scholarly journals Developing patient-centred MRI safety culture: a quality improvement report

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20180011
Author(s):  
Aiwain Yong ◽  
Avinash Kumar Kanodia ◽  
Milne Wendy ◽  
Sanjay Pillai ◽  
Gillian Duncan ◽  
...  
Keyword(s):  
Waiting Times ◽  
Compulsory Education ◽  
Feedback Mechanism ◽  
Royal Infirmary ◽  
Junior Doctors ◽  
Mri Safety ◽  
Allied Health Professionals ◽  
Near Misses ◽  
Safety Issues ◽  
Information Leaflets

Objective: Despite having a detailed MRI-safety questionnaire check at the point of referral, we have encountered a significant number of near-misses with patients being identified with MRI-Unsafe devices at the time of appointments, making this an important safety hazard. Methods and materials: A two-part survey was performed to assess referrer compliance of asking MRI-questionnaires. 120 outpatients across 3 MRI sites were interviewed at the time of appointment to confirm whether their referrers completed the MRI questionnaires with them at the time of referral. Location: Department of Radiology, Ninewells Hospital, Perth Royal Infirmary and Stracathro Hospital in Scotland. Results: Only 50–55 % of patients confirmed that they were asked about presence of a pacemaker at the point of referral. Less than 50 % of patients reported being asked about other potential hazards. Suggested strategies for change: (1) Risk Alert—Sent to all MRI referrers in the organization. ( 2) Changes to MRI Safety Questionnaire. (3) Feedback mechanism to referrers—NHS trust website publications on number of recorded near-misses and wasted appointments due to MRI-safety issues. (4) Compulsory education/training of future referrers (junior doctors/allied health professionals). (5) Education of patients/public on MRI safety—Displaying patient information leaflets/posters in waiting areas of the hospital. Key measures for improvement: (1) Reduction in number of recorded near-misses. (2) System improvements, referrer and patient education, reduction of wasted MRI appointments and improvement of waiting-times for MRI appointments Effects of survey and conclusions: The survey highlights the possibility of inadequate referrer attention, and poor patient communication about MRI safety questionnaire with regards to potential hazards of MRI examination in presence of undeclared implants. It initiated several interventions resulting in improved patient safety, with no events in next 12 months, whilst promoting public and referrer’s understanding of potential MRI safety issues. Such actions are recommended for all NHS centres across UK since there are significant similarities in functioning across UK.

scholarly journals Evaluation of Self-Reported Agricultural Tasks, Safety Concerns, and Health and Safety Behaviors of Young Adults in U.S. Collegiate Agricultural Programs

Safety ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 44
Author(s):  
J. L. Gibbs ◽  
K. Walls ◽  
C. Sheridan ◽  
D. Sullivan ◽  
M. Cheyney ◽  
...  
Keyword(s):  
Young Adults ◽  
Healthcare Providers ◽  
Health And Safety ◽  
Safety Behaviors ◽  
Medical Provider ◽  
Near Misses ◽  
Safety Issues ◽  
Agricultural Health ◽  
Safety Concerns ◽  
Agricultural Programs

Young adults enrolled in collegiate agricultural programs are a critical audience for agricultural health and safety training. Understanding the farm tasks that young adults engage in is necessary for tailoring health and safety education. The project analyzed evaluation survey responses from the Gear Up for Ag Health and Safety™ program, including reported agricultural tasks, safety concerns, frequency of discussing health and safety concerns with healthcare providers, safety behaviors, and future career plans. The most common tasks reported included operation of machinery and grain-handling. Most participants intended to work on a family-owned agricultural operation or for an agribusiness/cooperative following graduation. Reported safety behaviors (hearing protection, eye protection, and sunscreen use when performing outdoor tasks) differed by gender and education type. Male community college and university participants reported higher rates of “near-misses” and crashes when operating equipment on the roadway. One-third of participants reported discussing agricultural health and safety issues with their medical provider, while 72% were concerned about the health and safety of their family and co-workers in agriculture. These findings provide guidance for better development of agricultural health and safety programs addressing this population—future trainings should be uniquely tailored, accounting for gender and educational differences.

Independent Prescribing Pharmacists Supporting the Early Discharge of Patients Through Completion of Medical Discharge Summaries

2018 ◽  
Vol 33 (2) ◽  
pp. 173-175 ◽  
Author(s):  
Martin J. Biggs ◽  
Timothy C. Biggs
Keyword(s):  
Hospital Discharge ◽  
Medication Errors ◽  
Early Discharge ◽  
Discharge Summary ◽  
Medical Decision ◽  
Junior Doctors ◽  
Allied Health Professionals ◽  
Independent Prescribing ◽  
Discharge Summaries ◽  
Improve Service Delivery

Purpose: Independent prescribing pharmacists are able to independently prescribe medications following additional postgraduate training. This study examined their use in completing medical discharge summaries, normally completed by junior doctors, in order to assess their impact on expedited hospital discharge times. Methods: In total, 163 patients were studied through a 2-stage audit. The first cycle evaluated junior doctors completing medical discharge summaries (as is normal practice). Three independent prescribing pharmacists were then trained to complete discharge summaries, and a second cycle was completed. Results: Following implementation of independent prescribing pharmacists to complete medical discharge summaries, the time from medical decision to discharge to summary completion dropped significantly (mean of 2:42 hours to 1:35 hours, P < .001). The time from medical decision to discharge to actual hospital discharge also dropped significantly (mean of 5:21 hours to 3:58 hours, P < .01). The number of discharge summary medication errors dropped significantly ( P < .05) between audit cycles. Conclusion: The introduction of independent prescribing pharmacists to complete medical discharge summaries has significantly reduced the time to summary completion, discharge time, and the number of medication errors. In a time of limited medical resources and bed shortages, the use of allied health professionals to improve service delivery is of paramount importance. This project is the first of its kind within the literature.

scholarly journals Near-misses and Missed Opportunities: Poor Patient Handover In General Surgery

2008 ◽  
Vol 90 (3) ◽  
pp. 96-98 ◽  
Author(s):  
M Tokode ◽  
L Barthelmes ◽  
B O'Riordan
Keyword(s):  
General Surgery ◽  
Working Hours ◽  
Junior Doctors ◽  
Learning Potential ◽  
Missed Opportunities ◽  
Near Misses ◽  
Medical Careers ◽  
European Working ◽  
Working Time Directive ◽  
Patient Handover

Since the introduction of shift systems for junior doctors as part of the European Working Time Directive, different teams of doctors look after patients over the course of a day. This requires ro bust handover mechanisms to pass on inf ormation between differ ent teams of doctors to avoid misses and near-misses in patients' care. Modernising Medical Careers shortens the placements of doctors in foundation programmes in general surgery to four months compared with six-month placements as pre-registration house officers in the past. The reduction in working hours will therefore adv ersely aff ect exposur e and experience of junior doctors in general surg ery unless the learning potential of time spent at work is maximised.

scholarly journals The Clinical Frailty Scale: Do Staff Agree?

Geriatrics ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 40 ◽  
Author(s):  
Rebekah L. Young ◽  
David G. Smithard
Keyword(s):  
Medical Staff ◽  
Allied Health ◽  
Screening Method ◽  
Occupational Therapists ◽  
Junior Doctors ◽  
Case Scenario ◽  
Allied Health Professionals ◽  
Clinical Frailty Scale ◽  
Allied Health Professions ◽  
Staff Members

The term frailty is being increasingly used by clinicians, however there is no strict consensus on the best screening method. The expectation in England is that all older patients should have the Clinical Frailty Scale (CFS) completed on admission. This will frequently rely on junior medical staff and nurses, raising the question as to whether there is consistency. We asked 124 members of a multidisciplinary team (consultants, junior doctors, nurses, and allied health professionals; physiotherapists, occupational therapists, dietitians, speech and language therapists) to complete the CFS for seven case scenarios. The majority of the participants, 91/124 (72%), were trainee medical staff, 16 were senior medical staff, 12 were allied health professions, and 6 were nurses. There was broad agreement both between the professions and within the professions, with median CFS scores varying by a maximum of only one point, except in case scenario G, where there was a two-point difference between the most junior trainees (FY1) and the nursing staff. No difference (using the Mann–Whitney U test) was found between the different staff groups, with the median scores and range of scores being similar. This study has confirmed there is agreement between different staff members when calculating the CFS with no specific preceding training.

Oral anticancer medication: Does the patient understand?

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 219-219
Author(s):  
Donna M. Graham ◽  
Alan O'Shea ◽  
Jeffri R. M. Ismail ◽  
Richard Martin Bambury ◽  
Margaret O'Keefe ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Storage Conditions ◽  
Oral Chemotherapy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Safety Issues ◽  
Information Leaflets ◽  
Parametric Data ◽  
Region Data ◽  
Careful Handling

219 Background: Oral anti-cancer medication (OAM) prescribing is increasing. Safety and adherence issues surrounding OAM are causing a shift in the traditional roles and responsibilities of oncologists, nurses and pharmacists. This study aims to investigate patients’ perception of education and safety surrounding OAM use. Methods: Over a 6-month period an anonymous cross-sectional survey was offered to all patients (pts) attending for cancer treatment with OAM at Irish hospitals with cancer services in the South-West region. Data was prospectively analysed using standard statistical tools for non-parametric data. Results: A total of 172 surveys were distributed and 101 pts responded (59%). Of these, 53 (54%) were female. Median age was 62 (range 29-80 yrs). Diagnosis was colorectal cancer in 49 pts (48%), breast cancer in 13 (13%) and brain tumour in 12 (12%). Of treatments used, 85% were oral chemotherapy and 15% oral biological therapy. The most commonly used agent was capecitabine (61%). When commencing OAM, 17% of respondents felt they did not understand it. Understanding was improved by pt education by a doctor (p=0.03) or hospital-based nurse (p=0.04) and provision of information booklets (p=0.04). Pts were unaware of interactions in 30% of cases and 20% were not aware of any safety issues. Pts who had been given information leaflets were significantly more aware of safety including careful handling (p<0.001), storage conditions (p=0.02) and safe disposal (p<0.001). Pts attending nurse-led oral chemotherapy clinics (NOCC) were significantly more aware of safety issues (p=0.04). Of respondents, 1% reported taking too many tablets and 15% had forgotten to take OAM on ≥1 occasion. NOCC improved adherence (p=0.03). Conclusions: OAM, when indicated, is an option for selected pts who are compliant and educated about complications. This study highlights issues with pt education and safety awareness. To our knowledge the factors influencing this have not been previously explored. A significant proportion of our pts were sub-optimally educated regarding medication interactions, storage needs, handling and disposal precautions. Educational tools to aid healthcare professionals in pt instruction and NOCC significantly improve patient understanding.

scholarly journals Development of System-level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada

2016 ◽  
Vol 43 (3) ◽  
pp. 530-540 ◽  
Author(s):  
Claire E.H. Barber ◽  
Deborah A. Marshall ◽  
Dianne P. Mosher ◽  
Pooneh Akhavan ◽  
Lori Tucker ◽  
...  
Keyword(s):  
Performance Measures ◽  
Inflammatory Arthritis ◽  
Waiting Times ◽  
Models Of Care ◽  
System Level ◽  
Allied Health Professionals ◽  
Modified Delphi ◽  
Timely Access ◽  
Care Systems ◽  
Level Performance

Objective.To develop system-level performance measures for evaluating the care of patients with inflammatory arthritis (IA), including rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis.Methods.This study involved several methodological phases. Over multiple rounds, various participants were asked to help define a set of candidate measurement themes. A systematic search was conducted of existing guidelines and measures. A set of 6 performance measures was defined and presented to 50 people, including patients with IA, rheumatologists, allied health professionals, and researchers using a 3-round, online, modified Delphi process. Participants rated the validity, feasibility, relevance, and likelihood of use of the measures. Measures with median ratings ≥ 7 for validity and relevance were included in the final set.Results.Six performance measures were developed evaluating the following aspects of care, with each measure being applied separately for each type of IA except where specified: waiting times for rheumatology consultation for patients with new onset IA, percentage of patients with IA seen by a rheumatologist, percentage of patients with IA seen in yearly followup by a rheumatologist, percentage of patients with RA treated with a disease-modifying antirheumatic drug (DMARD), time to DMARD therapy in RA, and number of rheumatologists per capita.Conclusion.The first set of system-level performance measures for IA care in Canada has been developed with broad input. The measures focus on timely access to care and initiation of appropriate treatment for patients with IA, and are likely to be of interest to other arthritis care systems internationally.

scholarly journals Special Considerations on the Use of Vaccines for Immunoprophylaxis of Bacterial Infections

2019 ◽  
Vol 19 (3) ◽  
pp. 145-153
Author(s):  
N. A. Gavrilova ◽  
Е. А. Ustyugova ◽  
N. F. Nikityuk ◽  
Yu. I. Obukhov ◽  
V. P. Bondarev
Keyword(s):  
Bacterial Infections ◽  
Essential Element ◽  
Vaccination Schedule ◽  
Safety Issues ◽  
National Immunisation ◽  
Information Leaflets ◽  
Current State ◽  
Potential Risks ◽  
The Russian Federation ◽  
One Year

Mass vaccination is an essential element of immunoprophylaxis of infectious diseases, and the global community has agreed that it is crucial for preserving the lives and health of children and adults. The objective of this study was to analyse the current state of vaccination of infants under one year old against bacterial infections, given that the National Immunisation Schedule is overladen with various vaccines, and there are apparent inconsistencies between the types of marketed vaccines and recommendations on their use. The article summarises the types of antibacterial vaccines marketed in the Russian Federation, analyses some aspects of combination of different antigens and interchangeability of vaccines. The authors justify the need to amend recommendations on antibacterial vaccination and to develop common rules for the use and combination of vaccines, as well as for their interchangeability. Another important issue is adoption of requirements for the contents of patient information leaflets. The article summarises the main safety concerns regarding the use of polyvalent vaccines and simultaneous vaccination against several pathogens. It discusses safety issues of multiple immunisation and the strategy to reduce potential risks associated with an intensive vaccination schedule. The authors highlight the safety of current immunisations schedules and the need to update vaccination standards. They also demonstrate the need to harmonise national recommendations on the use of vaccines based on clinical data and the results of international clinical trials.

scholarly journals 212 Integrated Care Hubs for Older Persons; RIGHT PERSON, RIGHT TIME

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Niamh Phelan ◽  
Margaret Bolger ◽  
Emma Grant ◽  
Catherine Murphy ◽  
Suzanne Roche ◽  
...  
Keyword(s):  
Integrated Care ◽  
Multidisciplinary Team ◽  
Team Member ◽  
Waiting Times ◽  
Nurse Specialist ◽  
Staff Nurse ◽  
Reference Period ◽  
Process Data ◽  
Allied Health Professionals ◽  
The Right

Abstract Background The development of an Integrated Care Hub has resulted in a complete review of the triage system for older people referred to our service. Our aim was to develop a multidisciplinary triage process (MTP) to ensure patients are seen by the right person at the right time for a First Contact Assessment (FCA). Methods A quantitative retrospective analysis of referrals and frequency of multidisciplinary team input from January 2018 – June 2018, highlighted the majority of patients were seen for FCA by the staff nurse. This subsequently resulted in onward referrals to Allied Health Professionals within the ‘Hub’, and patients attended for multiple visits. A working group was formed to address these issues. This resulted in the development of the MTP where patients are triaged by the Multidisciplinary team (MDT) and allocated to the most appropriate team member based on the referring information. Following the introduction of this triage process, data analysed from November 2018 - April 2019 highlighted its impact on our service. Results In the first reference period the proportion of patients seen for FCA by each discipline was as follows; Staff nurse (SN) 53%, Clinical Nurse Specialist (CNS) 18%, Occupational Therapist (OT) 16% and Physiotherapist 9%. In the second reference period the proportions changed to the following; SN 12%, CNS 31%, OT 33%, Physiotherapist 20% and Dietitian 4%. It has reduced the number of patient visits to the ‘Hub’ and the waiting times to see the right person within the team. Conclusion Empowering supported MDT members to triage and the use of this new MTP has resulted in patients having rapid access to the most appropriate team member for FCA. It has resulted in a change in the distribution of the caseload to ensure patients are seen by the right person within the team, and at the right time for early patient centred intervention.

scholarly journals Do junior doctors at the Manchester Royal Infirmary know how to refer inpatients to medical specialties?

2019 ◽  
Vol 6 (Suppl 2) ◽  
pp. 57-57
Author(s):  
Sabine Jamal ◽  
Catriona Boyd ◽  
Basim Ali ◽  
Elinor Shuttleworth
Keyword(s):  
Royal Infirmary ◽  
Junior Doctors ◽  
Medical Specialties ◽  
Know How ◽  
Manchester Royal Infirmary
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