International Journal of Risk & Safety in Medicine - Volume 1, issue 1
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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: Because the community expects increasingly high standards of medical performance, there is every reason for meticulous recording of the problems which can arise during one's work. The aim must be to quantify risks, identify problem areas and create an instrument to facilitate quality control and the analysis of critical events. In the course of one calendar year, problems occurring in all 14,735 patients who underwent anaesthesia in a regional hospital were recorded systematically, classified as to their degree of severity, and entered alongside relevant patient data into individual anaesthesia records; following operation, the information was fed into a data base.…The system proved to work well in a heavily committed anaesthesia unit. The main methodological difficulties lay in acquiring the necessary discipline, applying consistently the definitions of complications and controlling data. In all 655 problems were registered in 599 patients, 80 of these being severe; among the most prominent were hypotension, difficulties with intubation, cardiac arrhythmias and laryngeal spasm. Such a system of registration promotes increased alertness to questions of patient safety. Registration of problems is now integrated into the unit's permanent routines.
Abstract: Mass screening of the population to detect cases of lipid derangement which could be at a higher risk for cardiovascular disease is not without its complications and risks. These have been demonstrated primarily in older screening programmes, e.g. for breast cancer or hypertension. They include the difficulties created by inconstant and variable findings, the risk of profound anxiety where findings are positive, the temptation to handle any abnormal finding by prolonged medicinal treatment, but also the neglect of healthy lifestyles where a negative finding suggests a “clean bill of health” or a drug is thought to guarantee normality. Screening and…treatment programmes created under technological, scientific or commercial pressures can seriously derange the allocation of health care resources. Such programmes should be instituted only for sound medical reasons and with adequate planning for patient guidance, follow-up and risk evaluation.