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Search results for "Information Professionals"

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Journal Article > Commentary

The promise of big data: improving patient safety and nursing practice.

Linnen D. Nursing. May 2016;46:28-34.

Big data is gaining attention as a way to improve quality and safety. This commentary discusses how outcomes data can be applied to enhance safety of nursing care and reviews limitations to successfully using analytics, including insufficient interoperability and inadequate funding to design effective tools.

Journal Article > Review

State-of-the-art usage of simulation in anesthesia: skills and teamwork.

Krage R, Erwteman M. Curr Opin Anaesthesiol. 2015;28:727-734.

Simulation training is a common method to enhance technical and nontechnical skills in health care. This review discusses simulation training in anesthesia and emphasizes the importance of learning objectives and activity design to drive success in high- and low-fidelity programs.

Journal Article > Commentary

Simulation, mastery learning and healthcare.

Dunn W, Dong Y, Zendejas B, Ruparel R, Farley D. Am J Med Sci. 2017;353:158-165.

Simulation has been adopted as a valuable teaching tool in health care. This commentary reviews mastery learning theory at the individual and system levels and suggests that it can be enhanced with simulation to engineer effective processes at the organizational level.

Cases & Commentaries

Unintended Consequences of CPOE

  • Spotlight Case
  • CME/CEU
  • Web M&M

Robert L. Wears, MD, PhD; October 2016

While attempting to order a CT scan with only oral contrast for a patient with poor kidney function, an intern ordering a CT for the first time selected "with contrast" from the list, not realizing that meant both oral and intravenous contrast. The patient developed contrast nephropathy.

Journal Article > Review

A literature review of the training offered to qualified prescribers to use electronic prescribing systems: why is it so important?

Brown CL, Reygate K, Slee A, et al. Int J Pharm Pract. 2017;25:195-202.

Insufficient training on electronic health record systems can hinder user satisfaction. This literature review assessed the evidence on training methods, such as simulation scenarios and classroom-based sessions, for electronic prescribing systems. The authors suggest that future research should examine how to educate users about challenges associated with electronic systems.

Journal Article > Study

Seeing through Google Glass: using an innovative technology to improve medication safety behaviors in undergraduate nursing students.

Schneidereith T. Nurs Educ Perspect. 2015;36:337-339.

This study describes the use of Google Glass with video recording to enable faculty to assess medication administration by nursing students participating in a simulation training program. The perspective provided by the video allowed faculty to see specific errors, such as exactly how the infusion pump was programmed, which may not have otherwise been apparent to faculty observers.

Book/Report

Health IT Safety Center Roadmap.

RTI International. Washington, DC: Office of the National Coordinator for Health Information Technology; July 2015.

The Institute of Medicine called for enhanced transparency in the reporting of health IT safety incidents to inform implementation and use of such technologies. This report reviews insights from a multidisciplinary task force that discussed how to design an entity focused on improving health IT–related safety that enables collaboration and learning.

Journal Article > Commentary

Nurse interrupted: development of a realistic medication administration simulation for undergraduate nurses.

Hayes C, Power T, Davidson PM, Daly J, Jackson D. Nurse Educ Today. 2015;3:981-986.

Interruptions pose a significant safety hazard for health care providers performing complex tasks and increase the risk of errors. This commentary describes a simulated training initiative to help prepare nursing students for experiencing and responding to interruptions during medication administration.

Journal Article > Commentary

Is it time to move beyond errors in clinical reasoning and discuss accuracy?

Wood TJ. Adv Health Sci Educ Theory Pract. 2014;19:403-407.

Highlighting how heuristics can both increase and reduce risk of diagnostic error, this commentary applies a set of recommended criteria to examine its usefulness in guiding research and augmenting understanding about factors that affect clinical reasoning and support accurate decision making.

Journal Article > Commentary

The ethical imperative to think about thinking.

Stark M, Fins JJ. Camb Q Healthc Ethics. 2014;23:386-396.

This commentary spotlights the importance of learning about cognitive science to understand and improve diagnostic reasoning in order to prevent errors. Underscoring limits of the Hippocratic Oath, the authors describe the ethical responsibility of individuals and organizations to augment clinical decision-making, judgment, and critical thinking skills as an integral component of professionalism.

Cases & Commentaries

It's Sarah, Not Stephen!

  • Spotlight Case
  • Web M&M

Urmimala Sarkar, MD, MPH; October 2013

Although the mother of a child, born male who identified as and expressed externally as a girl, had alerted the clinic of the child's preferred name when making the appointment, the medical staff called for the patient in the waiting room using her legal (masculine) name.

Journal Article > Study

Bar-code verification: reducing but not eliminating medication errors.

Henneman PL, Marquard JL, Fisher DL, et al. J Nurs Adm. 2012;42:562-566.

This simulation study identified several mechanisms by which medication errors could occur even when a bar-code medication administration system was used. These included patient identification errors and failure to heed computerized warnings.

Journal Article > Review

Systematic review of serious games for medical education and surgical skills training.

Graafland M, Schraagen JM, Schijven MP. Br J Surg. 2012;99:1322-1330.

This systematic review of the use of video games in medical education found evidence that games can be used to improve teamwork and surgical skills.

Special or Theme Issue

Quality of Anesthesia Care. 

Neuman MD, Martinez EA, eds. Anesthesiol Clin. 2011;29:1-178.

This special issue includes articles discussing safety in anesthesiology practice as well as quality improvement innovations.

Journal Article > Study

Effect of a comprehensive obstetric patient safety program on compensation payments and sentinel events.

Grunebaum A, Chervenak F, Skupski D. Am J Obstet Gynecol. 2011;204:97-105.

Implementing a comprehensive safety program, which included teamwork training, additional staffing and reduction of work hours, electronic medical records, and a dedicated patient safety nurse, was associated with a sharp reduction in malpractice lawsuits and sentinel events at an academic hospital.

Journal Article > Commentary

Making inpatient medication reconciliation patient centered, clinically relevant and implementable: a consensus statement on key principles and necessary first steps.

Greenwald JL, Halasyamani L, Greene J, et al. J Hosp Med. 2010;5:477-485.

A National Patient Safety Goal (NPSG) since 2005, medication reconciliation involves verifying medications and dosages as well as documenting and explaining medication changes. Medication reconciliation has been notoriously difficult to accomplish in both inpatient and outpatient settings. The Joint Commission currently does not evaluate medication reconciliation in accreditation surveys. This consensus statement, endorsed by The Joint Commission and other major professional societies, calls for recasting medication reconciliation in a patient-centered, patient safety–oriented fashion. Several key steps to develop effective and usable reconciliation tools include multidisciplinary involvement with clear roles among clinicians, patient-centered measurement strategies, and rigorous study and dissemination of implementation strategies. The findings of this consensus group will be used in the revised medication reconciliation NPSG, which will be issued in 2011.

Journal Article > Commentary

Empowering patient safety outreach through interprofessional partnerships: educating our communities.

Walton L, Childs C, Egeland M, Brooks MK, Zipperer L. J Hosp Libr. 2010;10:224-234.

This commentary describes a multidisciplinary initiative that engaged hospital staff, librarians, and community leaders in developing patient safety awareness programs for patients and families in rural Iowa.

Journal Article > Study

Safety of using a computerized rounding and sign-out system to reduce resident duty hours.

Van Eaton EG, McDonough K, Lober WB, Johnson EA, Pellegrini CA, Horvath KD. Acad Med. 2010;85:1189-1195.

Use of a computerized rounding and signout system improved continuity and resident efficiency in inpatient resident teams at two hospitals. However, this study found no significant reduction in voluntarily reported errors or adverse events.

Journal Article > Review

What have we learned about interventions to reduce medical errors?

Woodward HI, Mytton OT, Lemer C, et al. Annu Rev Public Health. 2010;31:479-497.

This narrative review provides a broad perspective on the current understanding of medical errors and the evidence behind commonly adopted prevention strategies. The authors then highlight a series of recommendations to improve patient safety.

Journal Article > Study

User satisfaction with computerized order entry system and its effect on workplace level of stress.

Ghahramani N, Lendel I, Haque R, Sawruk K. J Med Syst. 2009;33:199-205.   

This study surveyed providers after implementation of a CPOE system and found that younger, more familiar, and frequent users reported higher levels of satisfaction.

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