6 research outputs found
AVOIDable medical errors in invasive procedures : facts on the ground – An NHS staff survey
No full textBACKGROUND: Never Events represent a serious problem with a high burden on healthcare providers’ facilities. Despite introducing various safety checklists and precautions, many Never Events are reported yearly. OBJECTIVE: This survey aims to assess awareness and compliance with the safety standards and obtain recommendations from the National Health Service (NHS) staff on preventative measures. METHODS: An online survey of 45 questions has been conducted directed at NHS staff involved in invasive procedures. The questions were designed to assess the level of awareness, training and education delivered to the staff on patient safety. Moreover, we designed a set of focused questions to assess compliance with the National Safety Standards for Invasive Procedures (NatSSIPs) guidance. Open questions were added to encourage the staff to give practical recommendations on tackling and preventing these incidents. Invitations were sent through social media, and the survey was kept live from 20/11/2021 to 23/04/2022. RESULTS: Out of 700 invitations sent, 75 completed the survey (10.7%). 96% and 94.67% were familiar with the terms Never Events and near-miss, respectively. However, 52% and 36.49% were aware of National and Local Safety Standards for Invasive procedures (NatSSIPs-LocSSIPs), respectively. 28 (37.33%) had training on preventing medical errors. 48 (64%) believe that training on safety checklists should be delivered during undergraduate education. Fourteen (18.67%) had experiences when the checklists failed to prevent medical errors. 53 (70.67%) have seen the operating list or the consent forms containing abbreviations. 33 (44.00%) have a failed counting reconciliation algorithm. NHS staff emphasised the importance of multi-level checks, utilisation of specific checklists, patient involvement in the safety checks, adequate staffing, avoidance of staff change in the middle of a procedure and list order, and investment in training and education on patient safety. CONCLUSION: This survey showed a low awareness of some of the principal patient safety aspects and poor compliance with NatSSIPs recommendations. Checklists fail on some occasions to prevent medical errors. Process redesign creating a safe environment, and enhancing a safety culture could be the key. The study presented the recommendations of the staff on preventative measures
Rethinking mythology in Greek museums through contemporary culture
No full textThis thesis investigates the character with which Greek mythology, one of the most durable manifestations of ancient Greek heritage, survives in the perception of contemporary Greeks, and the role that Greek museums do and could play in this. The starting point for this investigation is the appraisal of Greek mythology as an ideological creation of ancient Greece that bears pan-human and diachronie intellectual and cultural potency and, as such, constitutes a significant interpretative tool for the contemporary Greek individual. More specifically, this thesis reconsiders the relationships between Greek mythology, Greek museums and Greek people, using as a bridge contemporary Greek art. It does so in three main chapters, which investigate and analyze different parameters of this nexus of relationships. Greek mythology’s adaptations by contemporary Greek society are also explored in an attempt to establish the dominant contemporary meanings of Greek mythology. Then, the relation of a specific cultural manifestation of contemporary Greek society, that of contemporary art, to Greek mythology is extensively analyzed through a series of interviews that were conducted exclusively for this thesis. In these interviews, contemporary Greek musicians, authors and visual artists speak of the position that Greek mythology possess (or does not possess) in their artistic expression, and discuss the intellectual and cultural significance that Greek myths retain for contemporary society and people. From these investigations, two antithetic poles emerge. On the one hand, there is the trivializing way in which Greek society deals with its myths through their exploitation, for example, for commercial or nationalist purposes. On the other hand, there is the sensitivity with which my interviewees pored over Greek myths, enabling them to emerge full of dynamism, and illuminating them as ever-active negotiators of life and human nature. Thus, contemporary art is identified as a powerful conveyor of mythology’s potency for the contemporary individual. Next, the position of Greek archaeological museums, as major official institutions that do, or could, represent and safeguard Greek mythology is explored and critically assessed. It emerges that Greek museums are rather unconcerned with Greek mythology’s representation and communication and thus, confirm that Greek mythology is a dead and irrelevant representative of a glorious, yet remote and strange, ancient civilization
Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis (Scientific Reports, (2020), 10, 1, (18671), 10.1038/s41598-020-74910-3)
No full textIn the original version of this Article, the VIP2 Study Group was incorrectly listed as an author in the author list. All members of the VIP2 Study Group are listed in the accompanying Supplementary Information file. The error has been corrected in the PDF and HTML versions of the Article, and in the Supplementary Information files.publishersversionpublishe
Intraoperative transfusion practices in Europe
No full text© 2016 The Author. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.Background: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. Methods: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. Results: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl-1 and increased to 9.8 (1.8) g dl-1 after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). Conclusions: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl-1), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold
a prospective cohort study
No full textFunding Information: The members of VIP1 and VIP2 study groups are listed in Additional file 1 and are listed in their individual PubMed records. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.Background: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient’s age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. Results: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81–87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). Conclusion: Knowledge about a patient’s frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)publishersversionpublishe
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
No full textAbstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
