...widely practiced by thousands of physicians, dentists, acupuncturists, and other practitioners for relief or prevention of pain and for various other health conditions. According to the 2007 National Health Interview Survey (NHIS), which included a comprehensive survey of NCCAM (National Center for Complementary and Alternative Medicine), an estimated 3.1 million U.S. adults and 250,000 children had used acupuncture for pain control in the previous year, and about 8,500 physicians in the major hospitals and 12,000 non-physician acupuncturists use acupuncture in private practice. One of the qualified nurses’ role in the U.S. Army has been extending to practice acupuncture – inserting and withdrawing needles - and appropriately educating the patients about their treatment. However,...
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...Abstract Healthcare unlike many high-risk industries has made slow progress in improving patient’s safety. The role of nursing in improving medication safety has been largely underestimated. Much of the research undertaken to date in relation to adverse medication events has neglected the impact that nurses have or could have in improving patient safety. In examining literature regarding adverse medication events one can see the urgent need for significant improvement in medication practices and processes. In addition that this health care issue will only improve with the participation of all disciplines working towards a common goal of improving the safety of those in our care. Introduction Medications play a key role in healthcare but can also be a significant key cause of medical error and of adverse patient outcomes. Nurses by the nature of their roles in medication administration can be the last line of defense in eliminating or reducing adverse medication events. The administration of medication is a common and almost routine activity in a nurse’s daily work, yet it is fraught with complexity and risk for both the patient and nurse. As a student nurse working in partnership with a registered nurse I have observed a variety of practices in medication administration that have varied from what I have been taught in class. On reflecting on these practices and questioning nurses why such practice has been adopted has illustrated to me both the flawed processes and environment...
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...Hospital Case Study and the Relationship with the readings from Managing Change: Equity & Action This case study on Children’s Hospital and Cinics gives an elaborate explanation on managing change. Julie Morath, who was the chief operating officer at the children’s Hospital brought in administration change in the hospital after an incident of medical errors on a patient. Patient safety became her priority. Morath attended some training that gave her a lot of impetus and skills to bring out effective management in the children’s hospital. This brought change and improved the performance of the hospital. Morath started by putting a core team of personnel in place to help in designing and launching the patient safety initiative. She took charge in the hospital and by August 1999, she had sought assistance of many people who were highly respected in the organization. Morath partnered with the hospital’s medical director to get his input and support so that she could make him understand her strategy for enhancing patient safety since she believed that leadership of the medical director would be very instrumental in creating support for the doctors and nurses in the children’s hospital. She then set out to accomplish major tasks which include making presentations to hospital staff about research on medical errors, conducted focus groups to learn more on patient safety and then developed a detailed strategic plan for the patient safety initiative...
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...Case Study 3 This case study focuses on a situation that is faced by most healthcare facilities in the United States. The problem involves growing needs versus shrinking financial budgets to meet required outlay of equipment, technology, staffing, and physical facilities. To meet the needs of the growing population of North Reno County, Langley Mason Health (LMH) must make some tough financial decisions in regards to patient safety strategies that effect immediate and long term obligations. LMH has a strategic plan and has set forth ten goals for implementation. Once the goals are implemented, the community and patients will have safe, efficient care and the health system will be in line with other facilities that are technologically proficient. LMH has a multi-phase approach to complete the process and implementation of the plan. To date, the only phase completed is the first, and there is indecision and uncertainty among the LMH management staff about subsequent phases. Staff opposes purchasing equipment for short term safety goals such as smart IV pumps versus purchase of technological systems that include suites such as computerized order entry (CPOE), robots, and smart IV pumps, bar coding, computerized medication delivery, and electronic patient education. While some management decision makers desire to study the strategic problem before dedicating the funds for any equipment or phase, the chief information officer Dr. Moore does not want to get bogged down in a lengthy...
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...safe handover : safe patients guidance on clinical handover for clinicians and managers diSclaimer This publication has been produced as a service to ama members. although every care has been taken to ensure its accuracy, this publication can in no way be regarded as a substitute for professional legal or financial advice and no responsibility is accepted for any errors or omissions. The ama does not warrant the accuracy or currency of any information in this publication. The australian medical association limited disclaims liability for all loss, damage, or injury, financial or otherwise, suffered by any persons acting upon or relying on this publication or the information contained in it, whether resulting from its negligence or from the negligence of employees, agents or advisers or from any cause whatsoever. cOPyriGhT This publication is the copyright of the australian medical association limited. Other than for bona fide study or research purposes, reproduction of the whole or part of it is not permitted under the copyright act 1968, without the written permission of the australian medical association limited. safe handover : safe patients guidance on clinical handover for clinicians and managers PREPARED BY THE AUSTRALIAN MEDICAL ASSOCIATION LIMITED ABN: 37 008 426 793 2006 Adapted from the British Medical Association’s resource ‘Safe Handover: Safe Patients.’ Dr Mukesh Haikerwal President, Australian Medical Association Dr Geoff Dobb Chair, AMA Coordinating...
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...Article/Case Law Search Paper Name: Ashley A Cox HCS 430 -Legal Issues in Health Law and Compliance Instructor: Patrick Nicovic Date: April 1, 2013 Article Case Law Search Health care providers and organizations have a legal and an ethical responsibility to provide protection to patients against infectious diseases. Health care facilities whom fail to provide efficient infection control precautions puts patient's safety at risk resulting in a SARS outbreak. “Improper sterilization of equipment exposed patients to diseases including HIV, Hepatitis, and bloodstream infections that risk patient safety” (Bailey & Ries, 2010, p. 141). A hospital, organization, or health care facility acquired infection exhibits signs as little as three days after a patient is admitted. Infections that occur in a hospital are defined as Nosocomial infections. Ineffective infection control can create safety concerns for patients because the result in most cases is the patient dying. Infections obtained in a medical facility are usually resistant to antibiotics. “Bloodstream infections (BSIs) are major causes of morbidity and mortality On the basis of data from death certificates, these infections are the 10th leading cause of death in the United States” (Wisplinghoff, Bischoff, Tallent, Seifert, Wenzel & Edmond, 2004, p. 309). Many lawsuits happen because of poor safety precautions. “Health Grades Inc., a U.S. company that evaluates...
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...IOM 1999, described the healthcare in the US as not safe as it should be. According to the two major studies, 44,000 people out of 98,000 die each year in the hospitals due to the medical errors which can be preventable. The issues which commonly occur during the provision of care are adverse drug effects, improper treatment, surgical injuries, wrong site surgeries, suicide, restraint injuries or death, falls, burns pressure ulcers and wrong patient identification. These errors cost between $ 17-29 billion per year in the hospitals worldwide. It also affects the trust and patient-provider relationship. The article further talks about the factors which are the leading cause of medical errors are a “decentralized and fragmented system” where...
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...The Silent Treatment VitalSmarts, AORN, & AACN present: Why Safety Tools and Checklists Aren’t Enough to Save Lives David Maxfield, Joseph Grenny, Ramón Lavandero, and Linda Groah Silence Kills was conducted immediately before AACN’s national standards for healthy work environments were released10. It identified seven concerns that often go undiscussed and contribute to avoidable medical errors. It linked the ability of health professionals to discuss emotionally and politically risky topics in a healthcare setting to key results like patient safety, quality of care, and nursing turnover, among others. The Silent Treatment shows how nurses’ failure to speak up when risks are known undermines the effectiveness of current safety tools. It then focuses on three specific concerns that often result in a decision to not speak up: dangerous shortcuts, incompetence, and disrespect. The Silent Treatment tracks the frequency and impact of these communication breakdowns, then uses a blend of quantitative and qualitative data to determine actions that individuals and organizations can take to resolve avoidable breakdowns. Imagine you are a nurse who has been given a set of new safety tools that warns you whenever your patients are in danger. That would be powerful, life-saving information, right? But what if nobody listened to you or heeded your warnings? This kind of breakdown is happening in hospitals every day. The quote below is one of 681 collected in the course of this...
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...Case Study: Merck and the Vioxx Recall Kelvin Gabel Benedictine University Case Study: Merck and the Vioxx Recall According to Lawrence and Weber (2014), former Merck CEO George W. Merck implied a corporate vision of social responsibility for Merck & Co., Inc. (Merck) when he stated in 1950 that medicine was for the people and that loyalty to that concept would lead to greater profits. On the surface, it appears Merck has historically lived its declared mission of putting people first. This is demonstrated by the company forfeiting patent and profits from the antibiotic streptomycin and the drug Mectizan (Lawrence, 2014). Merck was well rewarded for its people first philosophy. Though it was ranked fifth in asset and market value, it ranked first in profits. Additionally the company had a stellar reputation of being perceived as the most ethical and socially responsible of the major drug companies (Lawrence, 2014). Today Merck Pharmaceutical’s mission statement is “to discover, develop and provide innovative products and services that save and improve lives around the world (Merck, 2015).” Reading Merck’s current mission statement lacks both the compassion of placing people first and the implied social responsibility of Mr. Merck’s statement in 1950. To be contextually correct historically in forming a view of Merck and the Vioxx recall issue, I sought to find a corporate mission statement from the period of the recall which was in 2006. According to Culp...
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...Are Controlled Clinical Trials Really Ethical? Case Study In 2009, two cousins, Thomas and Brandon were diagnosed with the same type of deadly skin cancer within a 2 month time frame of each other. To date, here is no cure for skin cancer and once diagnosed the average life expectancy is approximately 8 months. Current standard of care treatments are aimed at shrinking the tumors and prolonging life. Unfortunately, these standard of care treatments only work in a very small percentage of patients and are very toxic with terrible side effects. Thomas learned of a new Phase 3 clinical research trial sponsored by Roche with an unapproved yet promising drug. His doctor explained that in earlier trials, a majority of volunteer patients who took the wonder drug had seen a drastic reduction in the size of their tumors with very few side effects. The only way ill patients can get the drug is by participating in this trial. The trial is a randomized controlled trial (RCT) which means half of the volunteers will get the experimental drug while the other half will be treated with another standard of care treatment. The purpose of the standard or control arm is to allow researchers to compare the long term effects of the new drug to that of the current standard treatment and determine whether it actually shrinks tumors and prolong remissions. Participants have a 50/50 chance of being placed in either arm of the study. Arm assignments are random and cannot be changed. With limited options...
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...lead to death or serious injury. Healthcare providers are often not knowledgeable about the origin, meaning, and implications of these ‘‘black box’’ warnings. In this review, our goal is to provide insight into how the Food and Drug Administration evaluates, communicates, and manages drug benefit/risk. We discuss drug labeling, the emphasis on safety throughout the drug approval process, legislative initiatives for safe use of drugs in children, and postmarketing safety surveillance. In addition, we encourage health care providers to report drug reactions to the Food and Drug Administration’s MedWatch program. A discussion of new Food and Drug Administration initiatives to improve drug safety processes and methods to serve the public better are highlighted. (J Allergy Clin Immunol 2006;117:34-9.) Key words: Food and Drug Administration, adverse drug reactions, MedWatch, ‘‘black box’’ warning, drug labeling, drug benefit/risk, risk management, postmarketing surveillance, drug development Abbreviations used AERS: Adverse Event Reporting System CDER: Center for Drug Evaluation and Research CFR: Code of Federal Regulations DSOB: Drug Safety Oversight Board FDA: US Food and Drug Administration IND: Investigational new drug PDR: Physicians Desk Reference NDA: New drug application It is late on a busy Friday afternoon in your practice and you are ready to write a...
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...Politics, Legislation, and Implications to Patient Care Abstract There are constant changes to laws and legislation regarding patient care and safety. The purpose of this report is to inform the reader of recent and upcoming changes to legislation that may affect nursing care of patients. Research by L. Aiken, et al. and A. Tourangeau, support the need for higher education of registered nurses. Their research proves that patient outcomes are improved when registered nurses carry a bachelor’s degree in nursing. Research conducted by J. Needleman, et al., concluded that reducing the nurse-patient ratio resulted in the patient being at less risk for developing hospital-acquired illnesses as well as a reduced risk of inpatient mortality. The reader will also be informed about the Joint Commission’s protocol for reducing the occurrence of wrong-patient, wrong-site, and wrong-procedure during surgical procedures. Politics, Legislation, and Implications to Patient Care As the American population ages, healthcare and its resources are in greater demand. As the demand for healthcare increases, the topic of patient safety has become increasingly important. Laws and legislation regarding patient care are changing almost constantly to maintain patient safety while still providing comprehensive patient care. This report will focus on informing the reader of recent and upcoming legislation regarding patient care, what has brought those changes about, and the effects it can...
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...more nurses in hospitals is becoming an issue in hospitals all over America. The patient’s safety is being put at risk due to the number of nurse to patient ratios (Welton 1). A low nurse to patient ratio will cause a lack of care for the patients. Nurses will have to take on more patients then they are capable of which will affect the health of the patient and the nurse. John M. Welton, an RN (Registered Nurse), said that “the safety of patients is directly related to the size and experience of the nursing staff” (Welton 1). A high nurse to patient ratio can be on the costly side for the hospitals. “Hospitals will not receive any additional revenue for providing more patient care”...
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...How to Prevent Infection with Safe Injection and Medication Practices? Infection transmission risks are present in all hospital settings (Siegel, Rhinehart, Jackson, Chiarello, & the Healthcare Infection Control Practices Advisory Committee, 2007, p. 31). A recent online survey of more than 5,000 healthcare practitioners revealed an alarming lapse in basic infection control practices associated with the use of syringes, needles, multi-dose vials, single-use vials, and flush solutions (Paparella, 2011, p. 564). According to the Centers for Disease Control and Prevention (CDC) there has been at least 49 infection outbreaks occurring because of contaminated injectable medical products since 2001 particularly at the time of administration. Out of the 49 outbreaks occurring, 26 of those took place in the past five years (Jayanthi, 2014). The transmission of bloodborne viruses and other microbial pathogens to patients during routine healthcare procedures continues to occur because of the use of unsafe and improper injection, infusion, and medication vial practices by health care professionals in various clinical settings throughout the United States. Breaches in safe injection, infusion, and medication vial practices continue to result in unacceptable and devastating events for patients (Dolan et al., 2010, p. 167). With this in mind it is necessary to understand the causes of and how to effectively prevent infection and injury with safe injection and medication vial practices...
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...Safe Lifting and Movement of Nursing Home Residents 1 Safe Lifting and Movement of Nursing Home Residents 2 Safe Lifting and Movement of Nursing Home Residents Safe Lifting and Movement of Nursing Home Residents by: James W. Collins, PhD, MSME Associate Director for Science Division of Safety Research National Institute for Occupational Safety and Health Centers for Disease Control and Prevention Morgantown, West Virginia Audrey Nelson, PhD, RN, FAAN Director Patient Safety Center for Inquiry James A. Haley Veteran’s Administration Hospital Tampa, Florida Virginia Sublet, PhD, RPh Senior Toxicologist Oak Ridge Institute for Science and Education Windermere, Florida DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health i 3 Safe Lifting and Movement of Nursing Home Residents This document is in the public domain and may be freely copied or reprinted. Disclaimer Mention of any company or product does not constitute endorsement by the National Institute for Occupational Safety and Health (NIOSH). In addition, citations to Web sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these Web sites. Ordering Information To receive documents or other information about occupational safety and health topics, contact NIOSH at: NIOSH-Publications Dissemination...
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