Circle Of Safety Research Articles

The Reconstructive Play of Memory: Commentary on David Edwards’ Case Study of Schema Therapy

This commentary discusses David Edwards’s (2022) case study of "Kelly’s circle of safety and healing: An extended schema therapy narrative and interpretative investigation," published in Pragmatic Case Studies in Psychotherapy. It examines Edwards’s efforts to integrate his imagistic/experiential therapeutic approach to a client’s maladaptive schemas based in childhood recollections with a contemporary model of autobiographical memory, Conway’s Self Memory System. Although I think there is much merit in this integration, particularly in highlighting reconstructive and re-imagining aspects of memory, I call attention to crucial relational dimensions of this reconstruction in a therapeutic dyad. Similarly, in encouraging continued development of this synthesis between schema therapy and autobiographical memory research, I suggest that constructs from Narrative Identity theory including the life story, self-defining memories, and narrative scripts would be of great value. Finally, I note that we are still in preliminary stages of establishing empirical linkages that would support Kelly’s full integrative vision.

Kelly’s Circle of Safety and Healing: An Extended Schema Therapy Narrative and Interpretative Investigation

This is a narrative case study of the psychotherapy of Kelly (pseudonym) that describes processes that took place within the last 17 sessions of a longer therapy of 67 sessions over a period of 26 months. A phenomenologically grounded and coherent account takes readers on an experiential journey that enables them to live through aspects of the process at least partially. These processes began in session 52 in which Kelly saw an image of a circle of caring people within which a series of child parts of herself were able to find a sense of safety and holding. Over the course of the sessions, eight different child parts approached and eventually entered the circle, each representing a different dissociated set of early schema patterns, each with its own related emotional distress. Through dialogue work and imagery rescripting, the predicament of each child and her unmet needs were brought into focus. This served as the basis for providing corrective emotional experiences that led to the child parts feeling able to voluntarily step into the circle. The material serves as the basis for theoretical-interpretative investigations with a focus on the phenomenology of memory and transformation in experiential psychotherapy. This is organized under several themes: (1) complexes, schemas, and internal working models; (2) autobiographical memory and the working self; (3) the “theater of consciousness” and the “theater of the imagination”; (4) understanding the figures that entered Kelly’s healing circle; (5) how far back can we remember? (6) reparenting, corrective experiences, and imagery rescripting; and (7) coping decisions and demanding and punitive features in coping modes. A brief conclusion aims to contribute to our understanding of the phenomenology of corrective experiences and psychological transformation.

Understanding the "Swiss Cheese Model" and Its Application to Patient Safety.

This article reviews several key aspects of the Theory of Active and Latent Failures, typically referred to as the Swiss cheese model of human error and accident causation. Although the Swiss cheese model has become well known in most safety circles, there are several aspects of its underlying theory that are often misunderstood. Some authors have dismissed the Swiss cheese model as an oversimplification of how accidents occur, whereas others have attempted to modify the model to make it better equipped to deal with the complexity of human error in health care. This narrative review aims to provide readers with a better understanding and greater appreciation of the Theory of Active and Latent Failures upon which the Swiss cheese model is based. The goal is to help patient safety professionals fully leverage the model and its associated tools when performing a root cause analysis as well as other patient safety activities.

Análise do impacto potencial de áreas com contaminação de solos sobre cursos d’água e poços no município de São Paulo

Este artigo tem como objetivo identificar corpos hídricos e poços no Município de São Paulo sob risco relativo à proximi-dade áreas de solos contaminados. Foram traçados raios de segurança entre as áreas contaminadas e os potenciais alvos de contaminação, conforme as características hidrogeológicas dos aquíferos. Assim, foi possível determinar inter-seções com rios e poços, mapeando-os como sob risco de contaminação. Em seguida, produziu-se um mapa de impacto acumulado da poluição na hidrografia, traduzindo a topologia hidrológica levando em consideração os potenciais pontos de contaminação à montante. Também foi mapeada a vulnerabilidade dos lençóis freáticos à contaminação, por meio de um índice de vulnerabilidade de aquíferos que considera a condutividade hidráulica e a profundidade da camada não saturada do aquífero. 49 poços (1,68%) apresentaram potencial de contaminação, sendo que 65,31% deles são declarados como de abastecimento humano, e localizam-se predominantemente em áreas com alta densidade popula-cional e vulnerabilidade extremamente alta de contaminação dos aquíferos. Nesse contexto, contribuiu-se para análise da situação dos recursos hídricos de São Paulo, para que usuários e o poder público possuam ciência dos riscos de contaminação e, assim, priorizar as medidas preventivas quanto a esses riscos.

Reinforcing Cardiology Training During a Pandemic: An Open Letter to Our Leaders.

Reinforcing Cardiology Training During a Pandemic: An Open Letter to Our Leaders.

설문조사에 의한 근로자 중심의 안전분임토의를 통한 건설업 위험성 평가 개선방안 사례연구

The current risk assessment system do not reflect workers' various opinion. However, the worker actually are in the center of work field and are exposed to accidents. In this regard, this study suggests enhanced risk assessment by 'safety circle discussion' on workers' hand. The self-administered surveys on supervisors and workers were done for the effect analysis of the safety circle discussion. According to the question investigation, even though the current risk assessment causes difficulties in preventing accidents by unsafe behaviors, the worker-oriented safety circle discussion establishing measures for risk factors of each work type will be able to prevent accidents more effectively. Also, it can positively contribute to safety health awareness, industrial accident prevention, accurate recognition on risk factors, improving safety facilities/work conditions, workers' compliance to safety health rules. Lastly, most respondents agreed that it is necessary to form organic relationship through circle discussion and deriving safety inspections that workers participate.

Poster

Poster

A continuous quality improvement project

Hospital Authority (HA), a statutory body responsible for managing public healthcare in Hong Kong, provides 90% of inpatient hospital services. The Surgical Outcomes Monitoring and Improvement Program was launched to monitor and improve the surgical outcomes of patients managed under HA. Tuen Mun Hospital, the largest acute hospital in Hong Kong, was committed to implement quality improvement projects to improve patients' outcomes after reviewing the first report in 2010. Other than the possibility of surgical technique failure, there were multiple cultural and managerial problems recognised, which could have contributed to the suboptimal outcome. The Surgical Quality and Safety Circle was formed, and was composed of hospital administrators and consultants from departments of surgery, anaesthesia and intensive care, and aimed to create a patient-centered culture. It also aimed to improve the fundamental standards of services provided, promote inter-departmental co-ordination and communication, ensure continuous medical education, and discuss policies and strategies regarding patient service management. Members attended meetings every four-to-six weeks, in which complicated cases were discussed. The four main areas focused on during case discussion were: interdisciplinary communication; logistics, workflow and policy making; continuous professional education; and improving communication between hospital management and clinicians. As a strategy for change, the ‘Speak up culture’, which was under-developed in the locality, was promoted. 400 comments and suggestions had been arrived at during group discussion across 25 meetings since February 2011. There were more than 10 inter-departmental and hospital based improvement programmes successfully implemented based on the clinical and system weakness identified in the meetings.

Cultural Safety Circles And Indigenous Peoples Perspectives: Inclusive Practices For Participation In Higher Education

Indigenous experiences, as found within traditional ways and cultural practices, are an acknowledgement of traditional methods for sharing, learning, and collective knowledge development and maintenance. The application of Cultural Safety Circles can help provide a collective space where definitions for cultural and educational exchange can take place and be identified. It is through this application that a discussion is presented on how the inherent issue of cultural safety, as it pertains to participation in higher education, can be explored to a deeper understanding.

Playground injuries in children

BackgroundRapid urbanization and unplanned population development can be detrimental to the safety of citizens, with children being a particularly vulnerable social group. In this review, we assess childhood playground injuries and suggest safety mechanisms which could be incorporated into playground planning.MethodsInclusion criteria were “children” as the focus group, “playground” as the main field of study, and “unintentional injury” and “safety” as the concepts of study. The keywords used for the PubMed search were “playground”, “children”, and “injury”. Initially we 182 articles. After screening according to inclusion criteria, 86 articles were found, and after reading the abstracts and then the full text, 14 articles were finally included for analysis. The papers reviewed included four case-control studies, three case studies, three descriptive studies, two interventional studies, one retrospective study, one cross-sectional study, and one systematic review.ResultsPlayground-related fractures were the most common accidents among children, underscoring the importance of safety promotion and injury prevention in playgrounds, lowrisk equipment and playing hours (week days associated with higher risk), implementation of standards, preventing falls and fall-related fractures, and addressing concerns of parents about unsafe neighborhoods. With the exception of one study, all of the reviewed papers had not implemented any practical safety plan. Safe engineering approaches were also ignored.ConclusionWe recommend a systematic safety approach based on the “safety circle” which includes three main areas, ie, equipment, environment, and children.

A Virtual Target-Based Underway Docking Procedure for Unmanned Surface Vehicles

AbstractThis paper considers the topic of safely docking a small unmanned surface vehicle (USV) with a larger mother ship moving in transit at sea. The proposed underway docking procedure is divided into two distinct phases to ensure a controlled and collision-free operation. Specifically, a safety circle is defined around the mother ship together with a virtual target point that can move along its circumference. During the whole procedure, the mother ship passively moves forward in a straight line while the USV actively tracks the target point using constant bearing guidance. In the first docking phase, the target is positioned at the projection of the USV position onto the safety circle surrounding the mother ship. When the USV has matched its position and velocity with the projected target point, the second phase is initiated by the target point starting to move along the safety circle until its bearing matches up with that of the desired docking point. Subsequently, the target point starts reducing its distance from the safety distance until it becomes equal to that of the docking point such that docking is finally achieved. The suggested underway docking procedure represents a simple and intuitive method which is easy to implement and tune. Its performance is illustrated through a computer simulation with an underactuated USV docking with a mother ship in transit.

Good Nutritional Practice from Producer to Consumer

Today we manage food safety through good practices at different levels of food production, distribution, and consumption. The paper analyses current good practices, parameters involved in the food safety circle along the food supply chain, and consumer dilemmas. As a result of the current situation the new approach called “Good Nutritional Practice” (GNP) is proposed to balance the food safety systems. It is shown how important it is to integrate actual the food safety solutions within GNP, which includes consumers, and is based on a model that covers subsystems from other relevant good practices (nine good practices along the food supply chain). It has been shown that present maintenance of food safety in the food supply chain can be easily broken down, because of the different kinds of barriers or a simple misunderstanding among stakeholders including consumers.

Consumers’ awareness of food safety from shopping to eating

Knowledge of food safety among consumers has various dimensions. Due to a number of food-related incidents and reported outbreaks worldwide, consumer confidence has begun to vacillate. The objective of this quantitative survey ( n = 1030) was to determine Slovenian consumers’ food safety knowledge and practices during purchase, transportation and storage of food, as well as food handling practices at home. The study highlighted gaps in food safety knowledge and some critical safety violations regarding food handling at home. Half of the respondents never thought of using a cooling bag for the transport of refrigerated or frozen foods. Approximately half of the respondents defrost meat on working surfaces and only one-third wash knives and cutting boards with hot water and detergent before re-use or use clean implements. Forty-four percent of respondents did not know the correct refrigerator temperature for the storage of perishable food. All other determinations concerning food safety knowledge and practices are presented and discussed. Consumer education should be the focus in order to reduce foodborne diseases. Educational material regarding Good Housekeeping Practice should be available to the general public from many sources. Only safety-conscious consumers can become active partners within the food safety circle.

Conscious sedation v. monitored anaesthesia care - 20 years in the South African context

Sedation of patients for minor procedures is here to stay. However, it is the responsibility of every physician to be aware of the potential complications associated with the combination of drugs administered and to practise in an environment where no risks are taken and no procedures performed outside the circle of safety. Furthermore, as an anaesthetic service, monitored anaesthesia care (MAC) is clearly distinct from moderate sedation and it is important for patient safety that these differences are recognised and adhered to. In essence, all practitioners must observe the strict distinctions between sedation and MAC to prevent the drift into deeper sedation under inappropriate circumstances.

First Birth Stories of Student Midwives: Keys to Professional Affective Socialization

ABSTRACTThe purpose of this article was to examine the professional affective socialization of midwifery students. Students from the Community‐Based Nurse‐Midwifery Education Program (CNEP) tell about their first births in their Lost My Hat stories posted on the electronic bulletin board of the Frontier School of Midwifery and Family Nursing. Qualitative analysis of 38 of these stories showed internalization of the values and beliefs of the midwifery model of care by students. Themes of the Lost My Hat stories were congruent with some of the aspects of the Model of Exemplary Midwifery Practice developed by Kennedy. Major themes included the circle of safety provided by the preceptor and a woman‐centered approach to care. These findings can help midwifery educators promote socialization of students in the profession.

First birth stories of student midwives: Keys to professional affective socialization

The purpose of this article was to examine the professional affective socialization of midwifery students. Students from the Community-Based Nurse-Midwifery Education Program (CNEP) tell about their first births in their Lost My Hat stories posted on the electronic bulletin board of the Frontier School of Midwifery and Family Nursing. Qualitative analysis of 38 of these stories showed internalization of the values and beliefs of the midwifery model of care by students. Themes of the Lost My Hat stories were congruent with some of the aspects of the Model of Exemplary Midwifery Practice developed by Kennedy. Major themes included the circle of safety provided by the preceptor and a woman-centered approach to care. These findings can help midwifery educators promote socialization of students in the profession.

The circle of safety: a campfire burn prevention campaign expanding nationwide.

Camping is a popular family activity, especially during the spring and summer months. Campfires are a common activity among campers. They offer a source of recreation but also pose a risk for severe burns. The rising number of children with campfire burns seen at our institution triggered a quest for a campaign for the prevention of these injuries. A chart review was performed to study the characteristics and the circumstances of burn injuries of all children treated for campfire-related injuries over a 4-year period between 1997 and 2001. Thirty-two children sustained campfire-related burn injuries, with 88% being under the age of 7. The children had either fallen into the campfire or walked into simmering coals. All accidents would have been prevented if the children had kept a safe distance from the campfire. Normal growth charts were used to determine the average height of 7-year-old children as being 48 inches. A campaign was started to encourage families to keep a safe distance of 4 feet from their campfires by drawing a "circle of safety" with a stick on the ground 4 feet away from the fire.

The midwife as an "Instrument" of care.

The midwife as an "Instrument" of care.

The “Circle of Safety”: A Method to Prevent Campfire Injuries

The “Circle of Safety”: A Method to Prevent Campfire Injuries Get access T. B. Curri, T. B. Curri 1Shriners Hospitals for Children, Northern California, Sacramento, CA Search for other works by this author on: Oxford Academic Google Scholar A. M. Martin, OTR, A. M. Martin, OTR 1Shriners Hospitals for Children, Northern California, Sacramento, CA Search for other works by this author on: Oxford Academic Google Scholar T. L. Palmieri, MD, T. L. Palmieri, MD 1Shriners Hospitals for Children, Northern California, Sacramento, CA Search for other works by this author on: Oxford Academic Google Scholar D. G. Greenhalgh, MD D. G. Greenhalgh, MD 1Shriners Hospitals for Children, Northern California, Sacramento, CA Search for other works by this author on: Oxford Academic Google Scholar The Journal of Burn Care & Rehabilitation, Volume 23, Issue suppl_2, March-April 2002, Page S83, https://doi.org/10.1097/00004630-200203002-00085 Published: 01 March 2002

The circle of safety: a tool for clinical preceptors

The Circle of Safety is a tool for all clinical faculty, regardless of profession and regardless of locale. Applying principles of teaching-learning, the Circle of Safety was originally developed by the author for use by clinical preceptors in nurse-midwifery education. Its purpose is to provide a structure that removes a major obstacle to learning and facilitates student efforts to learn in accord with an individual’s pattern of learning.