Chinks in the Armor: Activation Patterns of Hollow-Bore Safety-Engineered Sharp Devices

2012 ◽  
Vol 33 (8) ◽  
pp. 842-844 ◽  
Author(s):  
Lisa Black ◽  
Ginger Parker ◽  
Janine Jagger
Keyword(s):  
Healthcare Provider ◽  
Retrospective Review ◽  
Secondary Injury ◽  
Provider Type ◽  
Safety Device ◽  
Injury Rates ◽  
Activation Patterns ◽  
Safety Feature ◽  
Injury Data ◽  
Activation Rates

A retrospective review of secondary injury data was used to evaluate the characteristics of percutaneous injuries from safety-engineered sharp devices. Injury rates and safety device activation rates differed by healthcare provider type. Approximately 22.8%–32% of injuries could have been prevented had an available safety feature been activated after use.

The risk of pain syndrome affecting a previously non-painful limb following trauma or surgery in patients with a history of complex regional pain syndrome

2017 ◽  
Vol 14 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Ellen S. Satteson ◽  
Patrick W. Harbour ◽  
L. Andrew Koman ◽  
Beth P. Smith ◽  
Zhongyu Li
Keyword(s):  
General Population ◽  
Literature Review ◽  
Distal Radius Fracture ◽  
Incidence Rate ◽  
Complex Regional Pain Syndrome ◽  
Retrospective Review ◽  
Odds Ratio ◽  
Pain Syndrome ◽  
Secondary Injury ◽  
History Of

AbstractBackground and purposeComplex regional pain syndrome (CRPS) is a challenging complication after surgery or trauma. This study sought to determine the incidence of CRPS after a second inciting event in a previously unaffected extremity in patients with a history of an ongoing CRPS diagnosis in another extremity.MethodsA retrospective review identified patients with CRPS seen in clinic over a 20-month period. The incidence of CRPS after subsequent surgery or injury in a previous unaffected extremity was determined and compared to an average incidence reported in the literature.ResultsNinety-three patients had a diagnosis of primary CRPS. Nineteen (20.4%) developed CRPS in one or more additional extremity compared to the incidence of 23.4 per 100,000 (0.0234%) in the literature (odds ratio 1069.6, p < 0.0001,95% CI 562.0–2035.7). Twenty patients had a documented secondary injury or surgery in a second extremity. Fifteen (75%) developed secondary CRPS compared to a CRPS incidence rate of 6.4% following distal radius fracture, as determined by literature review (odds ratio 11.7, p < 0.001, 95% CI 5.9–23.2).ConclusionsThese result suggest that patients with a history of CRPS are more likely to develop secondary CRPS compared to the rates reported in the literature among the general population.ImplicationsPatients with a history of CRPS should be counselled that they may be at risk for developing secondary CRPS if they undergo surgery or sustain trauma to another extremity.

scholarly journals US Antiarrhythmic Drug Treatment for Patients With Atrial Fibrillation: An Insurance Claims–Based Report

2021 ◽  
Author(s):  
Jonathan G. Tardos ◽  
Christopher J. Ronk ◽  
Miraj Y. Patel ◽  
Andrew Koren ◽  
Michael H. Kim
Keyword(s):  
Atrial Fibrillation ◽  
Healthcare Provider ◽  
Healthcare Providers ◽  
Heart Association ◽  
Heart Rhythm ◽  
International Classification Of Diseases ◽  
Data Availability ◽  
Administrative Claims ◽  
Provider Type ◽  
First Line

Background Current American Heart Association/American College of Cardiology/Heart Rhythm Society guidelines and European Society of Cardiology guidelines recommend antiarrhythmic drugs (AADs) for maintenance of sinus rhythm in patients with atrial fibrillation. We assessed the concordance between healthcare provider real‐world practice and current guidelines with respect to first‐line AAD rhythm management. Methods and Results Administrative claims data from the deidentified Optum Clinformatics Data Mart database were used. Patients were included if they were initiated on an AAD in 2015 to 2016, had 1 year of continuous data availability before their first AAD pharmacy claim, and had a diagnosis for atrial fibrillation within that period. Concordance was assessed by comparing the AAD initiated by the healthcare provider against guideline recommendations for first‐line treatment, given the presence of heart failure, coronary artery disease, both, or neither (as determined by International Classification of Diseases, Ninth Revision and Tenth Revision [ ICD‐9 and ICD‐10 ] codes). Concordance was also assessed by provider type using Medicare taxonomy codes. For the 15 445 patients included, 51% of healthcare providers initiated AAD treatments with amiodarone, 18% flecainide, 15% sotalol, 8% dronedarone, 5% propafenone, and 2% dofetilide. The overall rate of guideline concordance was 61%, with differences by provider type: 67% for electrophysiologists, 61% for cardiologists, and 60% for others (internal medicine, etc). Conclusions There continues to be a sizable gap in concordance between practice and guidelines in first‐line rhythm management of patients with atrial fibrillation. Further research is needed to identify possible explanations for non–guideline‐recommended use of AADs, in addition to enhanced AAD educational strategies for practitioners.

scholarly journals Injury rates of the German Women’s American Football National Team from 2009 to 2011

2012 ◽  
Vol 4 (3) ◽  
pp. 28
Author(s):  
Marco Ezechieli ◽  
Stephan Berger ◽  
Christian-Heige Siebert ◽  
Oliver Miltner
Keyword(s):  
Injury Rate ◽  
The Body ◽  
American Football ◽  
Fracture Dislocation ◽  
Football Players ◽  
Injury Rates ◽  
World Championship ◽  
National Team ◽  
Injury Data ◽  
Or Practice

American football is one of the leading causes of athletic-related injuries. Injury rates in female elite players are mostly unknown. We hypothesized that the injury rates of female was comparable to those in men’s football during practice, as well as games. From 2009 to 2011, injury data were collected from the German female national team during training camps, World Championship 2010 and International friendly matches. The injury was categorized by location on the body and recorded as fracture/dislocation, strain, concussion, contusion or other injury. Injury rates were determined based on the exposure of an athlete to a game or practice event. The injury rate was calculated as the ratio of injuries per 1000 athlete exposures (AE). The rate of injury was significantly higher during games (58.8/1000 AE) than practices [16.3/1000 AE, (P&lt;0.01)]. Furthermore, the injury rate in the tryouts was significantly higher (24.05/1000 AE) compared to other training sessions with the national team (11.24/1000 AE). Our findings show that the injury rates in female elite American football players can be compared to those described for male players. Higher injury rates during matches than in training should also be underlined.

The Impact of Multifocused Interventions on Sharps Injury Rates at an Acute-Care Hospital

1999 ◽  
Vol 20 (12) ◽  
pp. 806-811 ◽  
Author(s):  
Robyn R.M. Gershon ◽  
Lisa Pearse ◽  
Martha Grimes ◽  
Patricia A. Flanagan ◽  
David Vlahov
Keyword(s):  
Incidence Rate ◽  
Acute Care ◽  
Healthcare Workers ◽  
Injury Incidence ◽  
Care Hospital ◽  
Injury Rates ◽  
Injury Data ◽  
Sharps Injury ◽  
The Impact ◽  
Sharps Injuries

AbstractObjective:To determine the impact of a multifocused interventional program on sharps injury rates.Design:Sharps injury data were collected prospectively over a 9-year period (1990-1998). Pre- and postinterventional rates were compared after the implementation of sharps injury prevention interventions, which consisted of administrative, work-practice, and engineering controls (ie, the introduction of an anti-needlestick intravenous catheter and a new sharps disposal system).Setting:Sharps injury data were collected from healthcare workers employed by a mid-sized, acute-care community hospital.Results:Preinterventional annual sharps injury incidence rates decreased significantly from 82 sharps injuries/1,000 worked full-time-equivalent employees (WFTE) to 24 sharps injuries/1,000 WFTE employees postintervention (P<.0001), representing a 70% decline in incidence rate overall. Over the course of the study, the incidence rate for sharps injuries related to intravenous lines declined by 93%, hollow-bore needlesticks decreased by 75%, and non-hollow-bore injuries decreased by 25%.Conclusion:The implementation of a multifocused interventional program led to a significant and sustained decrease in the overall rate of sharps injuries in hospital-based healthcare workers.

A Comprehensive Approach to Percutaneous Injury Prevention During Phlebotomy: Results of a Multicenter Study, 1993-1995

2003 ◽  
Vol 24 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Francisco Alvarado-Ramy ◽  
Elise M. Beltrami ◽  
Louise J. Short ◽  
Pamela U. Srivastava ◽  
Keith Henry ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Healthcare Worker ◽  
Ease Of Use ◽  
Comprehensive Approach ◽  
Injury Rates ◽  
Worker Training ◽  
Worker Satisfaction ◽  
Safety Features ◽  
Activation Rates ◽  
Sharps Injury

AbstractObjective:To examine a comprehensive approach for preventing percutaneous injuries associated with phlebotomy procedures.Design and Setting:From 1993 through 1995, personnel at 10 university-affiliated hospitals enhanced surveillance and assessed underreporting of percutaneous injuries; selected, implemented, and evaluated the efficacy of phlebotomy devices with safety features (ie, engineered sharps injury prevention devices [ESIPDs]); and assessed healthcare worker satisfaction with ESIPDs. Investigators also evaluated the preventability of a subset of percutaneous injuries and conducted an audit of sharps disposal containers to quantify activation rates for devices with safety features.Results:The three selected phlebotomy devices with safety features reduced percutaneous injury rates compared with conventional devices. Activation rates varied according to ease of use, healthcare worker preference for ESIPDs, perceived “patient adverse events,” and device-specific training.Conclusions:Device-specific features and healthcare worker training and involvement in the selection of ESIPDs affect the activation rates for ESIPDs and therefore their efficacy. The implementation of ESIPDs is a useful measure in a comprehensive program to reduce percutaneous injuries associated with phlebotomy procedures.

scholarly journals Epidemiology of Injuries in National Collegiate Athletic Association Women's Swimming and Diving: 2014–2015 Through 2018–2019

2021 ◽  
Vol 56 (7) ◽  
pp. 711-718
Author(s):  
Avinash Chandran ◽  
Sarah N. Morris ◽  
Bernadette A. D'Alonzo ◽  
Adrian J. Boltz ◽  
Hannah J. Robison ◽  
...  
Keyword(s):  
National Collegiate Athletic Association ◽  
Injury Rate ◽  
Temporal Patterns ◽  
Sports Injury ◽  
Injury Surveillance ◽  
Surveillance Program ◽  
Injury Rates ◽  
Injury Characteristics ◽  
Injury Data ◽  
Rate Ratios

Context The number of women's swimming and diving teams sponsored by the National Collegiate Athletic Association has increased over the last 5 years. Background Routine examinations of women's swimming and diving injuries are important for identifying emerging temporal patterns. Methods Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014–2015 through 2018–2019 athletic seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates. Results The overall injury rate was 1.78 per 1000 athlete-exposures in swimmers and 2.49 per 1000 AEs in divers. Shoulder (33.0%) injuries accounted for the largest proportion of all swimming injuries; most injuries were classified as overuse (51.3%). Head or face (29.4%) and trunk (20.2%) injuries accounted for the largest proportions of all diving injuries. Summary Findings indicated that shoulder and trunk injuries, as well as injuries resulting from overuse mechanisms, warrant further attention in swimming. Given the low in the National Collegiate Athletic Association Injury Surveillance Program observed across the study period, the need for greater participation in sports injury surveillance is also apparent.

Healthcare Provider Type and Switch to Biologics in Psoriasis: Evidence from Real-World Practice

BioDrugs ◽  
2016 ◽  
Vol 30 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Paul S. Calara ◽  
Jenny M. Norlin ◽  
Rikard Althin ◽  
Katarina Steen Carlsson ◽  
Marcus Schmitt-Egenolf
Keyword(s):  
Healthcare Provider ◽  
Real World ◽  
Provider Type

scholarly journals A comparison of oncologist versus mental health provider attitudes towards standardized and tailored patient-reported outcomes

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Salene M. W. Jones ◽  
Aliana Gaffney ◽  
Joseph M. Unger
Keyword(s):  
Mental Health ◽  
Healthcare Provider ◽  
Patient Reported Outcomes ◽  
Clinical Utility ◽  
Mental Health Provider ◽  
Mental Health Providers ◽  
Health Providers ◽  
Provider Type ◽  
Positive Attitudes ◽  
Patient Reported

Abstract Background Patient-reported outcomes (PROs) can be used to monitor patients during treatment. Healthcare provider preferences for individualized vs. standardized PROs have been understudied. Methods This study surveyed oncology and mental health providers to compare attitudes towards individualized and standardized PROs. We have developed a method for individualizing PROs, called precision PROs, and the survey specifically assessed preferences for this method. We compared attitudes and preferences by provider type and by whether respondents were current or never users of PROs. Results Oncology providers expressed more positive attitudes for standardized PROs in treatment planning compared to mental health providers (F(1,440) = 5.978, p = 0.015). The interaction between provider type (oncology vs. mental health) and type of PRO (individualized vs. standardized) was not significant for the attitudes about the clinical utility of PROs (p = 0.709). When directly asked about the precision PRO approach, oncologists were less likely to prefer standardized items (OR = 0.478, p = 0.001) or have no preference (OR = 0.445, p = 0.007) to the precision PRO approach when compared to mental health providers. Qualitative analyses suggested standardized PROs may be simpler or easier to understand whereas individualized PROs better capture patient variability and the unique aspects of each patient’s condition. Some mental health providers expressed reticence about letting patients choose how to tailor PROs. Never users of PROs reported more positive attitudes towards individualized measures than standardized measures whereas current users of PROs did not have a difference in attitudes (p = 0.010). User status was mostly unrelated to preferences. Conclusion Results suggest that healthcare provider preference for individualized PROs may differ by medical specialty. How PROs are tailored may need to differ by discipline. This is particularly important given that previous research showing a preference for individualized PROs over standardized was conducted with psychotherapists. Further research on patient preferences for individualized and standardized PROs is warranted as is research on the clinical utility of individualized PROs such as the precision PRO approach.

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