Medication Safety Issues Research Articles

CM-Pf deep brain stimulation in polyneuromodulation for epilepsy.

Neuromodulation is a viable option for patients with drug-resistant epilepsies. We reviewed the management of patients with two deep brain neurostimulators. In addition, patients implanted with a device targeting the centromedian-parafascicular (CM-Pf) nuclear complex supplements this report to provide an illustrative case to implantation and programming a patient with three active devices. A narrative review using PubMed and Embase identified patients with drug-resistant epilepsy implanted with more than one neurostimulator was performed. Combinations of vagus nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS) were identified. We provide a background of a newly reported case of an adult with a triple implant eventually responding to CM-Pf DBS as the third implant following suboptimal benefit from VNS and RNS. In review of the literature, dual-device therapy is increasing in reports of use with combinations of VNS, RNS, and DBS to treat patients with drug-resistant epilepsy. We review dual-device implants with thalamic DBS device combinations, functional neural networks, and programming patients with dual devices. CM-Pf is a new target for DBS and has shown a variable response in focal epilepsy. We report the unique case of 28-year-old male with drug-resistant focal epilepsy who experienced a 75% seizure reduction with CM-Pf DBS as his third device after suboptimal responses to VNS and RNS. After 9 months, he also experienced seizure freedom from recurrent focal to bilateral tonic-clonic seizures. No medical or surgical complications or safety issues were encountered. We demonstrate safety and feasibility in an adult combining active VNS, RNS, and CM-Pf DBS. Patients with dual-device therapy who experience a suboptimal response to initial device use at optimized settings should not be considered a neuromodulation "failure." Strategies to combine devices require a working knowledge of brain networks.

Exploring the influencing factors of patient safety competency of clinical nurses: a cross-sectional study based on latent profile analysis

BackgroundClinical nurses play an important role in ensuring patient safety. Nurses’ work experience, organizational environment, psychological cognition, and behavior can all lead to patient safety issues. Improving nurses’ attention to patient safety issues and enhancing their competence in dealing with complex medical safety issues can help avoid preventable nursing adverse events. Therefore, it is necessary to actively identify the latent profiles of patient safety competency of clinical nurses and to explore the influencing factors.MethodsA cross-sectional design was conducted. A total of 782 Chinese registered nurses were included in the study. Demographic characteristics questionnaire, Error Management Climate scale, Security Questionnaire, Proactive Behavior Performance scale and Patient Safety Competency Self-Rating Scale of Nurses were used. Latent profile analysis (LPA) was performed to categorize nurses into latent subgroups with patient safety competency differences. Multinomial logistic regression was conducted to explore the influencing factors of nurses’ patient safety competency (PSC) in different latent profiles.ResultsA total of 782 questionnaires were valid. Nurses’ PSC was positively related to error management climate, and psychological safety and proactive behavior. The PSC score was 121.31 (SD = 19.51), showing that the PSC of clinical nurses was at the level of the medium on the high side. The error management climate score was 70.28 (SD = 11.93), which was at a relatively high level. The psychological safety score was 61.21 (SD = 13.44), indicating a moderate to low level. The proactive behavior score was 37.60 (SD = 7.33), which was at a high level. The latent profile analysis result showed that three groups of profile models were fitted acceding to the evaluation of PSC. They were defined as Low-competency Group (74 (9.5%)), Medium-competency Group (378 (48.3%)) and High-competency Group (330 (42.2%). Working years, professional titles, departments, error management climate, psychological security and proactive behavior were the influencing factors of PSC in three latent profiles.ConclusionsThe PSC of clinical nurses had obvious classification characteristics, and the main influencing factors were working years, professional titles, working departments, error management climate, psychological security and proactive behavior. This study suggests that managers should pay attention to the continuous cultivation of patient safety competence among clinical nurses, provide targeted intervention measures for nurses at different work stages, professional titles, and departments, and use efficient management strategies to create a positive error management atmosphere. In patient safety management, providing nurses with more psychological security is conducive to stimulating more proactive behaviors and continuously improving the level of patient safety competence.

Quality improvement project to improve inhaler delivery in the intensive care unit

Background Late 2022, an ICU nurse discovered that Seretide™ (salmeterol/Fluticasone) Evohaler, a commonly used inhaler, did not change its dose counter when used with the inhaler connector 22M-22F. This was identified as a medication safety issue. Knowledge gaps of inhaler use in mechanically ventilated patients were identified as well. Aims To effectively administer metered dose inhalers to ventilated patients and increase its accuracy and safety. Methods We instituted education programs for healthcare professional in the ICU and introduced a new inhaler connector RTC 24-V. This was compared with the existing 22M-22F connector in a comparative study. Results The dose counter of Seretide™ recorded prior to initiation and extubation showed an obvious drop in doses ranging from 15 to 63 in patients randomized to use RTC 24-V, compared to 0 to 2 drop in doses for patients using 22M-22F. A total of 51 pre study and 33 post study questionnaires were completed. Confidence that the accurate dose of medications was administered rose from 58.8% to 84.8% after using the RTC 24-V. Responses that there was no issue compromising patient safety rose from 0% to 51.5% and fewer staff expressed concern about disconnections causing infections, dropping from 51% to 9.1%. 93.9% of respondents chose the new RTC 24-V as the preferred inhaler connector. Conclusion The new inhaler connector RTC 24-V was assessed to have less medication errors. ICU healthcare professionals expressed greater confidence in its safety and accuracy. We will implement the use of this connector with continued medical education.

Medication management of COVID-19 patients during transition to virtual models of care: a qualitative study

IntroductionExpansion of hospital service models was one of the strategies implemented to manage the COVID-19 pandemic through virtual models of care. COVID-19 patients were hospital inpatients transferred to virtual wards and managed outside the hospital. Pharmacists had to provide distance medication management and support services. Virtual care patient support incorporated telehealth consultations by doctors, pharmacists and nurses. This study explored hospital clinicians’ experiences and perspectives on medication management and safety issues of the COVID-19 patients transferred from inpatient units (IPUs) to virtual models of care at the time of transfer.MethodsSemi-structured qualitative interviews were conducted with purposively selected doctors, pharmacists and nurses involved in the management of COVID-19 patients in a virtual model of care (home or hotel). Clinicians were interviewed face-to-face or via MS Teams between March and May 2022. An interview schedule included 13 questions and prompts to explore perceptions of medication management and safety aspects.ResultsTwenty clinicians were interviewed: six doctors, seven pharmacists, and seven nurses. The average interview time was 26 min (SD: 4.7; range 21–39). Four major medication management and safety themes emerged from the data: (1) complexities involved in efficient handover between IPU and virtual models of care; (2) lack of clarity on roles and responsibilities between hospital and primary care clinicians; (3) communication challenges when pharmacists work remotely; and (4) proactive management of specific medication safety risks. A common thread throughout the themes was concerns for potential impact on patient safety.ConclusionOverall, clinicians were supportive of the virtual models although patient safety issues were raised that need to be addressed in the development of future services. The results from this study may inform improvements in medication safety implementation of future virtual models of care.

Medication Safety in Breastfeeding Mothers. The Current Situation in the Greek National Healthcare System

Mothers during lactation may encounter barriers including the need of medication intake due to a chronic or acute illness, which may affect mainly the duration of breastfeeding. In these cases, the issue of medication safety during lactation arises and maternal decisions usually depend on professional counseling. Providing scientifically valid information on the benefits of breastfeeding and the risk of exposure of the newborn/infant to medicines through breast milk is a responsibility of healthcare professionals. Reliable sources on the compatibility of medicines with breastfeeding vary and the information among them is conflicting or even insufficient, creating as a consequence difficulty for healthcare professionals to provide counseling. Given the fact that breastfeeding mothers are excluded from clinical trials as they are considered a vulnerable population, the scientific community has turned to alternative methods based on pharmacokinetic population modeling for medication safety during lactation. In addition, through pharmacovigilance science, databases related to drug compatibility with breastfeeding can be enriched with new data. Undoubtedly, the contribution of midwives and other healthcare professionals involved in breastfeeding plays a key role in the pharmacovigilance process through the observation and reporting of side effects. In the Greek national healthcare system, telephone helplines have been established to provide information on medication safety during lactation. Finally, information is provided on the guiding principles for midwives and other healthcare professionals regarding medication safety in breastfeeding mothers. The ultimate goal is to support and prolong breastfeeding with evidence-based knowledge.

Results of a multicenter cluster-randomized controlled clinical trial testing the effectiveness of a bioinformatics-enabled pharmacist intervention in transplant recipients

An ambulatory medication safety dashboard was developed to identify missing labs, concerning labs, drug interactions, nonadherence, and transitions in care. This system was tested in a 2-year, prospective, cluster-randomized, controlled multicenter study. Pharmacists at 5 intervention sites used the dashboard to address medication safety issues, compared with usual care provided at 5 control sites. A total of 2196 transplant events were included (1300 intervention vs 896 control). During the 2-year study, the intervention arm had a 11.3% (95% confidence interval, 7.1%-15.5%) absolute risk reduction of having ≥1 emergency department (ED) visit (44.2% vs 55.5%, respectively; P < .001, respectively) and a 12.3% (95% confidence interval, 8.2%-16.4%) absolute risk reduction of having ≥1 hospitalization (30.1% vs 42.4%, respectively; P < .001). In those with ≥1 event, the median ED visit rate (2 [interquartile range (IQR) 1, 5] vs 2 [IQR 1, 4]; P = .510) and hospitalization rate (2 [IQR 1, 3] vs 2 [IQR 1, 3]; P = .380) were similar. Treatment effect varied by comorbidity burden, previous ED visits or hospitalizations, and heart or lung recipients. A bioinformatics dashboard-enabled, pharmacist-led intervention reduced the risk of having at least one ED visit or hospitalization, predominantly demonstrated in lower risk patients.

Hospital case volume and maternal adverse events following abnormal deliveries: Analysis using a Japanese national in-patient database.

To clarify the relationship between the number of deliveries and maternal outcomes in Japan, considering the declining birth rate and the evidence that hospitals with few deliveries have medical safety issues. Hospitalizations for deliveries were analyzed using the Diagnosis Procedure Combination database from April 2014 to March 2019, after which maternal comorbidities, maternal end-organ injury, medical treatment during hospitalization, and hemorrhage volume during delivery were compared. Hospitals were divided into four groups based on the number of deliveries per month. A total of 792 379 women were included in the analysis, among whom 35 152 (4.4%) received blood transfusions, with a median blood loss of 1450 mL during delivery. Regarding complications, pulmonary embolism was significantly more frequent in hospitals with the lowest number of deliveries. Using a Japanese administrative database, this study suggests an association between hospital case volume and the occurrence of preventable complications, such as pulmonary embolisms.

Development and psychometric assessment of self-reported patient medication safety scale (SR-PMSS).

Patient medication safety can affect their clinical outcomes and plays an important role in patient safety management. However, few tools have been developed to assess patient medication safety. This study aimed to develop and validate the self-reported patient medication safety scale (SR-PMSS). We developed SR-PMSS guided by the Donabedian Structure-Process-Outcome framework and used psychometric methods to test its validity and reliability. A total of 501 patients with an average age of 56.81 ± 14.47 were enrolled in this study. The SR-PMSS consisted of 21 items and 5 factors. The content validity was good with item-level content validity index (CVI) > 0.78, average scale-level CVI (S-CVI) > 0.9, and universal agreement S-CVI > 0.8. Exploratory factor analysis extracted a five-factor solution with eigenvalues > 0.1, explaining 67.766% of the variance. Confirmatory factor analysis showed good model fit, acceptable convergent validity, and discriminant validity. The Cronbach's α coefficient for SR-PMSS was 0.929, the split-half reliability coefficient was 0.855, and the test-retest reliability coefficient was 0.978. The SR-PMSS was a valid and reliable instrument with good reliability and validity to evaluate the level of patient medication safety. The target users of the SR-PMSS are all people who are taking or have used prescription medications. The SR-PMSS can be used by healthcare providers in clinical practice and research to identify patients at risk for medication use and intervene with them to reduce adverse medication events and provide support for patient safety management. SR-PMSS - a self-reported tool to assess patient medication safetyMedication therapy was the most common and frequent treatment method to prevent and cure diseases. Medication safety issues may occur in the process of medication use. Patient medication safety can affect their clinical outcomes and plays an important role in patient safety management. However, there are few tools to assess patient medication safety currently, and most of them focused on medication safety related to hospitals or healthcare workers. We developed the self-reported patient medication safety scale (SR-PMSS) guided by the Donabedian Structure-Process-Outcome framework. Then, we conducted a two-round expert consultation, clarity verification, and item simplification to determine the final version of the scale. The SR-PMSS consisted of 21 items and 5 factors and it had good validity and reliability. The target users of the SR-PMSS are all people who are taking or have used prescription medications. Healthcare providers can use the SR-PMSS in clinical practice and research to identify patients at risk for medication use and intervene with them to reduce adverse medication events and provide support for patient safety management.

Perceptions of healthcare professionals and patients on the role of the pharmacist in TB management in Pakistan: A qualitative study.

Background: Globally, tuberculosis (TB) is the second major cause of death from infectious diseases, particularly in developing countries. A multidisciplinary approach to the management of TB may help to curb the disease burden. Objective: The objective of this study was to outline the perceptions of healthcare professionals and patients regarding the potential role of pharmacists in TB management in Pakistan. Method: This was a large-scale qualitative study conducted at the Chest Disease Unit (CDU) of the Bahawal Victoria Hospital (BVH), Punjab, Pakistan. Data were collected through semi-structured interviews with physicians, pharmacists, and patients recruited using a mix of convenient and snowball sampling. The sample size was decided through standard saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analyzed to draw conclusions using a thematic analysis approach. Results: Analysis of the data yielded 19 categories and seven themes. Physicians considered pharmacists qualified healthcare professionals, whereas patients considered them merely dispensers. Inventory management and dispensing of medicines were considered as major responsibilities of pharmacists. Physicians were extremely overburdened and wanted to delegate certain duties to pharmacists, subject to their prior extensive trainings. However, most of the physicians were unaware of the legal scope of pharmacy practice in Pakistan. With regard to the potential duties of pharmacists, physicians, pharmacists, and patients (patients-upon explaining the potential roles during the interview) endorsed monitoring, counseling, medicine brand selection, dose adjustment, inventory management, dispensing, and polypharmacy assessment as their potential roles. In view of all stakeholders, the rationale for integrating pharmacists in TB management included overburdened physicians, sub-standard patient care, medication safety issues, and patient dissatisfaction. The healthcare professionals highlighted that the major barriers to integrating pharmacists within the TB management system were limited interest of regulatory authorities and policy makers, followed by inadequate training and experience-driven questionable competency of pharmacists. Conclusion: The study participants acknowledged the potential role of pharmacists in TB management. However, it was emphasized that healthcare policy makers should devise strategies to overcome the underlying barriers before assigning medicine-related clinical roles to pharmacists.

Early Insights From a Pharmacogenomic-Enriched Comprehensive Medication Management Program Implementation in an Adult Employee Population.

The aims of the study are to assess adoption of a pharmacogenomic-enriched comprehensive medication management program in a self-insured employer setting and to better understand medication risks that affect employees. Employees were identified to be at high risk of medication mismanagement and were subsequently provided with a program and process to improve their health. DNA testing, a clinical decision support system, and pharmacists were used to identify medication safety and effectiveness issues and to recommend appropriate changes. A total of 10.6% of the invited employees enrolled in the program. Actionable recommendations were suggested by pharmacists for 85.8% of employees who completed the program, averaging 5.2 recommendations per person. Implementation of a PGx + CMM program in a self-insured employer setting is feasible, detects risks in prescription regimens, and offers opportunities to improve medication management and reduce the burden of healthcare expenses.

Health care professionals’ understanding of contraindications for physical activity advice in the setting of stem cell transplantation

PurposeMost patients receiving a hematopoietic stem cell transplantation (HSCT) are able to tolerate and benefit from physical activity (PA). Therefore, it is important that health care professionals (HCPs) advise patients to perform PA before, during, and after transplantation. By understanding which medical conditions and safety issues are associated with the (non-) promotion of PA, concrete actions and interventions can be planned and implemented.MethodsPhysicians (N = 51), nurses (N = 52), and physical therapists (N = 26) participated in a nationwide cross-sectional online survey. HCPs’ understanding of 15 medical conditions as contraindications for PA was assessed. Significant group differences were determined using chi-square analysis.ResultsAcute infection was the only condition which was considered as contraindication by all HCPs (62.7%). Cachexia (78%), having a stoma (91%), or port (96.2%), psychological problems (88.4%), and leukopenia (83.3%) were not considered as contraindications. Six conditions were rated inconsistently between the groups, whereas physicians had the least concerns regarding PA. Physicians with an additional training in PA perceived a platelet count of ≤ 50,000/μl significantly less often as contraindication (p < 0.05).ConclusionThe large number of potentially-answers especially in nursing staff and physical therapists might reflect caution or uncertainty. There is a clear need for a good multidisciplinary cooperation between all HCPs in order to support patients to confidently engage in PA. Furthermore, education possibilities and evidence-based courses to build knowledge regarding safety concerns should be the standard practice in the setting of HSCT. The investigative nature of the paper indicates that certain trends should be interrogated in a causal-longitudinal design.

The role of ultrasound and MRI in diagnosing of obstetrics cardiac disorders: A systematic review

Ultrasonography and magnetic resonance imaging (MRI) are used more commonly in diagnosing obstetrics disorders as non-invasive and non-ionizing methods. Ultrasonography is a safe and available modality that provides real-time images in multiple planes. MRI can perform as a subsequent evaluation for cases in which ultrasonography is doubtful. This systematic study aimed to identify the current knowledge regarding the use of ultrasonography and MRI in diagnosing obstetrics cardiac disorders, their medical applications, safety issues, limitations, and future applications.

CT-Derived 3D Printing for Coronary Artery Cannulation Simulator Design Manufacturing.

Mastering coronary angiography requires practice. Cadavers and animals do not accurately represent the human anatomical body, and practicing with actual patients has medical safety issues. Simulation offers safe and realistic conditions for cardiology intervention training. In this study, we propose a novel 3D printed simulator that contains physically realistic anatomy and has four access points. It increases safety for patients and students, and production is low-cost. We aimed to make and validate this simulator design as a prototype for coronary cannulation training. It was designed using computed tomography (CT) scan data of aorta, coronary, and heart models, and was printed by 3D printing with resin materials consisting of 75% or 85% clear resin and 25% or 15% flexible resin additive. The simulator was constructed with a camera above the simulator with a degree of LAO of 30°/0°, a display table, and an acrylic box. Twelve validators were interviewed for their expert opinions and analyzed by a qualitative method. They scored the simulator’s suitability on a four-point Likert scale questionnaire. They described the simulator as having admirable values for all aspects (85.8%), curriculum suitability (92%), educational importance (94%), accuracy (83%), efficiency (78%), safety (87.5%), endurance (81.2%), aesthetics (80.7%), storage (85.4%), and affordability (85.8%).

The importance of a World Health Organization international pharmacovigilance database (VigiBase): novel methods for safety monitoring and surveillance of medical products

Pharmacovigilance and medical product safety issues are important for all global citizens. Previous studies have analyzed the disaster caused by thalidomide in 1961. In 1963, the 16th World Health Assembly was determined to create the World Health Organization (WHO) Pilot Research Project for International Drug Monitoring in order to develop and understand adverse effects of medical products. In 1968, this pilot research project developed into the WHO Programme for International drug Monitoring (earlier versions of VigiBase) coordinated by the Uppsala Monitoring Center (Uppsala, Sweden) which expanded in scale to include 153 member countries, 22 associates, and many regional reporting centers as of March 2022. The main goal of the WHO Global ICSR Database System (VigiBase) is detecting, understanding, assessing, and preventing adverse effects of medical products (herbals, complementary medicines, biologic products, blood products, medical devices, and vaccines). This article aims to provide appropriate and strong reference of adverse reactions in specific drugs and novel method to identify specific features of adverse drug reactions through data and information achieved by VigiBase.

Multimedication Guidelines: Assessment of the Size of the Target Group for Medication Review and Description of the Frequency of Their Potential Drug Safety Problems with Routine Data

(1) Background: About 10 years ago, several guidelines for the better management of patients with polypharmacy were issued. A central issue is the definition of the target group. The primary aim of this study is therefore to assess the size of the target group, applying the criteria of the German guidelines. A further aim is to describe the frequency of occurrence of medication safety issues for patients of the target group. (2) Methods: The study is based on administrative data of one large statutory health insurer in Germany (n = 9,012,523). (3) Results: The criteria of multimorbidity (at least three chronic diseases) and utilization of five or more concurrent drugs over at least 91 days is fulfilled by 14.1% of the insured patients, or almost 1.3 million persons. About 5% of this multimorbid and poly-medicated population fulfilled at least three of out of five additional occasion-related criteria. Medication safety issues occur frequently: treatment prevalence with potentially inadequate medication, QT-drugs, benzodiazepine or Z-drugs and proton pump inhibitors was 30.4%, 28.9%, 11.1% and 52.4%, respectively. (4) Conclusions: The analysis shows the scope of patients eligible for a structured medication review and demonstrates the relevance for counselling based on the high percentage potentially at risk due to medication therapy safety problems.

Here’s what we know about FDA-authorized COVID-19 antivirals

Here’s what we know about FDA-authorized COVID-19 antivirals

Teaching Pharmacovigilance to Undergraduate Students: Our Experience in Poor-Resource Setting.

Using medicines associated with adverse drug reactions (ADRs) might cause serious health complications. The pharmacist plays a unique role in monitoring ADRs, either by themselves or with the assistance of other health-care professionals, to diminish the hazards of ADRs by distinguishing, reporting, and evaluating any proposed ADRs. To train future pharmacists who have adequate knowledge of ADRs and related aspects, it is highly recommended to introduce the WHO-ISoP pharmacovigilance (PV) in the core curriculum. In this article, we shared the suggested curriculum in Aden University. It is based on comprehensive outlines and reference books that offer a broad view of all aspects related to PV. A brief student course evaluation was carried out. Fifty students participated in the survey. Students expressed the importance of the course and indicated that they wanted to know more about the types of ADRs and common medication errors. Some of them lacked an understanding of the causal relationship between ADRs and risk assessment and not familiar with the reporting forms. They suggested for PV awareness programs for health-care staff and public. The curriculum should be tailored according to the country's needs because each country has its own medication safety issues and PV program. To reach the ultimate objective, this article reports the initiative to develop PV proficiencies in a university setting.

The impact of a student pharmacist‐led inpatient medication counseling initiative on medication safety in kidney transplant recipients

AbstractIntroductionEngaging student pharmacists as pharmacist extenders to facilitate medication education may represent a unique pathway for preventing medication safety issues and mitigating downstream consequences in the high‐risk kidney transplant (KTX) population. The aim of this study was to describe the implementation and impact of a student pharmacist‐led counseling initiative designed to promote patient and caregiver understanding of transplant medications.MethodsThis is a single‐center, retrospective quality improvement initiative comparing adult KTX recipients who received interventional student pharmacist‐led education vs a historical cohort. Data on clinical outcomes, including the incidence of medication errors (MEs), adverse drug events (ADEs), and readmissions, was extracted from the patient's electronic medical record. In the intervention cohort, attendee satisfaction was assessed based on responses obtained from surveys distributed to patients and caregivers on the day they attended the student pharmacist‐led class.ResultsA total of 311 KTX recipients were included in this analysis; 149 in the intervention cohort and 162 in the historical cohort. Patients in the intervention cohort experienced more MEs than those in the historical cohort (31 vs 11; P &lt; .001). Rates of ADEs within the first 30 days post‐transplant were comparable across cohorts (56 vs 52; P = .406). No significant difference in readmissions at days 7, 14, and 30 was observed between groups. Attendee satisfaction was high across all survey response fields.ConclusionThe results of this study demonstrate that KTX recipients who participated in student‐pharmacist led medication counseling had comparable rates of ADEs and readmissions to those who did not, but were more likely to experience MEs. Future research is needed to explore the role of structured medication counseling and the utility of student pharmacists in the clinical setting.

Perceptions, experiences and opportunities for occupational safety and health professionals arising out of the COVID-19 Pandemic

This study explored perceptions, experiences and opportunities for the occupational safety and health professional (OSHP) as a result of COVID-19. Using qualitative methods, interviews took place with OSHPs in two organisations to understand how their role developed during the pandemic. Additionally, seven focus groups were organised and met virtually, using the Zoom platform, each addressing a different topic identified by the researchers. Participants (n = 45) from 10 different countries were distributed among the focus groups. Topics were separated into four themes: impact on the workplace; the psychosocial dynamic; medical and health issues and occupational safety and health (OSH) issues. Results were subsequently divided into seven action categories and compared with the findings from the organisational interviews. Comparison pointed to an expanded role for the OSHP including business continuity, resilience and wellbeing in addition to assessing and controlling risks emerging during the pandemic. There is also the need for a means to adequately disseminate trustworthy information. Results indicated that there was no single ‘average’ role of the OSHP, demonstrating essential contributions as a member of the management team. Results also stressed that the pandemic carried three health-related co-morbidities, stress, Post-Traumatic Stress Disorder and burnout. Directions for future research included: the education of the OSHP to support a move away from compliance towards risk management; determining how mental health issues in organisations should be managed; expanded roles for OSHPs within business; and implications for professional bodies, membership institutions and academia in supporting the above-mentioned emerging roles.

Юридические и медицинские вопросы безопасности эпидуральной аналгезии в родах. Опыт Винницкой области

Эпидуральная аналгезия обеспечивает наиболее эффективное облегчение родовой боли. Применение инновационных комбинаций лекарственных средств и изменение подходов к интрапартальному обеспечению акушерской помощи привели к увеличению профиля безопасности эпидуральной аналгезии. Новым в оказании анестезиологической помощи акушерским пациентам является активный подход к управлению рисками. В данной статье отображен опыт анестезиологов Винницкой области по информированию пациентов, мероприятий по обеспечению оптимального ведения и документирования родов в условиях эпидуральной аналгезии с использованием разработанных и внедренных в клиническую практику информационных и коммуникационных инструментов.