Responsibility Of Health Professionals Research Articles

Effects of the Italian Law on Patient Safety and Health Professional Responsibilities Five Years after Its Approval by the Italian Parliament.

The application of the Italian law No. 24/2017, which focused on patient safety and medical liability, in the Italian National Health Service has been evaluated by a survey conducted five years after the promulgation of the law. The law required the establishment of healthcare risk management and patient safety centers in all Italian regions and the appointment of a Clinical Risk Manager (CRM) in all Italian public and private healthcare facilities. This study demonstrates that five years after the approval of the law, it has not yet been fully implemented. The survey revealed a lack of adequate permanent staff in all the Regional Centers, with two employees on average per Center. Few meetings were held with the Regional Healthcare System decision-makers with less than four meetings per year. This reduces the capacity to carry out functions. In addition, the role of the CRMs is weak in most healthcare facilities. More than 20% of CRMs have other roles in the same organization. Some important tasks have reduced application, e.g., assessment of the inappropriateness risk (reported only by 35.3% of CRM) and use of patient safety indicators for monitoring hospitals (20.6% of CRM). The function of the Regional Centers during the COVID-19 pandemic was limited despite the CRMs being very committed. The CRMs units undertake limited research and have reduced collaboration with citizen associations. Despite most of the CRMs believing that the law has had an important role in improving patient safety, 70% of them identified clinicians' resistance to change and lack of funding dedicated to implementing the law as the main barriers to the management of risk.

Ten characteristics of high-quality planetary health education-Results from a qualitative study with educators, students as educators and study deans at medical schools in Germany.

The climate and ecological crises are considered fundamental threats to human health. Healthcare workers in general and doctors in particular can contribute as change agents in mitigation and adaptation. Planetary health education (PHE) aims to harness this potential. This study explores perspectives among stakeholders involved in PHE at German medical schools on the characteristics of high-quality PHE and compares them to existing PHE frameworks. In 2021, we conducted a qualitative interview study with stakeholders from German medical schools involved in PHE. Three different groups were eligible: faculty members, medical students actively involved in PHE, and study deans of medical schools. Recruitment was performed through national PHE networks and snowball sampling. Thematic qualitative text analysis according to Kuckartz was used for the analysis. Results were systematically compared to three existing PHE frameworks. A total of 20 participants (13 female) from 15 different medical schools were interviewed. Participants covered a wide range of professional backgrounds and experience in PHE education. The analysis revealed ten key themes: (1) Complexity and systems thinking, (2) inter- and transdisciplinarity, (3) ethical dimension, (4) responsibility of health professionals, (5) transformative competencies including practical skills, (6) space for reflection and resilience building, (7) special role of students, (8) need for curricular integration, (9) innovative and proven didactic methods, and (10) education as a driver of innovation. Six of our themes showed substantial overlap with existing PHE frameworks. Two of our themes were only mentioned in one of the frameworks, and two others were not explicitly mentioned. Few important elements of the frameworks did not emerge from our data. In the light of increased attention regarding the connections of the climate and ecological crises and health, our results can be useful for anyone working toward the integration of planetary health into medical schools' and any health professions' curricula and should be considered when designing and implementing new educational activities.

Statistical Study: Vaccination Against HPV Among Dental Students in Romania

Vaccination against Human Papilloma Virus continues to remain a highly complex public health issue, as there are many countries or regions that show increasing reluctance. Romania is among the countries that do not provide HPV vaccine in the national vaccination scheme, but offers the opportunity to young girls between 11 and 18 years of age to benefit from free vaccination. It is the responsibility of health professionals in all health sectors to inform themselves correctly, but also to instruct patients in a prophylactic approach against infection with both HPV and other types of microorganisms. Accurate information and a thorough knowledge of the prophylactic means are achieved from the years of study. Our study focuses on the following aspects: the degree of vaccination among dental students, the willingness of students to get vaccinated if they have not done it so far, the degree of information about Human Papilloma Virus infection, including ways of transmission and methods of diagnosing the infection, the perception of students on how this topic has been promoted, the sources of information they access in order to obtain information about Human Papilloma Virus.

Malpractice and Responsibilities of Health Professionals

Malpraktis, “sağlık hizmeti sunumu sırasında uygun ve etik olmayan davranış, bilgisizlik, ilgisizlik, özensizlik, deneyimsizlik veya yanlış tedavi nedeniyle hastanın zarara uğraması” anlamına gelir ve sağlık hizmeti sunumunun her aşamasında ortaya çıkabilir. Tıbbi uygulama hataları, tıbbi işleme, ihmale ve uygulamaya bağlı olarak tanı, tedavi, koruyucu tedavi ve diğer hatalar ya da medikasyon ve cerrahi hatalar gibi farklı gruplara ayrılarak incelenebilir. Yasal düzenlemelerde geçen mesleki etik kurallar gereğince, sağlık profesyonelleri, ilgili yasalardaki genel tanımlar çerçevesinde cezai ve hukuki açıdan sorumlu hale gelmektedir. Sağlık profesyonelleri tarafından tıbbi hatalar kasti ve taksirli olarak ortaya çıkabilir. Sağlık profesyonellerinin gerekli tıbbi yardımı zamanında yapmaması halinde tıbbi sorumlulukları vardır. Bu durumda hasta ve hasta yakınlarının tazminat talep etme hakları vardır. Sağlık profesyoneli ile diğer vatandaşların bir insanın hayatı kaybına karşı aynı şekilde sorumludur. Sağlık profesyoneli hapis ya da adli para cezası ile yargılanır. Sorumsuzluk anlaşmasının yapılması, hastanın rızasının alınması sorumluluğu ortadan kaldıran durumlardandır. Sağlık profesyonelleri, tıbbi hatalar konusunda bilgili olmalıdır. Hasta güvenliği kültürü değerlendirilmeli ve geliştirilmeli, hasta güvenliği için iş birliği yapılmalı, hasta güvenliği kurumsal bir sorumluluk olarak benimsenmelidir. Sağlık profesyonelleri bağımsız, yarı bağımlı ve bağımlı rollerini yasa ve yönetmeliklere dikkate alarak görevlerini icra etmelidir. Sağlık profesyonelleri sağlık hizmeti verirken aksaklıklara dikkat etmeli ve tıbbi hataların en aza indirilmesi için önlemler almalıdır.

Health professionals' knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting: a cross-sectional study

BackgroundRespecting patients’ confidentiality is an ethical and legal responsibility for health professionals and the cornerstone of care excellence. This study aims to assess health professionals’ knowledge, attitudes, and associated factors towards patients’ confidentiality in a resource-limited setting.MethodsInstitutional based cross-sectional study was conducted among 423 health professionals. Stratified sampling methods were used to select the participants, and a structured self-administer questionnaire was used for data collection. The data was entered using Epi-data version 4.6 and analyzed using SPSS, version 25. Bi-variable and multivariable binary logistic regression analyses were used to measure the association between the dependent and independent variables. Odds ratio with 95% confidence intervals and P value was calculated to determine the strength of association and to evaluate statistical significance.ResultOut of 410 participants, about 59.8% with [95% CI (54.8–68.8%)] and 49.5% with [95% CI (44.5–54.5%)] had good knowledge and favorable attitude towards patents confidentiality respectively. Being male (AOR = 1.63, 95% CI [1.03–2.59]), taking training on medical ethics (AOR = 1.73, 95% CI = [1.11–2.70]), facing ethical dilemmas (AOR = 3.07, 95% CI [1.07–8.79]) were significantly associated factors for health professional knowledge towards patients’ confidentiality. Likewise, taking training on medical ethics (AOR = 2.30, 95% CI [1.42–3.72]), having direct contact with the patients (AOR = 3.06, 95% CI [1.12–8.34]), visiting more patient (AOR = 4.38, 95% CI [2.46–7.80]), and facing ethical dilemma (AOR = 3.56, 95% CI [1.23–10.26]) were significant factors associated with attitude of health professionals towards patient confidentiality.ConclusionThe findings of this study revealed that health professionals have a limited attitude towards patient confidentiality but have relatively good knowledge. Providing a continuing medical ethics training package for health workers before joining the hospital and in between the working time could be recommended to enhance health professionals’ knowledge and attitude towards patient confidentiality.

Knowledge and practice of nursing mother`s regarding complementary feeding

Complementary feeding is the systemic process of introduction of semisolid or solid food in infant at the right time in addition to mother’s milk in order to provide needed nutrition to the baby. A cross sectional study was conducted from January to December, 2020 to assess the level of knowledge and practice of nursing mothers regarding complementary feeding. Total 177 nursing mother were selected purposively and interviewed with a pre-tested semi-structured questionnaire. Face to face interview was conducted to collect data. P-value less than 0.05 were set as statistically significant. The knowledge and practice score were categorized into good (≥70%), satisfactory (50 to 70%), and poor (≤50%). Out of 177 respondents, majority 109(61.6%) had satisfactory knowledge regarding complementary feeding, 33(18.6%) had good knowledge and rest of them 35(19.8%) had poor knowledge regarding complementary feeding among the nursing mother. On the other hand 62.7% respondents had poor Practices, 24.9% had satisfactory practices and 12.4% had good practices regarding complementary feeding among the nursing mothers. There was highly significant association between knowledge and practice of complementary feeding (p <.000). Nursing mother’s knowledge regarding complementary feeding time was inadequate and practices were inappropriate. . It is the responsibility of health professionals to pass on the current information about proper infant feeding to mothers/care takers for promoting the healthy complementary feeding of the breastfeed child.

GÊNERO E SAÚDE: um olhar para a mulher estomizada no contexto social e familiar

This article presents results of a qualitative research, carried out with the objective of identifying aspects of overcoming in the family and social life of ostomized women. The information was collected through an interview during the monthly withdrawal of collection bags and accessories, provided by the Unified Health System (SUS), during 2019. Participated in the study, ostomized women living in municipalities covered by the 1st Management Regional Health Department of the State of Santa Catarina. Among the results, it was noticed that living with the ostomy caused significant changes related to the affective and loving relationships of women. Insecurity and fear of family and social rejection were highlighted as the main generators of negative feelings. These feelings were also evident in gender relations, due to the historical construction focused on the importance of appearance for the female sex. On the other hand, the adequacy to the condition of ostomized women was demonstrated by strong reports of the recovery of self-esteem and “option for life”. Carrying out the study enabled important reflections, among which, the responsibility of health professionals, to contribute so that the whole process that involves the condition of ostomy, is reduced and humanized.

Violência doméstica contra as mulheres: conhecimentos, atitudes e barreiras do enfermeiro de família

Enquadramento: a violência doméstica é um problema de saúde pública. O enfermeiro de família, enquanto contacto privilegiado com mulheres e famílias, pode desempenhar um papel relevante na abordagem à mulher vítima de violência. Objetivo: identificar os conhecimentos, atitudes e barreiras dos enfermeiros de família na abordagem às mulheres vítimas de violência doméstica. Metodologia: desenho quantitativo, exploratório, descritivo e transversal, numa amostra não probabilística por conveniência, constituída por cinquenta enfermeiros de família. O instrumento de recolha de dados foi um questionário de autopreenchimento. No tratamento recorreu-se aos aplicativos QDA Miner 4 Lite e IBM SPSS Statistic, versão 21.0. Resultados: dos participantes, 78% refere não ter tido formação sobre violência doméstica. Evidenciam falta de conhecimento, reconhecendo, no entanto, que a identificação e encaminhamento das vítimas é responsabilidade dos profissionais de saúde. Apontam como principais barreiras a falta de protocolos de atuação e de regulamentação que legitime a sua intervenção e, em menor percentagem, a falta de conhecimento/formação para a abordagem à vítima. Conclusão: torna-se assim necessário dimensionar as necessidades ao nível da formação pré e pós-graduada, infundindo nos currículos esta temática e capacitando assim atuais e futuros profissionais na abordagem à mulher vítima de violência doméstica.

MULTIDISCIPLINARY TREATMENT IN THE REHABILITATION OF PATIENTS WITH LIP AND/OR PALATINE FISSURE: A REVIEW

Objective: This study highlights through an integrative review the importance of multidisciplinary treatment in the rehabilitation of cleft lip and/or palate. Study Design: An integrative review was performed using SciELO and Lilacs databases, with the descriptors cleft lip, cleft palate, and multidisciplinary treatment. Results: Based on the literary works analyzed, it was noted that for the treatment to be successful, an intervention with multidisciplinary participation is necessary. It is the union of medicine with dentistry for surgical promotion, along with nutrition, phonoaudiology and psychology to obtain rehabilitation before and after the surgical procedure. Conclusion: The treatment of the patient with cleft lip or palate should be done by a multidisciplinary team, aiming at rehabilitation and avoiding physical and psychological consequences, along with a social monitoring of the families, thus evidencing the risk factors that can induce the cleft lip palate (CLP). Following this aspect, it is the responsibility of health professionals to adequately treat those affected, giving all the necessary support for their rehabilitation.

DOLO O CULPA EN LA RESPONSABILIDAD POR MALA PRAXIS DE LOS PROFESIONALES DE LA SALUD

En la presente investigación presentamos algunos criterios para determinar la responsabilidad penal de los profesionales de la salud (médicos) en sus diversas intervenciones de su praxis médica. Con lo que no pretendemos dejar agotado el problema pues se trata de una realidad que hoy en día se ha convertido en viral. Tenemos como objetivo que los operadores del derecho cuenten con mejores posibilidades de aplicación de las teorías que brinda el derecho penal, para efectos de determinar si constituye dolo eventual o culpa consiente, cuando con una mala praxis médica se lesionen bienes jurídicos tutelados como la vida o la salud de las personas. Para lo cual se ha revisado los diferentes criterios doctrinarios que han desarrollado en relación al dolo y culpa, además de tener en consideración la jurisprudencia que hasta el momento ha sido emitida por el Poder Judicial. Se ha logrado determinar que si el profesional de salud tiene conocimiento de que con su conducta incrementa el riesgo, esto sustentado en circunstancias específicas, como no tener condiciones de infraestructura adecuada, implementaciones de equipos de medicina para la posible atención de alguna emergencia, no tener ambulancia, no contar con personal asistencial adecuado, tener conocimiento que el lugar en que realiza una intervención quirúrgica no cuenta con autorización del Ministerio de Salud, y de la Municipalidad correspondiente, actúa con el elemento del conocimiento que requiere el dolo eventual. Así mismo el elemento volitivo del dolo eventual, está representado por decisión que toma el profesional de la salud, de continuar con la intervención quirúrgica en esas condiciones.

The experiences of family caregivers providing palliative cancer care in Thailand.

Family caregivers have a significant role in Thai healthcare, taking on responsibilities of health professionals. The purpose of this research was to explore Thai family caregivers' experiences of providing palliative cancer care. This qualitative study took a phenomenological approach. In-depth interviews were conducted with 14 family caregivers aged 33-72 years in a regional hospital in the north of Thailand. The data was analysed using Colaizzi's phenomenological approach. Rigour was established by following Lincoln and Guba's guidelines for qualitative research. The experiences of Thai family caregivers providing palliative cancer care could be categorised into four themes: caring as a team; caring as supportive care; taking care to keep patients happy; and caring for the self while looking after a relative. Health professionals can support family caregivers to deliver the best care for cancer patients and to help them decrease their stress. This study discusses ways how this may be done.

Health care curricula in multicultural societies.

Globalisation has led to increasing diversity worldwide. The rapid rise in the number of international migrants over the last 15 years has been unprecedented and currently accounts for more than 10% of the European and 16% of the Norwegian populations. Most countries in Europe attempt to provide equitable health care services to their citizens regardless of their ethnicity, religion, country of origin and other characteristics.1 Still, a large body of literature describes challenges in providing healthcare for multicultural populations for doctors and other health care professionals.2,3 Furthermore, European health professionals are not at ease providing adequate health care in multicultural societies and in many countries they are still to receive systematic training to tackle this new and complex situation.4 Intercultural challenges are often attributed to the immigrant patients alone. However, the responsibility of health professionals in initiating, maintaining or inadequately tackling these challenges cannot be ignored. Although international recommendations to improve cross-cultural care exist,5 health professionals still perform differently in diagnostic procedures undertaken,6,7 number of consultations needed for referral to secondary care,8,9 specificity of diagnoses provided or treatments given10,11 for immigrant patients compared to non-immigrants. Furthermore, immigrants from low and middle-income countries in Europe seem to be less satisfied with health care services than the majority population.12,13 The so-called refuge-crises in 2015 actualised the necessity of dealing with intercultural consultations as a part of everyday work for healthcare professionals. Not surprisingly the authors have frequently been contacted to lecture about migration and health for different audiences. This demand responds to self-perception of lack of knowledge, skills or competencies necessary to give equitable health care to a growing number of immigrant patients.14,15 This paper aims to present and argue the need for a profound change in the healthcare curricula by describing our observations and experiences within medical education. Teaching undergraduate students We will first describe the situation of undergraduate medical students at the end of their education. At the beginning of our lessons, we often explore their experiences and knowledge to ensure that our teaching builds from their current state. Typical questions are: · What health care entitlements can immigrants and refugees receive at the different stages of their life in Norway? · Are there specific risk factors or diseases to be kept in mind, in consultations with patients of migrant origin? · Do we talk about culture with patients? Should we talk about culture at all? How to have effective consultations with translators? · Should we culturally adapt healthcare interventions for specific groups or choose a diversity-sensitive approach that accommodates migrants? As per our observations, few students can answer these or similar questions despite their clinical encounters with patients with immigrant background through their clinical rotations during several semesters. Furthermore, they can seldom refer to senior clinicians who have been good role models for cross-cultural consultations. Moreover, the simple exercise of describing one’s own ethnic and cultural background is often an eye-opener for many students and practitioners. It makes them realise that it is far too easy to describe another persons’ background by the different colour of their skin, their different clothes or because they speak with an accent. It is relatively easy for immigrant students or for Norwegians, who are proud of their regions and local dialects, to describe themselves if they have moved within the country, but the task is far more challenging for those who have never moved out of these local communities.

Common mental health disorders in general practice

Practice nurses are likely to see a range of common mental health disorders in day-to-day practice. Sheila Hardy provides an overview of these conditions and the treatment their patients will be offered Common mental health disorders cause human distress and large costs for society. According to the National Institute for Health and Care Excellence, common mental health disorders include depression, generalised anxiety disorder, social anxiety disorder, panic disorder, obsessive compulsive disorder, and post-traumatic stress disorder. Practice nurses will see many patients with common mental health disorders and, while not every nurse will be involved in treatment, it is useful to have brief knowledge of the available treatment options. In this article, the definitions and treatments of each disorder are described, and the responsibilities of health professionals looking after people with common mental health disorders in primary care are explained.

КОДИФІКАЦІЯ МЕДИЧНОГО ЗАКОНОДАВСТВА З ПОЗИЦІЇ ПІДВИЩЕННЯ ПРАВОВОЇ КУЛЬТУРИ ЛІКАРІВ В УКРАЇНІ

The article, being offered, emphasizes the modern conditions of legislation in Ukraine on issues of health care. Presents the doctors survey results about level of their knowledge in the sphere of medical law. 610 respondents from 9 regions of Ukraine took part in the survey. The survey results indicate insufficient of doctors knowledge’s in the sphere of medical law at all stages of vocational training. Were identified difficulties in working with normative legal acts regulating medical practice, in particular due to their number and lack of systematization. Also, it was found that 100% of respondents would like to attend a medical law course, and examine the rights and responsibilities of health professionals, the legal protection of doctors, the legal aspects of the interaction between physicians and patients, health legislation, patients' rights and responsibilities. Was made the analysis of legal relations between entities in the sphere of health care as to issues, related to indemnification of harm, caused by handicap, other health injury or death of natural person in terms of Civil Code of Ukraine and practice of civil law proceeding. Article justifies the expediency of creating the Medical Code of Ukraine, that will systematize of national legislation in the sphere of health care through its codification and establishment of basic document – Medical Code of Ukraine – will assist to improvement in level of legal culture at doctors, improvement in their positive responsibility, consolidation of moral ethical values and high professional landmarks among medical men that will assist to improvement in quality of rendering the medical aid to population for reinforcement and preservation of the highest social value – human life and health.

Maternal gestational weight gain during pregnancy: prioritising the conversation.

Pregnancy is a critical stage of life requiring urgent attention when taking a lifespan approach to obesity prevention. Excessive gestational weight gain (GWG) is highly predictive of overweight and obesity later in life for women and their offspring. This discussion describes the challenges faced by health professionals (general practitioners, midwives, allied health) in primary care in Australia when addressing GWG, presents evidence that supports re-prioritising GWG and highlights strategies that can be used to address GWG. The revised National Health and Medical Research Council antenatal care guidelines (to be formally released in early 2018) indicate it will be the responsibility of health professionals in antenatal care to initiate conversations about GWG with women. Women are open to discussing this sensitive topic and health professionals in primary care have an opportunity to be proactive in addressing barriers that have hindered conversations about GWG in the past so that women are supported to manage their weight during pregnancy.

Peer teacher training (PTT) program for health professional students: interprofessional and flipped learning

BackgroundThe need for developing healthcare professional students’ peer teaching skills is widely acknowledged, and a number of discipline-based peer teacher training programs have been previously reported. However, a consensus on what a student peer teaching skills program across the health professions should entail, and the associated benefits and challenges, has not been previously described. The purpose of this study was to demonstrate the design and implementation of an interprofessional Peer Teacher Training (PTT) program, and explore outcomes and participant perceptions, using Experience-Based Learning (ExBL) theory.MethodsIn 2016, an interprofessional team of academics from across three healthcare faculties: Medicine, Pharmacy and Health Sciences, developed and implemented a six module, flipped learning, interprofessional PTT program. Pre- and post questionnaires, using a Likert scale of 1–5, as well as open ended questions, were distributed to students. Descriptive statistics were used to analyse quantitative data, and thematic analysis was used to analyse qualitative data.ResultsNinety senior students from across the three faculties participated. Eighty nine percent of participants completed a pre- and post-course questionnaire. Students felt the required pre-class preparation, including online pre-reading, discussion board, videos, and teaching activities enhanced their face-to-face learning experience. In class, students valued the small-group activities, and the opportunities to practice their teaching skills with provision of feedback. Students reported increased confidence to plan and deliver peer teaching activities, and an increased awareness of the roles and responsibilities of health professionals outside of their own discipline, and use of different terminology and communication methods. Students’ suggestions for improving the PTT, included; less large group teaching; more online delivery of theory; and inclusion of a wider range of health professional disciplines.ConclusionThe PTT program provided a theoretically informed framework where students could develop and practice their teaching skills, helping to shape students’ professional values as they assume peer teaching responsibilities and move towards healthcare practice. The flipped learning, interprofessional format was successful in developing students’ skills, competence and confidence in teaching, assessment, communication and feedback. Importantly, participation increased students’ awareness and understanding of the various roles of health professionals.

Practice of Staff Nurses regarding Intravenous Infusion (IV)

Intravenous infusion is a direct administration of medication or fluid directly into human circulation, helps to restore the fluid and electrolyte balance. Same time it is a very complicated route, which causes consequences if asepsis is not maintained. The main aim of the study was to explore the Practice of Staff Nurses regarding IV infusion in selected hospital at Mysuru. Practice of IV infusion was assessed among 50 Staff Nurses. Purposive sampling technique was adopted to select the 50 Staff Nurses. Data was collected by using practice check list. The result of the study revealed that all Staff Nurses (100%) has good Practice regarding IV infusion. Study finding stresses the responsibility of health Professionals in improving the practice of Staff Nurses regarding IV infusion, which helps to reduce Complications.

Orthopedic surgeons' attitudes to osteoporosis investigation and management after minimal trauma fracture (MTF).

The investigation and treatment of osteoporosis after minimal trauma fracture (MTF) is regarded as sub-optimal. There is strong evidence of the benefit of identifying and treating osteoporosis after MTF, and there has been discussion of the possible role that orthopedic surgeons might play in the management of osteoporosis after MTF. The study surveyed orthopedic surgeons in rural and regional Southeast Australia to determine their attitudes to investigation and management of osteoporosis, the role health professionals should play, and the communication and co-ordination of follow-up care. A survey was developed and piloted prior to being posted to 69 orthopedic surgeons asking for their opinions about the general management of osteoporosis, and the roles and responsibilities of health professionals in dealing with osteoporosis following an MTF. Responses were received from 42 participants (60.8%) with the majority of respondents agreeing that it is important to treat osteoporosis following MTF. Less than 15% of respondents felt that it was their responsibility to initiate discussion or treatment or investigation after MTF. No respondent felt that the coordination of osteoporosis care was good and 45% stated it was poor. Communication after discharge is mostly left to the hospital (30%), while 20% stated they did not follow up at all. This study shows that many rural orthopedic surgeons believe that follow-up in regard to osteoporosis after MTF is important, that responsibility for follow-up diagnosis and management of osteoporosis lies with primary health care and the current communication systems are poor.

Comparison of medication policies to guide nursing practice across seven Victorian health services

Objectives The objective of this paper is to review and compare the content of medication management policies across seven Australian health services located in the state of Victoria. Methods The medication management policies for health professionals involved in administering medications were obtained from seven health services under one jurisdiction. Analysis focused on policy content, including the health service requirements and regulations governing practice. Results and Conclusions The policies of the seven health services contained standard information about staff authorisation, controlled medications and poisons, labelling injections and infusions, patient self-administration, documentation and managing medication errors. However, policy related to individual health professional responsibilities, single- and double-checking medications, telephone orders and expected staff competencies varied across the seven health services. Some inconsistencies in health professionals' responsibilities among medication management policies were identified. What is known about the topic? Medication errors are recognised as the single most preventable cause of patient harm in hospitals and occur most frequently during administration. Medication management is a complex process involving several management and treatment decisions. Policies are developed to assist health professionals to safely manage medications and standardise practice; however, co-occurring activities and interruptions increase the risk of medication errors. What does this paper add? In the present policy analysis, we identified some variation in the content of medication management policies across seven Victorian health services. Policies varied in relation to medications that require single- and double-checking, as well as by whom, nurse-initiated medications, administration rights, telephone orders and competencies required to check medications. What are the implications for practitioners? Variation in medication management policies across organisations is highlighted and raises concerns regarding consistency in governance and practice related to medication management. Lack of practice standardisation has previously been implicated in medication errors. Lack of intrajurisdictional concordance should be addressed to increase consistency. Inconsistency in expectations between healthcare services may lead to confusion about expectations among health professionals moving from one healthcare service to another, and possibly lead to increased risk of medication errors.

Raw Data: Research and Health Care Goals Differ

In their Policy Forum “Raw personal data: Providing access” (24 January, p. [373][1]), J. E. Lunshof et al. suggest that more should be done to enable persons who had their genome sequenced, either as research subjects or as patients, to actively access their raw data. They argue that routinely providing them with personal access codes to those data would be a matter of transparency and respect for autonomy. We think Lunshof et al. underestimate the dangers of actively handing out data that we know are not fully reliable and can lead to misinterpretation. In our view, the proposed policy would be at odds with the responsibility of health professionals. In health care, clinical utility should have priority over social utility. An appeal to reciprocity between donors and users of genomic data does not change this argument. Patients are not the same as data donors. If patients become data donors by consenting to have their data stored in research registries, they should be aware that they have entered a different relationship, in which they primarily contribute to the benefit of future patients. Lunshof et al. ignore the crucial difference between health care and research when they criticize the recent recommendations of the European Society of Human Genetics (ESHG). To avoid the unnecessary generation of incidental findings, these recommendations advise the use of targeted forms of testing if that is sufficient to address the patient's problem ([ 1 ][2]). According to Lunshof et al. , this is problematic as it “systematically precludes the possible discovery of complex genetic causation.” We disagree: Discovery is the aim of research, not of health care. Conflating these aims risks turning patients into research subjects without their consent. 1. [↵][3] 1. C. G. van El 2. et al ., Eur. J. Hum. Genet. 21, 580 (2013). [OpenUrl][4][PubMed][5] 2. The authors are writing on behalf of the ESHG Public and Professional Policy Committee. [1]: /lookup/doi/10.1126/science.1249382 [2]: #ref-1 [3]: #xref-ref-1-1 View reference 1 in text [4]: {openurl}?query=rft.jtitle%253DEur.%2BJ.%2BHum.%2BGenet.%26rft.volume%253D21%26rft.spage%253D580%26rft_id%253Dinfo%253Apmid%252F23676617%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [5]: /lookup/external-ref?access_num=23676617&link_type=MED&atom=%2Fsci%2F343%2F6174%2F968.2.atom