigated (individual manager vs interdisciplinary team); c) learning from reporting (interventions having ambiguous linkages to the reporting system vs interventions having clear linkages to reported incidents); and d) feedback (limited feedback vs multiple feedback). CONCLUSIONS: The differences between the two divisions can be explained in terms of: a) the influence of litigation on practice, b) the availability or lack of interprofessional training, and c) the introduction of the reporting system (top-down vs bottom-up approach). A model based on the findings portraying the influences on incident reporting and learning is provided. Implications for practice are addressed. KEYWORDS: Internal medicine; Medical errors; Neonatology; Obstetrics; Patient safety; Qualitative research PDF Mejorando los informes sobre eventos de seguridad entre residentes y profesores Improving Patient Safety Event Reporting Among Residents and Teaching Faculty. Louis MY1, Hussain LR2, Dhanraj DN1, Khan BS1, Jung SR1, Quiles WR1, Stephens LA1, Broering MJ1, Schrand KV1, Klarquist LJ1. Ochsner J. 2016 Spring;16(1):73-80Abstract BACKGROUND: A June 2012 site visit report from the Accreditation Council for Graduate Medical Education Clinical Learning Environment Review revealed that residents and physicians at TriHealth, Inc., a large, nonprofit independent academic medical center serving the Greater Cincinnati area in Ohio, had an opportunity to improve their awareness and understanding of the hospital's system for reporting patient safety concerns in 3 areas: (1) what constitutes a reportable patient safety event, (2) who is responsible for reporting, and (3) how to use the hospital's current reporting system. METHODS: To improve the culture of patient safety, we designed a quality improvement project with the goal to increase patient safety event reporting among residents and teaching faculty. An anonymous questionnaire assessed physicians' and residents' attitudes and experience regarding patient safety event reporting. An educational intervention was provided in each graduate medical education program to improve knowledge and skills related to patient safety event reporting, and the anonymous questionnaire was distributed after the intervention. We compared the responses to the preintervention and postintervention questionnaires and tracked monthly patient safety event reports for 1 year postintervention. RESULTS: The number of patient safety event reports increased following the educational intervention; however, we saw wide variability in reporting per month. On the postintervention questionnaire, participants demonstrated improved knowledge and attitudes toward patient safety event reporting. CONCLUSION: The goal of this unique project was to increase patient safety event reporting by both residents and teaching faculty in 6 residency programs through education. We achieved this goal through an educational intervention tailored to the institution's new event reporting system delivered to each residency program. We clearly understand that improvements in quality and patient safety require ongoing effort. The keys to ongoing sustainability include (1) developing patient safety faculty and resident experts in each training program to teach patient safety and to be role models, (2) working toward decreasing the barriers to reporting, and (3) providing timely feedback and system changes. KEYWORDS: Education-graduate-medical; hospital incident reporting; medical errors; patient safety; quality improvement; risk management PDF 5to Curso Internacional de Anestesiología cardiotorácica, vascular, ecocardiografía y circulación extracorpórea. SMACT Mayo 4-6, 2017, Mexicali, México Informes Dr. Hugo Martínez Espinoza bajamed@hotmail.com  Regional Anesthesiology and Acute Pain Medicine Meeting April 6-8, 2017, San Francisco, California, USA ASRA American Society of Regional Anesthesia and Pain Medicine Información / Information California Society of Anesthesiologists Annual Meeting April 27-30, 2017 San Francisco California Información / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Revistas / Journals

Enero 10, 2017. No. 2565

Revista Colombiana de Anestesiología Número 1,Enero - Marzo 2017:Vol. 45. Núm. 1. Revista / Journal J Neuroanaesthesiol Crit Care January-April 2017;Volume 4 | Issue 1  Revista / Journal  Medicine December 2016 - Volume 95 - Issue 52 Revista / Journal  Cleveland Clinic J of Medicine Jan. 2017, Volume 84, Issue Number 1 Revista / Journal  Medical Gas Research October-December 2016;Volume 6 | Issue 4 Revista / Journal J Assoc Chest Physicians January-June 2017;Volume 5 | Issue 1 Revista / Journal Blood Transfusion 2017;15 Revista / Journal Saudi Journal of Anesthesia January-March 2017;Volume 11 | Issue 1  Revista / Journal Health Affairs November 2016; Volume 35, Issue 11 Revista / Journal Journal of International Medical Research Volume 44, Issue 6, December 2016 Revista / Journal 5to Curso Internacional de Anestesiología cardiotorácica, vascular, ecocardiografía y circulación extracorpórea. SMACT Mayo 4-6, 2017, Mexicali, México Informes Dr. Hugo Martínez Espinoza bajamed@hotmail.com  Regional Anesthesiology and Acute Pain Medicine Meeting April 6-8, 2017, San Francisco, California, USA ASRA American Society of Regional Anesthesia and Pain Medicine Información / Information California Society of Anesthesiologists Annual Meeting April 27-30, 2017 San Francisco California Información / Information

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

¿La técnica Latarjet tradicional asegura un mayor contacto óseo en comparación con la modificación del arco congruente?

¿La técnica Latarjet tradicional asegura un mayor contacto óseo en comparación con la modificación del arco congruente?





http://www.mihombroycodo.com.mx/academia/la-tecnica-latarjet-tradicional-asegura-un-mayor-contacto-oseo-en-comparacion-con-la-modificacion-del-arco-congruente/

Traditional Versus Congruent Arc Latarjet Technique: Effect on Surface Area for Union and Bone Width Surrounding Screws

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/?term=Traditional+Versus+Congruent+Arc+Latarjet+Technique%3A+Effect+on+Surface+Area+for+Union+and+Bone+Width+Surrounding+Screws

http://www.arthroscopyjournal.org/article/S0749-8063(16)30802-7/abstract

De:

Dumont GD¹, Vopat BG², Parada S³, Cohn R⁴, Makani A⁵, Sanchez G⁶, Golijanin P⁷, Beaulieu-Jones BR⁷, Sanchez A⁸, Provencher MT⁹.

Todos los derechos reservados para:

Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Abstract

PURPOSE:

To compare the surface area available for bony contact and the width of bone on each side of the Latarjet fixation screws in the traditional Latarjet technique versus the congruent arc modification of the Latarjet technique.

CONCLUSIONS:

The traditional Latarjet technique has greater bony contact with the glenoid and greater bone width on each side of the screws compared with the congruent arc modification of the Latarjet technique. This potentially allows for a larger surface for healing in the traditional Latarjet technique. Moreover, because of smaller width of the bone around the screw, the congruent arc modification is potentially less tolerant of screw-positioning error compared with the traditional Latarjet technique.

Resumen

PROPÓSITO:
Comparar la superficie disponible para el contacto óseo y la anchura del hueso en cada lado de los tornillos de fijación Latarjet en la técnica Latarjet tradicional versus la modificación con arco congruente de la técnica Latarjet.




CONCLUSIONES:

La técnica tradicional de Latarjet tiene mayor contacto óseo con la glenoide y mayor anchura ósea en cada lado de los tornillos en comparación con la modificación de arco congruente de la técnica Latarjet. Esto potencialmente permite una mayor superficie para la curación en la técnica tradicional de Latarjet. Además, debido a la menor anchura del hueso alrededor del tornillo, la modificación del arco congruente es potencialmente menos tolerante al error de posicionamiento de tornillo que la técnica Latarjet tradicional.

LEVEL OF EVIDENCE:

Level III, retrospective comparative study.

Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

PMID:  28049592  DOI:  10.1016/j.arthro.2016.09.035

[PubMed – as supplied by publisher]

¿Pensando en comenzar un nuevo programa #exercise en 2017?

¿Pensando en comenzar un nuevo programa #exercise en 2017?



http://www.lesionesdeportivas.com.mx/academia/pensando-en-comenzar-un-nuevo-programa-exercise-en-2017/

¿Pensando en comenzar un nuevo programa #exercise en 2017? Lea estas pautas de seguridad de @ AAOS1.

http://medilink.us/832s

Thinking of starting a new #exercise program in 2017? Read these safety guidelines from @AAOS1. https://t.co/mD4U5mTNAv

— Dr. Jeff Padalecki (@DrJeffPadalecki) 12 de enero de 2017