International Journal of Risk & Safety in Medicine - Volume 31, issue 2
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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: The ongoing COVID-19 pandemic has infected nearly 3,582,233 individuals with 248,558 deaths since it was first identified in human populations in December 2019 in Wuhan, China. No antiviral therapies or vaccines are available for their treatment or prevention. Passive immunization PI through broadly neutralizing antibodies that bind to the specific antigens of SARS-CoV 2 might be a potential solution to address the immediate health threat of COVID-19 pandemic while vaccines are being developed. The PI approach in treating COVID-19 is discussed herein, including a summary of its historical applications to confront epidemics.
Abstract: BACKGROUND: Many people use the Internet for obtaining information about their medications. OBJECTIVE: To investigate whether information about antidepressants on popular websites reflects the scientific evidence and enables people to make informed choices. METHODS: Cross-sectional study using a checklist with 14 predefined criteria of 39 websites from 10 countries. RESULTS: All 39 websites mentioned the benefits of antidepressants. Twenty-nine (74%) websites attributed depression to a “chemical imbalance” or claimed they could fix an imbalance. Sexual dysfunction was mentioned as a harmful effect on 23 (59%) websites while five (13%) mentioned emotional numbing. Twenty-five (64%)…stated that antidepressants may cause increased suicidal ideation, but 23 (92%) of them contained incorrect information, and only two (5%) websites noted that the suicide risk is increased in people of all ages. Twenty-eight websites (72%) warned patients about withdrawal effects but only one stated that antidepressants can be addictive. CONCLUSIONS: None of the websites met our predefined criteria. The information was generally inaccurate and unhelpful and has potential to lead to inappropriate use and overuse of antidepressants and reduce the likelihood that people will seek better options for depression like psychotherapy.
Abstract: BACKGROUND: Medication errors may account up to one-third of all medical errors in hospitals, thereby leading to adverse outcomes such as higher mortality rate and longer hospital stay. OBJECTIVES: The primary objective of the study was to determine whether patient safety can be improved by clinical pharmacy services. The study also aimed to reveal whether medication errors can be prevented by any means. METHODS: A prospective, observational study was conducted in a multispecialty hospital in India. Prescription audit was performed for patients followed by necessary intervention by the concerned physician. Chi-squared test, paired t-test and ANOVA…were performed to test statistical significance. RESULTS: A total of 699 errors were encountered by 501 of 1149 patients enrolled. Prescription errors accounted for the majority (87.1%) of errors followed by administration (7.4%), transcription (4.3%) and dispensing (1.2%) errors. Average error per patient showed a significant gradual decline from baseline (2.08) to the final follow-up (1.06). ICU patients encountered a higher rate (52.8%) of errors than general ward group (42.8%), while geriatric population witnessed a low error rate (18.8%) compared to adults (72%). CONCLUSIONS: The study was not only successful in highlighting the impact of medication error assessment on patient safety, but it also demonstrated that medication errors can be lowered with the help of clinical pharmacy services. Findings from the study conclude that medication errors can be prevented if healthcare professionals are educated appropriately to avoid recurrence of past mistakes.
Abstract: BACKGROUND: Pharmacovigilance is an important aspect of clinical practice; however, there is limited evidence that it exists as a theme in medical education curricula. OBJECTIVE: We developed and used a Basic Research Skill Special Study Module to introduce pharmacovigilance to medical students in the early years of their programme. METHODS: Students completing year one or two of the Faculty of Medical Sciences, Bachelor of Medicine, Bachelor of Surgery programme at The University of the West Indies, Jamaica participated in the four week experience from May 16th to June 12th 2019 to complete structured content sessions and…self-directed activity. Sessions focused on the importance of pharmacovigilance and guided steps to complete a secondary data research project on an adverse reaction reported for a drug of personal interest. The final output was a poster mini-symposium at which each student held a five minute oral presentation. Posters were assessed for compliance with content guidelines, quality and presentation. RESULTS: Ten students participated in this experience and nine students produced posters of greater than 80% compliance with the content guidelines that were provided. The points awarded also reflected high scores for the required elements, relevant graphics, attractiveness/neatness and oral presentation. Students expressed overall satisfaction with the learning experience of the module. CONCLUSION: Moving forward, the authors will continue using this innovative active learning methodology to increase student exposure to pharmacovigilance, conducting and sharing research. Quantitative outcome assessment tools will be developed and long term goals will focus on its utility in curriculum improvement.
Keywords: Medical students, curriculum, pharmacovigilance
Abstract: BACKGROUND: Pressure ulcers can cause disability, which can lead to a default in patients’ safety and results in frequent complications for patients. OBJECTIVES: This study aimed to determine the effect of educational intervention on nurses’ knowledge and attitude in preventing pressure ulcers. METHODS: In this study, 67 nurses of ICU wards at Ilam University of Medical Sciences were randomly assigned to the experimental or control group. Data collection tools included the demographic characteristics questionnaire, the Pieper Pressure Ulcer Knowledge test (PUKT) and the Attitude toward Pressure Ulcer tool (APuP). In the experimental group, the nurses were…allocated into groups of four-five persons and for each group four face-to-face training sessions and two virtual training sessions by means of educational videos on bed sores were performed. Gathered data were analyzed using SPSS software version 16, and descriptive and analytical tests were performed. RESULTS: PUKT questionnaire score in the experimental group improved from 15.68 (3.42) to 29.75 (12.33) (P = 0.000), while in the control group it was 16.40 (3.13) and 17.54 (6.62) before intervention, which was not significant (P > 0.05). Furthermore, the APUP questionnaire score in the experimental group improved from 27.12 (2.13) to 39.37 (3.21) (P = 0.000), while in the control group it was 27.65 (1.71) and 28.37 (5.00) before intervention, which was not significant (P > 0.05). CONCLUSIONS: Since educational intervention improved the knowledge and attitude of nurses in preventing pressure ulcers, it is required to conduct appropriate educational interventions to improve their knowledge and attitude.
Keywords: Knowledge, attitude, pressure ulcers, intensive care, nurses
Abstract: OBJECTIVE: To measure patient safety climate and the associated factors from the perspective of the multiprofessional team. METHOD: This was an analytical cross-sectional study, developed in a medium-sized hospital in the Southern region of Brazil. The Safety Attitudes Questionnaire (SAQ) was used as the data collection tool and applied to 199 workers of the multiprofessional and support team between November 2017 and February 2018. Data analysis was descriptive and analytical. A positive score was considered when ≥75. RESULTS: The overall SAQ score was positive (75.1). The domain Satisfaction at Work was the one with the highest…score (88.7), while Stress Perception showed the worst score (59.1). It was observed that professionals without a College/University degree better evaluated the domains Satisfaction at Work, Management Perception and Working Conditions, whereas the ones with a College/University degree had better stress perception. Medical doctors showed better Stress Perception when compared to the other health professionals. CONCLUSION: There is a positive safety climate in health organizations from the perspective of the multiprofessional team. However, the domains Safety Climate, Working Conditions and Stress Perception constitute areas that need improvement in terms of patient safety in the institution.