lunes, 30 de septiembre de 2024
domingo, 29 de septiembre de 2024
Factors influencing the reporting of medication errors and near misses among nurses: a systematic mixed methods review. September 25, 2024
https://psnet.ahrq.gov/issue/factors-influencing-reporting-medication-errors-and-near-misses-among-nurses-systematic-mixed
Factors influencing the reporting of medication errors and near misses among nurses: a systematic mixed methods review.
Braiki R, Douville F, Gagnon M‐P. Int J Nurs Pract. 2024;Epub Sep 3.
Underreporting of adverse events and near misses results in incomplete data for patient safety improvement efforts. This review sought to identify factors contributing to nurses' decisions to report medication errors and near misses. The main factor contributing to decision-to-report is the expected reaction of superiors, colleagues, and patients. Fear of retaliation or poor grades prevented reporting by nurses and nursing students, respectively.
Stop the line: interventions to prevent retained surgical items. September 25, 2024
https://psnet.ahrq.gov/issue/stop-line-interventions-prevent-retained-surgical-items
Stop the line: interventions to prevent retained surgical items.
Angelilli S. AORN J. 2024;120(2):71-81.
Retained surgical items (RSI) are a never event. This article describes implementation of an evidence-based improvement project to reduce RSI and increase reporting of RSI near misses. An important aim was to improve teamwork and assertive communication between operating room (OR) team members, which was achieved through use of the TeamSTEPPS program. Change in staff attitudes about teamwork was measured using the Teamwork Attitudes Questionnaire, which showed improved perceived teamwork.
What is safety leadership? A systematic review of definitions. September 25, 2024
https://psnet.ahrq.gov/issue/what-safety-leadership-systematic-review-definitions
What is safety leadership? A systematic review of definitions.
Adra I, Giga S, Hardy C, et al. J Safety Res. 2024;90:181-191.
Leadership commitment to safety strongly influences staff commitment to safety. This review sought to identify definitions and themes of "safety leadership." Three themes were derived from the definitions: 1) safety leadership improves safety performance; 2) safety leaders lead by influence and example, not authority; and 3) safety leadership can be practiced by leaders at all levels of the organization. Transformational and transactional leadership formed the foundation for many definitions, though the authors advise adopting multiple forms of leadership styles. The authors propose that future research focus on the relationship between leadership style and safety climate.
sábado, 28 de septiembre de 2024
'Diagnosis: Debt' series
Diagnosis: Debt
More than 100 million people in America — a startling 41% of adults — are saddled with medical bills they cannot pay, according to a KFF Health News investigation with NPR and CBS News. The project exposed that medical debt — rather than fighting disease — is now a defining feature of the nation’s health care system.
https://kffhealthnews.org/diagnosis-debt/?utm_campaign=KHN%20-%20Weekly%20Edition&utm_medium=email&_hsenc=p2ANqtz-9Ts8H6Gj-3g-V-yIoFnBKrUGJgkb35IXFw3d8bsN4EpLPVI-g5ErqxG-5x3Hn0pfGstpHpVc-uinpSuALJFeRYLnboQQ&_hsmi=326616596&utm_content=326616596&utm_source=hs_email
Bill of the Month
This crowdsourced investigation by KFF Health News dissects and explains your medical bills every month in order to shed light on U.S. health care prices and to help patients learn how to be more active in managing costs.
https://kffhealthnews.org/news/tag/bill-of-the-month/?utm_campaign=KHN%20-%20Weekly%20Edition&utm_medium=email&_hsenc=p2ANqtz--YVx-r42fGf2-ycoNe18K6xM0qZhAAzMRd8J6pF3Kh1QG1_Q1we_nmBdRzDJsLmcB-UmR-uHZGCJ_e_7mmN5rFxEBPYQ&_hsmi=326616596&utm_content=326616596&utm_source=hs_email
In Chronic Pain, This Teenager ‘Could Barely Do Anything.’ Insurer Wouldn’t Cover Surgery. By Lauren Sausser September 25, 2024
https://kffhealthnews.org/news/article/cpt-code-missing-sports-hernia-repair-september-bill-of-the-month/?utm_campaign=KHN%20-%20Weekly%20Edition&utm_medium=email&_hsenc=p2ANqtz-8WVO5wd7NFzF-JTL9lJXbMle4GbcAV31No_JVC8RmWyjQskJh1ERtg--oz4cbqWA2BixltOw_nW2mOp_-1BQw-cZwb9Q&_hsmi=326616596&utm_content=326616596&utm_source=hs_email
In Chronic Pain, This Teenager ‘Could Barely Do Anything.’ Insurer Wouldn’t Cover Surgery.
By Lauren Sausser
An Alabama teen was told he needed surgery for debilitating hip pain. But his family’s insurer denied coverage for the procedure, which lacked a medical billing code. Expected to pay more than $7,000, his father charged it to credit cards.
Enhanced Risk Assessment for Cardiovascular Disease: Coronary Artery Calcium Scoring September 26, 2024
Breastfeeding and Health Outcomes for Infants and Children
Breastfeeding and Health Outcomes for Infants and Children: The purpose of this systematic review is to provide a synthesis of the current evidence on the association between breastfeeding and the consumption of human milk and a range of health outcomes in infants and children. The review focused specifically on outcomes among infants born at term and in developed countries. The systematic review was nominated by the Centers for Disease Control and Prevention (CDC) to inform their program development activities. The intended audience includes guideline developers, maternal and infant health programmatic leaders, research funders and researchers, and clinicians who provide care to persons planning to become parents or expecting a birth.
Evidence Map on Home and Community-Based Services and Person-Centered Care for Older Adults
Evidence Map on Home and Community-Based Services and Person-Centered Care for Older Adults: This Technical Brief provides an evidence map that summarizes service categories of HCBS and describes the research on the interventions and populations have been studied and quality measures proposed for HCBS. This Technical Brief also identifies gaps in the evidence base.
Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: 2024 Update of the Evidence Base for the PTSD Trials Standardized Data Repository
Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: 2024 Update of the Evidence Base for the PTSD Trials Standardized Data Repository: The overarching purpose of this project is to identify randomized controlled trials (RCTs) of PTSD interventions for adults and abstract detailed, standardized data into evidence tables. This work is designed to provide a broad range of stakeholders with up-to-date, comprehensive data on PTSD treatment research.
Healthcare Delivery of Clinical Preventive Services for People With Disabilities
Healthcare Delivery of Clinical Preventive Services for People With Disabilities: The purpose of this systematic review was: (1) to document and summarize reported barriers and facilitators to the receipt of selected preventive services among people with disabilities, and (2) to identify and synthesize the literature on the effectiveness of interventions to improve receipt of preventive services among people with disabilities.
Behavioral Interventions for Migraine Prevention
Behavioral Interventions for Migraine Prevention: For this review, behavioral interventions were defined as nonpharmacologic strategies intended to enhance outcomes by modifying behavior and/or ways of thinking. The Agency for Healthcare Research and Quality (AHRQ), AHS, and the Patient-Centered Outcome Research Institute (PCORI) collaborated to conceive this systematic review. The review will be used by members of AHS to inform decisions about a clinical practice guideline.
Diagnostic Excellence in U.S. Rural Healthcare: A Call to Action
Diagnostic Excellence in U.S. Rural Healthcare: A Call to Action: This issue brief explores several critical challenges affecting diagnostic excellence in U.S. rural healthcare settings.
viernes, 27 de septiembre de 2024
Interrogating and uprooting systemic racism in the emergency department. September 25, 2024
Interrogating and uprooting systemic racism in the emergency department.
September 25, 2024
https://psnet.ahrq.gov/issue/interrogating-and-uprooting-systemic-racism-emergency-department
Sepsis Awareness Month 2024 Last Updated: September 24, 2024 Created By: AHRQ
https://psnet.ahrq.gov/curated-library/sepsis-awareness-month-2024
September is Sepsis Awareness Month! Explore the PSNet Sepsis Curated Library to explore cases on sepsis and learn about how organizations are working to prevent it.
System Approaches to Social Determinants of Health Screening and Intervention Innovation Summary September 23, 2024
https://psnet.ahrq.gov/innovation/system-approaches-social-determinants-health-screening-and-intervention-innovation
System Approaches to Social Determinants of Health Screening and Intervention Innovation Summary
UNC Health sought to intervene before poor health outcomes arise due to social determinants of health. They created an innovative screening program with a focus on four high priority SDOH domains: food insecurity, housing stability, financial resource strain, and transportation that was implemented in their primary care practices. In 2021 and 2022, UNC Health screened 250,000 patients for at least one of the four priority domains and 1,600 individuals were referred to UNC Health’s newly established community health team health to connect them to community resources and supports.
Zero Harm: Striving to Reduce Preventable Harms – Point, Counterpoint, and Areas of Agreement Carole Stockmeier, MHA, BS, Eric Thomas, MD, MPH, Merton Lee, PharmD, PhD, Sarah E. Mossburg, RN, PhD | September 24, 2024
https://psnet.ahrq.gov/perspective/zero-harm-striving-reduce-preventable-harms-point-counterpoint-and-areas-agreement
Zero Harm: Striving to Reduce Preventable Harms – Point, Counterpoint, and Areas of Agreement
In this point/counterpoint/agreement perspective essay, we discuss the concept of zero harm as it relates to patient safety. The goal of zero harm is to eliminate preventable harm related to healthcare. Critics suggest this goal is impossible and may create incentives to hide harms and further a culture of blame and shame. Proponents may agree that the goal looks impossible and believe that seeking an apparently impossible goal may lead to unprecedented improvements in safety.
Hypoxic Gas Supply from Cross-Connected Pipelines Christian Bohringer, MBBS, Adam Guemidjian, and Garth Utter, MD, MSc | September 25, 2024
https://psnet.ahrq.gov/web-mm/hypoxic-gas-supply-cross-connected-pipelines
Hypoxic Gas Supply from Cross-Connected Pipelines
In this WebM&M Case, an 8-year-old boy undergoing a neck mass aspiration experienced a sudden drop in oxygen saturation and heart rate, requiring CPR and intubation, due to being administered nitrous oxide instead of oxygen following a maintenance error by an inadequately trained employee. The patient was transferred to the intensive care unit (ICU) on a ventilator but remained unresponsive and died. The commentary discusses several approaches to improving patient safety during anesthesia administration in the surgical suite, such as use of oxygen analyzers and considering hypoxic gas mixture as the cause for sudden deterioration.
Errors in Managing an Open Wound of the Elbow Leading to Multiple Complications and Operations David K. Barnes, MD, FACEP and Garth Utter, MD, MSc, FACS | September 25, 2024
https://psnet.ahrq.gov/web-mm/errors-managing-open-wound-elbow-leading-multiple-complications-and-operations
Errors in Managing an Open Wound of the Elbow Leading to Multiple Complications and Operations
In this WebM&M Spotlight Case with CE/MOC, a man presented at the emergency department (ED) after a motorcycle crash. He had superficial lacerations on his left elbow, where wood chips were noted on exam and x-ray but were not fully removed before discharge. He was discharged with antibiotic prescriptions, but returned three days later with worsening symptoms, including pain, swelling, and pus, leading to additional foreign material being removed and further antibiotic treatment, but without repeat x-rays. Ultimately, he developed osteomyelitis, requiring multiple surgeries and a long hospital stay due to the retained foreign bodies. The commentary highlights the importance of evaluating patient risk of wound infection and poor wound healing, the role of imaging modalities to help identify foreign material in wounds, and diligent follow-up to prevent complications.
jueves, 26 de septiembre de 2024
National Academies Report Provides Goals to Improve Healthcare for Children, Youth, and Families
https://nap.nationalacademies.org/resource/27835/Healthcare_Report_Highlights.pdf
A new report from the National Academies of Sciences, Engineering and Medicine explores how to better meet all children's needs and leverage community support by rethinking healthcare financing, public health investment, community partnerships, and accountability. Despite advances in healthcare, children—especially those from historically marginalized groups—face rising rates of chronic diseases, obesity, and mental health challenges. AHRQ was a co-sponsor of the report, which highlights goals and recommendations for equitable child and adolescent healthcare:
Elevate the importance of child and adolescent health through continuous public focus on children and youth.
Finance health systems for all children, emphasizing prevention and health promotion.
Strengthen community-level health promotion and disease prevention.
Ensure co-creation and co-design of programs and structures with youth, family and community voices, and leadership.
Implement measurement and accountability to ensure equitable goal achievement.
Introducing the CAHPS Outpatient Mental Health Survey (Webcast)
Introducing the CAHPS Outpatient Mental Health Survey (Webcast): This webcast from AHRQ’s CAHPS® program focuses on the purpose and design of the new Outpatient Mental Health Survey.
Toolkit for Engaging Patients To Improve Diagnostic Safety
Toolkit for Engaging Patients To Improve Diagnostic Safety: This toolkit is designed to help patients, families, and health professionals work together as partners to improve diagnostic safety.
miércoles, 25 de septiembre de 2024
Webinar, Sept. 27: Technical Assistance for AHRQ Healthcare Extension Service Cooperative Applicants
Webinar, Sept. 27: Technical Assistance for AHRQ Healthcare Extension Service Cooperative Applicants: Sept. 27: Technical Assistance for AHRQ Healthcare Extension Service Cooperative Applicants
AHRQ Summit to Address Emergency Department Boarding
https://www.hhs.gov/live/index.html
An AHRQ summit on Oct. 8 from 9 a.m. to 1 p.m. ET will address the challenges of emergency department (ED) boarding. The live stream webcast will be aimed at identifying hospital- and health system-level solutions to circumstances that sometimes force patients to spend hours—or in some cases, days—in the ED while waiting for an inpatient bed or transfer to another facility. Interested audiences may include patients and consumers, clinicians, hospital and health system leaders, policy makers, experts in emergency medicine, community health, behavioral health, and specialty care providers. Brendan G. Carr, M.D., M.A., chief executive officer of Mount Sinai Health System, will be the featured speaker. The summit will also include a panel on the impacts of ED boarding and a session on “myths and matters” of ED boarding solutions.
The Patient’s Role in Diagnostic Safety and Excellence: From Passive Reception Toward Co-Design
The Patient’s Role in Diagnostic Safety and Excellence: From Passive Reception Toward Co-Design: Poor communication between medical professionals and patients is a key factor in all diagnostic error. Enhancing communication between patients and their healthcare team is central to improving diagnostic quality in healthcare delivery.
Shaping the Future of Patient Empowerment and Care Delivery Through Digital Healthcare Research
Shaping the Future of Patient Empowerment and Care Delivery Through Digital Healthcare Research: The newly released 2023 year-in-review report, Improving Healthcare Through AHRQ’s Digital Healthcare Research, showcases AHRQ-funded studies and projects focused on digital technologies that engage and empower patients and optimize and advance care delivery.
martes, 24 de septiembre de 2024
Workshop on Integration Site Analysis During Long Term Follow-Up for Gene Therapies with Integrating Viral Vectors November 14, 2024
https://www.fda.gov/news-events/otp-events-meetings-and-workshops/workshop-integration-site-analysis-during-long-term-follow-gene-therapies-integrating-viral-vectors?utm_medium=email&utm_source=govdelivery
What’s New for Biologics
Latest News from the Center for Biologics Evaluation and Research at FDA
https://www.fda.gov/vaccines-blood-biologics/news-events-biologics/whats-new-biologics?utm_medium=email&utm_source=govdelivery
lunes, 23 de septiembre de 2024
domingo, 22 de septiembre de 2024
What the 2024 Election Could Mean for Health Coverage, Affordability, and the Budget Fecha y hora1 oct 2024 01:00 p. m.
https://kff-org.zoom.us/webinar/register/6016575551704/WN_O_W7QXgCR2CCJdzDRdEf5Q?utm_campaign=KFF-This-Week&utm_medium=email&_hsenc=p2ANqtz-8ImYf6GpNRcUglt4XesMJ4C2NSKXrrgSVCGluzvDNjWGsDvGzECvxWGHhDs9BdP6jKuNcm_1dhkgMZl4ZNNVkv3XUODw&_hsmi=325561540&utm_content=325561540&utm_source=hs_email#/registration
UPCOMING EVENT: What the 2024 Election Could Mean for Health Coverage, Affordability, and the Budget
As the 2024 presidential election draws near, there are sharp differences in former President Trump’s and Vice President Harris’ records on health coverage and spending. At Noon ET on Tuesday, October 1, join a 45-minute discussion with veteran health policy advisors to explore the election’s potential impact on these issues.
sábado, 21 de septiembre de 2024
Basic Safety and Essential Performance of Medical Electrical Equipment, Medical Electrical Systems, and Laboratory Medical Equipment - Standards Specific Information for the Accreditation Scheme for Conformity Assessment (ASCA) Program Draft Guidance for Industry, Accreditation Bodies, Testing Laboratories, and Food and Drug Administration Staff
viernes, 20 de septiembre de 2024
AHRQ's Healthcare Extension Service: State-Based Solutions to Healthcare Improvement
AHRQ's Healthcare Extension Service: State-Based Solutions to Healthcare Improvement: The Agency for Healthcare Research and Quality (AHRQ) intends to publish a funding opportunity announcement to create State-based Healthcare Extension Cooperatives that can accelerate the implementation of actionable evidence into practice.
Diagnostic Safety Centers of Excellence
Diagnostic Safety Centers of Excellence: In fiscal year 2022, Congress authorized funding to support AHRQ's research to address failures in the diagnostic process, which may include the establishment of Research Centers of Diagnostic Excellence to develop systems, measures, and new technology solutions to improve diagnostic safety and quality. In response, AHRQ awarded 10 grants to establish Diagnostic Safety Centers of Excellence.
An Assessment of Sepsis in the United States and Its Burden on Hospital Care
An Assessment of Sepsis in the United States and Its Burden on Hospital Care: This report offers a comprehensive assessment of hospital care for sepsis in the United States. It begins with an overview of the Congress's directive in the Fiscal Year 2023 Omnibus Spending Bill, then provides background on sepsis, including causes, disease progression, comorbidities, risk factors, complications, and treatment.
Perceptions of hospital electronic health record (EHR) training, support, and patient safety by staff position and tenure. September 18, 2024
https://psnet.ahrq.gov/issue/perceptions-hospital-electronic-health-record-ehr-training-support-and-patient-safety-staff
Perceptions of hospital electronic health record (EHR) training, support, and patient safety by staff position and tenure.
Campione JR, Liu H. BMC Health Serv Res. 2024;24(1):955.
Electronic health record (EHR) design and usability can affect patient safety. This study used data from the 2017 AHRQ Surveys on Patient Safety Culture® (SOPS®) Hospital Survey Version 1.0 Database and the SOPS Health Information Technology Patient Safety Supplemental Items to assess staff perceptions of EHR safety and usability by staff position and tenure. Pharmacists gave more unfavorable scores to EHR usability compared to nurses. Staff who were employed less than one year were more likely to report worse EHR training, and those employed more than 10 years were most dissatisfied with the EHR overall.
ROI for a fall prevention intervention: invest a little, save a lot. September 18, 2024
https://psnet.ahrq.gov/issue/roi-fall-prevention-intervention-invest-little-save-lot
ROI for a fall prevention intervention: invest a little, save a lot.
Cooper AS. Nurs Adm Q. 2024;48(3):248-252.
Falls and falls with injury are significant sources of morbidity and mortality and can have substantial negative impact on organizational finances. Fall Tailoring Interventions for Patient Safety (Fall TIPS) is an evidence-based program that engages patients in their own fall prevention program. This study showed that after implementing the Fall TIPS program, falls and falls with injury decreased in several hospital units resulting in a return on investment of $982,700.
Assessing between- and within-hospital differences in patient safety between Medicaid and privately insured hospital patients. September 18, 2024
https://psnet.ahrq.gov/issue/assessing-between-and-within-hospital-differences-patient-safety-between-medicaid-and
Assessing between- and within-hospital differences in patient safety between Medicaid and privately insured hospital patients.
Gangopadhyaya A. J Patient Saf. 2024;Epub Aug 2024.
Patients from disadvantaged groups (e.g., patients of color, low income, non-English speaking) experience poorer medical outcomes. This study used hospital discharge data from nearly 2.1 million discharges for Medicaid and privately insured patients. Patients with Medicaid were more likely to be younger, Black or Hispanic, living in low-income neighborhoods, and have more comorbidities than patients with private insurance. When compared with privately insured patients, Medicaid patients experienced significantly higher rates of pressure injuries, catheter-related infections, and six-out-of-seven surgery-related safety indicators. This held true when adjusted for patient demographics, comorbidities, and location.
jueves, 19 de septiembre de 2024
Ownership of Practices
Ownership of Practices: The Compendium of U.S. Health Systems now includes data on ownership of healthcare practices. The visualization allows filtering by state to show the proportions of practices that are corporate owned, owned by integrated delivery networks, and independent.
Comparative Health System Performance Initiative
Comparative Health System Performance Initiative: AHRQ created the Comparative Health System Performance Initiative to study how health care delivery systems promote evidence-based practices in delivering care.
This final guidance provides recommendations for sponsors, investigators, and other interested community members regarding the implementation of clinical trials with decentralized elements. Decentralized elements allow trial-related activities to occur remotely at locations convenient for trial participants.
https://www.fda.gov/regulatory-information/search-fda-guidance-documents/considerations-generating-clinical-evidence-oncology-multiregional-clinical-development-programs?utm_medium=email&utm_source=govdelivery
Submit comments by November 18, 2024
The FDA issued a draft guidance for industry that, when finalized, will provide sponsors with recommendations for conducting multiregional clinical trials (MRCT) in support of applications for drugs intended to treat cancer. An MRCT is a trial that is conducted in more than one region under a single protocol, with region defined as a geographical region, country, or regulatory region.
Conducting Clinical Trials With Decentralized Elements September 2024
https://www.fda.gov/regulatory-information/search-fda-guidance-documents/conducting-clinical-trials-decentralized-elements?utm_medium=email&utm_source=govdelivery
This final guidance provides recommendations for sponsors, investigators, and other interested community members regarding the implementation of clinical trials with decentralized elements. Decentralized elements allow trial-related activities to occur remotely at locations convenient for trial participants.
Integrating Randomized Controlled Trials for Drug and Biological Products Into Routine Clinical Practice Draft Guidance for Industry September 2024
https://www.fda.gov/regulatory-information/search-fda-guidance-documents/integrating-randomized-controlled-trials-drug-and-biological-products-routine-clinical-practice?utm_medium=email&utm_source=govdelivery
Submit comments by December 17, 2024
The FDA issued this draft guidance to provide recommendations about how clinical trials can be moved into clinical practice settings. Also known as "point of care trials," these trials, like decentralized clinical trials, aim to bring trial-related activities to more convenient locations for patients. They may improve convenience and accessibility for participants and allow for enrollment of more representative populations, resulting in more generalizable trial results.
AHRQ's Healthcare Extension Service: State-Based Solutions to Healthcare Improvement
AHRQ's Healthcare Extension Service: State-Based Solutions to Healthcare Improvement: The Agency for Healthcare Research and Quality (AHRQ) intends to publish a funding opportunity announcement to create State-based Healthcare Extension Cooperatives that can accelerate the implementation of actionable evidence into practice.
miércoles, 18 de septiembre de 2024
Biometric data from smartwatches might predict COVID-19 | Drug Discovery News
Biometric data from smartwatches might predict COVID-19 | Drug Discovery News: A bioengineer mines the biometric data from smartwatches and smartphones to find digital biomarkers for respiratory infections like COVID-19.
Detecting disease with smartphone screens | Drug Discovery News
Detecting disease with smartphone screens | Drug Discovery News: To dismantle healthcare barriers in low-resource areas, researchers measure the color signatures of jaundice and anemia using a device that’s in everyone’s pocket.
How the immune system destroys cancer drugs | Drug Discovery News
How the immune system destroys cancer drugs | Drug Discovery News: Natural killer cells can sometimes attack beneficial CAR T cell immunotherapies. Now, researchers have discovered why and a potential way to stop them.
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