Error Checklist Research Articles

Assessing Chest Tube Insertion Skills Using a Porcine Rib Model-A Validity Study.

Assessments require sufficient validity evidence before their use. The Assessment for Competence in Chest Tube Insertion (ACTION) tool evaluates proficiency in chest tube insertion (CTI), combining a rating scale and an error checklist. The aim of this study was to collect validity evidence for the ACTION tool on a porcine rib model according to the Messick framework. A rib model, consisting of a porcine hemithorax that was placed in a wooden frame, was used as simulator. Participants were recruited from the departments of surgery, pulmonology, and emergency medicine. After familiarization with the rib model and the equipment, standardized instructions and clinical context were provided. They performed 2 CTIs while being scored with the ACTION tool. All performances were assessed live by 1 rater and by 3 blinded raters using video recordings. Generalizability-analysis was performed and mean scores and errors of both groups on the first performance were compared. A pass/fail score was established using the contrasting groups' method. Nine novice and 8 experienced participants completed the study. Generalizability coefficients where high for the rating scale (0.92) and the error checklist (0.87). In the first CTI, novices scored lower than the experienced group (38.1/68 vs. 47.1/68, P = 0.042), but no difference was observed on the error checklist. A pass/fail score of 44/68 was established. A solid validity argument for the ACTION tool's rating scale on a porcine rib model is presented, allowing formative and summative assessment of procedural skills during training before patient contact.

The effect of electronic medical records on medication errors, workload, and medical information availability among qualified nurses in Israel– a cross sectional study

BackgroundErrors in medication administration by qualified nursing staff in hospitals are a significant risk factor for patient safety. In recent decades, electronic medical records (EMR) systems have been implemented in hospitals, and it has been claimed that they contribute to reducing such errors. However, systematic research on the subject in Israel is scarce. This study examines the position of the qualified nursing staff regarding the impact of electronic medical records systems on factors related to patient safety, including errors in medication administration, workload, and availability of medical information.MethodsThis cross-sectional study examines three main variables: Medication errors, workload, and medical information availability, comparing two periods– before and after EMR implementation based on self-reports. A final sample of 591 Israeli nurses was recruited using online private social media groups to complete an online structured questionnaire. The questionnaires included items assessing workload (using the Expanding Nursing Stress Scale), medical information availability (the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire), and medical errors (the Medical Error Checklists). Items were assessed twice, once for the period before the introduction of electronic records and once after. In addition, participants answered open-ended questions that were qualitatively analyzed.ResultsNurses perceive the EMR as reducing the extent of errors in drug administration (mean difference = -0.92 ± 0.90SD, p < 0.001), as well as the workload (mean difference = -0.83 ± 1.03SD, p < 0.001) by ∼ 30% on average, each. Concurrently, the systems are perceived to require a longer documentation time at the expense of patients’ treatment time, and they may impair the availability of medical information by about 10% on average.ConclusionThe results point to nurses’ perceived importance of EMR systems in reducing medication errors and relieving the workload. Despite the overall positive attitudes toward EMR systems, nurses also report that they reduce information availability compared to the previous pen-and-paper approach. A need arises to improve the systems in terms of planning and adaptation to the field and provide appropriate technical and educational support to nurses using them.

The Effectiveness of Repeated Reading and Supported Cloze Procedure to Improve Beginning Reading Skills in Elementary School Slow Learner Students

Literacy plays a very important role in the academic performance and overall development of elementary school students. However, many elementary school age children experience problems in reading, including fluency, accuracy and reading comprehension. This affects the learning process and causes poor academic results. The initial reading ability of 4th grade elementary school slow learner students at MI Salafiyah Mahbubiyah still has not received special treatment to improve their reading ability. Improving initial reading skills in slow learner students must be done in the right way, one of which is repeated reading and supported cloze procedures. To overcome this problem, the intervention was carried out using the repeated reading method and supported cloze procedure. The aim of this research is to see the effectiveness of repeated reading and supported cloze procedures to improve the beginning reading abilities of slow learner students in grade 4 of elementary school. This intervention aims to improve early reading skills in elementary school children who experience slow learning. This research uses a single case experimental design, where the subjects are 4th grade elementary school students. The development of the subject's reading ability was measured using Gickling and Armstrong's checklist, namely Reading Proficiency and Error Checklists. The results of the research show that there is a difference after being given the repeated reading and supported cloze procedure technique and before being given the repeated reading and supported cloze procedure on the subject. This means that (Ha) is accepted and (Ho) is rejected. So, it can be concluded that the repeated reading and supported cloze procedure is effective in improving the initial reading skills of slow learner students in grade 4 of elementary school.

Self-administration medication errors at home and its predictors among illiterate and low-literate community-dwelling older adults with polypharmacy: A negative binomial hierarchical regression.

Older adults with polypharmacy are more prone to medication errors. People with low educational attainment have more difficulties in taking their medications. This study aimed to identify the extent of medication self-administration errors (MSEs) and the contributing factors among illiterate and low-literate community-dwelling older adults with polypharmacy. The present cross-sectional study was conducted among people aged 60 and above. The data were collected using the sociodemographic, clinical, and Belief about Medicines Questionnaires (BMQ). To determine the extent of MSE, a medication error checklist was used. The negative binomial hierarchical regression model in the five blocks was performed. The final sample size was 276 people. The frequency of MSEs in the last 6 months was 69.2%. Sixteen percent of participants had made four or more mistakes. The most common MSEs were forgetting, improper taking of medications with food, improper timing, incorrect dosage (lower dose), and forgetting the doctor's instructions. Near 18% of participants reported adverse events following their mistakes. The significant predictors of MSEs were being completely illiterate (p = 0.021), the higher number of doctor visits per year (p = 0.014), irregularly seeing doctors (p < .001), the higher number of medications (p < .001), and having poor medication beliefs (p < .001). Despite the high prevalence of MSEs among older patients, practical strategies to deal with them at their homes have not been established among health systems. MSE as a multifactorial event can be caused by a collection of internal and external factors. Further studies to identify the role of patients, clinicians, procedures, and systems in developing MSEs as interconnected components are needed.

A Study of Senior High Schools in Palembang: Students’ Errors in Writing

This research was intended to find out an error analysis of students' writing of eleventh grade of students of three senior high schools in Palembang. Quantitative content analysis research is conducted in this research as the methodology research. This research was conducted in three senior high schools in Palembang, namely, (1)SMA Muhammadiyah 6 Palembang which is accredited A, (2) SMA Nurul Amal Palembang which is accredited B, (3), SMA Muhammadiyah 8 Palembang which is accredited C. The total of participant of this research is 30 students. In collecting data, the researcher used writing sheet test and error checklist as the instrument of this research. The data was analyzed by using method of analyzing error by Ellis. The results of this research showed the errors of writing aspects on students writings of eleventh grade students of three high senior high schools in Palembang, namely, first is content errors, second is paragraph organizations errors, third is vocabulary error, forth is mechanic error, and fifth is grammar error. From the findings of this research could be conclude that some of eleventh-grade students in senior high schools in Palembang have less knowledge or lack information about five writing aspects as the essential knowledge to write text.

A critical analysis of labeling errors of high-alert medications – Safety assessment and remedial measures through case based approach

Background and objectiveWrong labeling of the drugs is one of the critical issues that can end up in serious health issues among patients. Labeling errors of high-risk medications can lead to permanent disability or death of patients in critical settings. This article aims in identifying and analyzing the critical labeling error of the parenteral products and draws a comprehensive outline of its remediations and unintended consequences with respect to patient safety. Materials and methodsThe pharmaceutical supply chain department of high-end Tertiary hospitals and community pharmacies located in Udupi and Dakshina Kannada districts in Karnataka, India were visually inspected using a validated checklist for labeling errors in parenteral products. Defective products with labeling errors were identified and procured. ResultsTwo defective samples with labeling errors were identified. A small volume parenteral (infusion) bottle having both 50% Dextrose and Atropine sulphate injection (100 mg) mentioned on the same label and a Biphasic Isophane Insulin Injection (a × b mL) cartridge with missing batch code was procured from the Hospital Pharmacies. ConclusionStreamlining the process of labeling errors, development of strategies, providing effective training to manufacturing personnel, dispensing pharmacists and all other healthcare professionals and improving regulatory compliance by adhering to current Good Manufacturing Practices can contribute to the reduction of labeling errors. This study will create sound awareness among the healthcare care professionals, pharmaceutical manufacturers, and stakeholders/policy makers by the in-depth exploration of real-life problems and help them in the initiation of necessary measures to avoid such problems in future.

Validation of a new assessment tool for chest tube insertion on Thiel embalmed human cadavers: a feasibility study

IntroThiel embalmed human cadavers are considered as high‐fidelity simulator for several surgical procedures, including Chest Tube Insertion (CTI). In proficiency‐based education, targeted feedback is essential in order to improve learners’ technical skills. Assessments must be validated prior to their use. Validity can be established using Messick’s framework, which collects evidence from five sources. The ACTION tool is a new assessment tool, and consists of a procedure‐specific Rating Scale and an error checklist. It has been developed by a Delphi panel, which ensures content evidence. This study evaluates the feasibility of a validation study for the ACTION tool on Thiel embalmed human cadavers.MethodsA convenience sample of three medical undergraduates and one PhD candidate was recruited. All provided informed consent and demographic information. Each participant was scored and recorded while performing a CTI. Each recording was later scored by three raters. Rater agreement was evaluated by calculating a two‐way mixed effects, absolute agreement, single unit of measurement intraclass correlation coefficient (ICC) model. Internal consistency of the assessment was evaluated using Cronbach Alfa. Feasibility was evaluated using structured questions regarding recruitment and data outcomes.ResultsRecruitment capability and data collection procedures were evaluated as being feasible and suitable for the target study participants. All necessary resources are available and data analysis can be carried out.Preliminary results for the procedural steps indicate an ICC of 0.62, indicating moderate rater agreement, and a Cronbach Alfa of 0.94, indicating excellent internal consistency. For the errors, an ICC of 0.63, and a Cronbach Alfa of 0.68 was observed.ConclusionValidation of the ACTION tool following Messick’s framework is feasible. A rater training session can increase reliability. After validation, the assessment tool can be used to evaluate learners’ proficiency in CTI on Thiel embalmed human cadavers, prior to patient contact.

Effect of Short-term-focused Training on a Phantom Model in Improving Operative Room Performance Among Surgical Residents: A Randomized Trial.

Meta-analysis has shown the effectiveness of various training methods for the acquisition of laparoscopic skills in surgical training. However, there is very limited literature focusing on the translation of skill acquisition on training models into improved operating room (OR) performance. This study was conducted to evaluate the effectiveness of the Tuebingen trainer with integrated Porcine tissue in improving OR the performance of surgical trainees using standard assessment tools. The study was a single-blinded double-armed randomized control study conducted between July 2016 and March 2018. Eighteen, fourth, and fifth semesters of surgery residents were included in the study. The baseline performance was assessed in OR by performing laparoscopic cholecystectomy using validated scores, that is, Global Operative Assessment of Laparoscopic Skills (GOALS), Additional Five Criteria, Task-specific Checklist, Error Checklist, Visual Analogue Scale. The residents were then randomized into trainee and nontrainee groups. The training group received 5 days of short-term-focused training on the Tuebingen trainer, and the improvement was reassessed in OR. The demographic profile of residents was similar. The baseline scores were comparable. The training group showed statistically significant improvement in GOALS (9.88±1.76 to 12±0.66, P=0.05 vs. 10.33±1.5 to 11.4±2.24, P=0.28), task-specific checklist (42.22±10.92 to 53.33±14.14, P=0.027 vs. 45.55±10.13 to 50±17.32, P=0.51), and error checklist. The operating time significantly reduced (36.0±4.03 vs. 50.44±11.39, P=0.0025) following training. Our study concludes that the training on the Tuebingen trainer with integrated porcine organs results in a statistically significant improvement in the OR performance of surgical residents as compared with the nontrained residents, thereby indicating a transfer of skills from training to OR.

Junior secondary school students' intralingual errors in essays written in French language

This study set out to identify students’ intralingual errors in the essays written in French. The study adopted the ex-post facto design, using the content analysis technique. The population comprised 2,893 copies of descriptive essays written in French Language by year 3 junior secondary school students in the Basic Education Certificate Examination (BECE) in 2015, 2016 and 2017 in Imo State. The sample of 228 essays was selected through stratified, purposive and proportionate random sampling techniques. The three instruments for the study were the question papers on French Language, the students’ answer scripts and a researcher-designed Checklist of Intralingual Errors for Learning French (CIELF). The data from the error analysis were subjected to analysis using the Statistical Package for the Social Sciences (SPSS) and the research question that guided the study was answered in percentages. The results showed that the students committed eight intralingual errors, which include overgeneralization, omission, addition, simplification of parts of speech, misinformation, agreement, verb forms and mechanical errors. Part of the recommendations is for teachers of French to build language instructions on students’ prior knowledge and experiences, thereby making French languagelearning to be real and interesting to the students.

In Praise of Sarah Richmond's Translation of &lt;i&gt;L'Être et le néant&lt;/i&gt;

This article surveys most of the recent reviews of Sarah Richmond’s excellent new translation of L’Être et le néant. It offers some close textual comparisons between Richmond’s translation, Hazel Barnes’ translation, and the Checklist of Errors of Hazel Barnes’ Translation of L’Être et le néant. This article concludes that Richmond delivers a higher semantic resolution translation that overcomes nearly all the liabilities found in Barnes and does so without sacrificing much by way of readability.

SAFER PRACTICES in the COVID-19 pandemic

COVID-19 has created a wave of uncertainty for nurses and healthcare practitioners, with new information on the virus being released constantly. Paul Silverston discusses the assessment of patients with symptoms of COVID-19 and how to reduce the risk of misdiagnosis Errors in diagnosis are relatively common in primary care which often result in serious harm to patients. The majority of these errors are preventable. This article describes a diagnostic error checklist, SAFER PRACTICES, which can be used to help clinicians prepare themselves for consulting in patients with suspected or confirmed COVID-19 disease so that they come to the consultation with the correct medical knowledge, clinical assessment plan and diagnostic reasoning required to reduce the risk of diagnostic error. It can also be used during the consultation to deliver a systematic approach to the prevention and detection of diagnostic errors.

SAFER PRACTICES: reducing the risk of diagnostic errors

Diagnostic errors are relatively common in general practice. Paul Silverston describes a mnemonic-based system to prevent and detect these errors Diagnostic errors in primary care are relatively common and they have the potential to cause serious harm to patients. Up to 80% of these errors are believed to be preventable. This article describes a mnemonic-based system that practice nurses can use to prevent diagnostic errors from arising, as well as to detect these errors when they occur. The mnemonic is designed to be used pre-consultation to reduce the risk of errors arising through better preparation; during the consultation, as a diagnostic error checklist; and after the consultation to encourage reflective practice and critical thinking.

Improving service delivery using the self-reporting of errors by midwives and midwifery student.

INTRODUCTION:Reporting medical errors is one of the common methods for identifying and preventing mistakes in-hospital care. This study was conducted to identify the status of reporting and related factors in two groups of midwives and midwifery students.METHODOLOGY:This research was analytic correlational; it was conducted among all the midwives working in the midwifery and labor departments and midwifery students in Isfahan University of Medical Sciences. The data collection tool included a checklist of errors and the researcher-construed questionnaires of awareness and attitude toward reporting errors. The results were examined using descriptive and inferential statistics (ANOVA, Pearson and Spearman correlation coefficient, and independent t-test) by SPSS software version 20.RESULTS:In this research, the error reporting in midwifery staff was 79.1% and the most frequent error was related to the patient's process of testing; the error reporting among the students was 90% and the most frequent error occurred in the labor processes. The present study also showed that there was a direct relationship between awareness and attitude toward reporting medical errors (P < 0.001), while there was not a significant relationship between the midwifery students’ awareness and attitude toward reporting the medical errors (P = 0.31).CONCLUSION:According to the study, hospital midwives reporting is less than midwifery students. Accordingly, it is recommended to focus on the error and risk management committee to strengthen the reporting system.

An audit of Preanalytical errors as a quality measure in central clinical laboratory of Rural Tertiary Care Hospital in Eastern Uttar Pradesh

Introduction: Quality lab reports require high degree of precision and accuracy. This study was undertaken to study pre-analytical errors as a quality measure in Central Clinical Laboratories of rural Tertiary Care Hospital. Materials and Methods: This study was a non-participatory observational study for a period of two months from 6/7/2019 to 6/9/2019 conducted at HIMS, UP, India. After obtaining clearance from Institutional Human Ethical committee, study was undertaken in Central Clinical Laboratory(CCL). The blood samples of OPD and IPD were included. Checklist for pre-analytical errors was followed. Results: Total 13604 blood samples were received in CCL in study periodand pre-analytical error was found to be 398 (2.93%). The commonest error was inadequate (underfilled/Overfilled) samples(1.15%), second commonest was Clotted sample (0.99%), Hemolyzed samples were 0.26%, Lipemic samples were 0.15%, and remaining were diluted sample, incorrect vaccutainer and sample spillage each accounted for 0.08%, followed by test ID form missing (0.06%) and specimen ID and order form mismatch (0.02%). There was a statistical difference between pre-analytical errors in IPD(3.68%) and OPD(0.87%) samples with p value less than Conclusion: Pre-analytical errors are avoidable and could be manage by preventive and corrective measures and proper education and skill enhancing training to paramedical staff and efficient monitoring by Lab managers. Keywords: Blood samples, Central clinical laboratory, Pre-analytical errors.

Error Analysis Of Translated Text Made By Maritime Students (in Maritime Context)

Despite its importance, translation is just newly concerned for studies. Maritime students learning Maritime English are often faced with translation activity, especially as a way to introduce new field-specific terms in the learning process. The complex nature of the field has become a challenge to the beginner learners involved in the activity related to the field. The purpose of the study is to investigate the types of error that students often make when translating maritime texts. The participants of the study were 5 maritime students at first year involving in the subject of Maritime English. Instrument utilized in the study was a checklist of translation errors adapted from the theory of Nord (1997). The results indicated that most of translation errors made were related to linguistics translation errors. The conclusion drawn was that the students faced a challenge concerning the lack of English vocabulary, both General English vocabulary and Maritime English terms.

Validity and reliability of metrics for translation of regional anaesthesia performance from cadavers to patients

BackgroundOur goal is to develop metrics that quantify the translation of performance from cadavers to patients. Our primary objective was to develop steps and error checklists from a Delphi questionnaire. Our second objective was to show that our test scores were valid and reliable. MethodsSixteen UK experts identified 15 steps conducive to good performance and 15 errors to be avoided during interscalene block on the soft-embalmed cadaver and patients. Thereafter, six experts and six novices were trained, and then tested. Training consisted of psychometric assessment, an anatomy tutorial, volunteer scanning, and ultrasound-guided needle insertion on a pork phantom and on a soft-embalmed cadaver. For testing, participants conducted a single interscalene block on a dedicated soft-embalmed cadaver whilst wearing eye tracking glasses. ResultsWe developed a 15-step checklist and a 15-error checklist. The internal consistency of our steps measures were 0.83 (95% confidence interval [CI]: 0.78–0.89) and 0.90 (95% CI: 0.87–0.93) for our error measures. The experts completed more steps (mean difference: 3.2 [95% CI: 1.5–4.8]; P<0.001), had less errors (mean difference: 4.9 [95% CI: 3.5–6.3]; P<0.001), had better global rating scores (mean difference: 6.8 [95% CI: 3.6–10.0]; P<0.001), and more eye-gaze fixations (median of differences: 128 [95% CI: 0–288]; P=0.048). Fixation count correlated negatively with steps (r=–0.60; P=0.04) and with errors (r=0.64; P=0.03). ConclusionsOur tests to quantify ultrasound-guided interscalene nerve block training and performance were valid and reliable.

Randomised controlled trial of simulation-based education for mechanical cardiopulmonary resuscitation training

IntroductionMechanical cardiopulmonary resuscitation (M-CPR) is increasingly used in the management of cardiac arrest. There are no previously reported randomised studies investigating M-CPR training. This study of newly trained M-CPR providers...

The hands and head of a surgeon: Modeling operative competency with multimodal epistemic network analysis

BackgroundThis paper explores a method for assessing intraoperative performance by modeling how surgeons integrate psychomotor, procedural, and cognitive skills to manage errors. MethodsAudio-video data were collected from general surgery residents (N = 45) performing a simulated laparoscopic ventral hernia repair. Errors were identified using a standard checklist, and speech was coded for elements related to error recognition and management. Epistemic network analysis (ENA) was used to model the integration of error management skills. ResultsThere was no correlation between number or type of errors committed and operative outcome. However, ENA models showed significant differences in the integration of error management skills between high-performing and low-performing residents. ConclusionThese results suggest that error checklists and surgeons' speech can be used to model the integration of psychomotor, procedural, and cognitive aspects of intraoperative performance. Moreover, ENA can identify and quantify this integration, providing insight on performance gaps in both individuals and populations.

Identifying medication errors in the neonatal intensive care unit and paediatric wards using a medication error checklist at a tertiary academic hospital in Gauteng, South Africa

Background. Paediatric patients are particularly prone to medication errors as they are classified as the most fragile population in a hospital setting. Paediatric medication errors in the South African healthcare setting are comparatively understudied. Objectives. To determine the incidence of medication errors in neonatal and paediatric inpatients, investigate the origin of medication errors that occurred and describe and categorise the types of medication errors made in both the neonatal intensive care unit (NICU) and paediatric wards. Methods. The study followed a prospective, quantitative design with a descriptive approach. A prospective record review of inpatients’ medication charts was undertaken to determine what was prescribed by the physician, dispensed by the pharmacy and administered by the nurses. The researcher also directly observed the preparation and administration techniques as performed by the nurses. A medication error checklist was used to collect the data. Results. A total of 663 medication errors were detected in 227 patients over the study period of 16 weeks, of which 177 (78%) patients had one or more error(s). There were 338 (51%) administration errors and 309 (47%) prescribing errors. Incorrect dosing was the most frequent type of error (34%), followed by omission of medication (18.5%) and medication given at the incorrect time (12%). The causes of these medication errors were mostly due to miscalculation (26%), failure to monitor (15%) and procedures not followed (15%). Anti-infectives (43%) and analgesics (25%) had the most errors. In 118 (67%) patients the errors resulted in no harm to the patient, whereas in 59 (33%) patients the medication error resulted in some level of harm. Conclusion. The incidence of medication errors in the NICU and paediatric wards at the teaching hospital was higher than values reported elsewhere globally. Most errors occur during prescribing and administration of medication. Dosing errors are a common problem in paediatrics. Therefore, a formalised system to record these errors should be introduced alongside regular discussions on preventive measures among the multidisciplinary team.

Examining the link between burnout and medical error: A checklist approach

BackgroundThe aim of this cross-sectional study was to develop an evidence-based systematic Medical Error Checklist (MEC) for self-reporting of medical errors. In addition the study examined the comparative influence of individual, structural, and organizational factors on the frequency of self-reported medical errors. Research designA three-step process was followed in order to develop three checklists, for internists, surgeons and pediatricians respectively. The Maslach Burnout Inventory (MBI), the Utrecht Work Engagement Scale (UWES) and the teamwork-subscale of the Hospital Survey on Patient Safety Culture (AHRQ) were used in order to measure physicians’ levels of burnout, job engagement and teamwork respectively. A total of 231 doctors working in a large teaching hospital in Greece participated in the study (response rate: 49.8%). ResultsInternal reliability coefficients were high for all three checklists. Gender, age, clinical experience, and working hours were not related to medical errors in any of the medical specialties. In surgeons, medical errors were negatively related to engagement (R2=0.210, p=0.004), while teamwork and depersonalization were the only predictive factors of frequency of medical errors, in both pediatricians and internists (R2=0.306 p<0.001). ConclusionsThe Medical Error Checklists developed in this study advance the study of medical errors by proposing a comprehensive, valid and reliable self-assessment tool. The results highlight the importance of hospital organizational factors in preventing medical errors.