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Search results for "Medical Complications"
Journal Article > Review
The preventable proportion of healthcare-associated infections 2005–2016: systematic review and meta-analysis.
Schreiber PW, Sax H, Wolfensberger A, Clack L, Kuster SP; Swissnoso. Infect Control Hosp Epidemiol. 2018;39:1277-1295.
Health care–associated infections (HAIs) represent a significant source of preventable harm to patients. Targeted interventions have been shown to be effective in decreasing HAIs and events once deemed unavoidable, such as central line–associated bloodstream infections, are now considered preventable. In this systematic review and meta-analysis, investigators sought to determine the proportion of HAIs prevented by infection control efforts across countries of different income levels. From the 144 studies ultimately included in the analysis, they found that implementation of evidence-based interventions was associated with an overall reduction in HAIs and that there was no relationship to the financial status of the country in which the study was conducted. A past PSNet perspective discussed infection prevention and patient safety.
Tools/Toolkit > Government Resource
Boston University School of Public Health. Rockville, MD: Agency for Healthcare Research and Quality; September 2012. AHRQ Publication No. 120082EF.
Audiovisual > Audiovisual Presentation
Impact of participation in the California Healthcare-Associated Infection Prevention Initiative on adoption and implementation of evidence-based practices for patient safety and health care–associated infection rates in a cohort of acute care general hospitals.
Halpin HA, McMenamin SB, Simon LP, et al. Am J Infect Control. 2013;41:307-311.
This study demonstrated that hospitals participating in the California Healthcare-Associated Infection Prevention Initiative (CHAIPI) had significant improvements in adoption and implementation of evidence-based patient safety practices. However, there were no differences in health care–associated infection rates compared with non-CHAIPI hospitals.
Journal Article > Commentary
Wachter RM, Pronovost PJ. N Engl J Med. 2009;361:1401-1406.
An early focus of the patient safety movement was a shift from the traditional culture of individual blame to one that investigated errors as the failure of systems, popularized by adoption of James Reason's Swiss cheese model of organizational accidents. In recent years, there has been some backlash against a unidimensional systems-focused model, with past commentaries exploring the tension between a "no blame" culture and individual accountability. Articles in this genre have considered this tension in the educational setting, and a popular construct involves a just culture framework, which differentiates "no blame" from blameworthy acts. This commentary, written by two of the leaders in the safety field, further explores the relationship between blame and accountability, discusses why enforcement of safety standards tends to be lax (particularly in cases involving physicians), and proposes a working balance that not only promotes a safety culture but also safe patient care. The authors highlight hand hygiene non-compliance as an example of a behavior that should be managed through an accountability framework, with providers held accountable for failure to adhere to a known safety standard. They also offer suggested penalties (mostly involving suspension of clinical privileges) for repeated failures to comply with hand hygiene and other established safe practices.
Journal Article > Study
Use of a standardized protocol to decrease medication errors and adverse events related to sliding scale insulin.
Donihi AC, DiNardo MM, DeVita MA, Korytkowski MT. Qual Saf Health Care. 2006;15:89-91.
Investigators implemented a sliding scale insulin protocol and physician order form to standardize the delivery of insulin. They found the tool was used in 91% of orders and considerably reduced prescription errors and episodes of hyperglycemia.