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62,554 نتائج ل "Medical errors"
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Resident Duty Hours
Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety.
Patient Safety
Increased concern for patient safety has put the issue at the top of the agenda of practitioners, hospitals, and even governments. The risks to patients are many and diverse, and the complexity of the healthcare system that delivers them is huge. Yet the discourse is often oversimplified and underdeveloped. Written from a scientific, human factors
Charlatans
\"Newly minted chief resident at Boston Memorial Hospital Noah Rothauser is swamped in his new position, from managing the surgical schedules to dealing with the fallouts from patient deaths. Known for its medical advances, the famed teaching hospital has fitted several ORs as \"hybrid operating rooms of the future\"--an improvement that seems positive until an anesthesia error during a routine procedure results in the death of an otherwise healthy man. Noah suspects Dr. William Mason, an egotistical, world-class surgeon, of an error during the operation and of tampering with the patient's record afterward. But Mason is quick to blame anesthesiologist, Dr. Ava London. When more anesthesia-related deaths start to occur, Noah is forced to question all of the residents on his staff, including Ava, and he quickly realizes there's more to her than what he sees. A social-media junkie, Ava has created multiple alternate personas for herself on the Internet. With his own job and credibility now in jeopardy, Noah must decide which doctor is at fault and who he can believe--before any more lives are lost\"-- Provided by publisher.
Changes in Medical Errors after Implementation of a Handoff Program
The authors developed an intervention to improve the quality of the handoff of hospitalized patients; it was associated with reductions in medical errors and in preventable adverse events. Handoff duration, time with patients, and time spent on computers did not change. Preventable adverse events — injuries due to medical errors — are a major cause of death among Americans. Although some progress has been made in reducing certain types of adverse events, 1 – 3 overall rates of errors remain extremely high. 4 Failures of communication, including miscommunication during handoffs of patient care from one resident to another, are a leading cause of errors; such miscommunications contribute to two of every three “sentinel events,” the most serious events reported to the Joint Commission. 5 The omission of critical information and the transfer of erroneous information during handoffs are common. 6 As resident work hours have been . . .
Human factors in healthcare : a field guide to continuous improvement
Have you ever experienced the burden of an adverse event or a near-miss in healthcare and wished there was a way to mitigate it? This book walks you through a classic adverse event as a case study and shows you how. It is a practical guide to continuously improving your healthcare environment, processes, tools, and ultimate outcomes, through the discipline of human factors. Using this book, you as a healthcare professional can improve patient safety and quality of care. Adverse events are a major concern in healthcare today. As the complexity of healthcare increases-with technological advances and information overload-the field of human factors offers practical approaches to understand the situation, mitigate risk, and improve outcomes. The first part of this book presents a human factors conceptual framework, and the second part offers a systematic, pragmatic approach. Both the framework and the approach are employed to analyze and understand healthcare situations, both proactively-for constant improvement-and reactively-learning from adverse events. This book guides healthcare professionals through the process of mapping the environmental and human factors; assessing them in relation to the tasks each person performs; recognizing how gaps in the fit between human capabilities and the demands of the task in the environment have a ripple effect that increases risk; and drawing conclusions about what types of changes facilitate improvement and mitigate risk, thereby contributing to improved healthcare outcomes.
Sleep Disturbance and Short Sleep as Risk Factors for Depression and Perceived Medical Errors in First-Year Residents
Abstract Study Objectives: While short and poor quality sleep among training physicians has long been recognized as problematic, the longitudinal relationships among sleep, work hours, mood, and work performance are not well understood. Here, we prospectively characterize the risk of depression and medical errors based on preinternship sleep disturbance, internship-related sleep duration, and duty hours. Methods: Survey data from 1215 nondepressed interns were collected at preinternship baseline, then 3 and 6 months into internship. We examined how preinternship sleep quality and internship sleep and work hours affected risk of depression at 3 months, per the Patient Health Questionnaire 9. We then examined the impact of sleep loss and work hours on depression persistence from 3 to 6 months. Finally, we compared self-reported errors among interns based on nightly sleep duration (≤6 hr vs. >6 hr), weekly work hours (<70 hr vs. ≥70 hr), and depression (non- vs. acutely vs. chronically depressed). Results: Poorly sleeping trainees obtained less sleep and were at elevated risk of depression in the first months of internship. Short sleep (≤6 hr nightly) during internship mediated the relationship between sleep disturbance and depression risk, and sleep loss led to a chronic course for depression. Depression rates were highest among interns with both sleep disturbance and short sleep. Elevated medical error rates were reported by physicians sleeping ≤6 hr per night, working ≥ 70 weekly hours, and who were acutely or chronically depressed. Conclusions: Sleep disturbance and internship-enforced short sleep increase risk of depression development and chronicity and medical errors. Interventions targeting sleep problems prior to and during residency hold promise for curbing depression rates and improving patient care.
A mistake : a novel
\"Elizabeth is a gifted surgeon--the only female consultant at her hospital. But while operating on a young woman with life-threatening blood poisoning, something goes horribly wrong. In the midst of a new scheme to publicly report surgeons' performance, her colleagues begin to close ranks, and Elizabeth's life is thrown into disarray. Tough and abrasive, Elizabeth has survived and succeeded in this most demanding, palpably sexist field. But can she survive a single mistake? A Mistake is a page-turning procedural thriller about powerful women working in challenging spheres. The novel examines how a survivor who has successfully navigated years of a culture of casual sexism and machismo finds herself suddenly in the fight of her life. When a mistake is life-threatening, who should ultimately be held responsible?\"-- Provided by publisher.
After Harm
Medical error is a leading problem of health care in the United States. Each year, more patients die as a result of medical mistakes than are killed by motor vehicle accidents, breast cancer, or AIDS. While most government and regulatory efforts are directed toward reducing and preventing errors, the actions that should follow the injury or death of a patient are still hotly debated. According to Nancy Berlinger, conversations on patient safety are missing several important components: religious voices, traditions, and models. In After Harm, Berlinger draws on sources in theology, ethics, religion, and culture to create a practical and comprehensive approach to addressing the needs of patients, families, and clinicians affected by medical error. She emphasizes the importance of acknowledging fallibility, telling the truth, confronting feelings of guilt and shame, and providing just compensation. After Harm adds important human dimensions to an issue that has profound consequences for patients and health care providers.