Enhance Patient Safety Research Articles

Impacts of Just Culture on Perioperative Nurses' Attitudes and Behaviors With Regard to Patient Safety Incident Reporting: Cross-Sectional Nationwide Survey

PurposeJust culture refers to a culture that encourages members of an organization to exchange important safety information and compensates them when they perform such information exchanges. The establishment of a just culture in hospital organizations might be an important means of enhancing patient safety incident reporting. This study aimed to investigate the impact of just culture on the attitudes and behaviors toward patient safety incident reporting in perioperative nurses. MethodsA nationwide cross-sectional survey was performed using structured questionnaires. The participants were 208 perioperative nurses in tertiary general hospitals in South Korea. Data were collected by self-reported on-line questionnaires, from August to September 2020. Data were analyzed with descriptive statistics, independent t-test, chi-square test, Fisher’s exact test, one-way ANOVA, Scheffé test, Pearson's correlation analysis, Spearman rank correlation analysis, hierarchical multiple regression, and hierarchical logistic regression using the SPSS WIN 23.0 program. ResultsHierarchical multiple regression analysis revealed that just culture explained an additional 34.5%p of the attitudes on patient safety incident reporting. Hierarchical logistic regression analysis showed that just culture was a significant predictor of behaviors regarding patient safety incident reporting (odds ratio = 2.25, p = 0.017). The final regression model accounted for 16.0% of the behaviors regarding patient safety incident reporting. ConclusionsThis study empirically shows that just culture impacted the attitudes and behaviors regarding patient safety incident reporting in perioperative nurses. This study provides an evidence about the importance of the just culture in every day nursing practice setting. Personnel and organizational efforts for improving or implementing just culture are required to ensure greater patient safety by enhancing the patient safety incident reporting of perioperative nurses in hospitals.

Enterprise risk management implementation challenges in medical laboratories in Harare, Zimbabwe.

Medical laboratories play crucial roles in healthcare, and effective enterprise risk management (ERM) is necessary to ensure business continuity, patient safety, and quality of care. In medical laboratories, ERM is important for enhancing patient safety, regulatory compliance and accreditation, quality management, business continuity, and cyber security. By following ERM principles and approaches, the medical laboratories can proactively manage their risks, improve patient safety, and maintain a high level of quality and reliability of outcomes. However, implementing ERM in medical laboratories faces unique challenges. This study explored the specific challenges and offers practical solutions for overcoming them to ensure successful ERM implementation in Harare, Zimbabwe. A cross-sectional survey was done through 41 self-administered questionnaires and interviews with medical laboratory staff from the six main medical laboratories in Harare. Data were analyzed using the Statistical Package for Social Sciences version 22. Quantitative data were analyzed using descriptive statistics such as frequencies and percentages. Qualitative data were analyzed using mean scores of Likert scale responses. The main challenges identified in the study included increased workload, staffing, organizational structures, timeliness of information, inadequate information technology support, and insufficient financial support in ERM. These can be addressed by portfolio management of risks, leveraging on cutting edge technology, restructuring to ensure swift responses to issues and redistributing staff workload, and training personnel to avoid burnouts and ensure maximum efficiency. Implementing ERM in medical laboratories requires understanding and addressing these challenges. By following the ERM principles and approaches the medical laboratories can proactively manage their risks, improve patient safety and maintain a high level of quality and reliability of outcomes ERM is still a new approach in the sector and needs further research.

From FUSE to a hands-on electrosurgery course using a cadaveric model.

Surgical procedures in contemporary practice frequently employ energy-based devices, yet comprehensive education surrounding their safety and effectiveness remains deficient. We propose an innovative course for residents that aims to provide basic electrosurgery knowledge and promote the safe use of these devices. We developed a simulated training course for first-year general surgery and orthopedic residents. First, a survey was conducted regarding their knowledge perception about energy devices. The course consisted of two online theoretical sessions, followed by three in-person practical sessions. First-year residents performed three video-recorded attempts using a cadaveric model and were assessed through a digital platform using the Objective Structured Assessment of Technical Skill (OSATS), a Specific Rating Scale (SRS), and a surgical energy-based devices scale (SEBS). Third-year residents were recruited as a control group. The study included 20 first-year residents and 5 third-year residents. First-year residents perceived a knowledge gap regarding energy devices. Regarding practical performance, both OSATS and checklist scores were statistically different between novices at their first attempt and the control group. When we analyzed the novice's performance, we found a significant increase in OSATS (13 vs 21), SRS (13 vs 17.5), and SEBS (5 vs 7) pre- and post-training scores. The amount of feedback referred to skin burns with the electro-scalpel reduced from 18 feedbacks in the first attempt to 2 in the third attempt (p-value = 0.0002). When comparing the final session of novices with the control group, no differences were found in the SRS (p = 0.22) or SEBS (p = 0.97), but differences remained in OSATS (p = 0.017). This study supports the implementation of structured education in electrosurgery among surgical trainees. By teaching first-year residents about electrosurgery, they can acquire a skill set equivalent to that of third-year residents. The integration of such courses can mitigate complications associated with energy device misuse, ultimately enhancing patient safety.

Preoperative anxiety management for elderly patients undergoing cataract surgery: An integrative review

BackgroundPreoperative anxiety in elderly cataract surgery patients presents challenges, demanding effective non-pharmacological interventions to ensure patient safety. MethodA comprehensive review was conducted on PubMed, CINAHL, and Embase from 2013 to 2023. Twelve experimental studies were analyzed. Interventions such as music therapy, education videos, hand massages, and non-fasting protocols were evaluated, with anxiety measured using various scales and physiological indicators. ResultOverall, the findings highlight the efficacy of these interventions in managing preoperative anxiety among elderly cataract surgery patients. Seven studies measured physiological indicators such as blood pressure or heart rate alongside anxiety scales, with four studies showing significant reductions of those indicators alongside anxiety reduction. ConclusionThese non-pharmacological interventions offer an effective alternative to pharmacological approaches, enhancing patient safety and potentially reducing healthcare costs related to polypharmacy. The international scope of the studies suggests broad applicability across diverse cultural contexts, advocating for their inclusion in hospital protocols.

Innovative nano-shielding for minimizing stray radiation dose in external radiation therapy: A promising approach to enhance patient safety

This study investigates the effectiveness of novel nanocomposite shielding materials in reducing out-of-field radiation doses during radiation therapy, employing Geant4 Monte Carlo (MC) simulations alongside an anthropomorphic female phantom. The research focuses on two radiation modalities: 6 MV beams with and without flattening filters. Utilizing the Geant4 MC code, detailed simulations of a Varian Clinac 2100C/D linear accelerator and an ICRP-145 mesh-type human phantom were conducted to estimate the doses to out-of-field organs from unintended secondary radiation. This involved simulating a comprehensive linac model, including all relevant beam-line components, and assessing the shielding effects of three different nanocomposites doped with metal nanoparticles at various thicknesses. The nanocomposites, comprising Polytetrafluoroethylene (PTFE), with PtO2, IrO2, and Bi2O3 nanoparticles, were evaluated for their potential to reduce patient organ doses from stray photon doses. The results showed that these materials could significantly lower radiation exposure to non-target tissues.

Falls characteristics experienced by working-age adults during inpatient post-stroke rehabilitation and their impact on length of stay, discharge functional status, ambulation and destination

BackgroundIn-hospital falls are frequent post-stroke medical complications and will remain of concern because it may not be possible to prevent all of them. We aimed to i) compare admission clinical and sociodemographic characteristics between fallers and non-fallers ii) determine falls characteristics iii) compare length of stay (LOS), discharge functional independence, ambulation and destination between fallers and non-fallers. MethodsA matched case-control study, comparing individuals (n = 302) who fell during inpatient post-acute rehabilitation, matched (on time to admission, age and motor Functional Independence Measure (mFIM)) to individuals (n = 302) who didn´t fall, admitted within 3 months post-injury to a center between 2008 and 2023. Ambulation was assessed using the Functional Ambulation Category (FAC). ResultsMean age at admission was 50±8 years. No baseline differences were seen between groups in the proportion of patients with aphasia, diabetes, dyslipidemia, hypertension, neglect, atrial fibrillation, dysphagia, dominant side affected, medication for depression, FAC assessment, body mass index and educational level.A first-fall in the first week was experienced by 22.2 % and in the first three weeks by 54.3 %. Most falls occurred at the patients’ room (75.1 %) mostly due to distractions (55.3 %) and transferring without help (32.4 %) with 18 % occurring in the bathroom, fallers were alone in 68.6 % of the cases.Fallers had an 8-day longer mean LOS compared to non-fallers, yet there were no differences in discharge mFIM or FAC scores. While non-fallers had a higher proportion of poor mFIM outcomes (28.5 % vs. 17.9 %) and no ambulation (20.7 % vs. 12.4 %), fallers showed greater mFIM gains (26 vs. 22 points). Discharge destinations were similar across both groups. ConclusionsDespite no baseline differences, fallers experienced longer stays with comparable independence and ambulation scores at discharge. Most falls occurred in patients' rooms during unsupervised activities. Preventive recommendations have been provided to address these risks and enhance patient safety.

Non-operating Room Anesthesia (NORA): A Comprehensive Review of Monitored Anesthesia Care.

Monitored anesthesia care (MAC) is being increasingly employed in non-operative environments, particularly in the realms of endoscopy and magnetic resonance imaging (MRI) procedures. This in-depth analysis delves into the essential components of MAC within these specific contexts, with a primary focus on ensuring patient safety, evaluating efficacy, and assessing procedural outcomes. It is a common practice in endoscopic procedures to necessitate sedation for the purpose of alleviating discomfort and anxiety, ultimately ensuring patient cooperation and the successful completion of the procedure. MAC, which entails the administration of sedatives and analgesics under the close supervision of an anesthesia professional, offers a personalized approach that carefully balances the depth of sedation with maintaining optimal patient safety standards. Within the domain of MRI procedures, where challenges such as claustrophobia and motion artifacts can significantly impact the process, MAC plays a crucial role in providing a controlled setting that not only enhances image quality but also improves patient compliance throughout the procedure. The review extensively investigates the various pharmacological agents commonly utilized in these scenarios, including but not limited tomidazolamand fentanyl, shedding light on their pharmacokinetic and pharmacodynamic properties specific to these contexts. Furthermore, the critical role of the anesthesia provider in effectively managing potential complications, such as respiratory depression, hemodynamic instability, and allergic reactions, is thoroughly examined and discussed. The analysis extends to the implementation of MAC protocols, encompassing pre-procedural assessments, continuous intra-procedural monitoring, and comprehensive post-procedural care, all aimed at ensuring the best possible outcomes for patients. Additionally, the review delves into the economic considerations associated with MAC, taking into account its impact on procedural efficiency, healthcare costs, and patient throughput within these settings. By exploring current guidelines and recommendations established by professional societies such as the American Society of Anesthesiologists (ASA), this review aims to provide a holistic understanding of the best practices in MAC for both endoscopy and MRI procedures. Through the synthesis of available evidence, the primary objective of this review is to contribute to informing clinical practices, enhancing patient safety measures, improving procedural success rates, and ultimately advocating for the broader adoption of monitored anesthesia care in diverse non-operative medical settings.

Enhancing patient safety using failure mode and effect criticality analysis: a benchmarking study on selected hospitals

PurposePatient safety is a top priority globally. A robust healthcare system requires strategic collaboration between research and development. The author analysed over 300 cases from seven hospitals using the failure modes, effects, and criticality analysis (FMECA) tool to understand the underlying causes of medical errors.Design/methodology/approachThe author studied seven hospitals and 300 cases using FMECA to prioritise activities. The findings showed that high-priority events occurred less frequently but had the potential to cause the most harm. Team members evaluated independently to ensure unbiased evaluations. This approach is useful for setting priorities or assessing difficulties.FindingsPoor communication and lack of coordination among staff in a healthcare organisation caused misunderstandings, ineffective decision-making, delays in patient care, and medical errors. Implementation of effective communication and coordination protocols can help avoid these problems.Practical implicationsThe study recommends using FMECA to identify and prioritise failures and conducting in-depth analyses to understand their root causes. It also highlights the importance of interdisciplinary knowledge and soft skills for healthcare staff.Originality/valueThis study reveals the significance of FMECA in healthcare risk management and benchmarking. FMECA helps identify system failures, develop prevention strategies, and evaluate effectiveness against industry benchmarks. It offers healthcare professionals a valuable tool to enhance patient safety and improve healthcare quality.

Intraoperative Rare Complication of Excision of a Large Loop Transformation Zone

The case study discussed patient oriented quality care can enhance patient safety and increase the competency of healthcare professionals, even when they follow standard operating procedures and deal with unforeseen complications in performing LLETZ. This case report aims at validating the qualitative routine procedures against rare and complicated cases of LLETZ. The case concludes that every surgery should be performed carefully and properly to avoid unnecessary aftereffects in order to maintain efficient quality control. Simple and normal procedures were carried out by surgeons performing to the best of their abilities, competently, and with careful attention to patient safety. Though complications arose and were difficult and uncommon, the trained professional successfully navigated the procedure in such circumstantial emergencies.

Exploring the relationship between patient safety culture and the full-range leadership theory in primary care settings: a conceptual analysis

PurposeThis study aims to investigate the conceptual relationship between full-range leadership theory (FRLT) and patient safety culture in primary care settings, aiming to understand how leadership styles influence the development and sustainability of a culture prioritizing patient safety.Design/methodology/approachUsing a conceptual analysis approach, the study builds a theoretical framework that integrates FRLT – which includes transformational, transactional and laissez-faire leadership styles – with the elements of patient safety culture. This framework serves as the basis for a comprehensive literature review, allowing for the formulation of hypotheses regarding the impact of each leadership style on patient safety culture.FindingsThe analysis demonstrates that transformational leadership bolsters patient safety culture by fostering open communication, encouraging error reporting and facilitating continuous improvement. Transactional leadership yields mixed effects, effectively supporting compliance and operational outcomes but showing limitations in promoting a proactive safety culture. Conversely, laissez-faire leadership is associated with negative outcomes for patient safety culture, mainly due to its passive and detached approach.Originality/valueThe originality of this study is rooted in its focused examination of FRLT’s impact on patient safety culture within primary care settings, the development of a unique conceptual framework and its contribution of actionable insights for health-care leadership. These elements collectively advance the understanding of how leadership can enhance patient safety culture, providing a solid foundation for future research and practical application in primary care environments.

Electronic nursing documentation for patient safety, quality of nursing care, and documentation: a systematic review .

To evaluate the impact of electronic nursing documentation on patient safety, quality of nursing care and documentation. The systematic review was conducted in December 2022, and comprised a comprehensive search on Scopus, ScienceDirect, ProQuest, PubMed, Cumulative Index to Nursing and Allied Health Literature, Sage Journals and Google Scholar databases for English-language human studies published between 2018 and 2022. The key words used in the search included "Nursing", "care", "documentation", "record", "electronic", "process" and "health services". The risk of bias was assessed using Strengthening the Reporting of Observational Studies in Epidemiology tool. Of the 469 items initially identified, 15(3.2%) were analysed in detail, indicating a positive influence of electronic nursing documentation on patient safety, care quality, and documentation. However, shortcomings were observed in the development of electronic nursing documentation for optimal effectiveness. Electronic nursing documentation significantly enhanced patient safety, care quality and documentation. To facilitate its integration into clinical settings, a standardised and logically structured electronic nursing documentation system is essential.

Unlocking the Potential of Free Text in Electronic Health Records with Large Language Models (LLM): Enhancing Patient Safety and Consultation Interactions.

Computer-mediated clinical consultation, involving clinicians, electronic health record (EHR) systems, and patients, yield rich narrative data. Despite advancements in Natural Language Processing (NLP), these narratives remain underutilised. Free text recording in EHRs allows expressivity, complements structured data from clinical coding systems, and facilitates collaborative care. Large language models (LLMs) excel in understanding and generating natural language, enabling complex dialogue processing. Integrating LLM tools into consultations could harness the untapped potential of free text to identify patient safety concerns, support diagnosis and provide content to enhance clinical-patient interactions. Tailoring LLMs for specific consultation tasks through pre-training and fine-tuning is viable. This paper outlines approaches for adopting LLMs in primary care and suggests that using fine-tuned LLMs with prompt engineering could enhance computer-mediated clinical consultation cost-effectively.

A Case-Study of Metoclopramide Prescription Error : A Grim Reminder

The integration of Computerized Provider Order Entry (CPOE) systems in hospitals has been instrumental in reducing medication errors and enhancing patient safety. This study examines the implications of a software oversight in a CPOE system : Metoclopramide had a concentrated formulation (100 mg) delisted (and then not manufactured) in 2014 due to safety concerns. Despite this, the CPOE system continued to accept prescriptions for this formulation because it was not removed from the medication library by the pharmacist. The objective of our study was to describe this specific prescription error related to an outdated the medication library of the CPOE. We analyzed all metoclopramide prescriptions from 2014, to 2023. Our findings showed that errors involving 100 mg or more dosages were relatively rare, at 2.98 per 1000 prescriptions (34 errors in 11,372 prescriptions). Notably, 47.1% of these errors occurred during on-call shifts, and 68% of these errors led to actual administration. These errors correlated with periods of higher nurse workload. The findings advocate for the integration of dedicated pharmacists into ICU teams to minimize medication errors and enhance patient outcomes, and a proactive medication management in healthcare.

UNICOM Test Lab: Implementation of ISO's IDMP Standards Across the EU.

The UNICOM Test Lab enhances patient safety and healthcare efficiency by implementing ISO's IDMP standards across the EU. Funded by the EU's HORIZON Programme, this initiative unites diverse stakeholders to enable the seamless exchange of medicinal product information. This paper details the interoperability challenges and methodologies employed, highlighting the UNICOM Test Lab's role in validating and testing tools for IDMP standards implementation, aiming for semantic interoperability and a safe pharmaceutical supply chain within the EU.

Strategies for minimizing repeated exposures in diagnostic radiography

Advancements in diagnostic radiography have significantly improved medical imaging, yet the associated radiation exposure poses health risks, particularly with repeated examinations. Technological innovations, including the transition from analog to digital radiography, have led to substantial reductions in radiation doses while enhancing image quality. Digital systems, coupled with automatic exposure control (AEC), dynamically adjust radiation levels based on patient size and diagnostic requirements, minimizing unnecessary exposure. Iterative reconstruction algorithms in CT imaging further reduce radiation doses by efficiently processing images and reducing noise. Hardware improvements, such as high-efficiency detectors, capture high-quality images with lower radiation levels, contributing to dose reduction. Standardizing radiographic protocols across healthcare settings ensures consistent practices, reducing variability in radiation doses. Techniques such as beam collimation and appropriate shielding protect surrounding tissues and enhance image quality, while continuous education for technologists maintains proficiency in dose-reduction strategies. Patient education is crucial for minimizing repeated exposures. Informing patients about the risks of ionizing radiation and the importance of adhering to follow-up schedules can reduce unnecessary examinations. Electronic health records (EHRs) facilitate the tracking of cumulative radiation doses, enabling informed decision-making regarding additional imaging studies. Adherence to the ALARA principle (As low as reasonably achievable) in clinical practice ensures that radiation exposure is minimized while achieving diagnostic goals. Special considerations for vulnerable populations, such as children and pregnant women, further enhance safety. Implementing radiation safety measures and maintaining a commitment to ongoing professional development for healthcare providers fosters a culture of safety within radiology departments. By integrating these strategies, healthcare providers can balance the diagnostic benefits of radiography with the imperative to protect patients from unnecessary radiation exposure, ultimately enhancing patient safety and improving diagnostic outcomes. This comprehensive approach ensures that radiographic procedures remain both effective and safe, optimizing patient care in medical imaging.

Safety in spinal surgery-Empowering clinicians to report concerns in motor function.

Timely identification of neurological deterioration in patients with spinal disorders, through spinal motor assessment, is paramount in achieving early intervention to reduce the risk of permanent deficits. This project was initiated to meet the requirement for safe, timely spinal motor assessment through establishing and addressing clinician's educational needs. Mixed methods study conducted through online survey and concurrent focus groups June 2022-April 2023. Pre-intervention online survey and focus groups identified insufficient provision of education targeted at identifying changes in motor function and as a result, clinicians lacked confidence and competence in completing assessments and caring for patients with spinal disorders. An e-learning package was created and shared widely along with additional interventions to support assessment completion. To establish the success of the project a post-intervention online survey was distributed. Survey respondents reported that the e-learning package has influenced their practice to either some extent or to a great extent with 91% reporting increased confidence in completing a spinal motor assessment. Post-intervention results also demonstrated an increase in confidence in caring for spinal surgery patients. Through engaging with clinicians to establish and address educational needs, this quality improvement project has successfully increased competence and confidence in this area of spinal care. This study highlights the importance of targeted education to ensure that clinicians are appropriately skilled to identify neurological deterioration and demonstrates the effectiveness of digital education in providing this. This study addressed concerns around timely identification of deterioration of spinal patients. Study findings were the success in utilizing digital education to increase clinician's confidence and competence and thus enhance patient safety. This research will have an impact on clinical areas caring for patients with spinal disorders. SQUIRE guidelines. No patient or public contribution.

Quality improvement in neonatal care through enhanced patient safety and clinical risk management: a before-and-after study about neonatal sepsis.

Neonatal sepsis, classified into early-onset and late-onset based on symptom timing, poses significant risks of morbidity and mortality, especially in low birth weight infants. Effective clinical risk management protocols are crucial in reducing these risks. This before-and-after study evaluated the impact of a newly implemented clinical risk management protocol in the Neonatology and Neonatal Intensive Care Unit (NICU) at Policlinico Hospital-University of Bari. The study included 399 neonates over three years, comparing pre- and post-protocol outcomes. Data collection focused on maternal and neonatal demographics, infection rates, and hospital stay lengths. Statistical analysis included t-tests, Wilcoxon-Mann-Whitney tests, and logistic regression models. The study found no significant differences in neonatal pathologies or demographics between pre- and post-protocol groups. However, post-protocol implementation showed a notable reduction in umbilical venous catheter (UVC) infections (p = 0.018) and improved hospital stay lengths. Blood and urine cultures did not show significant changes in microbial patterns post-protocol. The findings underscore the effectiveness of structured clinical risk management protocols in enhancing neonatal outcomes, particularly in reducing specific infection risks. Despite the study's limitations, including its observational nature and sample size, the results advocate for broader adoption and further research on these protocols in diverse healthcare settings. The positive outcomes highlight the importance of continuous clinical risk management efforts in high-risk neonatal environments.

Management of Medical Emergencies in Dental Office - A Review Article

Effective management of medical emergencies in a dental office is crucial for ensuring patient safety and maintaining a high standard of care. The importance of pre-emptive preparation, including staff training, emergency equipment availability and clear action plans is emphasized. The integrity of patient’s medical history and risk assessments into routine practice is a preventive measure to mitigate the likelihood of emergencies. By fostering a proactive approach to emergency management, dental offices can enhance patient safety and improve outcomes in critical situations. Keywords: Dental offices, medical emergencies, Risk assessment and management.

Unlocking the potential of advanced large language models in medication review and reconciliation: A proof-of-concept investigation

BackgroundMedication review and reconciliation is essential for optimizing drug therapy and minimizing medication errors. Large language models (LLMs) have been recently shown to possess a lot of potential applications in healthcare field due to their abilities of deductive, abductive, and logical reasoning. The present study assessed the abilities of LLMs in medication review and medication reconciliation processes. MethodsFour LLMs were prompted with appropriate queries related to dosing regimen errors, drug-drug interactions, therapeutic drug monitoring, and genomics-based decision-making process. The veracity of the LLM outputs were verified from validated sources using pre-validated criteria (accuracy, relevancy, risk management, hallucination mitigation, and citations and guidelines). The impacts of the erroneous responses on the patients' safety were categorized either as major or minor. ResultsIn the assessment of four LLMs regarding dosing regimen errors, drug-drug interactions, and suggestions for dosing regimen adjustments based on therapeutic drug monitoring and genomics-based individualization of drug therapy, responses were generally consistent across prompts with no clear pattern in response quality among the LLMs. For identification of dosage regimen errors, ChatGPT performed well overall, except for the query related to simvastatin. In terms of potential drug-drug interactions, all LLMs recognized interactions with warfarin but missed the interaction between metoprolol and verapamil. Regarding dosage modifications based on therapeutic drug monitoring, Claude-Instant provided appropriate suggestions for two scenarios and nearly appropriate suggestions for the other two. Similarly, for genomics-based decision-making, Claude-Instant offered satisfactory responses for four scenarios, followed by Gemini for three. Notably, Gemini stood out by providing references to guidelines or citations even without prompting, demonstrating a commitment to accuracy and reliability in its responses. Minor impacts were noted in identifying appropriate dosing regimens and therapeutic drug monitoring, while major impacts were found in identifying drug interactions and making pharmacogenomic-based therapeutic decisions. ConclusionAdvanced LLMs hold significant promise in revolutionizing the medication review and reconciliation process in healthcare. Diverse impacts on patient safety were observed. Integrating and validating LLMs within electronic health records and prescription systems is essential to harness their full potential and enhance patient safety and care quality.

Navigating the unexpected: Insights into bladder injuries during emergency cesarean deliveries

Bladder injury is a recognized complication of emergency cesarean sections, yet comprehensive studies elucidating its incidence and associated risk factors are limited. This retrospective study analyzed data from emergency cesarean deliveries performed over a three-year period at a tertiary care center. Cases with documented bladder injury were identified, and relevant clinical variables including patient demographics, surgical details, various risk factors, and obstetric history were collected and analyzed.Among the emergency cesarean cases reviewed (n= 12218), bladder injury was identified in 22 cases making a incidence rate of 0.18%. The majority of injuries occurred during the initial phase of uterine incision. Significant risk factors associated with bladder injury included a history of previous cesarean sections, presence of adherent placenta, and intraoperative adhesions. Distribution analysis revealed varying prevalence rates across different clinical variables.Bladder injury represents a notable complication of emergency cesarean deliveries, necessitating a comprehensive understanding of associated risk factors and preventive measures. This study contributes valuable insights into the epidemiology and clinical correlates of bladder trauma in urgent obstetric interventions, emphasizing the importance of tailored interventions to enhance patient safety and reduce maternal morbidity.