BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for preho...BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all.RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure.CONCLUSION: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.展开更多
Introduction: A lot of literature is available on critical incidents and near misses but specialty based critical incidents are very scanty. Aim: In this audit, we aimed to report critical incident and near misses dur...Introduction: A lot of literature is available on critical incidents and near misses but specialty based critical incidents are very scanty. Aim: In this audit, we aimed to report critical incident and near misses during conduct of obstetric anesthesia over a period of two years. Methodology: Critical incident forms were collected, entered, analyzed and categorized on the basis of American Standards Association (ASA), phase of incidents, system involved, and type of errors, outcome and action taken. Human error was further categorized on the basis of their contributing factor marked in form. Results: During the reporting period, 5511 anaesthetics were administered and 55 reports were received out of which 53 reports were included in analysis. Fifty three reports were divided into 33 critical incidents and 20 near misses. Out of 33 critical incidents, 54.5% involved CVS system and musculoskeletal system, followed by neuromuscular (n = 5), drug related (n = 4), airway/respiratory system (n = 2), central nervous system (n = 2) and renal system (n = 1). Forty five incidents possess no untoward effect while 7 led to minor and only one to severe physiological disturbance. Human errors were (n = 30) 57% reports and failure to check was the main contributory factor. Conclusion: Critical incidents reporting needs to be introduced in sub-specialties at departmental, national and international level. Checking of equipment, medication and anesthesia machine must be part of regular checks in elective and emergency cases.展开更多
Introduction: Critical incident monitoring is important in quality improvement as it identifies potential risks to patients by analyzing adverse events or near-misses. Methods: This study analyses the reported inciden...Introduction: Critical incident monitoring is important in quality improvement as it identifies potential risks to patients by analyzing adverse events or near-misses. Methods: This study analyses the reported incidents in a tertiary hospital over a 4-year period. Results: A total of 441 incidents were reported out of 98,502 anesthetics performed during the study period. Of these incidents, 67 resulted in no harm caused, 116 with unanticipated ICU admissions and 20 mortalities. The odds of having a critical incident increased with ASA status: from an odds ratio of 2.08 (95% CI: 1.58 to 2.74) for ASA 2 patients compared to ASA1, to OR of 13.70 (5.91 to 31.74) in ASA 5 compared to ASA 1. Critical incidents also have higher odds occurring out of hours (OR 1.7 (1.45 to 2.23) compared to daytime hours (08:00-17:00). They occurred most commonly in maintenance phase (142, 32.7%), followed by induction (120, 27.6%). The most common types of incidents include airway and respiratory (110, 24.9%) followed by drug related incidents (67, 15.2%). Human error was attributed as a significant contributing factor in 276 incidents (61.5%) followed by patient factors in 112 incidents (25.4%). Mitigating factors such as vigilance by staff involved were significant in 136 incidents (30.3%). Conclusion: Higher ASA status appears to be the most important factor associated with actual or potential patient harm in our study. Also significant, was time of incident, with incidents more likely out of hours. Critical incident reporting is a valuable part of quality assurance. We should continue to invest in incident reporting, incident analysis and improvement plans.展开更多
Intercultural literacy is attached increasingly great importance in this interconnected world.People from diversified cultural backgrounds need to interact with each other for various purposes.Schools and organization...Intercultural literacy is attached increasingly great importance in this interconnected world.People from diversified cultural backgrounds need to interact with each other for various purposes.Schools and organizations offer courses to improve people’s intercultural competence.This paper examines two effective techniques to teach intercultural competence in the classroom setting:critical incident activity and cultural story telling.These two strategies can help achieve the desired objectives of Michael Byram’s intercultural communication model.展开更多
The UNHCR 2017 report stated that about 44,400 people are displaced from their homes daily and about 68.5 million people are currently displaced globally. This article aims at critically analyzing the tuberculosis ris...The UNHCR 2017 report stated that about 44,400 people are displaced from their homes daily and about 68.5 million people are currently displaced globally. This article aims at critically analyzing the tuberculosis risks among displaced people especially as there is an increase in the number of migrants globally and proliferation of man-made and natural disasters. Research conducted among displaced persons and most of the studies concluded that active surveillance and proper case follow-up are the best ways to ensure adequate tuberculosis case management. In conclusion, the application of diverse methods in tackling tuberculosis risks should be especially through a culturally, acceptable precise and feasible plans without compromising international standards.展开更多
Despite the stigma that is associated with law enforcement officers receiving mental health resources and treatment to combat secondary traumatic stress,it is widely the most effective form for recovery and having a f...Despite the stigma that is associated with law enforcement officers receiving mental health resources and treatment to combat secondary traumatic stress,it is widely the most effective form for recovery and having a fulfilling career.Law enforcement officers are superheroes and,they are known for saving the day.That is why it is critical for mental health offerings to be normalized in law enforcement agencies and constant evaluation of the psychological and cognitive well-being of officers.Unfortunately,the stress of the profession will not go away,but having resources and incentives to address several factors that officers face will assist with their overall feeling about the important work they do.As such,it is recommended that law enforcement agencies adopt programs to treat secondary traumatic stress,such as Critical Incident Stress Debriefing,Peer-Support Program,and Crisis Intervention Team.While there is no perfect program,these programs are designed to reduce the risk of serious injury or death during an emergency interaction between citizens and law enforcement officers.Ultimately,it is the responsibility of those charged with protecting law enforcement officers to understand the stress and how it affects the mind and body of those officers in managing life,work,and citizens.展开更多
目的研究ICU患者暴露性角膜炎的发生率和影响因素,为预防暴露性角膜炎发生提供循证参考。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库(CBM)、PubMed、Embase、Cochrane Library、Web of Science、CI...目的研究ICU患者暴露性角膜炎的发生率和影响因素,为预防暴露性角膜炎发生提供循证参考。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库(CBM)、PubMed、Embase、Cochrane Library、Web of Science、CINAHL数据库建库至2024年6月发表有关ICU暴露性角膜炎发生率及影响因素研究。采用Stata 18.0进行Meta分析。结果共纳入14篇文献,涉及2938名患者和28项影响因素。ICU暴露性角膜炎发生率为30.1%(95%CI=20.9%~40.2%)。住院时间≥5 d(OR=6.27,95%CI=0.97~40.58)、使用机械通气/气管切开术/插管(OR=7.11,95%CI=3.20~15.8)、机械通气时间≥7 d(OR=1.13,95%CI=1.05~1.22)、使用镇静剂(OR=2.74,95%CI=1.58~4.75)、使用神经肌肉阻滞剂(OR=0.41,95%CI=0.02~9.43)、眼裂闭合不全(OR=10.89,95%CI=5.61~21.13)、眼球暴露(OR=5.73,95%CI=0.41~81.03)、结膜水肿(OR=4.67,95%CI=2.20~9.91)、眶周水肿(OR=5.73,95%CI=0.41~81.03)、眨眼反射≤5次/min(OR=0.99,95%CI=0.01~82.13)、眼表分泌物(OR=11.04,95%CI=2.13~57.30)是ICU发生暴露性角膜炎的影响因素。结论ICU暴露性角膜炎发生率仍然处于较高水平,对入住ICU第5天和使用机械通气第7天的患者进行眼部检查可预防ICU暴露性角膜炎的发生。展开更多
An intelligent security systems engineering approach is used to analyze fire and explosive critical incidents, a growing concern in urban communities. A feed-forward back-propagation neural network models the damages ...An intelligent security systems engineering approach is used to analyze fire and explosive critical incidents, a growing concern in urban communities. A feed-forward back-propagation neural network models the damages arising from these critical incidents. The overall goal is to promote fire safety and sustainable security. The intelligent security systems engineering prediction model uses a fully connected multilayer neural network, and considers a number of factors related to the fire or explosive incident including the type of property affected, the time of day, and the ignition source. The network was trained on a large number of critical incident records reported in Toronto, Canada between 2000 and 2006. Our intelligent security systems engineering approach can help emergency responders by improving cr^tical incident analysis, sustainable security, and fire risk management.展开更多
This paper examines how cybersecurity is developing and how it relates to more conventional information security. Although information security and cyber security are sometimes used synonymously, this study contends t...This paper examines how cybersecurity is developing and how it relates to more conventional information security. Although information security and cyber security are sometimes used synonymously, this study contends that they are not the same. The concept of cyber security is explored, which goes beyond protecting information resources to include a wider variety of assets, including people [1]. Protecting information assets is the main goal of traditional information security, with consideration to the human element and how people fit into the security process. On the other hand, cyber security adds a new level of complexity, as people might unintentionally contribute to or become targets of cyberattacks. This aspect presents moral questions since it is becoming more widely accepted that society has a duty to protect weaker members of society, including children [1]. The study emphasizes how important cyber security is on a larger scale, with many countries creating plans and laws to counteract cyberattacks. Nevertheless, a lot of these sources frequently neglect to define the differences or the relationship between information security and cyber security [1]. The paper focus on differentiating between cybersecurity and information security on a larger scale. The study also highlights other areas of cybersecurity which includes defending people, social norms, and vital infrastructure from threats that arise from online in addition to information and technology protection. It contends that ethical issues and the human factor are becoming more and more important in protecting assets in the digital age, and that cyber security is a paradigm shift in this regard [1].展开更多
文摘BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all.RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure.CONCLUSION: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.
文摘Introduction: A lot of literature is available on critical incidents and near misses but specialty based critical incidents are very scanty. Aim: In this audit, we aimed to report critical incident and near misses during conduct of obstetric anesthesia over a period of two years. Methodology: Critical incident forms were collected, entered, analyzed and categorized on the basis of American Standards Association (ASA), phase of incidents, system involved, and type of errors, outcome and action taken. Human error was further categorized on the basis of their contributing factor marked in form. Results: During the reporting period, 5511 anaesthetics were administered and 55 reports were received out of which 53 reports were included in analysis. Fifty three reports were divided into 33 critical incidents and 20 near misses. Out of 33 critical incidents, 54.5% involved CVS system and musculoskeletal system, followed by neuromuscular (n = 5), drug related (n = 4), airway/respiratory system (n = 2), central nervous system (n = 2) and renal system (n = 1). Forty five incidents possess no untoward effect while 7 led to minor and only one to severe physiological disturbance. Human errors were (n = 30) 57% reports and failure to check was the main contributory factor. Conclusion: Critical incidents reporting needs to be introduced in sub-specialties at departmental, national and international level. Checking of equipment, medication and anesthesia machine must be part of regular checks in elective and emergency cases.
文摘Introduction: Critical incident monitoring is important in quality improvement as it identifies potential risks to patients by analyzing adverse events or near-misses. Methods: This study analyses the reported incidents in a tertiary hospital over a 4-year period. Results: A total of 441 incidents were reported out of 98,502 anesthetics performed during the study period. Of these incidents, 67 resulted in no harm caused, 116 with unanticipated ICU admissions and 20 mortalities. The odds of having a critical incident increased with ASA status: from an odds ratio of 2.08 (95% CI: 1.58 to 2.74) for ASA 2 patients compared to ASA1, to OR of 13.70 (5.91 to 31.74) in ASA 5 compared to ASA 1. Critical incidents also have higher odds occurring out of hours (OR 1.7 (1.45 to 2.23) compared to daytime hours (08:00-17:00). They occurred most commonly in maintenance phase (142, 32.7%), followed by induction (120, 27.6%). The most common types of incidents include airway and respiratory (110, 24.9%) followed by drug related incidents (67, 15.2%). Human error was attributed as a significant contributing factor in 276 incidents (61.5%) followed by patient factors in 112 incidents (25.4%). Mitigating factors such as vigilance by staff involved were significant in 136 incidents (30.3%). Conclusion: Higher ASA status appears to be the most important factor associated with actual or potential patient harm in our study. Also significant, was time of incident, with incidents more likely out of hours. Critical incident reporting is a valuable part of quality assurance. We should continue to invest in incident reporting, incident analysis and improvement plans.
文摘Intercultural literacy is attached increasingly great importance in this interconnected world.People from diversified cultural backgrounds need to interact with each other for various purposes.Schools and organizations offer courses to improve people’s intercultural competence.This paper examines two effective techniques to teach intercultural competence in the classroom setting:critical incident activity and cultural story telling.These two strategies can help achieve the desired objectives of Michael Byram’s intercultural communication model.
文摘The UNHCR 2017 report stated that about 44,400 people are displaced from their homes daily and about 68.5 million people are currently displaced globally. This article aims at critically analyzing the tuberculosis risks among displaced people especially as there is an increase in the number of migrants globally and proliferation of man-made and natural disasters. Research conducted among displaced persons and most of the studies concluded that active surveillance and proper case follow-up are the best ways to ensure adequate tuberculosis case management. In conclusion, the application of diverse methods in tackling tuberculosis risks should be especially through a culturally, acceptable precise and feasible plans without compromising international standards.
文摘Despite the stigma that is associated with law enforcement officers receiving mental health resources and treatment to combat secondary traumatic stress,it is widely the most effective form for recovery and having a fulfilling career.Law enforcement officers are superheroes and,they are known for saving the day.That is why it is critical for mental health offerings to be normalized in law enforcement agencies and constant evaluation of the psychological and cognitive well-being of officers.Unfortunately,the stress of the profession will not go away,but having resources and incentives to address several factors that officers face will assist with their overall feeling about the important work they do.As such,it is recommended that law enforcement agencies adopt programs to treat secondary traumatic stress,such as Critical Incident Stress Debriefing,Peer-Support Program,and Crisis Intervention Team.While there is no perfect program,these programs are designed to reduce the risk of serious injury or death during an emergency interaction between citizens and law enforcement officers.Ultimately,it is the responsibility of those charged with protecting law enforcement officers to understand the stress and how it affects the mind and body of those officers in managing life,work,and citizens.
文摘An intelligent security systems engineering approach is used to analyze fire and explosive critical incidents, a growing concern in urban communities. A feed-forward back-propagation neural network models the damages arising from these critical incidents. The overall goal is to promote fire safety and sustainable security. The intelligent security systems engineering prediction model uses a fully connected multilayer neural network, and considers a number of factors related to the fire or explosive incident including the type of property affected, the time of day, and the ignition source. The network was trained on a large number of critical incident records reported in Toronto, Canada between 2000 and 2006. Our intelligent security systems engineering approach can help emergency responders by improving cr^tical incident analysis, sustainable security, and fire risk management.
文摘This paper examines how cybersecurity is developing and how it relates to more conventional information security. Although information security and cyber security are sometimes used synonymously, this study contends that they are not the same. The concept of cyber security is explored, which goes beyond protecting information resources to include a wider variety of assets, including people [1]. Protecting information assets is the main goal of traditional information security, with consideration to the human element and how people fit into the security process. On the other hand, cyber security adds a new level of complexity, as people might unintentionally contribute to or become targets of cyberattacks. This aspect presents moral questions since it is becoming more widely accepted that society has a duty to protect weaker members of society, including children [1]. The study emphasizes how important cyber security is on a larger scale, with many countries creating plans and laws to counteract cyberattacks. Nevertheless, a lot of these sources frequently neglect to define the differences or the relationship between information security and cyber security [1]. The paper focus on differentiating between cybersecurity and information security on a larger scale. The study also highlights other areas of cybersecurity which includes defending people, social norms, and vital infrastructure from threats that arise from online in addition to information and technology protection. It contends that ethical issues and the human factor are becoming more and more important in protecting assets in the digital age, and that cyber security is a paradigm shift in this regard [1].
