29 research outputs found
Patient Safety in eye surgery
No full textuseful defense mechanisms, in order to face the consequences in
the event of an error occurring. To reduce these events it
is necessary to improve the quality of health care through
Clinical Governance namely Risk Management or
Clinical Risk Management, which aim at identifying,
analyzing, evaluating, communicating, eliminating and
monitoring risks associated with any health activityuseful defense mechanisms, in order to face the consequences in
the event of an error occurring. To reduce these events it
is necessary to improve the quality of health care through
Clinical Governance namely Risk Management or
Clinical Risk Management, which aim at identifying,
analyzing, evaluating, communicating, eliminating and
monitoring risks associated with any health activit
Improving quality through clinical risk management: A triage sentinel event analysis
No full text"Triage" is a useful tool used in emergency departments (EDs) to prioritize the care of patients. Through a methodical process of different sequential steps, the triage nurse assigns a color code which goes from red-critical patient with immediate access to medical examination-to a white code that represents no urgency. Clinical studies have shown that patients can be victims of errors during the process of care, especially in complex systems such as EDs. To reduce errors it is essential to map the risks in order to identify the causes (both individual and organizational); the introduction of corrective changes cannot be postponed. The incorrect assessment at triage represents one of the major errors in EDs. By monitoring this activity, through the analysis of sentinel events we can reduce adverse consequences. Missed recognition of a red code indicates a sentinel event. We used a "root cause analysis" to explain an episode of missed recognition of red code at triage. A nurse without specific training in triage and inexperienced in critical care was identified as the "root cause" of the sentinel event. To make improvements we planned a triage training course (for newly employed nurses and a refresher course for existing staff) and created a team of dedicated triage nurses. © 2011 SIMI
The case of Patient Safety Indicator 12 (PSI12): Use of administrative data to estimate the incidence of "Postoperative Pulmonary embolism or Deep Vein Thrombosis". A pilot study in a General Hospital
No full textIntroduction: The AHRQ Quality Indicators (QIs) were created in order to both identify the performance and to track the improvement of patient safety. Patient Safety Indicator 12 (PSI12) is relative to the risk of Post Operatory Pulmonary Embolism or Deep Venous Thrombosis (PO DVT/PE). This pilot study has three main objectives. Firstly, to perform an analysis of the performance of different hospital wards by using administrative data; secondly, to analyze defects in the process that led to the occurrence of the adverse event; thirdly, reviewing the single PO DVT/PE. Methods: Data were extracted from a Hospital Information data flow (SIO) and compared to Clinical Discharge Record. PSI12 estimates were computed before and after the screening. Control Charts allowed the static analysis of performance between different hospital wards in 2014. The Ishikawa diagram was drawn for the analysis of the underlying causal process. Results: The number of PSI12 cases provided by DRGs through SIO data flow decreased from 45 to six after the comparison with the correspondent clinical records. Four clinical records provided full information allowing the analysis of process. The Ishikawa Diagram identified the defects in the process of prophylaxis that resulted into a PO DVT/PE. Discussion: The clinical records screening revealed a lower incidence of PO DVT/PE with respect to the DRGs statistics. Overall the PO DVT/PE occurrence in 2014 fell into the control limits, although the result could be undermined by the low quality of clinical records compilation. The failure in the prophylaxis procedure was imputable to pitfalls in the health care management and to the individual attitude towards patient safety procedures. In conclusion, the reliability and validity of administrative data in monitoring quality and safety are worthy to be explored in the context of further validation studies
Knowledge of Emergency Department Triage nurses in management of patients with mental health needs: comparisons with the Triage Model of Lazio (TLM)
No full textTo refer the current competences of Triage Nurses (TRNs) assessing the person with metal health problems in Emergency Departments (ED), and the impact of the Triage Lazio Model (TLM) upon it
Six months follow up of a single intravitreal injection of ocriplasmin for symptomatic vitreomacular adhesion
No full textPurpose: To evaluate the efficacy and the safety of the enzymatic vitreolysis with a single intravitreal injection of ocriplasmin 125 μg across a group of patients with symptomatic vitreomacular adhesion (sVMA) during 6 months follow up.
Design: A randomized, placebo-controlled, double-masked, 6-month follow up study.
Participants: A total of 28 patients (12 M / 16F) (19 receiving ocriplasmin; 9 receiving placebo), mean aged 71 years old, diagnosed with sVMA, VMT, FTMH e ERM by optical coherence tomography.
Methods: A single intravitreal injection of ocriplasmin 125 μg or placebo. Primary endpoint was sVMA resolution or FTMH closure. Secondary endpoint included the integrity of the external membrane and the inner and outer segments of the photoreceptor interface using OCT. The evaluation was carried out at baseline and during 6 months after intravitreal injection of ocriplasmin or placebo.
Results: After a 6 months follow-up period, the rate of VMA resolution was 42.1% in the Ocriplasmin group vs the 22% in the placebo group. FTMH closure rate was 50% in the Ocriplasmin group vs 0% in the placebo group. The best results were optained within 28 days from the treatment. No case of uveitis, endophthalmitis, retinal tears, retinal detachment or bleeding during follow-up were reported. One patient reported floaters and transitional photopsias.
Conclusions: The study confirmed the efficacy and safety of Ocriplasmin injection for patients with VMT, including when associated with full-thickness macular holes during six months follow up. Long term studies are certainly needed to confirm these results
Conley Scale: assessment of a fall risk prevention tool in a General Hospital
No full text"Umberto I" Teaching Hospital adopted 'Conley scale' as internal procedure for fall risk assessment, with the aim of strengthening surveillance and improving prevention and management of impatient falls
Proletários de todos os países, UNI-VOS em Cristo: trabalhadores católicos e o Círculo Operário de Florianópolis (1937-1945)
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Filosofia e Ciências Humanas. Programa de Pós-Graduação em HistóriaNeste trabalho proponho analisar a intervenção e influência da Igreja católica entre os trabalhadores da capital catarinense através da formação e organização do Círculo Operário de Florianópolis no período entre sua fundação em 1937 ao ano de 1945. Pretendo compreender as relações estabelecidas de acordo com suas estratégias e objetivos com diversas outras organizações, sejam elas católicas, de trabalhadores ou o Estado, bem como analisar de que forma o COF interagiu com a própria cidade e sua população. Mais do que um estudo institucional sobre o Círculo Operário, busco saber quem era o #circulista# e quais seus espaços de sociabilidade e de ação. The aim of this article is to analyse the interventions and influence of Catholic Church among workers of the capital of Santa Catarina due to the creation and organization of "Círculo Operário de Florianopólis" (Florianopolis workers group) since it was created in 1937 until 1945. It also tries to understand the relations settled according to the strategies and aims with many other organizations: catholic, workers´ or belonging to the State, as well as to analyse how the COF acted with the city and population. More than a study about the workers´ group, one of the aims is to know who the "circulistas" were, and where their places to socialize and act used to be
Quality assessment of medical record as a tool for clinical risk management: a three year experience of a teaching hospital Policlinico Umberto I, Rome
No full textIntroduction: The medical record was defined by the Italian Ministry of Health in 1992 as "the information tool designed to record all relevant demographic and clinical information on a patient during a single hospitalization episode". Retrospective analysis of medical records is a tool for selecting direct and indirect indicators of critical issues (organizational, management and technical). The project’s aim being the promotion of an evaluation and self-evaluation process of medical records as a Clinical Risk Management tool to improve the quality of care within hospitals.
Methods: The Authors have retrospectively analysed, using a validated grid, 1,184 medical records of patients admitted to the Teaching Hospital “Umberto I” in Rome during a three-year period (2013-2015). Statistical analysis was performed using SPSS for Windows © 19:00. All duly filled out criteria (92) were examined. “Strengths” and "Weaknesses" were identified through data analysis and Best and Bad Practice were identified based on established criteria.
Conclusion: The data analysis showed marked improvements (statistically significant) in the quality of evaluated clinical documentation and indirectly upon behaviour. However, when examining some sub-criteria, critical issues emerge; these could be subject to future further corrective action
Áreas verdes: espaços de articulação e interação socioambiental, um estudo de caso no município de Chapecó, SC
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Enhenharia CivilO objetivo deste estudo de caso exploratório e descritivo foi constatar se parques e praças do Município de Chapecó podem ser enquadrados como Áreas Verdes. Através do método de observação, sem intervenção, foram levantados dados que compilados viraram registros, em 2011. Esses foram equiparados perante as funções previstas em diploma legal para essas áreas, em domínio público. Apesar dos parques e praças cumprirem funções na cidade de Chapecó, não estão enquadrados como Áreas Verdes diante do conceito legal existente
Malpractice and patient safety descriptors: an innovative grid to evaluate the quality of clinical records
No full textIntroduction: The medical record contains all the health information related to the patient’s clinical condition and its evolution during
hospitalization. It was defined by the Italian Ministry of Health in 1992 as "The information tool designed to record all relevant
demographic and clinical information about a patient during a single episode of hospitalization". The documents and information in a
Medical Record must meet the following criteria: traceability, clarity, accuracy, authenticity, pertinence and completeness. The objectives of
our study was to develop a tool capable of assessing the quality of the clinical record and pointed the critical point at the Organizational,
Technical - Professional, Managerial level.
Methods: To evaluate the quality of the medical documentation, we created an assessment grid composed of 4 sections with a total of 92
criteria. This grid was tested on 200 medical records that were randomly selected from 25 (18 medical and 7 surgical) wards of a teaching
hospital in Rome.
Results: The grid contains 4 sections. The first part regards administrative and clinical data; the second assesses the quality of hospital stay
and surgical/invasive procedures; the third part is concerned with the discharge of the patient and the fourth aims to identify the presence of
advisory reports given to the patient.
This grid has been validated to verify internal consistency with Cronbach's Alpha = 0,743.
Conclusions: Medical records were analyzed using a validated tool with grids to identify critical issues in care activities. Weaknesses in the
system were identified in order to improve planning. The sample testing also in terms of ‘self-assessment' represents a tool to introduce
activities to improve safety and quality of care, greatly reducing the costs of litigation
