Since 1999, the problem of patient safety has drawn particular attention, becoming a priority in health care. A "medication error"(ME) is any preventable event occurring at any phase of the pharmacotherapy p...Since 1999, the problem of patient safety has drawn particular attention, becoming a priority in health care. A "medication error"(ME) is any preventable event occurring at any phase of the pharmacotherapy process(ordering, transcribing, dispensing, administering, and monitoring) that leads to, or can lead to, harm to the patient. Hence, MEs can involve every professional of the clinical team. MEs range from those with severe consequences to those with little or no impact on the patient. Although a high ME rate has been found in neonatal wards, newborn safety issues have not been adequately studied until now. Healthcare professionals working in neonatal wards are particularly susceptible to committing MEs due to the peculiarities of newborn patients and of the neonatal intensive care unit(NICU) environment. Current neonatal prevention strategies for MEs have been borrowed from adult wards, but many factors such as high costs and organizational barriers have hindered their diffusion. In general, two types of strategies have been proposed: the first strategy consists of identifying human factors that result in errors and redesigning the work in the NICU in order to minimize them; the second one suggests to design and implement effective systems for preventing errors or intercepting them before reaching the patient. In the future, prevention strategies for MEs need to be improved and tailored to the special neonatal population and the NICU environment and, at the same time, every effort will have to be made to support their clinical application.展开更多
Several well-publicized cases of improper cleaning,disinfection or sterilization of contaminated reusable medical equipment that posed an increased risk of patientto-patient disease transmission were reported within t...Several well-publicized cases of improper cleaning,disinfection or sterilization of contaminated reusable medical equipment that posed an increased risk of patientto-patient disease transmission were reported within the past few years,resulting in the notification of approximately 20 000 patients.These medical errors,the specific infection-control standards they breached,and assessments of the risk of infection associated with each are discussed.Other topics discussed include the Food and Drug Administration’s(FDA)regulation of medical devices and infection-control products;the use of adulterated,misbranded,and investigational devices;consent decrees and associated Certificates of Medical Necessity;and informed patient consent.Focus is placed on liquid chemical sterilization,its history,and the FDA’s recent censure and discontinuation of a medical device labeled with this claim,namely,the STERIS System 1 processor.Recommendations are provided for healthcare facilities,regulatory agencies,manufacturers of reusable medical devices,and professional healthcare organizations and administrations to improve public health and prevent healthcareassociated infections.展开更多
Background: Medication errors are a common problem in Chinese hospital, with potentially harmful consequences for patients. The objective of this study was to analyze the cause of typical serious medication errors in ...Background: Medication errors are a common problem in Chinese hospital, with potentially harmful consequences for patients. The objective of this study was to analyze the cause of typical serious medication errors in some first-class provincial hospital to prevent medication error and improve rational use of drug and ensure patients administration security. Medication errors were collected between September 1, 2012 and August 31, 2013. 332 cases’ medication errors were categorized as harmful or not according to NCC MERP’s Index and other indexes such as type of error and causes of error. We focus on analyzing the 3 serious cases (0.9%, n = 3) among the all MEs that may have contributed to or resulted in temporary harm to the patient and required intervention, including the process and the cause and the background of the errors. The case analysis reminds us to pay more attention to prevent medication errors. The preventive medication error’s measures are explored through the analysis of the causes, such as forcing functions and constraints, automation and standardization, double-checking systems, rules and policies, information and more careful working. Conclusion: This analytical study demonstrates that medication error is an objective existent in hospital. It is especially important to ensure patient medication safety for reporting and analyzing medication error in order to explore measures preventing medication error.展开更多
Copying,compiling,publishing,disseminating,and referencing anti-epidemic books of medical formularies were common activities during the outbreak of epidemics in the Qing dynasty.Its emergence,motivated by epidemic dis...Copying,compiling,publishing,disseminating,and referencing anti-epidemic books of medical formularies were common activities during the outbreak of epidemics in the Qing dynasty.Its emergence,motivated by epidemic disease again and again,was important component parts of epidemic prevention and control.They played a unique role as media on affairs such as treating patients suffering from infectious diseases,mobilizing peoples to make contributions to anti-epidemic activities,integrating and popularizing knowledge of epidemic prevention.Anti-epidemic books of medical formularies were important to link peoples,things,and substances related with epidemic prevention and control,and were a kind of motivation to actively deal with the infectious disease,control the epidemic,and maintain health.Compared to other common measures,anti-epidemic books of medical formularies participated in many prevention and control practices deeply,which actually built a low cost,spontaneous,dispersed and non-institutional system to respond to epidemic,and the system had characteristics of stronger conductibility,bigger coverage area,and better external benefits.展开更多
The global incidence of infectious diseases has increased in recent years,posing a significant threat to human health.Hospitals typically serve as frontline institutions for detecting infectious diseases.However,accur...The global incidence of infectious diseases has increased in recent years,posing a significant threat to human health.Hospitals typically serve as frontline institutions for detecting infectious diseases.However,accurately identifying warning signals of infectious diseases in a timely manner,especially emerging infectious diseases,can be challenging.Consequently,there is a pressing need to integrate treatment and disease prevention data to conduct comprehensive analyses aimed at preventing and controlling infectious diseases within hospitals.This paper examines the role of medical data in the early identification of infectious diseases,explores early warning technologies for infectious disease recognition,and assesses monitoring and early warning mechanisms for infectious diseases.We propose that hospitals adopt novel multidimensional early warning technologies to mine and analyze medical data from various systems,in compliance with national strategies to integrate clinical treatment and disease prevention.Furthermore,hospitals should establish institution-specific,clinical-based early warning models for infectious diseases to actively monitor early signals and enhance preparedness for infectious disease prevention and control.展开更多
Objective To improve the management level of pharmacy dispensing center,reduce dispensing errors and promote the safety of drug use.Methods Hospital pharmacies could be managed according to the theory of quality contr...Objective To improve the management level of pharmacy dispensing center,reduce dispensing errors and promote the safety of drug use.Methods Hospital pharmacies could be managed according to the theory of quality control circle(QCC).Based on the ten steps of QCC,the internal difference error rate in pharmacies could be reduced.Results and Conclusion The error rate of pharmacies was reduced from 2.74‰to 0.57‰,and the goal achievement rate was 108.466.Besides,the progress rate reached 84.82%.The abilities of circle members were improved,and the operation of pharmacy was more standardized.The activity of QCC is helpful to reduce the internal difference error rate,improve the operation level of pharmacy and ensure the safety of drug use.展开更多
During the prevention of coronavirus disease 2019(COVID-19),epidemiological data is essential for controlling the source of infection,cutting off the route of transmission,and protecting vulnerable populations.Followi...During the prevention of coronavirus disease 2019(COVID-19),epidemiological data is essential for controlling the source of infection,cutting off the route of transmission,and protecting vulnerable populations.Following Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases and other related regulations,medical institutions have been authorized to collect the detailed information of patients,while it is still a formidable task in megacities because of the significant patient mobility and the existing information sharing barrier.As a smart city which strengthens precise epidemic prevention and control,Shanghai has established a multi-department platform named"one-net management"on dynamic information monitoring.By sharing epidemiological data with medical institutions under a safe environment,we believe that the ability to prevent and control epidemics among medical institutions will be effectively and comprehensively improved.展开更多
Many medication errors could be avoided if administration was more closely linked with structured monitoring. The contributory factors to administration errors occurred in one recent year were reviewed and identified ...Many medication errors could be avoided if administration was more closely linked with structured monitoring. The contributory factors to administration errors occurred in one recent year were reviewed and identified contributory factors to errors as six domains of administration principles according to the report from the Quality and Safety website. The current measures including guidelines, policy, and practices to prevent the administration errors identified in the previous step were searched from the United Christian Hospital (UCH) homepage. Meanwhile, the international measures suggested in literature were identified to address the administration errors identified. 41 cases were identified as medication errors related to administration error events, with total twenty contributory factors identified according to the incident report which identified five contributory factors as common causes. Measures to prevent interruption of medication round and measures to improve individual knowledge and skills, and personal responsebility were suggested to fill the gaps. The medication administration errors should be avoided through both education reinforcing programme and preventive interventions of distraction or interruption to the procedure after comparing the existing measures to the suggested measures from literature. This study was so important to improve the current measures to prevent medication administration errors.展开更多
During the epidemics in the Qing dynasty,many medical professionals,nonprofessionals,and social organizations collected and sorted medical prescriptions related to infectious diseases.These people also compiled,publis...During the epidemics in the Qing dynasty,many medical professionals,nonprofessionals,and social organizations collected and sorted medical prescriptions related to infectious diseases.These people also compiled,published,disseminated,and consulted related medical formularies.The above historical event can be viewed as the construction and dissemination of medical knowledge.They edited and published medical formularies on infectious diseases with lower cost and in flexible ways by taking the initiative and giving full scope to creativity.Diverse anti-epidemic medical prescriptions from these medical formularies can be used for infectious diseases in the event of the outbreaks.However,the therapeutic effects of classical prescriptions and folk recipes cannot be regarded as the same.The wide circulation of anti-epidemic medical prescriptions and medical formularies was essentially a process of epidemic prevention resource allocation.Not only did it enable many nonprofessionals to participate in epidemic prevention and control,but it also enhanced awareness,knowledge,and capacity for epidemic prevention at the individual level.At the same time,due to the uneven quality and individual differences in the physical fitness and condition of the prescriptions and formularies,they had the capacity of causing inconveniences to the readers or patients.展开更多
目的分析对医护人员实施重症监护病房(intensive care unit,ICU)感染防控管理的效果。方法选取2022年1月—2023年12月在新疆生产建设兵团第九师医院ICU病房工作的21名医护人员作为研究对象,2022年1—12月(对照组)行常规管理,2023年1—12...目的分析对医护人员实施重症监护病房(intensive care unit,ICU)感染防控管理的效果。方法选取2022年1月—2023年12月在新疆生产建设兵团第九师医院ICU病房工作的21名医护人员作为研究对象,2022年1—12月(对照组)行常规管理,2023年1—12月(观察组)行ICU感染防控管理。对比两组医院感染发生情况与感染控制措施执行评分。结果观察组医护人员医院感染发生率为0,低于对照组的9.52%(2/21)。观察组环境控制评分为(95.43±2.23)分、物品消毒评分为(94.23±1.89)分、无菌操作评分为(95.13±3.87)分、手卫生评分为(95.09±3.92)分,均高于对照组的(90.34±3.14)分、(90.87±2.10)分、(90.11±2.87)分、(90.87±3.88)分,差异有统计学意义(t=7.239、6.514、5.707、4.191,P均<0.05)。结论ICU感染防控措施能有效减少医院感染情况,提高医护人员的感染控制措施执行力。展开更多
文摘Since 1999, the problem of patient safety has drawn particular attention, becoming a priority in health care. A "medication error"(ME) is any preventable event occurring at any phase of the pharmacotherapy process(ordering, transcribing, dispensing, administering, and monitoring) that leads to, or can lead to, harm to the patient. Hence, MEs can involve every professional of the clinical team. MEs range from those with severe consequences to those with little or no impact on the patient. Although a high ME rate has been found in neonatal wards, newborn safety issues have not been adequately studied until now. Healthcare professionals working in neonatal wards are particularly susceptible to committing MEs due to the peculiarities of newborn patients and of the neonatal intensive care unit(NICU) environment. Current neonatal prevention strategies for MEs have been borrowed from adult wards, but many factors such as high costs and organizational barriers have hindered their diffusion. In general, two types of strategies have been proposed: the first strategy consists of identifying human factors that result in errors and redesigning the work in the NICU in order to minimize them; the second one suggests to design and implement effective systems for preventing errors or intercepting them before reaching the patient. In the future, prevention strategies for MEs need to be improved and tailored to the special neonatal population and the NICU environment and, at the same time, every effort will have to be made to support their clinical application.
文摘Several well-publicized cases of improper cleaning,disinfection or sterilization of contaminated reusable medical equipment that posed an increased risk of patientto-patient disease transmission were reported within the past few years,resulting in the notification of approximately 20 000 patients.These medical errors,the specific infection-control standards they breached,and assessments of the risk of infection associated with each are discussed.Other topics discussed include the Food and Drug Administration’s(FDA)regulation of medical devices and infection-control products;the use of adulterated,misbranded,and investigational devices;consent decrees and associated Certificates of Medical Necessity;and informed patient consent.Focus is placed on liquid chemical sterilization,its history,and the FDA’s recent censure and discontinuation of a medical device labeled with this claim,namely,the STERIS System 1 processor.Recommendations are provided for healthcare facilities,regulatory agencies,manufacturers of reusable medical devices,and professional healthcare organizations and administrations to improve public health and prevent healthcareassociated infections.
文摘Background: Medication errors are a common problem in Chinese hospital, with potentially harmful consequences for patients. The objective of this study was to analyze the cause of typical serious medication errors in some first-class provincial hospital to prevent medication error and improve rational use of drug and ensure patients administration security. Medication errors were collected between September 1, 2012 and August 31, 2013. 332 cases’ medication errors were categorized as harmful or not according to NCC MERP’s Index and other indexes such as type of error and causes of error. We focus on analyzing the 3 serious cases (0.9%, n = 3) among the all MEs that may have contributed to or resulted in temporary harm to the patient and required intervention, including the process and the cause and the background of the errors. The case analysis reminds us to pay more attention to prevent medication errors. The preventive medication error’s measures are explored through the analysis of the causes, such as forcing functions and constraints, automation and standardization, double-checking systems, rules and policies, information and more careful working. Conclusion: This analytical study demonstrates that medication error is an objective existent in hospital. It is especially important to ensure patient medication safety for reporting and analyzing medication error in order to explore measures preventing medication error.
基金financed by the grant from the National Social Science Fund of China(No.18ZDA175)Youth Fund for Humanities and Social Sciences Research of the Ministry of Education(No.20YJC770021)。
文摘Copying,compiling,publishing,disseminating,and referencing anti-epidemic books of medical formularies were common activities during the outbreak of epidemics in the Qing dynasty.Its emergence,motivated by epidemic disease again and again,was important component parts of epidemic prevention and control.They played a unique role as media on affairs such as treating patients suffering from infectious diseases,mobilizing peoples to make contributions to anti-epidemic activities,integrating and popularizing knowledge of epidemic prevention.Anti-epidemic books of medical formularies were important to link peoples,things,and substances related with epidemic prevention and control,and were a kind of motivation to actively deal with the infectious disease,control the epidemic,and maintain health.Compared to other common measures,anti-epidemic books of medical formularies participated in many prevention and control practices deeply,which actually built a low cost,spontaneous,dispersed and non-institutional system to respond to epidemic,and the system had characteristics of stronger conductibility,bigger coverage area,and better external benefits.
文摘The global incidence of infectious diseases has increased in recent years,posing a significant threat to human health.Hospitals typically serve as frontline institutions for detecting infectious diseases.However,accurately identifying warning signals of infectious diseases in a timely manner,especially emerging infectious diseases,can be challenging.Consequently,there is a pressing need to integrate treatment and disease prevention data to conduct comprehensive analyses aimed at preventing and controlling infectious diseases within hospitals.This paper examines the role of medical data in the early identification of infectious diseases,explores early warning technologies for infectious disease recognition,and assesses monitoring and early warning mechanisms for infectious diseases.We propose that hospitals adopt novel multidimensional early warning technologies to mine and analyze medical data from various systems,in compliance with national strategies to integrate clinical treatment and disease prevention.Furthermore,hospitals should establish institution-specific,clinical-based early warning models for infectious diseases to actively monitor early signals and enhance preparedness for infectious disease prevention and control.
基金Source of the project:General Project of Liaoning Social Science Planning Fund[No.L19BGL034]。
文摘Objective To improve the management level of pharmacy dispensing center,reduce dispensing errors and promote the safety of drug use.Methods Hospital pharmacies could be managed according to the theory of quality control circle(QCC).Based on the ten steps of QCC,the internal difference error rate in pharmacies could be reduced.Results and Conclusion The error rate of pharmacies was reduced from 2.74‰to 0.57‰,and the goal achievement rate was 108.466.Besides,the progress rate reached 84.82%.The abilities of circle members were improved,and the operation of pharmacy was more standardized.The activity of QCC is helpful to reduce the internal difference error rate,improve the operation level of pharmacy and ensure the safety of drug use.
文摘During the prevention of coronavirus disease 2019(COVID-19),epidemiological data is essential for controlling the source of infection,cutting off the route of transmission,and protecting vulnerable populations.Following Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases and other related regulations,medical institutions have been authorized to collect the detailed information of patients,while it is still a formidable task in megacities because of the significant patient mobility and the existing information sharing barrier.As a smart city which strengthens precise epidemic prevention and control,Shanghai has established a multi-department platform named"one-net management"on dynamic information monitoring.By sharing epidemiological data with medical institutions under a safe environment,we believe that the ability to prevent and control epidemics among medical institutions will be effectively and comprehensively improved.
文摘Many medication errors could be avoided if administration was more closely linked with structured monitoring. The contributory factors to administration errors occurred in one recent year were reviewed and identified contributory factors to errors as six domains of administration principles according to the report from the Quality and Safety website. The current measures including guidelines, policy, and practices to prevent the administration errors identified in the previous step were searched from the United Christian Hospital (UCH) homepage. Meanwhile, the international measures suggested in literature were identified to address the administration errors identified. 41 cases were identified as medication errors related to administration error events, with total twenty contributory factors identified according to the incident report which identified five contributory factors as common causes. Measures to prevent interruption of medication round and measures to improve individual knowledge and skills, and personal responsebility were suggested to fill the gaps. The medication administration errors should be avoided through both education reinforcing programme and preventive interventions of distraction or interruption to the procedure after comparing the existing measures to the suggested measures from literature. This study was so important to improve the current measures to prevent medication administration errors.
基金financially supported by the National Social Science Foundation of China(No.ZDA175)the Humanities and Social Science Foundation of the Ministry of Education(No.20YJC770021)。
文摘During the epidemics in the Qing dynasty,many medical professionals,nonprofessionals,and social organizations collected and sorted medical prescriptions related to infectious diseases.These people also compiled,published,disseminated,and consulted related medical formularies.The above historical event can be viewed as the construction and dissemination of medical knowledge.They edited and published medical formularies on infectious diseases with lower cost and in flexible ways by taking the initiative and giving full scope to creativity.Diverse anti-epidemic medical prescriptions from these medical formularies can be used for infectious diseases in the event of the outbreaks.However,the therapeutic effects of classical prescriptions and folk recipes cannot be regarded as the same.The wide circulation of anti-epidemic medical prescriptions and medical formularies was essentially a process of epidemic prevention resource allocation.Not only did it enable many nonprofessionals to participate in epidemic prevention and control,but it also enhanced awareness,knowledge,and capacity for epidemic prevention at the individual level.At the same time,due to the uneven quality and individual differences in the physical fitness and condition of the prescriptions and formularies,they had the capacity of causing inconveniences to the readers or patients.
文摘目的分析对医护人员实施重症监护病房(intensive care unit,ICU)感染防控管理的效果。方法选取2022年1月—2023年12月在新疆生产建设兵团第九师医院ICU病房工作的21名医护人员作为研究对象,2022年1—12月(对照组)行常规管理,2023年1—12月(观察组)行ICU感染防控管理。对比两组医院感染发生情况与感染控制措施执行评分。结果观察组医护人员医院感染发生率为0,低于对照组的9.52%(2/21)。观察组环境控制评分为(95.43±2.23)分、物品消毒评分为(94.23±1.89)分、无菌操作评分为(95.13±3.87)分、手卫生评分为(95.09±3.92)分,均高于对照组的(90.34±3.14)分、(90.87±2.10)分、(90.11±2.87)分、(90.87±3.88)分,差异有统计学意义(t=7.239、6.514、5.707、4.191,P均<0.05)。结论ICU感染防控措施能有效减少医院感染情况,提高医护人员的感染控制措施执行力。