International Journal of Risk & Safety in Medicine - Volume 11, issue 3
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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: All physicians, not merely those who are dysfunctional, make mistakes and commit errors. Patients suffer because of such faults, while the doctor is burdened by feelings of guilt and self‐reproach. The taboo regarding errors in medicine however impedes doctors from learning from their mistakes. Adequate management of these situations is of great importance. In order to minimise emotional damage to the patient and his relatives and to improve the quality of medical practice, acknowledgement of having made a mistake comes first: the general practitioner should be aware of personal defence mechanisms such as projection, denial or rationalisation. He should share…his experience with some colleagues; in an atmosphere of trust the emotions of regret, shame and anger can be aired. Next a peer group should assist in analysing the incident step by step. This analysis will make it possible to learn from the error and perhaps to take measures to prevent recurrence. Thereafter management with respect to the patient or his relatives should be established with the help of the group. Important principles are: make an appointment without delay; take ample time and avoid disturbance; listen to the patient and respect his feelings, express regret with regard to the consequences for the patient; contact the patient again after an interval to check if new questions have arisen. This approach is helpful in restoring the patient–doctor relationship after a mistake has been made.
Abstract: The risk of having a child with congenital heart disease is far higher than that of the rest of the population if a parent or a previous sibling has congenital heart disease. Malta is a small Island in the Mediterranean with a relatively closed population of approximately 370,000. The aim of this study was to test the null hypothesis that such a small population would produce higher recurrence rates in siblings and parents of patients with congenital heart disease due to a potential concentration of gene(s) which may predispose to these malformations. There were 231 patients diagnosed as having congenital…heart disease born between 1990–1994 from a birth cohort of 26,117 live births. The recurrence rate for siblings was 6%, while 2% had affected parents. These rates are similar to those found for larger populations. Therefore, the population of Malta is not small enough to concentrate any gene or genes which predispose to the development of congenital heart disease and the null hypothesis is accepted.