Safety Matters Research Articles

Instruments for measuring incidents related to patient safety in the context of paediatric intensive care\u2014protocol for a scoping review

BackgroundPatient safety is a fundamental principle of health care but is one of the biggest challenges currently faced and a serious public health problem, since the occurrence of adverse events is probably one of the main causes of morbidity and mortality worldwide. The vulnerability of the paediatric population, combined with the potentially dangerous context of intensive care, makes Paediatric Intensive Care Units services of particular complexity in matters of safety, where there is a greater likelihood of incidents with serious consequences. It is agreed that research on the topic of PS should start with the measuring of different types of harm that exist in the contexts, to identify high-risk areas and define priorities. For this, it is necessary to resort to a multiplicity of valid, reliable and specific measurement instruments and to learn their advantages and limitations. The objective of this review will be to identify and map in scientific literature the instruments for measuring incidents related to patient safety applicable in the context of paediatric intensive care.MethodsThis review will cover studies and documents that refer to all measurement instruments used in the field of patient safety in a context of paediatric intensive care. Quantitative, qualitative, or mixed nature published studies, as well as grey literature, produced in the last 5 years and relevant to the topic will be included, in Portuguese, English or Spanish languages. The sources of information include several databases (such as MEDLINE, CINAHL, Cochrane Library, JBI Databases) and sources relevant to grey literature. Two reviewers will independently screen all citations, full-text articles and abstract data. The extracted data, after being organised in the extraction table, will be mapped in a descriptive and logical way, taking into account the defined review questions.DiscussionThe mapping of the tools in these protocols will allow to summarise the most widely used instruments, to know their specificities and to guide researchers to use the most appropriate measurement tools for their context, specifically, in paediatric intensive care.Systematic review registrationOpen Science Framework (osf.io/b5m7j).

Limitations of the new ISO standard for health and wellness apps

Limitations of the new ISO standard for health and wellness apps

Principals’ leadership styles: Critical components to the security management in selected secondary schools in Mandera county, Kenya

Introduction: Leadership styles of school principals plays a significant role in making the school a safe haven for students. This is because principals interact with the school community more often, and hence understand the school environment better. Purpose: Determine the critical leadership style in the security management in Mandera County, Kenya Methodology: The correlational study design was used as the framework that anchored the study. The survey targeted a population of 424 teachers, 46 principals, 460 BOM members and 13,387 students in Mandera County which makes a total population of 14,317. The sample size was 201 teachers, 40 principals, 210 BOM members and 373 students and thus narrowing the sample size to 824 respondents. The respondents were stratified, proportionately and randomly sampled. Questionnaires for teachers, semi- structured interview guides for principals and BOM members, and focus groups were adopted as instruments of collecting information. Before the main study, the researcher conducted a pilot study in schools that had characteristics similar to those of the sampled schools. Content validity was determined using expert judgment from specialist in the education management. Instrument reliability was established using the Cronbach alpha technique. Thematic analysis was used to analyze qualitative data, while quantitative data were analyzed using descriptive statistics in terms of frequencies, means, and inferential statistics in terms of regression analysis. Results: The results of this research show a prediction that for each increase in the leadership styles of secondary school principals, there was a 29.7% increase in security management. Recommendation: Major recommendation is that school leadership need to adopt the correct management strategies to ensure security. Furthermore, the community where the school is located should be involved in matters of student security and safety.

Evaluating the Viewpoints of Postgraduate Health Students of Qazvin University of Medical Sciences toward the Effectiveness of Health Safety and Environment Workshop in 2020

It is necessary for managers in all types of organizations to take an appropriate training approach in order to maintain and promote health, achieve safety, and prevent environmental damages. We aimed to evaluate the effectiveness of Health Safety and Environment training workshops from the students’ point of view to inform the relevant officials about the participants’ opinions and make efficient decisions in order to improve the quality of training courses in the field of health, safety, and environment. A qualitative study was conducted using face-to-face or telephone interviews with a purposeful number of 37 students studying at the faculty of the health of Qazvin University of Medical Sciences. To analyze data, thematic analysis using a framework approach was applied. Findings related to the students’ viewpoint about the effectiveness of the HSE workshop were presented in six main themes including satisfaction with the educational content, awareness about HSE concepts before the workshop, the importance of HSE subject in the participants’ field of study, important topics presented in the workshop, experience from HSE workshop, major workshop problems, and solutions. Based on the study results, one of the key objectives of all medical universities should be training their students about health and safety matters to potentially prepare them for future job positions with maximum safe behaviors in workplaces. In fact, medical universities play a key role in developing the health and safety knowledge of students helping them in protecting themselves while working in hazardous working conditions.

There is no health without cultural safety: why cultural safety matters

Background: Nurses and midwives predominately work in western-centric health care settings, which may not align with Indigenous perspectives of health and wellbeing. Nurses and midwives will also view care through their own cultural lens. Culturally inappropriate health care can reduce access and engagement in services and contribute to reduced health outcomes for Indigenous peoples. Australian codes of conduct for nurses and midwives now advocate for care that is holistic, free of bias and racism, challenges beliefs based on assumption, and is culturally safe for Indigenous peoples. However, there are varying understandings of cultural care, what it looks like, and how to best achieve it. Aim: To highlight the importance of cultural safety in health care and discuss the integration into nursing and midwifery practice. Design: Discussion paper. Discussion: Cultural safety has emerged in Australia as the framework to improve the access and quality of health care for Indigenous people and to improve disparities in health care outcomes. However, the application of these principles for nurses and midwives has not been widely explored. Misconceptions around the concept remain despite the inclusion in national standards and practice frameworks. Conclusion: Evaluation and research that contributes to evidence-based knowledge specifically on the integration of cultural safety in nursing and midwifery practice is required. Impact Statement: This paper provides an overview of the importance of cultural safety in nursing and midwifery practice. Although cultural safety is now embedded in professional codes and standards, there is limited evidence of how this is translated to clinical care. Research and evaluation are needed to evaluate the application of cultural safety principles by nurses and midwives.

Organizational and legal problems of functioning of public councils under the Ministry of Internal Affairs of Russia and its territorial bodies in matters of road safety

The subject of the study is the organizational and legal problems of the functioning of public councils under the Ministry of Internal Affairs of Russia and its territorial bodies in matters of road safety. The object of the study is public relations related to the functioning of public councils under the Ministry of Internal Affairs of Russia and its territorial bodies. As a result of the analysis of normative legal acts, scientific literature, the author comes to the conclusion that despite the existence of public councils for more than ten years, the analysis of the practice of their functioning allows us to assert that there are separate problems, both legal and organizational, that do not allow them to fully fulfill their intended purpose expressed in the coordination of the coordination of socially significant interests, solutions to the most important issues of the activities of internal affairs bodies, including in the field of road safety. The methodological basis of the research was a complex of general scientific and private scientific methods of cognition (formal legal, analytical, system analysis, synthesis, modeling, comparison, etc.), special scientific (technical and legal analysis, etc.). The scientific novelty of the research is expressed in the author's vision of the solution of the identified problems of the functioning of public councils. The author's general conclusion is the statement that the high social significance of the road traffic sphere for society determines the need to improve the mechanisms of citizens' participation in the management of public relations related to ensuring the safety in question, one of which is the public councils under the federal executive authority in the field of internal affairs and its territorial bodies. For the effective functioning of the institution under consideration, it is necessary to improve the organizational and legal foundations that help transform it into a real tool for expressing the position of civil society, allowing for managerial influence on the sphere of traffic.

АНАЛИЗ ЭКОЛОГИЧЕСКИХ ПРОБЛЕМ И РАЗРАБОТКА ПРОЕКТНЫХ РЕШЕНИЙ С ПРИМЕНЕНИЕМ ТРЕХМЕРНОЙ КАРТЫ ТЕРРИТОРИИ

In the modern world, the ecological situation remains very tense. In this regard, solving the envi-ronmental problems of individual territories is an urgent task. The work is devoted to the application of the cartographic method for studying the ecological situation in the territory of the municipal district of the Altai Region. One of the most effective methods of research is the cartographic representation of the terrain in three-dimensional form, providing ease of perception, facilitating the processes of analysis, planning and design. Some environmental problems in the territory are highlighted, the state of protective forest strips is studied in detail. A 3D map of the actual state of the problem situation has been compiled, solutions have been proposed, and the planned results of project activities are visually displayed. The features of using the map are described; the possibility and necessity of interaction of various spheres and branches of activity in matters of environmental safety are noted.

THE CONCEPT OF PERSONAL SECURITY IN THE CONTEXT OF THE TRANSFORMATION OF LEGAL RELATIONS IN SOCIETY

The article examines the basic concepts of personal security, defines an analytical model of personal security in the context of the transformation of society. The main problems in matters of personal safety have been studied. The actual developments in the formation of the personal safety model in modern realities are analyzed. The state of scientific development of forms of personal safety management is characterized, as well as the directions of their modernization are determined.

Health Safety Guidelines and 5G Wireless Radiation [Health Matters

The rollout of 5G cellular communication technology is well underway worldwide. The advocates of 5G mobile technology hail it as a faster and more secure technology than its predecessor, 3G and 4G systems. The major enabling infrastructure uses millimeter-wave (mm-wave) and phased-array technology to achieve line-of-sight directivity, high data rates, and low latency. A central vulnerability or security threat is that it may allow spying on users. Nevertheless, this is a system architecture and technology or regulatory issue but not a biological effect or health safety matter.

The Inter-Agency Committee on Radiation Safety—30 years of international coordination of radiation protection and safety matters

The Inter-Agency Committee on Radiation Safety (IACRS) was constituted in 1990, as a forum for collaboration and coordination between international bodies with regards to radiation safety. It consists today of representatives of eight intergovernmental member organizations (the European Commision, Food and Agriculture Organization, International Atomic Energy Agency (IAEA), International Labour Office, Organisation for Economic Co-operation and Development/ Nuclear Energy Agency (OECD/NEA), Pan American Health Organization, United Nations Scientific Committee on the Effects of Atomic Radiation and the World Health Organization) and five observer non-governmental organizations (International Commission on Radiological Protection, International Commission on Radiation Units & Measurements, International Electrotechnical Commission, International Radiation Protection Association and International Organization for Standardization). The IACRS provides a platform for interaction between these relevant international bodies to contribute to a common understanding of the scientific basis and legal framework for the application of the system of radiation protection, towards global harmonisation of radiation safety standards. The IACRS played a key role in the development of the International Basic Safety Standards (BSS) in 1996 and in its revision in 2014. Further, an IACRS specific Task Group—chaired by the IAEA—fosters the implementation of the BSS in a consistent and coherent manner in all Member States of the United Nations. The IACRS operates via a standing secretariat jointly provided by the IAEA and OECD/NEA and is chaired by one of its member organizations on a rotating basis for periods of about 18 months. This approach has proved to be effective and was the foundation for ensuring continuity of the work of the committee and at the same time allowing a rotating leadership for all member organizations. Currently, the IACRS is chaired by the WHO. The International Radiation Safety Framework under which the IACRS works is structured around four main areas: (a) science; (b) principles; (c) standards; and (d) practice. This paper presents briefly the mandates, roles and functions of the various international bodies that are relevant to the four above mentioned areas of work, discusses how these bodies coordinate their actions and complement each other to enhance radiation protection and safety worldwide and describes their contribution to the achievement of the Sustainable Development Goals. The paper also provides an overview of the main accomplishments of the IACRS since its inception 30 years ago, and an outlook on key challenges for its future activities.

Disciplinary Action Against UK Health Professionals for Sexual Misconduct: A Matter of Reputational Damage or Public Safety?

ABSTRACT The regulation of health care professionals in the United Kingdom (UK) falls under the authority of one of nine General Councils, each of which has a statutory duty to ensure the fitness to practice of a subdivision of these professionals. Among the matters that may call fitness to practice into question are deviations from published standards of behavior, which include the maintenance of appropriate sexual boundaries by practitioners. The aim of this article is to examine how the common fitness-to-practice process utilized by General Councils deals with registered health care professionals who have exceeded these boundaries. Deductive thematic analysis was carried out on cases involving academic misconduct among registrants of the General Medical Council, General Dental Council, General Pharmaceutical Council, and Nursing and Midwifery Council, using themes derived from each council’s standards for registrants and guidance for disciplinary panel members. While each of these four cases involved some form of sexually motivated misconduct, the facts in each case were significantly different; however, not only was the outcome the same, but the rationale was similar in each instance. While the protection of the health, safety and well-being of the public may be considered in cases involving sexual misconduct, the need to maintain public and professional confidence in their respective professions is sufficient grounds alone to end the careers of health professionals who engage in sexual misconduct.

Using Heinrich’s (Bird’s) Pyramid of Adverse Events to Assess the Level of Safety in an Airline

Abstract One of the key concepts in matters of flight safety is that of special (abnormal) situations, with airworthiness regulation and certification of aviation equipment being based on this concept. At the same time, one is forced to admit that today there is no explicit interpretation of the standardized traits of special situations, nor are they not fully elucidated in the scientific literature. In this article we propose a pyramid-based approach to interpreting special (abnormal) in-flight situations, which allows for risk assessment not using risk matrices, but instead relying only on the probabilistic characteristics of the occurrence of events. Using the presence of a causal relationship between the layers of the pyramid, we propose an algorithm for the transition of varying degrees of danger of special situations. This algorithm can be used to develop an on-board device that informs the pilot about the dynamics of transitions from one situation to another, representing each emergency situation in a certain color.

Client-led promotion of health and safety through the procurement process on public construction projects in developing countries

Public clients are increasingly expected to integrate health and safety (H&S) matters into their procurement decisions and practices to promote H&S on their projects. However, there is limited guidance on how clients, particularly those in developing countries, can promote H&S matters through the procurement of public projects. This study proposes a framework that provides clients with practical guidance on how to promote construction H&S in the procurement of public projects. Semi-structured interviews were conducted with 25 public clients and contractors who have extensive experience in the procurement process for public projects. Data was subjected to both deductive and inductive thematic analysis. It was found that H&S can be promoted within the various stages of the construction procurement process by implementing key management actions, such as setting and communicating clear H&S objectives and targets, appointing competent designers, providing for H&S in project estimates, assigning adequate weight to H&S criterion, selecting competent contractors, ensuring adequate H&S provisions in contract, collecting periodic reports on H&S from contractors, among others. This study contributes to the broader research on construction H&S improvement in developing countries by providing a framework which could serve as a practical guidance material for promoting H&S in public procurement.

Inclusion of learners’ views in safety and security matters at schools

Violence and bullying in schools keep escalating and have become a world-wide problem – also in South Africa. This problem is continuing unabated, despite the different intervention strategies in place. Intervention strategies include the Child-Friendly Schools (CFS) programme, the National School Safety Framework (NSSF), the Safe Schools Programme (SSP), the Hlayiseka Early Warning System, the Care and Support for Teaching and Learning (CSTL) framework, Speak Out, We Care, and the life orientation curriculum. As part of the intervention strategies, learners’ views should be included in the decision-making process. With this article I intend to report on a study that was conducted on the inclusion of learners’ views in matters focusing on safety and security at schools. A qualitative approach was used in the study. Observation, interviewing, and document analysis were used as methods of data generation. Data were analysed by developing themes. The findings reveal that learners’ views were not included in matters related to safety and security at schools. I argue that the main reason for the continuing violence is that stakeholders who are in authority do not include the views of learners in the development and the implementation of safety and security strategies. I suggest that all stakeholders should be assisted in understanding the value of an inclusive approach in the decision-making process.

Development of a 6-DOF Testing Platform for Multirotor Flying Vehicles with Suspended Loads

The development of multirotor vehicles can often be a dangerous and costly undertaking due to the possibility of crashes resulting from faulty controllers. The matter of safety in such activities has primarily been addressed through the use of testbeds. However, testbeds for testing multirotor vehicles with suspended loads have previously not been reported. In this study, a simple yet novel testing platform was designed and built to aid in testing and evaluating the performances of multirotor flying vehicles, including vehicles with suspended loads. The platform allows the flying vehicle to move with all six degrees of freedom (DOF). Single or three-DOF motions can also be performed. Moreover, the platform was designed to enable the determination of the mass properties (center of mass and moments of inertia) of small multirotor vehicles (which are usually required in the development of new control systems). The applicability of the test platform for the in-flight performance testing of a multirotor vehicle was successfully demonstrated using a Holybro X500 quadcopter with a suspended load. The test platform was also successfully used to determine the mass properties of the vehicle.

Family life starts at home: Fathers’ experiences of a newly implemented Swedish home-based postnatal care model – an interview study

ObjectiveTo explore and describe fathers’ experiences of a newly implemented Swedish home-based postnatal care model. DesignA descriptive cross-sectional qualitative study was conducted as a part of a larger study. SettingFamilies who qualified to be discharged early were offered to participate in a postnatal home-based model of midwifery care by a hospital in Stockholm, Sweden. Participants and MeasurementsIn total, 16 fathers participated in a semi-structured telephone interview, averaging 43 min. Data were analyzed using systematic text condensation. FindingsThree major themes emerged: To decide on home- or hospital-based postnatal care – a matter of safety, To be offered professional midwifery postnatal support at home, and To be at home helped fathers to navigate parenthood. Fathers appreciated the home-based postnatal care and felt safe because of the received professional support from midwives. Key conclusionsHome-based postnatal care was valued by fathers whose partner had a non-complicated vaginal birth because they felt safe in their home environment and supported by midwives. The home environment aided fathers in supporting their partners and developing a father-infant bond. Implications for practiceHome-based postnatal care was valued by fathers and should be considered an option for new families. To offer home-based postnatal care may result in less overcrowded postnatal wards. Midwives need to enable fathers’ participation and support their parental role regardless of where the care takes place.

Impact of Radiation-Induced Microstructures on the Integrity of Spent Nuclear Fuel (SNF) Elements in Long-Term Storage

Abstract. The current safety concept provides for a period in the range of 40 years for interim storage of spent fuel elements. Since the requirement for proof of safety for to up to 100 years arises, the integrity of the spent fuel elements in prolonged interim storage and long-term repositories is becoming a critical issue. In response to this safety matter, this study aims to assess the impact of radiation-induced microstructures on the mechanical properties of spent fuel elements, in order to provide reliable structural performance limits and safety margins. The physical processes involved in radiation damage and the effect of radiation damage on mechanical properties are inherently multiscalar and hierarchical. Damage evolution under irradiation begins at the atomic scale, with primary knock-on atoms (PKAs) resulting in displacement cascades (primary damage), followed by the defect clusters leading to microstructural deformations. In this context, we have developed and applied a multiscale simulation methodology consistent with the multistage damage mechanisms and the corresponding effects on the mechanical properties of spent fuel cladding and its integrity. Within the improved hierarchical modelling sequence, the effect of the radiation field on the fuel element cladding material (Zircalloy-4) is assessed using Monte Carlo methods. A molecular dynamics method is employed to model damage formation by PKAs and primary damage defect configurations. The formation of clusters and evolution of microstructures are simulated by extending the simulation sequence to a longer time scale with the kinetic Monte Carlo (KMC) method. Transferring the calculated radiation-induced microstructures into macroscopic quantities is ultimately decisive for the structural/mechanical behaviour and stability of the cladding material, and thus for long-term integrity of the spent fuel elements. Results of the multiscale modelling and simulations as well as a comparison with experimental results will be presented at the conference session.

Reversing physician hesitancy to recommend COVID-19 vaccination for pregnant patients

Physician hesitancy is said to occur when physicians do not recommend COVID-19 vaccination, and it is a contributing factor for the low vaccination rate for COVID-19 in pregnant women. Physician hesitancy has become a major, unaddressed problem with regard to the quality and safety of obstetrical care. We identify 3 root causes of physician hesitancy and describe how professional ethics in obstetrics should guide in reversing these root causes. They are clinical misapplications of key components of professionally responsible obstetrical practice: therapeutic nihilism, shared decision-making, and respect for patient autonomy. Therapeutic nihilism directs the obstetrician to avoid any clinical interventions during pregnancy to prevent teratogenic effects that might be unknown. Therapeutic nihilism is misapplied when there is a documented net clinical benefit with no evidence of clinical harm. Shared decision directs the obstetrician to only offer but not recommend clinical management. Shared decision-making plays a major role when there is uncertainty in clinical judgment but is misapplied when it becomes a universal model. It does not apply when there is a net clinical benefit. When there is a net clinical benefit, clinical management should be recommended, not simply offered. The ethical principle of respect for patient autonomy plays an indispensable role in decision-making with patients. It is misapplied when it is assumed that respect for autonomy requires physicians not to make recommendations and to defer to and implement patients’ decisions without exception. There is evidence that the obstetrician’s recommendations about the management of pregnancy are the most important factor in a pregnant woman’s decision-making. Simply deferring to the patient’s decisions makes for misapplied respect for patient autonomy. Obstetricians must end physician hesitancy about COVID-19 vaccination of pregnant women by reversing these 3 root causes of physician hesitancy. Reversing the root causes of physician hesitancy is an urgent matter of patient safety. The longer physician hesitancy continues and the longer the low vaccine acceptance rate of pregnant women lasts, preventable serious diseases, deaths of pregnant women, intensive care unit admissions, stillbirths, and other maternal and fetal complications of unvaccinated women will continue to occur. Physician hesitancy should not be permitted to influence the response to future pandemics.

Erythema Multiforme after Pfizer- BioNTech COVID-19 Vaccination in Iraqi Patient

COVID-19 vaccine emerges as a revolutionary solution for the pandemic, but the rapid developmentof vaccines may misses non intentionally certain adverse events that may make a conflict on matter ofsafety of these vaccines.Skin reaction may be one of the most noted short term side effects of the vaccines and erythemamultiforme may be one of these presentations.

Top Bunk, Bottom Bunk: Cellsharing In Prisons

The politics involved in cell-sharing reach into the most personal parts of prisoners’ lives and are highly determinate of their experiences of imprisonment. While there is a small amount of research on the impact of cell-sharing on personal wellbeing and prison quality, much less has been written about the daily dynamics and significance of negotiating shared space under conditions of coercion. In this paper, based on in-depth research undertaken in England & Wales, we explore the experience of cell-sharing and how dynamics in the cell matter both intimately and socially. Essentially, we locate the cell as one of the primary sites of ‘where the action is’ in prisons, and where matters of safety, dignity and abjection are of particular relevance.