Medicine and Health Sciences Commons^™

Perioperative Team-Based Morbidity And Mortality Conferences: A Systematic Review Of The Literature, Aubrey Samost-Williams, Roni Rosen, Alexander Hannenberg, Melis Lydston, Garrett M Nash, Mary Brindle

Journal Articles

OBJECTIVE: This systematic review aimed to identify key elements of perioperative team-based morbidity and mortality conferences (TBMMs) and their impact on patient safety, education, and quality improvement outcomes.

BACKGROUND: Patient safety in the perioperative period is influenced by system, team, and individual behaviors. However, despite this recognition, single-discipline morbidity and mortality conferences remain a mainstay of educational and quality improvement efforts.

METHODS: A structured search was conducted in MEDLINE Complete, Embase, Web of Science, ClinicalTrials.gov, Cochrane CENTRAL, and ProQuest Dissertations and Theses Global in July 2022. Search results were screened, and the articles meeting inclusion criteria were abstracted.

RESULTS: Seven …

Second Victim Syndrome And Organizational Support For Healthcare Providers: A Scoping Review, Kaitlyn R. Petryszyn, Justin P. Young, Elizabeth R. Neil, Jennifer E. Benedict, Lindsey E. Eberman

Internet Journal of Allied Health Sciences and Practice

Purpose: Healthcare providers may experience critical incidents, medical errors, or other adverse patient events in their clinical practice.Providers that encounter such events can experience second victim syndrome (SVS), a condition where providers feel psychological, cognitive, or physical reactions rendering care in these instances. Organizational support may mediate the impacts of SVS after an adverse patient event. We conducted a scoping review to explore and synthesize the literature on the support strategies implemented by healthcare organizations for healthcare providers after adverse patient events. Methods: The initial search strategy yielded 244 articles, 84 of which were removed for duplication. The 3-person …

Real-Life Outcomes For Oral Disease-Modifying Treatments Of Relapsing-Remitting Multiple Sclerosis Patients: Adherence And Adverse Event Profiles From Marmara University, Ezgi̇ Vural, Esi̇n Engi̇n, Güli̇n Sünter, Kadri̇ye Ağan Yildirim, Di̇lek Günal

Turkish Journal of Medical Sciences

Background/aim: Disease-modifying treatments (DMT) are used to prevent future relapses and disability. High long-term adherence to treatment is important to achieve disease control. This study aims to investigate and compare adherence, adverse event (AE) profiles, and frequencies, main reasons for treatment discontinuation under Teriflunomide (TERI), Dimethyl Fumarate (DMF), and Fingolimod (FNG) for relapsing-remitting MS (RRMS) patients. This study is designed to explore patient-reported experiences in real-life settings. Materials and methods: Patients who were older than 18 years with a definite diagnosis of RRMS and no history of stem-cell transplantation were included. Outpatient clinic data files at the Neurology Department of …

Exploring Risk, Antecedents And Human Costs Of Living With A Retained Surgical Item: A Narrative Synthesis Of Australian Case Law 1981–2018, Sonya Osborne, Tina Cockburn, Juliet Davis

Journal of Perioperative Nursing

Objective(s): This study aimed to critically examine the circumstances contributing to, and the human costs arising from, the retention of surgical items through the lens of Australian case law.

Design, setting and participants: We reviewed Australian cases from 1981 to 2018 to establish a pattern of antecedents and identify long-term patient impacts (human costs) of retained surgical items. We used a modified fourstep process to conduct a systematic review of legal doctrine, combined with a narrative synthesis approach to bring the information together for understanding. We searched LexisNexis, AustLII, Coroner Court websites, Australian Health Practitioner Regulation Agency Tribunal Decisions and …

Moving On After Critical Incidents In Health Care: A Qualitative Study Of The Perspectives And Experiences Of Second Victims, Melanie Buhlmann, Beverley Ewens, Amineh Rashidi

Research outputs 2022 to 2026

Aims To gain a deeper understanding of nurses and midwives' experiences following involvement in a critical incident in a non-critical care area and to explore how they have 'moved-on' from the event. Design An interpretive descriptive design guided inductive inquiry to interpret the meaning of moving-on. Methods Purposive sampling recruited 10 nurses and midwives. Data collection comprised semi-structured interviews, memos and field notes. Data were concurrently collected and analysed during 2016–2017 with NVivo 11. The thematic analysis enabled a coherent analytical framework evolving emerging themes and transformation of the data into credible interpretive description findings, adhering to the COREQ reporting …

The Impact Of Critical Incidents On Nurses And Midwives: A Systematic Review, Melanie Buhlmann, Beverley Ewens, Amineh Rashidi

Research outputs 2014 to 2021

Aims:

To synthesise the existing literature, which focuses on the impact of critical incidents on nurses and midwives, and to explore their experiences related to the support they received in the current healthcare environment to move on from the event.

Design:

Systematic review and qualitative synthesis.

Data sources:

The electronic databases CINAHL, MEDLINE, PsycINFO, PubMed, Embase and Nursing and Allied Health (ProQuest) were systematically searched from 2013–2018, and core authors and journals identified in the literature were manually investigated.

Review methods:

Qualitative studies of all research design types written in English were included according to the PRISMA reporting guidelines. The …

Fanconi Syndrome Leading To Hypophosphatemic Osteomalacia Related To Tenofovir Use., Mana Rao, Liam Dadey, Thomas Glowa, Peter Veldkamp

Parkview Pharmacy Department

Tenofovir disoproxil fumarate (TDF) is used worldwide to treat and prevent Human Immunodeficiency Virus (HIV) infection. Fanconi syndrome is a complication of TDF use and is characterized by inadequate reabsorption of glucose, phosphate and protein in the proximal tubule of the kidney which may eventually lead to osteomalacia manifested by symptoms of pain, muscular weakness and difficulty ambulating. We present a patient with severe osteomalacia due to progressive and unrecognized Fanconi's syndrome, who responded rapidly to TDF withdrawal, oral phosphate repletion and calcitriol. With the widespread use of TDF-containing antiviral regimens, it is critically important that physicians adhere to screening …

The Aboriginal Gap In Online Active Vaccine Safety Surveillance, Patrick Cashman, Sally-Anne Munnoch, Katrina Clark, Natalie Allan, Stephen Clarke, Kristine Macartney, David Durrheim

Australian Indigenous HealthBulletin

Objectives: To investigate if Aboriginal people are equally included in new forms of vaccine safety post-marketing surveillance that support safety signal detection and confidence in the vaccine program by comparing the use of Vaxtracker active adverse events following immunisation (AEFI) surveillance between Aboriginal and non-Aboriginal parents of vaccinated children.

Methods: In 2016, automated AEFI surveillance was conducted to monitor seasonal influenza vaccine in children aged 18 months to less than 5 years and for DTPa vaccine after the inclusion of a new dose at 18 months of age. To explore reasons for non-response, Aboriginal Immunisation Officers contacted the …

Somatic Acupoint Stimulation For Cancer-Related Sleep Disturbance: A Systematic Review Of Randomized Controlled Trials, Xian-Liang Liu, Hui Lin Cheng, Simon Moss, Carol Chunfeng Wang, Catherine Turner, Jing-Yu Tan

Research outputs 2014 to 2021

Aim. The aim of this systematic review was to analyze and synthesize available evidence for the effects of somatic acupoint stimulation (SAS) on cancer-related sleep disturbance in adults with cancer. Methods. Nine databases and four clinical trial registries were searched from their inception to July 2019 to identify potential articles and registered trials. Two authors independently extracted data and appraised the methodological quality of the included studies. The included studies could not be subjected to meta-analysis due to the significant variations in SAS intervention protocols and outcome measurement instruments. This systematic review therefore reported the results of the …

Postpartum Endometritis And Infection Following Incomplete Or Complete Abortion: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, C E. Rouse, L O. Eckert, F M. Muñoz, J S A. Stringer, S Kochhar, L Bartlett, M Sanicas, D J. Dudley, D M. Harper, Fyezah Jehan

Department of Paediatrics and Child Health

Abstract are not provided by the author/publisher

Moving On After Critical Incidents In Health Care. Second Victims: A Qualitative Study Of The Experiences Of Nurses And Midwives, Melanie Buhlmann

Theses: Doctorates and Masters

Aims: The aims of this study were to gain a deeper understanding of the experiences of nurses and midwives who have been involved in a critical incident in a non-critical care area and to explore how they have ‘moved-on’ from the event.

Background: It is irrefutable that health care is intrinsically risk-laden and perceived to be personally and professionally demanding for those who are employed within it. The term ‘second victim’ has been assigned to health care professionals who experienced emotional distress as a result of their involvement in critical incidents. Despite the recognition that critical incidents contribute to workrelated …

Health Supplement Use And Related Adverse Events In Dubai, United Arab Emirates: A Cross-Study, Naseem Mohammed Rafee Abdulla

Philosophy Dissertations

Health supplement products contain ingredients of more than a thousand chemicals. Several of these chemicals may adversely affect human health. Previous studies have found that consumers are generally unaware of the risks of health supplements and their associated adverse events. In addition, they are unaware of the appropriate reporting process to relevant authorities should adverse events occur. Moreover, many healthcare professionals have inadequate knowledge, attitude, and practice in health supplement consumption-related adverse events and their reporting. The purpose of this research was to measure the health supplement consumption in the population of Dubai, the adverse events thereof, and the level …

Hydrophilic Polymer Embolism: Implications For Manufacturing, Regulation, And Postmarket Surveillance Of Coated Intravascular Medical Devices, Rashi I. Mehta, Rupal I. Mehta

Clinical and Translational Science Institute

Hydrophilic polymers are ubiquitously applied as surface coatings on catheters and intravascular medical technologies. Recent clinical literature has heightened awareness on the complication of hydrophilic polymer embolism (HPE), the phenomenon wherein polymer coating layers separate from catheter and device surfaces, and may be affiliated with a range of unanticipated adverse reactions. Significant system barriers have limited and delayed reporting on this iatrogenic complication, the full effects of which remain under-recognized by healthcare providers and manufacturers of various branded devices. In 2015, the United States Food and Drug Administration acknowledged rising clinical concerns and stated that the agency would work with …

Low Birth Weight: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, Clare L. Cutland, Eve M. Lackritz, Tamala Mallett-Moore, Azucena Bardají, Ravichandran Chandrasekaran, Chandrakant Lahariya, Muhammad Imran Nisar, Milagritos D. Tapia, Jayani Pathirana, Sonali Kochhar

Department of Paediatrics and Child Health

No abstract provided.

Respiratory Distress In The Neonate: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunization Safety Data, Leigh R. Sweet, Cheryl Keech, Nicola P. Klein, Helen S. Marshall, Beckie N. Tagbo, David Quine, Pawandeep Kaur, Ilia Tikhonov, Muhammad Imran Nisar, Sonali Kochhar

Department of Paediatrics and Child Health

No abstract provided.

Small For Gestational Age: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunisation Safety Data, Elizabeth P. Schlaudecker, Flor M. Munoz, Azucena Bardají, Nansi S. Boghossian, Asma Khalil, Hatem Mousa, Mirjana Nesin, Muhammad Imran Nisar, Vitali Pool, Hans M.L. Spiegel

Department of Paediatrics and Child Health

No abstract provided.

Congenital Microcephaly: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Safety Data After Maternal Immunisation, Malini Desilva, Flor M. Munoz, Erick Sell, Helen Marshall, Alison Tse Kawai, Alisa Kachikis, Paul Heath, Nicola P. Klein, James M. Oleske, Fyezah Jehan

Department of Paediatrics and Child Health

No abstract provided.

Comparison Of Post-Marketing Surveillance Approaches Regarding Infections Related To Tumor Necrosis Factor (Tnf) Inhibitors, Cheng Chen

Pharmaceutical Sciences ETDs

Objective: Both spontaneous (voluntary) reporting systems and observational approaches serve as important tools in post-marketing surveillance for adverse drug events, however, each has its own advantages. The primary purpose of this project was to compare and contrast the FDA Adverse Event Reporting System (FAERS) data and findings from observational studies in post-marketing surveillance through examining TNF inhibitors (etanercept, adalimumab, infliximab, certolizumab and golimumab) related infections, and secondarily, to examine the applicability of additional analyses in FAERS, such as multiple logistic regressions and time to onset of event analysis.

Methods: Using MedDRA^® preferred terms (PTs), infection and infestation cases in …

Sentinel Event Management Model: A Performance Improvement Project, Kelly M. Johnson

Graduate Theses, Dissertations, and Capstones

The purpose of this performance improvement project was to implement a standard sentinel event management model in an acute care hospital that is part of a healthcare system based on best practices and principles of high reliability organizations. The project used define, measure, analyze, improve and control (DMAIC) methodology and Lewin’s Theory of Planned Change. High rates of medical harm and preventable deaths have been demonstrated around the world. It is estimated that one in four American families will be affected by preventable harm in healthcare involving further medical care, disability or even death. Despite international awareness and substantial efforts …

The Just Culture, Second Victimization And Clinician Support: An Educational/Awareness Program, Shawna M. Butler

Doctor of Nursing Practice (DNP) Projects

Due to the continued numbers of medical errors and unexpected patient outcomes, the student project manager identified the collateral damage that health care providers involved in the patient care events experienced while acting as a risk manager at one medical center. This concept is referred to as "second victimization". The patient and/or family are the primary victims of errors and unexpected outcomes, but the close second is that of the clinician caring for the patient. As a result of this, the concern for the needs of these second victims was considered. A review of the literature was conducted. The review …

Comparison Of Post-Licensure Safety Surveillance Of 13-Valent Pneumococcal Conjugate Vaccine And 7-Valent Pneumococcal Conjugate Vaccine: Data From The Vaccine Advere Event Reporting System (Vaers), Jorge E. Arana

Public Health Theses

Comparison of Post-licensure safety surveillance of 13-Valent Pneumococcal Conjugate vaccine and 7-Valent Pneumococcal Conjugate vaccine: Data from the Vaccine Adverse Event Reporting System (VAERS).

Background: On February 24, 2010, Food and Drug Administration (FDA) licensed a 13-valent pneumococcal conjugate vaccine (Prevnar 13^®, [PCV13]) for use among children aged 6 weeks--71 months. The Advisory Committee on Immunization Practices (ACIP) recommended PCV13 routine vaccination of all children aged 2--59 months, children aged 60--71 months with underlying medical conditions, with PCV13 replacing PCV7 for all doses.

Methods: We searched case reports to the Vaccine Adverse Event Reporting System (VAERS), a US …

Safety Culture As A Contemporary Healthcare Construct: Theoretical Review, Research Assessment, And Translation To Human Resource Management., Patrick Albert Palmieri

Patrick Albert Palmieri

Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures in order to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established via modification in employee safety perspective and work behavior, human resource professionals need to contribute to this developing organizational domain. The IOM …

Suspected Malignant Hyperthermia During The 6th General Anesthesia : A Case Report, P. Sirichotvithyakorn

Chulalongkorn Medical Journal

No abstract provided.