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At least 19 recordsLinked to original sources
PubMed1992

Interventions related to patient safety.

Patient safety is a growing priority in today's increasingly complex, highly technologic, and business-oriented health care system. This increasing emphasis is being fueled by issues such as cost containment, risk management, quality assurance, health care consumer activism, and legal accountability for practice. In such an environment, it is important that nursing be able to quantify and communicate what it does to promote and maintain patient safety. A standardized language of patient safety interventions provides nursing with the tool to do this. It provides a common language to use when dealing with patient safety issues in the practice, education, research, and administrative arenas. It also allows nurses to package and market the "product" of nursing care to health care consumers, other health care professionals, hospital administrators, and politicians, all of whom share an interest in ensuring that patient safety is maintained and promoted in the most comprehensive yet cost-efficient manner possible.

Accident Prevention↗
PubMed2025

Transforming Medical Education to Make Patient Safety Part of the Genome of a Modern Health Care Worker.

Medical education has not traditionally recognized patient safety as a core subject. To foster a culture of patient safety and enhance psychological safety, it is essential to address the barriers and facilitators that currently impact the development and delivery of medical education curricula. The aim of including patient safety and psychological safety competencies in education curricula is to insert these into the genome of the modern health care worker.

Patient Safety↗
PubMedDate not supplied

Medical equipment ordinance and lack of personnel: two contrary factors influencing anesthesia patient safety.

In January 1986, West German legislators enacted the Medical Equipment Ordinance (MedGV) to define specific regulations for both manufacturers and operators of medical equipment and to offer a measure of safety to patients. We describe the history of MedGV, its regulations, and the mechanisms developed to enforce those regulations. We also evaluate its impact on clinical practice in light of the current staff shortages in anesthesia practice and research in Germany. Finally, we focus our discussion on the distinction between improved equipment as a minor factor in critical-incidents and the inadequate manpower as a major factor in anesthesia mishaps. It is unclear what will develop after 1993, when the national states in Europe form a common market.

Anesthesia↗
PubMed1978

A conductive catheter to improve patient safety during cardiac catheterization.

A 60 Hz current, as small as 20 microamperemeter (rms) is capable of causing ventricular fibrillation when directly applied to the heart. Significant cost and engineering effort has been spent to construct monitoring equipment which satisfies the safety regulations requiring maximum leakage currents below this value. Patients undergoing cardiac catheterization are particularly at risk from electrical hazards, primarily because catheters are made from nonconductive materials. A conductive catheter should allow externally applied currents to leak through its walls before reaching the catheter tip. A new electrically conductive catheter was compared with a standard nonconductive catheter. Five dogs were studied, with 81 attempts to cause fibrillation. Sixty-hertz voltage between the catheter and an external electrode was increased until fibrillation occurred or 130 V was reached. Eight states were studied in randomized sequence: conductive or nonconductive catheter, guidewire or saline-filled and tip touching wall, or free in left ventricle (verified by fluoroscopy and cineangiography). The saline-filled and conductive catheter was safer in that fibrillation never occurred, while fibrillation nearly always occurred with the nonconductive catheter. A conductive guidewire negates the protection of the conductive catheter. The application of conductive catheters could reduce instrumentation costs in laboratories and intensive care units and improve patient safety.

Animals↗
PubMed1991

Use of ethanol as marker substance to increase patient safety during transurethral prostatic resection. Screening investigation of irrigating fluid absorption in four hospitals and comparison of experienced and inexperienced urologists.

Of 472 patients at four different hospitals electively undergoing transurethral resection of the prostate (TURP), 192 received Sorbitur as an irrigating fluid with 2% ethanol (w/v) as a marker. Using a breath analyzer (Alcol-meter), the amount of ethanol in expired air was measured regularly during the operation to detect the absorption of irrigating fluid. The ethanol concentration in expired air was plotted against time. The time-ethanol concentration product was used as a measurement of absorbed ethanol marked irrigating fluid. A unit of more than 2.5 was considered to be a major absorption with possible clinical significance. This criterion was fulfilled in 24 percent of the patients. Postoperative serum sodium was shown to decrease more in patients with major absorption than in patients with minor absorption in comparison to preoperative values. The weight of resected tissue and the bleeding per resected gram of tissue was higher in the patients with major absorption, but the resected tissue per operating time was the same in both groups. The experienced urologists had as many patients with absorption as did the inexperienced ones. Ethanol-marked irrigating fluid is a simple, safe, noninvasive, rapid, and cheap method of detecting absorption of irrigating fluid thus increasing patient safety during TURP. This method indicates absorption before clinical signs and symptoms of the TUR syndrome occur. It also provides an easy method for estimating the frequency of absorption of irrigating fluid routinely in clinical work.

Absorption↗
PubMed1992

Confronting the issues of patient safety and investigator conflict of interest in an international clinical trial of myocardial reperfusion. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) Steering Committee.

The Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO) trial is a large scale international trial of new myocardial reperfusion strategies. The primary hypothesis is that early and sustained coronary artery recanalization will be associated with a significant reduction in mortality. The four regimens that are being tested are 1) streptokinase with subcutaneous heparin; 2) streptokinase with intravenous heparin; 3) accelerated recombinant tissue-type plasminogen activator (rt-PA) with intravenous heparin; and 4) combination streptokinase, rt-PA and intravenous heparin. The planned recruitment of 41,600 patients in 1,500 sites from 15 countries is expected to be completed by December 1992 and will enable detection of a 15% reduction or 1% absolute difference in mortality compared with that associated with standard therapy (streptokinase and subcutaneous heparin). In designing the trial, two important issues were directly addressed. First, a strategy was developed to provide assurance of patient safety during large scale investigational use of an aggressive thrombolytic regimen. This includes fascimile transmission of a one-page safety summary form to the Data Coordinating Center within 24 h of death or discharge, acceptance of the concept of "net clinical benefit" and close surveillance of the trial's progress by the independent Data and Safety Monitoring Committee. Second, to avoid potential conflict of interest beyond elimination of any position of financial equity, the Steering Committee unanimously voted to prohibit any honoraria for speaking engagements, payment for consultancy or travel or reimbursement of any kind from any of the five corporate sponsors until 1 year after publication of the results. Incorporation of these approaches may facilitate the design of future large scale randomized trials in cardiovascular medicine.

Biomedical Research↗
PubMed1991

[Ambulatory coronary angiography. Organization--patient safety--economic benefits].

916 (63%) of 1,452 coronary angiographies performed at the University Hospital in Trondheim from 1988 to 1990 were done policlinically. The study shows that coronary angiography can be carried out safely on an outpatient basis, and that more than 50% of all patients admitted for a coronary angiography can be examined in this way.

Ambulatory Care↗
PubMedDate not supplied

Structural codes and patient safety: does strict compliance make sense?

The authors of this Comment note recent trends rigidifying the enforcement of building and safety codes for health care facilities and compare the estimated costs (in terms of dollars spent) of those trends with their anticipated benefits (in terms of potential years of human life saved). They estimate that for each potential year of life saved, strict enforcement of the Life Safety Code of the National Fire Protection Association would cost $12.7 to $63.5 million for hospitals and $1.1 to $2.6 million for nursing homes, the latter figure based on Massachusett's experience. These figures are contrasted to the cost of routine kidney dialysis, which is generally acknowledged to be an extremely expensive technology, costing approximately $20,000 per potential year of life saved. The authors suggest that even if strict enforcement of the Code were fully effective (which, given the current structure of the Code, seems doubtful), a portion of the substantial financial resources expended from our limited national health care budget in hewing to the letter of the Code might be better spent on other activities with greater potential yield in improving the quality of life for patients in hospitals and nursing homes.

Accident Prevention↗