Patient Safety in Healthcare - Free Essay Example

Sample details Pages: 9 Words: 2842 Downloads: 5 Date added: 2017/06/26 Category Medicine Essay Type Essay any type Level High school Did you like this example? Introduction and background Patient safety has always been the heart of healthcare practice and nursing through the history of medicine. However, all through the world occasional non-deliberate accidental harm occurs to patients looking for care. Such unfavourable incidents can occur at all levels of healthcare whether clinical or managerial, curative or preventive, and in general healthcare, or private. Don’t waste time! Our writers will create an original "Patient Safety in Healthcare" essay for you Create order It may occur at any stage of management (radiology, laboratory, operating room, ward, or ICU). The WHO, at the meeting held on July 2006, in New Delhi, India, identified an adverse event as a separate unconnected incident associated with health care, which results in in-deliberate injury, illness, or death. Such incidents can be preventable as with contaminated injections. Published surveys on patient safety show that in industrialized advanced countries, more than half of these adverse events are preventable and occur because of a shortage in system or organization design or operation rather than because of poor performance of healthcare providing staff (WHO report, 2006). Harvard Medical Centre study in 1991 (after WHO report, 2006) was the first to draw the attention to the volume of patient safety problem. Based on medical records review, the rate of adverse event in three US medical centres ranged between 3.2 to 5.4 percent. In UK, the rate was 11.7 percent and in Denmark, the rate was 9 percent (WHO report, 2002). Results of recent studies suggest the rate is between 3.2 and 16.6 percent (per 100 hospital admissions). The situation in the less well-documented health care centres in the developing countries is more serious (WHO report, 2006). The cost of adverse events that endanger patient safety can be very high, considering all the aspects. It includes, loss of confidence and credibility and reputation of health care institutions, loss of enthusiasm and job gratification among the working staff. In addition, the cost includes damage to the patients and their relatives especially when taking defensive attitudes and keeping information hidden from patients families. Other added costs are those of prolonged hospital stay and increased medical expenses and those of lawsuit demands (WHO report, 2006). Objective The objective of this paper is to review, in brief, the problem of patient safety with particular attention to patient safety in the ICU being one of the essential patient care systems in a health care organization. Besides, the vulnerability of ICU patients augments the importance of patient safety concept. Methodology This thesis is a literature review study. The researcher performed an article search using the following internet databases: National Centre for Biotechnology à ¢Ã¢â€š ¬Ã¢â‚¬Å" National Library of Medicine à ¢Ã¢â€š ¬Ã¢â‚¬Å" National Institutes for Health (NCBI), at https://www.ncbi.nlm.nih.gov Medscape database, at https://www.medscape.com Amedeo: The Medical Literature Guide, at https://www.amedeo.com British Medical Journals, at https://group.bml.com/products/journals World health organization à ¢Ã¢â€š ¬Ã¢â‚¬Å" Publications, at https://www.who.int/en/publications Yahoo and Google scholar general databases, site of .org, .gov and.edu only considered. Terms of search were patient safety, basics, and principles of patient safety, review of patient safety, patient safety in the ICU and the critically ill patient safety. Findings Patient safety event is a wide term; it does not only mean a medical error during the course of medical management and nursing. The Department of Health and Human Services, 2008, defined a patient safety event as an incident, which takes place during providing a health care service. It causes or may have caused a harmful outcome to the patient. It includes errors of not doing (omission) or errors of doing (commission), it also includes faults and mistakes of the patient care processes (involving drugs and equipments) or the environment where these processes are carried out. The phrase, one cannot manage what cannot be measured hold true for patient safety. One of the reasons of the lack of effective patient safety strategies is the need for a measurement tool to provide measures, consequently, reduce medical errors and improve patient safety. The Agency for Healthcare Research and Quality (AHRQ) developed an array of Patient Safety Indicators planned to screen administr ative data for events related to patient safety. This list of indicators includes 16 situations where a threat to patient safety may occur during the course of healthcare delivery. Using this measurement tool shows that patient safety incident of highest rates are failure to rescue, decubitus ulcers and postoperative wound infection (which is specifically increased by 35% during the period 2002-2006) (Health Grades Inc, 2006). Infection control: An important part of patient safety Bruke, 2006, has provided a comprehensive review of infection control as an important aspect in patient safety strategy. Based on many studies, hospital acquired infection; in this context, alternatively called health care associated infection, is one the most frequent risks for patient safety in patients admitted to hospitals. The answer to the question of why it is an important aspect for patient safety lies in the fact that 5-10 percent of patients admitted to acute care hospitals acquire one or more nosocomial infection. In the US, 2 million patients acquire hospital infection every year with 90.000 deaths. This adds a cost of 4.5 to 5.7 billion US $ to the health care cost (Bruke, 2006). There are four types of hospital-acquired infections, which account for 80% of the total rate. These are infection associated with urinary catheterization, blood borne infection (usually with vascular invasive procedures), surgical wounds infections, and pneumonia (usually associated with the use of ventilators). Therefore, it is understandable that 25 per cent of these infections occur in the ICU (Bruke, 2006). The increased awareness of patient safety resulted in reorganizing the concepts of infection control and placing it in the domain of public health with consequent increased surveillance and epidemiological studies. It is true that recognizing risk factors allows clarification of what is adjustable and what is not, however modification of some terms is advisable. Instead of saying avoiding the use of catheters, we should recommend reducing the duration of use of catheters. Many other terms as use antibiotics intelligently, and training and staff education are hazy and indistinct, accordingly, tricky to employ (Bruke, 2006). Nursing practice and patient safety The report of the Institute of Medicine, 2004 (after Armstrong and Laschinger, 2006) recognized nursing role as pivotal to patient safety. The report suggests the degree of activity of hospital nurses and the extent of giving them authority to take part in decisions, directly affects the quality and perception of patient safety. The results of Armstrong and Laschinger, 2006 supported this assumption; they recommended that nurses should enjoy better communication and participation in decision-making. The responsibility of nurse managers, at the unit level, is even greater. They take part to establish nursing practices, which support patient safety culture, they also sustain professional nursing practices, and they should listen carefully to nurses relevant affairs. If nursing managers achieve their direct responsibilities, then they work with others in the healthcare establishment to make the organizational process better as regards limiting the nurses competence towards bet ter patient care. The result of Armstrong and Laschinger, 2006 suggested that nurse managers (nurse leaders) have the capability of developing patient safety in healthcare organizations. Medication management and patient safety Duthie and colleagues, 2004, analyzed the 108 reports submitted to the New York State Department of Health investigating the medical errors in New York State healthcare organizations. From quantitative viewpoint, their results suggested that nursing the first discipline to be involved in such errors and they provided the explanation that nurses are the end dispenser since they give the medications to patients directly. In addition, they showed that patients over 65 years are the most vulnerable to these errors, perhaps because of the increased number of medications prescribed at this age. From a qualitative viewpoint, they suggested that what may endanger patient safety is dispensing system malfunction, failure to rescue situations and working space limitations. They suggested the need to educational initiatives and pointing out possible dispensing system malfunctions. Adamski, 2005, suggested the following precautions to minimize medication errors: Monitoring how patients respond to medications as long as it is dispensed in the healthcare organization. Diagnosis and indication for a particular medication should be available in the patients progress notes, history or examination sheets. Clear order forms to dispense medications in order to ensure clear and mutual understanding among the prescribing physician, pharmacist, and thenurse who administers the medication. Davis and colleagues, 2006, examined the patient role in medication errors. They suggested that low literacy patients (up to 6th grade level) are more liable to misunderstand medications label instructions. However, they suggested that lower reading and writing skills and high number of medications prescriptions link separately to misunderstanding of instructions on medications labels. Hospital design and device purchase in patient safety strategies Reiling, 2005, suggested that building a hospital (whether new or relocated) around the principles of patient safety would have two important impacts on return of investment. First, it combines safety and efficiency, second, it reduces the costs of adverse effect and hospital stay therefore; reduces the patients cost on discharge. To achieve a safety cantered hospital design, Reiling, 2005, suggested that architects, engineers, contractors, heads of departments and executive managers should participate in discussions around what they need. There is no specific design but contributions of the whole team from the perspectives of patient safety culture are mandatory. Johnson and colleagues, 2004, examined the patient safety in purchasing equipment. They analysed purchasing decisions taken at three different healthcare centres. Johnson and other, 2004, assumed there were points of strengths and others of weaknesses. The points of weaknesses draw the attention to the necessi ty of having guidelines to help healthcare providers to assess issues of patient safety when purchasing medical devices. Patient safety in the ICU There are many reasons that make the ICU a special unit to look at specifically as regards patient safety. Of these reason, the patients are critically ill, which renders them vulnerable to the adverse effect of medical errors. Second, the great effort performed by nurses and internists with sometimes exhaustive shift work, which may result in sleep deprivation and possibly lack of concentration. Third, the diverse use of equipment (ventilators, catheters, monitors etc) and the invasive procedures sometimes adopted (emergency tracheotomy, central venous pressure or arterial-venous cannulation) which add to the risk of hospital-acquired infection or increase the incidence of adverse effects (Rothschild and others, 2005). Rothschild and colleagues, 2005 conducted a one-year prospective observation study as a part of Harvard Hours and Health Study (2002-2003). They designed their study as a multidisciplinary epidemiological study to portray both frequency and types of adver se effects in the ICU. The result were informative, there were 120 adverse events reported (80.5 per 1000 patient-day). Of the patients who suffered adverse effects, 13.8% suffered one adverse effect, and there were 16 life-threatening adverse effects. The commonest were respiratory, infection, and cardiovascular system (19%, 15%, and 12% respectively). The incidence of serious medical errors was 149.7 per 1000 patient-day of which, 11% were life threatening. Incident discovery was by direct observation in 62% of the cases and the patients nurses discovered 36 % of the cases. In 74.8% of cases, errors occurred during the course of treatment or a procedure. An intern failure to wash hands after attending a patient formed 51% of sterility hazards related to procedures. Although their results cannot be applied to all ICU units, yet it draws the attention to how frequent and how serious patient safety can be compromised in ICU units. At the same time, their result show how r esults of treatment in the ICU would improve, despite the hard work, if teams stick to unit protocols and principle of patient safety (Rothschild and others, 2005). Kho and others, 2005, used the Safety Climate Survey (a tool approved by the Institute of Health Care Improvement) to measure patient safety in four ICU units, 56.9% of those responded to the survey were nurses. Based on their results, they assumed that Safety climate survey and Safety culture scales are reliable tools to measure patient safety in ICU. Chang and other, 2005, suggest that reform of patient safety in the ICU should start by establishing physician and nurse leadership, once this is achieved, carrying out patient safety protocols becomes a matter of team effort and commitment to the concept. Identifying a specific group of patients to start with (as an example, patients on ventilators), planning carefully the procedures, and opening a communication channel among the staff should reach the best re sults. Following evaluation of what progress made, the next move is for another group of patients. At the end, this should provide synchronization among the staff that makes decision making in shortage of time easier and provides better training and education to the newly coming staff. Obstacles facing the implementation of patient safety Cook and colleagues, 2000, considered the complexity of healthcare as an overwhelming obstacle to achieve desired patient safety levels. Technical work in healthcare needs appropriate and quick decision making, critical to the patients safety at times, moreover, it is risky by nature. It is true that health practitioners whether physicians, nurse, technicians or other staff are trying to cope with this complexity, however this complexity creates a disparity in healthcare practice and nursing (they called it gap). Cook and colleagues assumed the means of improving patient safety is by supporting practitioners ability to perceive and cross these disparities, rather than making changes in authority or different roles with possible division of professional work force. The search and detection of these disparities or gaps as a research goal should make the breakthrough in patient safety achievements. During this research pursuit, disparities indicate areas of weaknesses and sus ceptibility and may elicit the means complexity flows through health care systems to patients (Cook and colleagues, 2000). Amalberti and colleagues, 2005, identified five system barriers to even safer healthcare; the first is regulations, which significantly limit the risk allowed, thus, limiting maximum performance of healthcare givers. There is a real need for proper balance between the industrial notions to get a high productivity whatever it takes, and the concepts of patient safety culture. Doing that, researchers should take into consideration the economic troubles of the healthcare system and the spontaneous drive of productivity among healthcare workers. Second, other important issues need dealing with before or in conjunction with the issue of patient safety, an important example to these issues is the need for standardization of healthcare practice and nursing. Third, the core of healthcare work is synchronization among practitioners, therefore recommendations s hould stress on teamwork and opening communication channels among the healthcare staff, instead of trying to reach optimal performance of each organizational level separately. The fourth obstacle is the need for system-level mediation to improve patient safety planning. References WHO Regional Office for South-East Asia (2006). Working Paper: Promoting Patient Safety At Healthcare Institutions. Retrieved 28/04/2008, from https://www.searo.who.int/en/sea/pdm/meet.43/TD/1.3-Rev.1.pdf WHO Secretariat report (2002). Quality of care: patient safety. Retrieved 30/04/2008, from https://www.who.int/en/publications Department of Health and Human Services. (2008). Patient Safety and Quality Improvement. Washington DC: Federal Register. Vol.73 (29): 8112-8183. Health Grades Inc. (2006). Third Annual Patient Safety in American Hospital Study. Golden, Colorado. Bruke, J. P. (2006). Infection Control A Problem for Patient Safety. The New England Journal of Medicine, 348 (7), 651-656. Armstrong. K J. and Laschinger H (2006). Structural Empowerment, Magnet Hospital Characteristics, and Patient Safety Culture: Making the Link. J Nurs Care Qual, 21 (2), 124-132. Duthie E, Favreau B, Ruperto A et al. (2004). Quantitative and Qualitative Analysis of Medication Errors: The New York Experience. Advances in Patient Safety, Vol. 1, 131-144. Adamski P (2005). Medication Management: A patient safety priority. Nurs Manag, 36 (10), 14. Davis T C. Wolf M S. Bass P F. et al (2006). Literacy and Misunderstanding Prescription Drug Labels. Annals of Internal Medicine, 145 (12), 887-894. Reiling J G. (2005). Creating a Culture of Patient Safety through Innovative Hospital Design. Advances in Patient Safety, Vol. 2, 425-439 Johnson T R., Zhang J., Patel V L. et al (2004). The Role of Patient Safety in the Device Purchasing Process. Advances in Patient Safety, Vol. 1, 341-352. Rothschild J M., Landrigan, C P., Cornin J W. et al (2005). The Critical Care Safety Study: The Incidence and Nature of Adverse Events and Serious Medical Errors in Intensive Care. Crit Care Med, 33 (8), 1694-1700. Kho M E, Carbone J M, Lucas J and Cook D J (2005). Safety Climate Survey: reliability of results from a multicenter ICU survey. Quality and Safety in Health Care, 14, 273-278. Chang, S.Y., Multz, A. S. and Hall, J. B (2005). Critical Care Organization. Critical Care Clinics. Vol. 21 (5), 43-53 Cook R I. Render M. and Woods D. D (2000). Gaps in the continuity of care and progress on patient safety. BMJ, 320 (7237), 791-794. Amalberti, A, Auroy, Y, Berwick, D and Barach, P (2005). Five System Barriers to Achieving Ultrasfe Health care. Annals of Internal Medicine. Vol. 142 (9), 756-764 Wilson, A R., Dowd, B E. and Kralweski, J E. (2005). Patient Safety Research in Medical Group Practices: Measurement and Data Challenges. Advances in Patient Safety, Vol. 2, 51-62 Woolf, S H. (2004). Patient Safety Is Not Enough: Targeting Quality Improvements To Optimize the Health of the Population. Ann Inter Med, Vol. 140, 33-36 Baxter, S K and Brumfitt, SM (2008). Benefits and Losses: a qualitative study exploring healthcare staff perception of teamworking. Quality and Safety in Health Care, Vol.17, 127-130 Pstay, B M. and Bruke, S P. (2006). Protecting the Health of the Public: Institute of Medicine Recommendations on Drug Safety. The New England Journal of Medicine, Vol. 355, 1753-1755

Essay on coming of age in samoa - 1705 Words

Coming of Age in Somoa Margaret Mead’s â€Å"Coming of Age in Samoa†, which was actually her doctoral dissertation, was compiled in a period of six months starting in 1925. Through it, people were given a look at a society not affected by the problems of 20th century industrial America. She illustrated a picture of a society where love was available for the asking and crime was dealt with by exchanging a few mats. This book helps one to realize the large role played by social environment. One of Mead’s biggest challenges was probably the fact that her fieldwork was done entirely in the Samoan language. In Samoa, few, if any natives spoke English. To get information, Mead spent her time talking to approximately 25 Samoan women. However,†¦show more content†¦As far as the act of sex, much pressure is put on the man to perform: The Samoan puts the burden of amatory success upon the man and believes that woman need more initiating, more time for maturing of sexual feeling. A man who fails to satisfy a woman is looked upon as clumsy, inept blunderer....(91) The day in Samoa begins at dawn, and you can hear the shouts of young men. Most of the time, the people go to sleep around midnight and after that you only hear the whispers of lovers. Mead tells of how birthdays are not of importance, but the day of birth is, especially with highly ranked babies. On this day there is a great feast and property is given away. The first baby must always be born in the village of the mother. For months before the birth, the family of the father brings food while the family of the mother makes clothes. At the birth, the fathers mother or sister must be present to take care of the newborn. There is no privacy and the woman is not allowed to cry out in pain. It is not uncommon for 20 to 30 people to be present at the birth, and to stay all night if necessary. Once the cord is cut by the midwife the feast begins. 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Passionate year free essay sample

They came in quietly enough, but there was an atmosphere of subdued expectancy of which Speed was keenly conscious; the boys tared about them, grinned at each other, seemed as if they were waiting for something to happen. Nevertheless, at five past seven all was perfectly quiet and orderly, although It was obvious that little work was being done. Speed felt rather as if he were sitting on a powder-magazine, and there was a sense in which he was eager for the storm to break. At about a quarter past seven a banging of desk-lids began at the far end of the hall. He stood up and said. quietly, but in a voice that carried well: l dont want to be hard on anybody, so Id better warn you that I shall punish any disorderliness very severely. There was some tittering, and for a moment or so he wondered If he had made a fool of himself. We will write a custom essay sample on Passionate year or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Then he saw a bright, rather pleasant-faced boy in one of the back rows deliberately raise a desk-lid and drop it with a bang. Speed consulted the map of the desks that was in front of him and by counting down the rows discovered the boys name to be Worsley. He wondered [1 3] how the name should be pronounced † whether the first syllable should rhyme with purse or with horse. Instinct in him, that uncanny feeling for atmosphere, embarked him on an outrageously bold adventure, nothing less than a piece of acetiousness, the most dangerous weapon in a new Masters armoury, and the one most of all likely to recoil on himself. He stood up again and said: Wawsley or Wurssley † however you call yourself † you have a hundred linesl3 The whole assembly roared with laughter. That frightened him a little. Supposing they did not stop laughing! He remembered an occasion at his own school when a class had ragged a certain Master very neatly ana suDtly Dy preten01ng to go OTT Into nysterlcs of laughter at some trifling witticism of his. When the laughter subsided, a lean, ather clever-looking boy rose up in the front row but one and said, impudently: Please sir, Im Worsley. I didnt do anything. Speed replied promptly: Oh, didnt you? Well, youve got a hundred lines, anyway. What for, sir † in hot indignation. For sitting in your wrong desk. Again the assembly laughed, but there was no mistaking the respectfulness that underlay the merriment. And, as a matter of fact, the rest of the evening passed entirely without incident. After the others had gone, Worsley came up to the dais accompanied by the pleasant-faced boy who dropped the desk-lid. Worsley pleaded for the remission of his hundred lines, and the other boy supported him urging that it was he a nd not Worsley who had dropped the lid. And whats your name? asked Speed. Naylor, sir. Very well, Naylor, you and Worsley can share the hundred lines between you. He added smiling: Ive no doubt youre neither of you worse than anybody else but you must pay the penalty of being pioneers. They went away laughing. That night Speed went into Clanwells room for a chat before bedtime, and Clanwell congratulated him fulsomeTy on his successful passage of the ordeal. 4 As a matter f fact, Clanwell said, l happen to know that theyd prepared a star benefit performance for you but that you put them off, somehow, from the beginning. The [14] prefects5 get to hear of these things and they tell me. Of course, I dont take any official notice of them. It doesnt matter to me what plans people make † its when any are put into execution that I wake up. Anyhow, you may be interested to know that the members of School House6 subscribed over fifteen shillings to purchase fireworks which they were going to let off after the switches had been turned off Alas for fond hopes ruined! Clanwell and Speed leaned back in their armchairs and roared with laughter. Commentary 1 . o take prep: to be in charge of preparation of lessons in a regular period at school. 2. to rag {coll. ): to play practical Jokes on; treat roughly. 3. You have a hundred lines

Archimedes Essay Example For Students

Archimedes Essay Archimedes was a Greek mathematician and scientist. He was born in Syracuse, Sicily in the year 287 B.C. He was educated in Alexandria, Egypt. Due to the lack of information about Greek mathematics, many Greek mathematicians and their works are hardly known. Archimedes is the exception. Archimedes was very preoccupied with mathematics. For instance, he often forgot to eat and bathe because of his always wanted to solve problems. He found areas and volumes of spheres, cylinders and plain shapes. He showed that the volume of a sphere is two-thirds of the volume of the smallest cylinder that can contain the sphere. Archimedes was so proud of this concept that he requested that a cylinder enclosed a sphere, with an explanation of this concept, be engraved on his grave. Archimedes also gave a method for approximating pi. He was able to estimate the value of pi between 3 10/71 and 3 1/7. Math wasnt as sophisticated enough to find out the exact pi (3.14). Archimedes was finding square roots and he found a method based on the Greek myriad for representing numbers as large as 1 followed by 80 million billion zeros. One of Archimedes accomplishments was his creation of the lever and pulley system. Archimedes proved his theory of the lever and pulley to the king by moving a ship, of the royal fleet, back into the ocean. Then, Archimedes moved the ship into the sea with only a few movements of his hand, which caused a lever and pulley device to move the ship. This story has become famous because Archimedes said, Give me a place to stand on and I will move the earth. Another invention he invented was the Archimedean screw. This machine was built for raising water to highland areas in Egypt that could not receive water directly from the Nile River. This device is still used today for irrigation purposes even is some countries today. The most famous story of Archimedes life involves the discovery of Archimedes Principle. The story begins when King Hieron asking a goldsmith to construct a gold wreath to the immortal gods. After some time, the king came to suspect that the wreath was not pure gold but rather filled with silver. In order to end his suspicion, the king asked Archimedes to determine whether the wreath was pure gold or filled with gold without destroying it. Archimedes agreed to try to solve the kings problem. Then one day, while he was taking a bath, Archimedes noticed that the water level rose in the bath as he entered the water. Archimedes was so excited by this discovery that he jumped out of his bath and ran naked through the streets yelling, Eureka, Eureka!! meaning, I have found it. Archimedes had discovered that a body immersed in a fluid displaces its weight of fluid. This principle in turn helped Archimedes prove that the gold wreath was not solid gold. Archimedes was probably most famous during the time he lived because he developed techniques defenses for Syracuse against the Romans. Syracuse was able to hold off the invasion for three years due to Archimedess inventions. He invented catapults, which hurled blocks of stone, and cranes, which dropped large stones on approaching ships. Also, he developed scaling ladders, which helped soldiers climb over enemy walls. Archimedes can use mirrors to reflect sunlight on the adversarial ships burning them. The Romans finally invaded Syracuse and overtook the city Archimedes was drawing circles in the dirt. When a soldier commanded Archimedes to surrender, Archimedes instead drew his sword and told the soldier that he wanted to finish the proof he was working on before surrendering. The soldier became angry and killed Archimedes. This shows that Archimedes was so committed to his expertise that he took the chance to dying in order to work on his last problem. Archimedes was so thoughtful with the study of math, and because of it, it led to many important discoveries and principles for us today. What helped me the most were encyclopedias, books and the Internet. I think I got enough information to basically point out the general account of it. I cant really think of anything I can do differently. I learned that Archimedes was a very significant man of his time that was perfected pi, his principles and his inventions. He was far beyond any mans thinking capabilities.