Статті в журналах: "Safety outcome"

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Easter, Kathy, and Linda M. Tamburri. "Understanding Patient Safety and Quality Outcome Data." Critical Care Nurse 38, no. 6 (December 1, 2018): 58–66. http://dx.doi.org/10.4037/ccn2018979.

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The need for nurses to understand patient safety and quality outcome data is pressing in the current era of data transparency. Health care outcomes data are now publicly reported and readily accessible to consumers, are necessary for performance-based reimbursement, and are required by government and regulatory agencies. In order for nurses at all levels of practice to own their outcomes and be accountable for making improvements, they must possess skills in collecting, analyzing, evaluating, and acting on outcome data. This article provides basic tools and clinical examples for nurses to use in a focused application of outcome data and a structured process for improving nursing care outcomes.

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Hicks, Gemma, Donna Buttigieg, and Helen De Cieri. "Safety climate, strain and safety outcomes." Journal of Management & Organization 22, no. 1 (December 7, 2015): 19–31. http://dx.doi.org/10.1017/jmo.2015.45.

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AbstractThe purpose of this study is to employ Koeske and Koeske’s stressor-strain-outcome model of stress to examine the extent to which strain, a central component of occupational stress, mediates the relationship between safety climate and safety-related outcomes. The relationship between safety climate, strain and safety outcomes has been relatively under tested where strain is a mediating variable. This study makes a contribution to the literature by examining the dynamics of these relationships. Questionnaires were sent to 1,800 employees of an electricity provider, with a 41.4% response rate. The hypothesized model was tested using structural equation modeling. Analysis of the hypothesized model indicated that, while safety climate had a significant direct relationship with safety-related behaviors, the model was also partially mediated by the experience of strain. Understanding the relationship between safety climate, strain and safety outcomes is important. Support for the model verifies that safety climate is mediated by strain in terms of safety outcomes. Practical implications include the need to manage safety climate through management attitudes to safety, maintaining high safety standards and communication to reduce ambiguity on safety norms.

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Dinesh, H. N., Ravya R. S., and Sunil Kumar V. "Surgical safety checklist implementation and its impact on patient safety." International Surgery Journal 5, no. 11 (October 26, 2018): 3640. http://dx.doi.org/10.18203/2349-2902.isj20184637.

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Background: Surgery has become an integral part of global health care, with an estimated 234 million operations performed yearly. Surgical complications are common and often preventable. Although surgical and anesthetic caregivers seek to deliver optimal quality in peri-operative service, surgery still carries considerable risk for the patient. WHO surgical safety checklist outlines essential standards of surgical care and has been shown to reduce complications and death associated with surgery.Methods: Pre-intervention and post-intervention study. The effect on patient outcomes and documentation of WHO surgical safety checklist was examined. After an education programme, the checklist implementation and patient safety outcome indicators were studied.Results: Checklist compliance increased over time. The median number of items documented was 16. After implementation of the checklist, mortality decreased from 3.13% to 2.85%. Most causes of death did not significantly differ between the implementation periods, except for multiorgan failure and major bleeding. Adjustment of the association between implementation period and outcome for all variables revealed a decreased mortality after checklist implementation.Conclusions: Implementation of the checklist showed improved outcomes. Use of the WHO surgical safety checklist in urgent operations is feasible and should be considered. Implementation proved neither costly nor lengthy. Further research is needed to confirm these findings and reveal additional factors supportive of checklist implementation.

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Abdul Kadir, A. Z., Jafri Mohd Rohani, and Matthew Oluwole Arowolo. "Road Safety Outcome Model among Commercial Bus." Advanced Materials Research 1125 (October 2015): 546–50. http://dx.doi.org/10.4028/www.scientific.net/amr.1125.546.

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Road safety outcome is a complex issue involving high number of risk factors and indicators that contributes to road accidents and their severity related to human-vehicle–road interactions. This requires a multi-dimensional model in order to fully understand the road safety situation especially among commercial bus drivers. This study identified some of the risk factors with the objective of establishing the relationship between them through a model for assessing the road safety outcome. The model was developed using data collected from 465 commercial bus drivers in Johor, Malaysia. The estimated model yielded significant relationship between the risk factors (Drivers, Vehicle and Road) and road safety outcomes. The statistical analysis of these risk factors shows that the model has significant fit to the data. The results therefore, yielded a road safety output guideline formula suitable for road safety performance indicator for safety practitioners and stakeholders. The study pointed out three critical risk factors (e.g. Drivers, Vehicle and Road) with their various levels of risk contributions as influence on road safety among commercial bus. Six recommendations based on this finding were made in an attempt to reduce commercial bus accidents.

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Lee, Seung Eun, and Brenna L. Quinn. "Safety Culture and Patient Safety Outcomes in East Asia: A Literature Review." Western Journal of Nursing Research 42, no. 3 (May 23, 2019): 220–30. http://dx.doi.org/10.1177/0193945919848755.

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This review examined associations between safety culture aspects and patient safety outcomes in East Asian hospitals and identified relevant research priorities. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, 16 articles were identified for review. Patient safety nursing activity was the most commonly investigated outcome in relation to safety culture aspects. Among safety culture aspects, feedback and communication, frequency of event reporting, teamwork within units, and managers’ support for patient safety were most significantly related to patient safety outcomes. Areas for further research include the use of theory or theoretical frameworks, consensus upon the scoring strategies for computation of safety culture scores, and selecting appropriate units of analysis and statistical analyses. Finally, researchers should examine relations between unit-specific and nation-specific safety culture and patient safety outcomes, given the influence of cultural attitudes and behaviors on patient safety.

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de Vries, Friso, Daniel J. Lobatto, Marco J. T. Verstegen, Pieter J. Schutte, Irene C. Notting, Mark C. Kruit, S. Faisal Ahmed, Alberto M. Pereira, Wouter R. van Furth, and Nienke R. Biermasz. "Outcome Squares Integrating Efficacy and Safety, as Applied to Functioning Pituitary Adenoma Surgery." Journal of Clinical Endocrinology & Metabolism 106, no. 9 (March 6, 2021): e3300-e3311. http://dx.doi.org/10.1210/clinem/dgab138.

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Abstract Context Transsphenoidal surgery is standard care in the treatment of hormone-secreting pituitary adenomas. Current clinician-reported surgical outcome measures are one-dimensional, typically focusing primarily on complete or partial resection, and secondarily on complication rates. However, outcomes are best reflected by the delicate balance of efficacy and complications at patient level. Objective This study proposes a novel way to classify and report outcomes, integrating efficacy and safety at the patient level. Methods Retrospective chart review of all pure endoscopic transsphenoidal surgical procedures for acromegaly, Cushing’s disease, and prolactinoma between 2010 and 2018 in a single tertiary referral center. We present our results in a classic (remission and complications separate) and in a novel outcome square integrating both outcomes, focusing on intended and adverse effects (long-term complications). This resulted in 4 outcome groups, ranging from good to poor. We use this approach to present these outcomes for several subgroups. Results A total of 198 surgical procedures were included (44 reoperations). Remission was achieved in 127 operations (64%). Good outcome was observed after 121 (61%), and poor outcome after 6 (3%) operations. When intended effect of surgery was applied (instead of remission), good outcome as intended was achieved after 148 of 198 surgeries (75%) and poor outcome after 4 (2%). Conclusion Quality of a surgical intervention can be presented in 4 simple categories, integrating both efficacy and safety with flexibility to adapt to the individualized situation at patient, disease, and surgical strategy and to the outcome of interest.

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Collares, Felipe Birchal, Mehru Sonde, Kenneth Harper, Michael Armitage, Diana L. Neuhardt, and Helane S. Fronek. "Patient safety in phlebology: The ACP Phlebology Safety Checklist." Phlebology: The Journal of Venous Disease 33, no. 4 (February 23, 2017): 273–77. http://dx.doi.org/10.1177/0268355517694725.

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Objectives To assess the current use of safety checklists among the American College of Phlebology (ACP) members and their interest in implementing a checklist supported by the ACP on their clinical practices; and to develop a phlebology safety checklist. Method Online surveys were sent to ACP members, and a phlebology safety checklist was developed by a multispecialty team through the ACP Leadership Academy. Results Forty-seven percent of respondents are using a safety checklist in their practices; 23% think that a phlebology safety checklist would interfere or disrupt workflow; 79% answered that a phlebology safety checklist could improve procedure outcomes or prevent complications; and 85% would be interested in implementing a phlebology safety checklist approved by the ACP. Conclusion A phlebology safety checklist was developed with the intent to increase awareness on patient safety and improve outcome in phlebology practice.

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Zhu, Motao, Susan B. Hardman, and Lawrence J. Cook. "Backseat safety belt use and crash outcome." Journal of Safety Research 36, no. 5 (January 2005): 505–7. http://dx.doi.org/10.1016/j.jsr.2005.10.014.

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Traboulsee, Anthony L., Lindsay Machan, J. Marc Girard, Jean Raymond, Reza Vosoughi, Brian W. Hardy, Francois Emond, et al. "Safety and efficacy of venoplasty in MS." Neurology 91, no. 18 (September 28, 2018): e1660-e1668. http://dx.doi.org/10.1212/wnl.0000000000006423.

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ObjectiveTo determine the safety and efficacy of balloon vs sham venoplasty of narrowing of the extracranial jugular and azygos veins in multiple sclerosis (MS).MethodsPatients with relapsing or progressive MS were screened using clinical and ultrasound criteria. After confirmation of >50% narrowing by venography, participants were randomized 1:1 to receive balloon or sham venoplasty of all stenoses and were followed for 48 weeks. Participants and research staff were blinded to intervention allocation. The primary safety outcome was the number of adverse events (AEs) during 48 weeks. The primary efficacy outcome was the change from baseline to week 48 in the patient-reported outcome MS Quality of Life–54 (MSQOL-54) questionnaire. Standardized clinical and MRI outcomes were also evaluated.ResultsOne hundred four participants were randomized (55 sham; 49 venoplasty) and 103 completed 48 weeks of follow-up. Twenty-three sham and 21 venoplasty participants reported at least 1 AE; one sham (2%) and 5 (10%) venoplasty participants had a serious AE. The mean improvement in MSQOL-54 physical score was +1.3 (sham) and +1.4 (venoplasty) (p = 0.95); MSQOL-54 mental score was +1.2 (sham) and −0.8 (venoplasty) (p = 0.55).ConclusionsOur data do not support the continued use of venoplasty of extracranial jugular and/or azygous venous narrowing to improve patient-reported outcomes, chronic MS symptoms, or the disease course of MS.ClinicalTrials.gov identifierNCT01864941.Classification of evidenceThis study provides Class I evidence that for patients with MS, balloon venoplasty of extracranial jugular and azygous veins is not beneficial in improving patient-reported, standardized clinical, or MRI outcomes.

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Vergeire-Dalmacion, Godofreda. "The Safety of Dengvaxia and Should Hospitalization be an Outcome for its Clinical Trial?" Pharmaceutics and Pharmacology Research 1, no. 1 (October 8, 2018): 01–02. http://dx.doi.org/10.31579/2693-7247/003.

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The uncertainties on the efficacy and safety of Dengvaxia continue to haunt doctors, parents, and lawmakers alike in the Philippines. After the mass immunization of about 850,000 children with Dengvaxia, there has been a continuing report of deaths, unofficially 29 to date among those who received the vaccine between 2016-2017. Countries in the Asia Pacific region, including the Philippines, were one of the sites for the Dengvaxia Clinical Trial. In 2014, the Efficacy Trial of Dengvaxia covering the period after completion of the 3 doses up to the 28th day was published by Capeding, et al. An overall efficacy rate of 56.5% was reported but it can be misleading since the efficacy rates for each serotype varied widely. The uncertainties on the efficacy and safety of Dengvaxia continue to haunt doctors, parents, and lawmakers alike in the Philippines. After the mass immunization of about 850,000 children with Dengvaxia, there has been a continuing report of deaths, unofficially 29 to date among those who received the vaccine between 2016-2017. Countries in the Asia Pacific region, including the Philippines, were one of the sites for the Dengvaxia Clinical Trial. In 2014, the Efficacy Trial of Dengvaxia covering the period after completion of the 3 doses up to the 28th day was published by Capeding, et al. An overall efficacy rate of 56.5% was reported but it can be misleading since the efficacy rates for each serotype varied widely. The uncertainties on the efficacy and safety of Dengvaxia continue to haunt doctors, parents, and lawmakers alike in the Philippines. After the mass immunization of about 850,000 children with Dengvaxia, there has been a continuing report of deaths, unofficially 29 to date among those who received the vaccine between 2016-2017. Countries in the Asia Pacific region, including the Philippines, were one of the sites for the Dengvaxia Clinical Trial. In 2014, the Efficacy Trial of Dengvaxia covering the period after completion of the 3 doses up to the 28th day was published by Capeding, et al. An overall efficacy rate of 56.5% was reported but it can be misleading since the efficacy rates for each serotype varied widely.

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Alruways, Naif Hezam Fahad, Geza Abdulah AlAlwey, Ahmad Rayan Alfuraydi, Suliman Ali Alhussain, Nasser Ibrahim Aleidi, Adel Abdulah Aldukhil, Mohammed Nasser algdairy, Talal Saad Almutoua, Moteb Khaled Aldhwyan, and Satam awed al harbi. "The Future of Healthcare Quality and Safety." International Journal Of Pharmaceutical And Bio-Medical Science 02, no. 12 (December 16, 2022): 646–51. http://dx.doi.org/10.47191/ijpbms/v2-i12-11.

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A Health Care Organization (HCO) is by definition a complex organization due to the intangible outcome of service and a mix of diverse professional personnel. Healthcare quality management is a critical requirement in the health sector. Quality principles have always been present in health care. However, quality is not a physical characteristic of a service. The use of the term "Health Care Service" rather than "Medical Care" further defines the field and positions it as an entity that can be assessed, monitored, and improved. A quality healthcare system is "accessible, appropriate, available, affordable, effective, efficient, integrated, safe, and patient-centered." Practitioners in allied health services, dentistry, midwifery, obstetrics, medicine, nursing, optometry, pharmacy, psychology, and other care providers provide health care. Quality management in health care is a broad concept. It was initially perceived as directing healthcare personnel on what to do. However, its current meaning is to manage the care process. It refers to viewing organizational functions as a jumble of procedures and processes that can be addressed both individually and collectively. Despite the fact that various models have been proposed, Donabedian's concept of the triad of structure, process, and outcome remains the foundation of quality assessment today. Quality management has emerged as a more pressing need than ever before, owing to the new definition of quality, which includes patient satisfaction as an outcome of service. The quality of services provided to patients is critical. The traditional view of quality control focused on defect detection, whereas the current concept focuses on defect prevention, continuous process improvement, and an outcome-driven system guided by the needs of the patients. As a result, there is an urgent need to effect a paradigm shift in the quality of health care delivery. The authorities must take the initiative to become involved in quality. Currently, quality is being addressed more in the medical field than in allied fields such as dentistry and nursing, as well as in developing countries.

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Walther, Felix, Jochen Schmitt, Maria Eberlein-Gonska, Ralf Kuhlen, Peter Scriba, Olaf Schoffer, and Martin Roessler. "Relationships between multiple patient safety outcomes and healthcare and hospital-related risk factors in colorectal resection cases: cross-sectional evidence from a nationwide sample of 232 German hospitals." BMJ Open 12, no. 7 (July 2022): e058481. http://dx.doi.org/10.1136/bmjopen-2021-058481.

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ObjectivesStudies analysing colorectal resections usually focus on a specific outcome (eg, mortality) and/or specific risk factors at the individual (eg, comorbidities) or hospital (eg, volume) level. Comprehensive evidence across different patient safety outcomes, risk factors and patient groups is still scarce. Therefore the aim of this analysis was to investigate consistent relationships between multiple patient safety outcomes, healthcare and hospital risk factors in colorectal resection cases.DesignCross-sectional study.SettingGerman inpatient routine care data of colorectal resections between 2016 and 2018.ParticipantsWe analysed 54 168 colon resection and 20 395 rectum resection cases treated in German hospitals. The German Inpatient Quality Indicators were used to define colon resections and rectum resections transparently.Primary outcome measuresAdditionally to in-hospital death, postoperative respiratory failure, renal failure and postoperative wound infections we included multiple patient safety outcomes as primary outcomes/dependent variables for our analysis. Healthcare (eg, weekend surgery), hospital (eg, volume) and case (eg, age) characteristics served as independent covariates in a multilevel logistic regression model. The estimated regression coefficients were transferred into ORs.ResultsWeekend surgery, emergency admissions and transfers from other hospitals were significantly associated (ORs ranged from 1.1 to 2.6) with poor patient safety outcome (ie, death, renal failure, postoperative respiratory failure) in colon resections and rectum resections. Hospital characteristics showed heterogeneous effects. In colon resections hospital volume was associated with insignificant or adverse associations (postoperative wound infections: OR 1.168 (95% CI 1.030 to 1.325)) to multiple patient safety outcomes. In rectum resections hospital volume was protectively associated with death, renal failure and postoperative respiratory failure (ORs ranged from 0.7 to 0.8).ConclusionsTransfer from other hospital and emergency admission are constantly associated with poor patient safety outcome. Hospital variables like volume, ownership or localisation did not show consistent relationships to patient safety outcomes.Trial registration numberISRCTN10188560.

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Klokker, Louise, Peter Tugwell, Daniel E. Furst, Dan Devoe, Paula Williamson, Caroline B. Terwee, Maria E. Suarez-Almazor, et al. "Developing an OMERACT Core Outcome Set for Assessing Safety Components in Rheumatology Trials: The OMERACT Safety Working Group." Journal of Rheumatology 44, no. 12 (October 15, 2016): 1916–19. http://dx.doi.org/10.3899/jrheum.161105.

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Objective.Failure to report harmful outcomes in clinical research can introduce bias favoring a potentially harmful intervention. While core outcome sets (COS) are available for benefits in randomized controlled trials in many rheumatic conditions, less attention has been paid to safety in such COS. The Outcome Measures in Rheumatology (OMERACT) Filter 2.0 emphasizes the importance of measuring harms. The Safety Working Group was reestablished at the OMERACT 2016 with the objective to develop a COS for assessing safety components in trials across rheumatologic conditions.Methods.The safety issue has previously been discussed at OMERACT, but without a consistent approach to ensure harms were included in COS. Our methods include (1) identifying harmful outcomes in trials of interventions studied in patients with rheumatic diseases by a systematic literature review, (2) identifying components of safety that should be measured in such trials by use of a patient-driven approach including qualitative data collection and statistical organization of data, and (3) developing a COS through consensus processes including everyone involved.Results.Members of OMERACT including patients, clinicians, researchers, methodologists, and industry representatives reached consensus on the need to continue the efforts on developing a COS for safety in rheumatology trials. There was a general agreement about the need to identify safety-related outcomes that are meaningful to patients, framed in terms that patients consider relevant so that they will be able to make informed decisions.Conclusion.The OMERACT Safety Working Group will advance the work previously done within OMERACT using a new patient-driven approach.

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Anadani, Mohammad, Adam S. Arthur, Ali Alawieh, Yser Orabi, Andrei Alexandrov, Nitin Goyal, Marios-Nikos Psychogios, et al. "Blood pressure reduction and outcome after endovascular therapy with successful reperfusion: a multicenter study." Journal of NeuroInterventional Surgery 12, no. 10 (December 5, 2019): 932–36. http://dx.doi.org/10.1136/neurintsurg-2019-015561.

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BackgroundElevated systolic blood pressure (SBP) after mechanical thrombectomy (MT) correlates with worse outcome. However, the association between SBP reduction (SBPr) and outcome after successful reperfusion with MT is not well established.ObjectiveTo investigate the association between SBPr in the first 24 hours after successful reperfusion and the functional and safety outcomes of MT.MethodsA multicenter retrospective study, which included 10 comprehensive stroke centers, was carried out. Patients with acute ischemic stroke and anterior circulation large vessel occlusions who achieved successful reperfusion via MT were included. SBPr was calculated using the formula 100×([admission SBP−mean SBP]/admission SBP). Poor outcome was defined as a modified Rankin Scale (mRS) score of 3–6 at 90 days. Safety endpoints included symptomatic intracerebral hemorrhage, mortality, and requirement for hemicraniectomy during admission. A generalized mixed linear model was used to study the association between SBPr and outcomes.ResultsA total of 1361 patients were included in the final analysis. SBPr as a continuous variable was inversely associated with poor outcome (OR=0.97; 95% CI 0.95 to 0.98; p<0.001) but not with the safety outcomes. Subanalysis based on reperfusion status showed that SBPr was associated with lower odds of poor outcome only in patients with complete reperfusion (modified Thrombolysis in Cerebral Infarction (mTICI 3)) but not in patients with incomplete reperfusion (mTICI 2b). When SBPr was divided into categories (<1%, 1%–10%, 11%–20%, >20%), the rate of poor outcome was highest in the first group.ConclusionSBPr in the first 24 hours after successful reperfusion was inversely associated with poor outcome. No association between SBPr and safety outcome was found.

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Colt, H. G. "Thoracoscopy. A prospective study of safety and outcome." Journal of Bronchology 4, no. 1 (January 1997): 87. http://dx.doi.org/10.1097/00128594-199701000-00030.

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Roberts, R. A., and T. Monticello. "Preclinical (safety) toxicology testing predicts the clinical outcome." Toxicology Letters 258 (September 2016): S14. http://dx.doi.org/10.1016/j.toxlet.2016.07.018.

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Abdur‐Razzaq, Malik. "Illness episode vs treatment outcome: questions regarding safety." Mental Health Review Journal 16, no. 4 (December 9, 2011): 197–204. http://dx.doi.org/10.1108/13619321111202359.

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Sager, Philip T., Jonathan Seltzer, J. Rick Turner, Jeffrey L. Anderson, William R. Hiatt, Peter Kowey, Judith J. Prochaska, Norman Stockbridge, and William B. White. "Cardiovascular Safety Outcome Trials: A meeting report from the Cardiac Safety Research Consortium." American Heart Journal 169, no. 4 (April 2015): 486–95. http://dx.doi.org/10.1016/j.ahj.2015.01.007.

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Widi Hastuti, Siti Kurnia, Daru Respati Puspaningtyas, and Nur Syarianingsih Syam. "Implementation of patient safety culture in outcome level in X general hospital in Yogyakarta." International Journal Of Community Medicine And Public Health 7, no. 1 (December 25, 2019): 36. http://dx.doi.org/10.18203/2394-6040.ijcmph20195829.

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Background: Creating a culture of patient safety is something that must be considered. This is because culture contains two important components, namely values and beliefs that can change organizations. Most safety incidents of Yogyakarta District Hospital in 2018 were 21 near miss incidents, incidents in total, then 17 incident, not injured and 5 events in unexpected events, while in potential injured there were no incidents during 2018. In 2018 there were still several months of data that had not yet met patient safety incident targets. From a preliminary study the researcher obtained, data on patient safety incident reporting has not been optimally performed by nurses. The purpose of this study was to determine the implementation of patient safety culture at the outcome level.Methods: This research is mixed methods research with an explanatory sequential design. Primary data obtained from in-depth interviews, a description of the implementation of patient safety culture at the Outcome level data obtained from questionnaires given to 72 nurses.Results: The culture of patient safety Yogyakarta District Hospital has been implemented well. At the level of patient safety culture outcomes related to the frequency of reporting patient safety events have been carried out but related to incidents that have no potential for injury when reporting is not appropriate, the perception of patient safety at the patient safety level, the number of reporting of events at the Yogyakarta District Hospital has been carried out properly.Conclusions: The safety culture of patients at Yogyakarta District Hospital at the outcome level has been implemented well.

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Momattin, Hisham, Mohammed Zogheib, Ali Homoud, and Jaffar A. Al-Tawfiq. "Safety and Outcome of Pharmacy-Led Vancomycin Dosing and Monitoring." Chemotherapy 61, no. 1 (November 10, 2015): 3–7. http://dx.doi.org/10.1159/000440607.

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Background: Therapeutic vancomycin trough levels correlate with therapeutic success and the development of renal failure. In this study, we aimed to describe the safety and outcome of pharmacy-led vancomycin dosing and monitoring. Methods: We included adults requiring vancomycin for >48 h and who had a vancomycin trough level drawn near steady state. The primary outcome of the comparison was the achievement of therapeutic trough levels, defined as 10-20 µg/ml. Secondary outcome included acute renal failure. We compared these outcomes before and after the implementation of pharmacy-led vancomycin dosing and monitoring. Result: During the study period, a total of 278 patients were in the preimplementation phase and 286 were in the postintervention phase. There was a clear increase in the percentage of patients achieving the therapeutic range (50.5 vs. 79.7%, p = 0.0001) and an increase in the percentage of levels within the therapeutic range (31.6 vs. 59.1%; p = 0.0001). The number of cases receiving vancomycin increased by 5% and the duration of therapy decreased by 19.5%. More patients attained a therapeutic range of 10-20 µg/ml (i.e. the level was 31.6% in the preintervention and 59.1% in the postintervention phase). Conclusions: A higher percentage of patients achieved a therapeutic range and less nephrotoxicity when using a pharmacy-led protocol for vancomycin dosing.

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Isha, Akulwar-Tajane. "Effectiveness and Safety of Physical Therapy Intervention in Adult Dermatomyositis: A Case Report and Review." Journal of Clinical Cases & Reports 4, S9 (June 30, 2021): 5–20. http://dx.doi.org/10.46619/joccr.2021.4.s9-1002.

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BACKGROUND The evidence for positive effects of exercise is insufficient in dermatomyositis. This article aims to outline the effects of physical exercise with regard to structure (Disease activity, inflammation, metabolic milieu and muscle structure) as well as clinical outcome in terms of impairment, activity limitation, participation restriction according to the ICF; and QOL in an adult patient with dermatomyositis. CASE DESCRIPTION A 47-years old female diagnosed with definite DM since last 10 months was referred by a Rheumatologist for physical therapy intervention. INTERVENTION 12 weeks (Three days a week) of Physiotherapy (Moderate intensity, individualized, closely monitored) along with a structured home exercise program (Low intensity, 5 days - 6 days a week). OUTCOME MEASURES Assessment of muscular pain, muscle strength, endurance, balance, functional evaluation, and QOL along with serological investigations. RESULTS Effectiveness Patient continued to show meaningful and clinically significant improvement on standardized outcome measures: 1. A major clinical response (total improvement score of 77) on IMAC S core set measures. 2. Improvement across all domains of ICF viz. muscle strength; endurance; movement coordination; balance; aerobic endurance; confidence and performance in activities of daily living; participation in social activities. 3. Probable disease-modifying effect: Progressively tapering dose of prescribed corticosteroids medication and improvement in disease-specific biochemical markers. 4. Patient reported measures: Reduction in muscular pain, shortness of breath & fatigue; and improvement in Healthrelated QOL. SAFETY (As evident clinically and from the investigations): 1. No adverse reaction to exercises or physical activity. 2. Remained in remission - stable disease activity. CONCLUSION Moderate intensity of physiotherapy intervention along with home exercise program is effective and safe in improving functional outcomes for dermatomyositis in a stable disease activity state. This case report enhances our understanding of the effects of physical exercise and may improve treatment and outcome in patients with dermatomyositis.

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Kallinen, Kari. "A Good Safety Culture Correlates with Increased Positive and Decreased Negative Outcomes." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 60, no. 1 (September 2016): 1627–31. http://dx.doi.org/10.1177/1541931213601375.

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In the present paper, we examined the safety culture and its correlations to negative and positive outcome variables among 1637 Finnish Defense Forces personnel. Participants rated the organizational, group and individual level of safety culture as well as levels of stress, lack of motivation, job satisfaction, positive atmosphere and number of risky incidents using a 92 part safety culture questionnaire. As expected, a good safety culture was positively correlated with positive and negatively correlated with negative outcomes.

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Bansal, Reema, Amod Gupta, Vishali Gupta, Samyak Mulkutkar, Mohit Dogra, Deeksha Katoch, Mangat R. Dogra, et al. "Safety and Outcome of Microincision Vitreous Surgery in Uveitis." Ocular Immunology and Inflammation 25, no. 6 (May 18, 2016): 775–84. http://dx.doi.org/10.3109/09273948.2016.1165259.

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Viegas, Janaina Ferreira, Martina Lichtenfels, Alessandra Borba Anton de Souza, Betina Vollbrecht, Francisco Laitano Neto, Felipe Pereira Zerwes, and Antônio Luiz Frasson. "Aesthetic outcome and oncological safety of nipple-sparing mastectomy." Mastology 29, no. 1 (March 2019): 4–9. http://dx.doi.org/10.29289/2594539420190000418.

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Braakhekke, M., E. I. Kamphuis, F. Mol, R. J. Norman, S. Bhattacharya, F. van der Veen, and B. W. J. Mol. "Effectiveness and safety as outcome measures in reproductive medicine." Human Reproduction 30, no. 10 (September 17, 2015): 2249–51. http://dx.doi.org/10.1093/humrep/dev201.

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Logallo, N., C. E. Kvistad, H. Naess, U. Waje-Andreassen, and L. Thomassen. "Mild stroke: safety and outcome in patients receiving thrombolysis." Acta Neurologica Scandinavica 129 (March 4, 2014): 37–40. http://dx.doi.org/10.1111/ane.12235.

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Konje, Justin C., Richard de Chazal, Keith Abrams, and David J. Taylor. "Safety and fetal outcome of early and midtrimester amniocentesis." Lancet 351, no. 9113 (May 1998): 1434. http://dx.doi.org/10.1016/s0140-6736(05)79480-0.

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Saura, R., L. Taine, F. Guyon, R. Mangione, and J. Horovitz. "Safety and fetal outcome of early and midtrimester amniocentesis." Lancet 351, no. 9113 (May 1998): 1434–35. http://dx.doi.org/10.1016/s0140-6736(05)79481-2.

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Eiben, Bernd, Wilhelm Hammans, Richard Goebel, and Jörg T. Epplen. "Safety and fetal outcome of early and midtrimester amniocentesis." Lancet 351, no. 9113 (May 1998): 1435. http://dx.doi.org/10.1016/s0140-6736(05)79482-4.

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Wilson, R. Douglas. "Safety and fetal outcome of early and midtrimester amniocentesis." Lancet 351, no. 9113 (May 1998): 1435–36. http://dx.doi.org/10.1016/s0140-6736(05)79483-6.

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Fischer, U., P. Taussky, J. Gralla, M. Arnold, C. Brekenfeld, M. Reinert, N. Meier, et al. "Decompressive craniectomy after intra-arterial thrombolysis: safety and outcome." Journal of Neurology, Neurosurgery & Psychiatry 82, no. 8 (June 20, 2010): 885–87. http://dx.doi.org/10.1136/jnnp.2009.198648.

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Kon, O. M., M. Goyal, E. Filley, G. Gleissberg, D. Cunningham, G. A. W. Rook, and R. J. Shaw. "Mycobacterium vaccae: a study of safety and outcome measures." Respiratory Medicine 92, no. 3 (March 1998): 597–98. http://dx.doi.org/10.1016/s0954-6111(98)90316-x.

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Goffman, Dena, Michael Brodman, Arnold Friedman, Howard Minkoff, Damion Nero, Angela Laurio, Peter Bernstein, et al. "623: A collaborative obstetric patient safety initiative improves outcome." American Journal of Obstetrics and Gynecology 206, no. 1 (January 2012): S280. http://dx.doi.org/10.1016/j.ajog.2011.10.641.

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Galketiya, K. B., V. Pinto, R. Perera, R. Rohankumar, N. Kumarasinghe, and A. Shaminda. "Laparoscopic pancreatic resections: review of feasibility, safety and outcome." Sri Lanka Journal of Surgery 35, no. 1 (April 30, 2017): 27. http://dx.doi.org/10.4038/sljs.v35i1.8351.

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Newcomer, Sophia R., Martin Kulldorff, Stan Xu, Matthew F. Daley, Bruce Fireman, Edwin Lewis, and Jason M. Glanz. "Bias from outcome misclassification in immunization schedule safety research." Pharmacoepidemiology and Drug Safety 27, no. 2 (January 2, 2018): 221–28. http://dx.doi.org/10.1002/pds.4374.

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Addeo, P., E. Oussoultzoglou, P. Fuchshuber, E. Rosso, C. Nobili, S. Langella, D. Jaeck, and P. Bachellier. "Safety and outcome of combined liver and pancreatic resections." British Journal of Surgery 101, no. 6 (March 25, 2014): 693–700. http://dx.doi.org/10.1002/bjs.9443.

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Najjar, Shahenaz, Elfi Baillien, Kris Vanhaecht, Motasem Hamdan, Martin Euwema, Arthur Vleugels, Walter Sermeus, Ward Schrooten, Johan Hellings, and Annemie Vlayen. "Similarities and differences in the associations between patient safety culture dimensions and self-reported outcomes in two different cultural settings: a national cross-sectional study in Palestinian and Belgian hospitals." BMJ Open 8, no. 7 (July 2018): e021504. http://dx.doi.org/10.1136/bmjopen-2018-021504.

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ObjectivesTo investigate the relationships between patient safety culture (PSC) dimensions and PSC self-reported outcomes across different cultures and to gain insights in cultural differences regarding PSC.DesignObservational, cross-sectional study.SettingNinety Belgian hospitals and 13 Palestinian hospitals.ParticipantsA total of 2836 healthcare professionals matched for profession, tenure and working hours.Primary and secondary outcome measuresThe validated versions of the Belgian and Palestinian Hospital Survey on Patient Safety Culture were used. An exploratory factor analysis was conducted. Reliability was tested using Cronbach’s alpha (α). In this study, we examined the specific predictive value of the PSC dimensions and its self-reported outcome measures across different cultures and countries. Hierarchical regression and bivariate analyses were performed.ResultsEight PSC dimensions and four PSC self-reported outcomes were distinguished in both countries. Cronbach’s α was α≥0.60. Significant correlations were found between PSC dimensions and its self-reported outcome (p value range <0.05 to <0.001). Hierarchical regression analyses showed overall perception of safety was highly predicted by hospital management support in Palestine (β=0.16, p<0.001) and staffing in Belgium (β=0.24, p<0.001). The frequency of events was largely predicted by feedback and communication in both countries (Palestine: β=0.24, p<0.001; Belgium: β=0.35, p<0.001). Overall grade for patient safety was predicted by organisational learning in Palestine (β=0.19, p<0.001) and staffing in Belgium (β=0.19, p<0.001). Number of events reported was predicted by staffing in Palestine (β=−0.20, p<0.001) and feedback and communication in Belgium (β=0.11, p<0.01).ConclusionTo promote patient safety in Palestine and Belgium, staffing and communication regarding errors should be improved in both countries. Initiatives to improve hospital management support and establish constructive learning systems would be especially beneficial for patient safety in Palestine. Future research should address the association between safety culture and hard patient safety measures such as patient outcomes.

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Shaw, Pamela A. "Use of composite outcomes to assess risk–benefit in clinical trials." Clinical Trials 15, no. 4 (July 18, 2018): 352–58. http://dx.doi.org/10.1177/1740774518784010.

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Before a novel treatment can be deemed a clinical success, an assessment of its risk–benefit profile must be made. One of the inherent challenges for this assessment comes from the multiplicity that arises from comparing treatment groups across multiple outcomes. Composite outcomes that summarize a patient’s clinical status, or severity, across a prioritized list of safety and efficacy outcomes have become increasing popular. In this article, we review these approaches and illustrate through examples some of the challenges and complexities of a composite derived from prioritized outcomes, such as the win ratio. These challenges include the difficult tension between the analytical validity that comes from choosing a pre-specified outcome and an evaluation that is responsive to unexpected safety events that arise during the course of a trial. Other challenges include a sensitivity of the resulting test statistic to the underlying censoring distribution and other nuisance parameters. Approaches that resolve some of the difficulties of the analytical challenges associated with prioritized outcomes are then discussed. Ultimately, a composite outcome of net clinical benefit is another decision tool, but one to be used alongside more traditional analyses of efficacy and safety, and with the broader perspective that investigators, the data safety monitoring board, and regulators bring to an evaluation of risk–benefit.

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Stretton, Paul. "The Lilypond: An integrated model of Safety II principles in the workplace. A quantum shift in patient safety thinking." Journal of Patient Safety and Risk Management 25, no. 2 (April 2020): 85–90. http://dx.doi.org/10.1177/2516043520913420.

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The Lilypond is a new conceptual model to describe patient safety performance. It radically diverges from established patient safety models to develop the reality of complexity within the healthcare systems as well as incorporating Safety II principles. There are two viewpoints of the Lilypond that provide insight into patient safety performance. From above, we are able to observe the organisational outcomes. This supersedes the widely used Safety Triangle and provides a more accurate conceptual model for understanding what outcomes are generated within healthcare. From a cross-sectional view, we are able to gain insights into how these outcomes come to manifest. This includes recognition of the complexity of our workplace, the impact of micro-interactions, effective leadership behaviours as well as patterns of behaviour that all provide learning. This replaces the simple, linear approach of The Swiss Cheese Model when analysing outcome causation. By applying the principles of Safety II and replacing outdated models for understanding patient safety performance, a more accurate, beneficial and respectful understanding of safety outcomes is possible.

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Zhang, Jiangchi, Chaowu Xie, Alastair M. Morrison, Rui Huang, Yuxi Li, and Gaoyang Wu. "The effects of hotel employee ternary safety behavior on negative safety outcomes: the moderation of job vigor and emotional exhaustion." Journal of Service Theory and Practice 32, no. 4 (June 28, 2022): 565–85. http://dx.doi.org/10.1108/jstp-01-2022-0023.

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PurposeThe effect of hotel employee safety behavior has not as yet been investigated. The purpose of this research is to determine the impact of hotel employee ternary safety behavior on negative safety outcomes, as well as the moderation effects of job vigor and emotional exhaustion.Design/methodology/approachA questionnaire survey of 16 medium- and high-star-rated hotels in southeast China was conducted and 571 responses were received for model estimation. The statistical analysis techniques adopted were confirmatory factor analysis, correlation analysis, hierarchical regression, and structural equation modeling.FindingsThe results showed that: (1) safety compliance and participation positively predicted safety adaptation; (2) the three dimensions of safety behavior contributed to reducing negative safety outcomes, and there was a multiple mediation process in their relationship; and (3) job vigor positively moderated the influence of safety compliance and adaption on negative safety outcomes, and emotional exhaustion negatively moderated the influence of safety participation on negative safety outcomes.Originality/valueThis research provides greater insights into the relationship between safety behavior and outcome performance within the hotel industry, and yields theoretical and practical implications for improving employee safety behavior and hotel safety performance.

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Sinnott, J., and E. Chisholm. "Balloon sinuplasty: two-year follow up using Sino-Nasal Outcome Test-22 outcomes." Journal of Laryngology & Otology 135, no. 5 (April 29, 2021): 415–19. http://dx.doi.org/10.1017/s0022215121000700.

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AbstractBackgroundBalloon sinuplasty is a relatively new surgical technology proposed as a less invasive way of treating chronic rhinosinusitis and frontal sinus disease. It is crucial to monitor safety and efficacy to allow informed clinical decisions and appropriate counselling of patients. There are few papers with long-term follow up.MethodPatients were selected for surgery based on symptoms of frontal pain and pressure or headache, pre-operative Sino-Nasal Outcome Test-22 scores, and computed tomography findings. All were resistant to appropriate medical therapy. Balloon sinuplasty was performed followed by a Sino-Nasal Outcome Test-22 questionnaire at two months and then two years.ResultsAll patients underwent successful operations with no failure of technology or technique. There were no significant complications. The average Sino-Nasal Outcome Test-22 score reduced from 46 pre-operatively (standard error: +/− 5.7, n = 9) to 23 at 2 months (standard error: +/− 7.6, n = 7). At 2 years, the average Sino-Nasal Outcome Test score was 23 (standard error: +/− 4.3, n = 6). There was an even larger lasting benefit when pain or pressure symptoms were analysed in isolation.ConclusionThis study adds to the evidence of technique safety and feasibility. The procedure resulted in a significant long-term improvement in symptoms.

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Dr.Ashutosh Muduli, Sujata Sinha,. "Exploring the antecedents, drivers, and outcome of Behaviour-based safety: A literature review." Psychology and Education Journal 58, no. 1 (January 20, 2021): 5578–81. http://dx.doi.org/10.17762/pae.v58i1.2176.

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Organisations good at managing safety tend to manage operations well. Safety culture is a subset of organisational culture and is the observable degree of effort with which all the organisation members exert their attention and action towards safety. People neither deterministically controlled by their environments nor entirely self-determining. They are in a state of reciprocal determinism with their settings, where they and their environments influence one another. Safety leadership can positively impact an individual’s safety-related behaviour by up to 86% and reduce accidents by around 35%. Evidence directs us towards safety culture and safety leadership as prominent precursors to workers' safety behaviour (WSB). This study conducts a rigorous review of approximately 20-25 published papers from 2000 to 2019, related articles in books and articles published in the corresponding field journals. The research evidence shows that Cooper's reciprocal model of safety culture encompassing psychological, behavioural and situational factors is well supported by most studies. They offer non- existent to a weak relationship between psychological factors and strong and steady situational and behavioural factors with the safety outcomes. Organisations should concentrate 80% of their safety culture improvement efforts on situational and behavioural factors to prevent process safety and SIF’(Significant incidents and fatalities). Behavioural-based safety (BBS) process serves as a comprehensive tool in altering at-risk behaviour positively. BBS will help the practitioners design enhanced BBS intervention for a more sustainable and persistent impact on workers' safety behaviour (WSB). Further research should be undertaken to establish the empirical links of safety culture and safety leadership constructs with safe outcomes.

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Zhang, Jin-Wen, Ware Branch, Matthew Hoffman, Ank De Jonge, Sheng-Hui Li, James Troendle, and Jun Zhang. "In which groups of pregnant women can the caesarean delivery rate likely be reduced safely in the USA? A multicentre cross-sectional study." BMJ Open 8, no. 8 (August 2018): e021670. http://dx.doi.org/10.1136/bmjopen-2018-021670.

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ObjectivesTo identify obstetrical subgroups in which (1) the caesarean delivery (CD) rate may be reduced without compromising safety and (2) CD may be associated with better perinatal outcomes.DesignA multicentre cross-sectional study.Setting19 hospitals in the USA that participated in the Consortium on Safe Labor.Participants228 562 pregnant women in 2002–2008.Main outcome measuresMaternal and neonatal safety was measured using the individual Weighted Adverse Outcome Score.MethodsWomen were divided into 10 subgroups according to a modified Robson classification system. Generalised estimated equation model was used to examine the relationships between mode of delivery and Weighted Adverse Outcome Score in each subgroup.ResultsThe overall caesarean rate was 31.2%. Repeat CD contributed 29.5% of all CD, followed by nulliparas with labour induction (15.3%) and non-cephalic presentation (14.3%). The caesarean rates in induced nulliparas with a term singleton cephalic pregnancy and women with previous CD were 31.6% and 82.0%, respectively. CD had no clinically meaningful association with perinatal outcomes in most subgroups. However, in singleton preterm breech presentation and preterm twin gestation with the first twin in non-cephalic presentation, CD was associated with substantially improved maternal and perinatal outcomes.ConclusionsWomen with repeat CD, term non-cephalic presentation, term twins or other multiple gestation and preterm births may be the potential targets for safely reducing prelabour CD rate, while nulliparas or multiparas with spontaneous or induced labour, women with repeat CD, term non-cephalic presentation, term twins or other multiple gestation and preterm births are potential targets for reducing intrapartum CD rate without compromising maternal and neonatal safety in the USA. On the other hand, CD may still be associated with better perinatal outcomes in women with singleton preterm breech presentation or preterm twins with the first twin in non-cephalic presentation.

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Haugen, Arvid Steinar, Eirik Søfteland, Nick Sevdalis, Geir Egil Eide, Monica Wammen Nortvedt, Charles Vincent, and Stig Harthug. "Impact of the Norwegian National Patient Safety Program on implementation of the WHO Surgical Safety Checklist and on perioperative safety culture." BMJ Open Quality 9, no. 3 (July 2020): e000966. http://dx.doi.org/10.1136/bmjoq-2020-000966.

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ObjectivesOur primary objective was to study the impact of the Norwegian National Patient Safety Campaign and Program on Surgical Safety Checklist (SSC) implementation and on safety culture. Secondary objective was associations between SSC fidelity and safety culture. We hypothesised that the programme influenced on SSC use and operating theatre personnel’s safety culture perceptions.SettingA longitudinal cross-sectional study was conducted in a large Norwegian tertiary teaching hospital.ParticipantsWe invited 1754 operating theatre personnel to participate in the study, of which 920 responded to the surveys at three time points in 2009, 2010 and 2017.Primary and secondary outcome measuresPrimary outcome was the results of the patient safety culture measured by the culturally adapted Norwegian version of the Hospital Survey on Patient Safety Culture. Our previously published results from 2009/2010 were compared with new data collected in 2017. Secondary outcome was correlation between SSC fidelity and safety culture. Fidelity was electronically recorded.ResultsSurvey response rates were 61% (349/575), 51% (292/569) and 46% (279/610) in 2009, 2010 and 2017, respectively. Eight of the 12 safety culture dimensions significantly improved over time with the largest increase being ‘Hospital managers’ support to patient safety’ from a mean score of 2.82 at baseline in 2009 to 3.15 in 2017 (mean change: 0.33, 95% CI 0.21 to 0.44). Fidelity in use of the SSC averaged 88% (26 741/30 426) in 2017. Perceptions of safety culture dimensions in 2009 and in 2017 correlated significantly though weakly with fidelity (r=0.07–0.21).ConclusionThe National Patient Safety Program, fostering engagement from trust boards, hospital managers and frontline operating theatre personnel enabled effective implementation of the SSC. As part of a wider strategic safety initiative, implementation of SSC coincided with an improved safety culture.

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Humphreys, Christopher, Sarah Fletcher, Nishan Sharma, Rahim Kachra, and Shannon Marie Ruzycki. "Validation of Electronic Health Record Detection of Patient Safety Outcomes." Canadian Journal of General Internal Medicine 14, no. 3 (August 21, 2019): 16–22. http://dx.doi.org/10.22374/cjgim.v14i3.321.

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Background: Adverse events (AE) are common for hospitalized Canadians, and lead to worse patient outcomes. Monitoring patient safety is logistically challenging. We aimed to validate the use of our electronic health record (EHR) to monitor important patient safety. Methods: EHR data was used to identify patients who were exposed to one of four high-priority safety outcomes: venous thromboembolism, dysglycemia, Clostridium difficile(C. difficile) infection, and prolonged nil per os(NPO) orders. A manual chart review was performed to determine the sensitivity and specificity of the EHR for each patient safety outcome. Results: The sensitivity and specificity ranged from 38.4% to 78.1% and 88.1 to 99.2%, respectively, for the prespecified patient safety outcomes. Conclusion: The EHR is reasonably sensitive and specific to monitor rates of dysglycemia, C. difficileinfection, and prolonged NPO in medical inpatients, but does not have adequate sensitivity to be used to capture venous thromboembolism safety outcomes.

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Dosenovic, Svjetlana, Antonia Jelicic Kadic, Milka Jeric, Matija Boric, Domagoj Markovic, Katarina Vucic, and Livia Puljak. "Efficacy and Safety Outcome Domains and Outcome Measures in Systematic Reviews of Neuropathic Pain Conditions." Clinical Journal of Pain 34, no. 7 (July 2018): 674–84. http://dx.doi.org/10.1097/ajp.0000000000000574.

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Kim, Karl. "Crash- and Injury-Outcome Multipliers." Transportation Research Record: Journal of the Transportation Research Board 1717, no. 1 (January 2000): 10–13. http://dx.doi.org/10.3141/1717-02.

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In 1992 the University of Hawaii was one of six institutions to receive a Crash Outcome Data Evaluation System grant from the U.S. Department of Transportation, NHTSA. As part of the Hawaii CODES Project, police crash data, emergency medical services (EMS) data, and hospital data were linked using a probabilistic linkage software known as Automatch. An advantage of linked data is the ability to determine injury outcomes for various types of crashes. A simple technique—crash and injury outcome multipliers for examining the relative safety of various types of crashes—is presented. Using the crash as the unit of analysis, a measure is derived that indicates the number of fatalities, incapacitating injuries, nonserious injuries, EMS transports, and hospitalizations produced over a period of time by those particular crash types. In addition to comparing vehicle-to-vehicle crashes, various crash types such as head-on, rollover, sideswipe, broadside, and fixed-object collisions are also examined. The relative crash and injury outcomes for speed-related crashes, alcohol-related collisions, or any number of other types of safety concerns can also be tabulated. The simple technique is illustrated using both conventional police crash data on injuries and a linked file containing EMS and hospital records. In addition to demonstrating the technique, some potential uses are described.

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Dinagaran, D., K. R. Balasubramanian, and S. P. Sivapirakasam. "Behavior Based Safety Approach to Improve Workplace Safety in Multistory Building Construction." Advanced Science, Engineering and Medicine 12, no. 12 (December 1, 2020): 1491–99. http://dx.doi.org/10.1166/asem.2020.2588.

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Behavior Based Safety (BBS) approach is the “usage of science for changing the behavior of an individual”. “Behavior Based Safety” focuses on action of workmen on day-to-day safety behavior and its improvement. This study presents a case study within the multistory building construction in India. This research work plans the outline of the BBS method into 7 steps and encapsulates a number of behavioral safety methods to prevent the workplace accident. The objective of this paper is to create a safe work environment in construction industries by decreasing frequency severity of injuries and increase the safe behavior. The outcome of this research work revealed that a method related to observation, a real-time measure of safety behavior with appreciative and constructive feedback for the significant improvement of the safety performance in multistory building construction. Observers educated to provide appreciative feedback when the workers performed the task safely and to offer constructive feedback to unsafe task performers. Baseline data of current safety performance was calculated before the BBS approach implementation and compared with the safety performance weekly data to identify the improvements.

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Naleway, Allison L., Bradley Crane, Stephanie A. Irving, Don Bachman, Kimberly K. Vesco, Matthew F. Daley, Darios Getahun, et al. "Vaccine Safety Datalink infrastructure enhancements for evaluating the safety of maternal vaccination." Therapeutic Advances in Drug Safety 12 (January 2021): 204209862110212. http://dx.doi.org/10.1177/20420986211021233.

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Background: Identifying pregnancy episodes and accurately estimating their beginning and end dates are imperative for observational maternal vaccine safety studies using electronic health record (EHR) data. Methods: We modified the Vaccine Safety Datalink (VSD) Pregnancy Episode Algorithm (PEA) to include both the International Classification of Disease, ninth revision (ICD-9 system) and ICD-10 diagnosis codes, incorporated additional gestational age data, and validated this enhanced algorithm with manual medical record review. We also developed the new Dynamic Pregnancy Algorithm (DPA) to identify pregnancy episodes in real time. Results: Around 75% of the pregnancy episodes identified by the enhanced VSD PEA were live births, 12% were spontaneous abortions (SABs), 10% were induced abortions (IABs), and 0.4% were stillbirths (SBs). Gestational age was identified for 99% of live births, 89% of SBs, 69% of SABs, and 42% of IABs. Agreement between the PEA-assigned and abstractor-identified pregnancy outcome and outcome date was 100% for live births, but was lower for pregnancy losses. When gestational age was available in the medical record, the agreement was higher for live births (97%), but lower for pregnancy losses (75%). The DPA demonstrated strong concordance with the PEA and identified pregnancy episodes ⩾6 months prior to the outcome date for 89% of live births. Conclusion: The enhanced VSD PEA is a useful tool for identifying pregnancy episodes in EHR databases. The DPA improves the timeliness of pregnancy identification and can be used for near real-time maternal vaccine safety studies. Plain Language Summary Improving identification of pregnancies in the Vaccine Safety Datalink electronic medical record databases to allow for better and faster monitoring of vaccination safety during pregnancy Introduction: It is important to monitor of the safety of vaccines after they have been approved and licensed by the Food and Drug Administration, especially among women vaccinated during pregnancy. The Vaccine Safety Datalink (VSD) monitors vaccine safety through observational studies within large databases of electronic medical records. Since 2012, VSD researchers have used an algorithm called the Pregnancy Episode Algorithm (PEA) to identify the medical records of women who have been pregnant. Researchers then use these medical records to study whether receiving a particular vaccine is linked to any negative outcomes for the woman or her child. Methods: The goal of this study was to update and enhance the PEA to include the full set of medical record diagnostic codes [both from the older International Classification of Disease, ninth revision (ICD-9 system) and the newer ICD-10 system] and to incorporate additional sources of data about gestational age. To ensure the validity of the PEA following these enhancements, we manually reviewed medical records and compared the results with the algorithm. We also developed a new algorithm, the Dynamic Pregnancy Algorithm (DPA), to identify women earlier in pregnancy, allowing us to conduct more timely vaccine safety assessments. Results: The new version of the PEA identified 2,485,410 pregnancies in the VSD database. The enhanced algorithm more precisely estimated the beginning of pregnancies, especially those that did not result in live births, due to the new sources of gestational age data. Conclusion: Our new algorithm, the DPA, was successful at identifying pregnancies earlier in gestation than the PEA. The enhanced PEA and the new DPA will allow us to better evaluate the safety of current and future vaccinations administered during or around the time of pregnancy.

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Akinyi, M., C. K. Kabubo, and M. M. O. Winja. "Road Safety in Kenya: A Case Study of Nairobi Southern Bypass (UCA-2) Road." Engineering, Technology & Applied Science Research 10, no. 3 (June 7, 2020): 5724–27. http://dx.doi.org/10.48084/etasr.3532.

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The fundamental objective of transportation is to ensure that people and goods are safely and effectively moved from one place to another. Analyzing the design consistency is one of the ways in which the road’s safety can be maintained or enhanced. In order to obtain a balance in highway design, all the geometric components should, along with being economical functional, be designed to provide safety at speeds likely to occur under ordinary conditions. Distinguishing and treating any geometric inconsistency on an expressway can altogether enhance its safety outcome.

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