International Journal of Risk & Safety in Medicine - Volume 3, issue 5-6
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The International Journal of Risk and Safety in Medicine is concerned with rendering the practice of medicine as safe as it can be; that involves promoting the highest possible quality of care, but also examining how those risks which are inevitable can be contained and managed.
This is not exclusively a drugs journal. Recently it was decided to include in the subtitle of the journal three items to better indicate the scope of the journal, i.e. patient safety, pharmacovigilance and liability and the Editorial Board was adjusted accordingly. For each of these sections an Associate Editor was invited. We especially want to emphasize patient safety. Our journal wants to publish high quality interdisciplinary papers related to patient safety, not the ones for domain specialists. For quite some time we have also been devoting some pages in every issue to what we simply call WHO news. This affinity with WHO underlines both the International character of the journal and the subject matter we want to cover. Basic research, reports of clinical experience and overviews will all be considered for publication, but since major reviews of the literature are often written at the invitation of the Editorial Board it is generally advisable to consult with the Editor in advance. Submission of news items will be appreciated, as will be the contribution of letters on topics which have been dealt with in the journal.
Abstract: With the spread of the Human Immunodeficiency virus (HIV) and hepatitis Band C viruses, knowledge about clinical safety, infection control and assessment of occupational risks is now an essential requirement for all health care workers. A pilot study of a cross section of United Kingdom health care staff at two hospitals, attending “AIDS awareness” meetings, indicated that staff may not have sufficient knowledge to enable them to make accurate risk assessments in clinical safety or to follow risk reduction strategies to obviate needlestick injury and exposure to blood-borne viruses. The value of organising AIDS awareness meetings, the need for formal…training programmes and implementation of clinical safety recommendations are discussed.
Abstract: One thousand members of a United Kingdom medical protection organisation, working in the specialties of obstetrics and gynaecology, orthopaedic surgery, general surgery and anaesthetics, were surveyed in order to determine what factors they believed to be important in causing accidents in medicine and whether they were in favour of research being carried out in this area. The response rate was 50.3%. The majority of respondents believed that medical accidents should be investigated and that human error is a major factor in their causation. There was some disagreement between consultants and senior house officers about factors believed to cause accidents. The…former ranked lack of skills as most important followed by failure to consult while the latter ranked fatigue and stress first followed by failure of senior staff to supervise adequately. Results are discussed in terms of their implications for further research in the area of medical accidents and approaches to accident prevention.
Keywords: Medical accidents, Avoidable factors, Medical education
Abstract: Caesarean sections have, in some countries, increased to alarming proportions, in recent years. This trend has been evident in the Maltese Islands. The maternal and infant characteristics in cases delivered by Caesarean section are reviewed and statistically compared to those of cases delivered vaginally. Mothers were statistically more likely to be elderly, obese and short, with a history of a poor previous obstetric outcome, and a current pregnancy complicated by hypertension and antepartum haemorrhage. Labour was more likely to have been induced in these patients. The infant was more likely to be of low birthweight or macrosomic. The maternal morbidity…was increased as a result of problems of bleeding and sepsis, while a subsequent pregnancy was more likely to require delivery by a repeat operative abdominal delivery.
Abstract: Medical records and peer review documents are important items in assessing claims brought against physicians for malpractice. In the United States, the adequacy of these documents and the extent to which their production can be mandatory is a complex subject governed by the statutory and/or common law of the individual states. Spoliation of medical records is not frequently encountered and will probably remain an isolated phenomenon. There is, however, constant development in the law regarding the discovery of documents compiled by health care providers and the extent to which these can be considered to constitute privileged information.
Keywords: Medical records, evidence, malpractice litigation