Safety Communication Research Articles

Adherence to infliximab treatment in patients with immune-mediated inflammatory diseases from a referral center in Brazil: a cohort study

BackgroundInfliximab therapy is effective in controlling symptoms and attaining clinical remission of immune-mediated inflammatory diseases. However, treatment adherence is essential to achieve the therapeutic objective. This study aimed to determine the rate of adherence to infliximab treatment in patients treated at a referral center at a university hospital.MethodThis ambispective cohort study included patients treated at the Professor Edgard Santos University Hospital (HUPES) referral center of our university hospital between March 2022 and February 2023. Sociodemographic, clinical, and pharmacotherapeutic data were collected from 101 patients through interviews and medical record reviews using a structured form. The adherence rate was defined as the proportion of days covered in a year. Patients who achieved an adherence rate > 80% were considered adherent.ResultsThe treatment adherence rate was 91.04%. Individuals with inflammatory bowel diseases had a 39.1% higher risk of non-adherence to treatment compared with other patients in our sample (p < 0,05). Most patients achieved remission or control of the underlying disease activity and had good functional capacities. The main reason for absence on the scheduled date was difficulty traveling to the referral center.ConclusionsDespite the reported difficulties, treatment adherence was observed to be high. As the study was conducted in a reference unit with multidisciplinary care and continuous monitoring for treatment effectiveness, safety, and adherence, welcoming and good communication between professionals and patients may have contributed to the high adherence rate.

Latency Analysis of Drone-Assisted C-V2X Communications for Basic Safety and Co-Operative Perception Messages

Drone-assisted radio communication is revolutionizing future wireless networks, including sixth-generation (6G) and beyond, by providing unobstructed, line-of-sight links from air to terrestrial vehicles, enabling robust cellular cehicle-to-everything (C-V2X) communication networks. However, addressing communication latency is imperative, especially when considering autonomous vehicles. In this study, we analyze different types of delay and the factors impacting them in drone-assisted C-V2X networks. We specifically investigate C-V2X Mode 4, where multiple vehicles utilize available transmission windows to communicate the frequently collected sensor data with an embedded drone server. Through a discrete-time Markov model, we assess the medium access control (MAC) layer performance, analyzing the trade-off between data rates and communication latency. Furthermore, we compare the delay between cooperative perception messages (CPMs) and periodically transmitted basic safety messages (BSMs). Our simulation results emphasize the significance of optimizing BSM and CPM transmission intervals to achieve lower average delay as well as utilization of drones’ battery power to serve the maximum number of vehicles in a transmission time interval (TTI). The results also reveal that the average delay heavily depends on the packet arrival rate while the processing delay varies with the drone occupancy and state-transition rates for both BSM and CPM packets. Furthermore, an optimal policy approximates a threshold-based policy in which the threshold depends on the drone utilization and energy availability.

The implementation of a "safety officer" program: an innovative approach to improve infection prevention and control practices in Ethiopia.

Effective infection prevention and control (IPC) was central to keeping healthcare workers (HCWs) safe during the COVID-19 pandemic. However, as the pandemic continued, the maintenance of high-quality IPC practices waned, placing HCWs at increased risk of infection. A COVID-19 Safety Officer (SO) program was piloted by the United States Agency for International Development (USAID)-funded Reaching Impact, Saturation and Epidemic Control (RISE) project across two health facilities in Ethiopia, which trained clinical and non-clinical HCWs on IPC protocols to promote safe practices in patient care areas. We sought to evaluate the implementation and effectiveness of the SO program in improving IPC practices within the clinical setting. This is a post-implementation evaluation of the SO program, implemented in two hospitals in Ethiopia between May 2022 and December 2022. Participants completed a 4-day course on COVID-19 epidemiology, IPC, safety communication, and learning theory as a part of the Training of Trainers component (n = 23), and were posted in clinical wards to provide staff training and support to maintain IPC protocols. The program was evaluated at 6 months using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Effectiveness was measured using direct observation of IPC practices across intervention sites. Implementation outcomes were measured using surveys and qualitative interviews to capture training cascade, knowledge, comfort, acceptability, and maintenance. Participants were able to cascade training to an additional 167 clinical (67.6%) and 80 non-clinical (32.3%) staff across both sites. Direct observation of clinical staff at 6 months showed that 95% (59/62) wore at least a surgical mask with patients and were compliant with masking and/or distancing protocol. Clinical interviews revealed that SOs contributed to increased perceived comfort with screening and isolation procedures and environmental cleaning procedures. The SO training program was widely adopted, and effective in improving the implementation and comfort of maintaining IPC practices in clinical settings.

Patient safety education in Umm Al-Qura dental school: A comprehensive analysis of curriculum content and student confidence

BackgroundPatient safety (PS) is a critical component in dental education, yet it is not clear how dental schools include PS education in their curricula. AimTo assess how PS topics are presented in the current Umm Al-Qura undergraduate dental (UQUDENT) curriculum and to investigate the self-perceptions of dental students regarding the PS confidence they have attained from their dental program. MethodThe UQUDENT curriculum was mapped using keywords developed from the WHO PS manual. Courses contained intended learning outcomes (ILOs), and lecture topics were identified and ranked based on the level of PS content. In addition, dental students and interns were asked to fill in a modified version of the Health Professional Education in Patient Safety Survey. ResultsA total of 73.2% of the courses included ILOs or topics related to PS. Keywords related to the teamwork topic were the most common (60.9%), followed by patient engagement (24.3%), medication safety (12.2%), and infection control (9.8%). None of the courses included items on overall PS concepts, understanding systems, or quality improvement in relation to PS.Dental students were most confident in their learning regarding clinical safety and effective communication. They were least confident in what they learned about teamwork with other health professionals. There were no statistically significant differences in PS domain scores between classroom and clinical learning. ConclusionThe UQUDENT curriculum covers many aspects of PS. However, the PS content should be explicitly taught and assessed. Areas such as interprofessional education, clinical risk management, learning from errors, and teamwork should be augmented.

Use of Hydrochlorothiazide in the United States Following Label Update About Skin Cancer Risk.

On August 20, 2020, the United States (U.S.) Food and Drug Administration (FDA) issued a Drug Safety Communication (DSC) along with labeling updates to inform the public about a small increased risk of non-melanoma skin cancer (NMSC) associated with hydrochlorothiazide (HCTZ) use. This study aims to assess whether the DSC impacted HCTZ use in the U.S. We conducted a trend analysis in the Sentinel Distributed Database using national healthcare administrative data from January 2017 to November 2022. We identified two cohorts each month: An overall cohort of all enrollees and a skin cancer cohort of those with a history of NMSC. For each cohort, we plotted the monthly proportion of patients receiving HCTZ-containing products among those receiving any thiazide diuretics. We performed interrupted time series analyses to quantify the impact of the DSC on these monthly proportions. Secondary analyses were conducted on the proportion of HCTZ users among patients receiving any antihypertensives. In the overall cohort, the DSC was only associated with a statistically significant but clinically negligible trend change of monthly HCTZ proportion within this cohort (0.018%; 95% CI, 0.012%-0.025%). Similar results were observed in the skin cancer cohort. The secondary analysis found no significant level change or trend change in the monthly proportion of HCTZ use among antihypertensive users. We did not observe significant changes in HCTZ use following the DSC about its NMSC risk, among the overall population and those with a history of NMSC. Our findings were in accordance with the DSC recommendation.

Topic identification and content analysis of internet medical policies under the background of Healthy China 2030.

This study aims to analyse the content of internet medical policies, grasp the inherent laws of the development of internet medical policies and provide references for improving the policy system. On the basis of web crawler technology, 436 internet medical policies issued by the central and local governments after the Healthy China Strategy was proposed were collected. The BERTopic model was used to extract topics, and a comprehensive analysis of China's internet medical policy texts was conducted through the analysis of topic content, topic hierarchy and topic clusters. A total of 27 topics were identified in China's internet medical policies, mainly focussing on five topic clusters: medical service regulation, elderly nursing and children's healthcare using traditional Chinese medicine, user safety guarantees, health education and communication and infectious disease treatment and recovery guidance. Different topic contents play a role in promoting the comprehensive and standardized development of internet medical services. However, there is still room for further improvement in policy integrity, consideration of multiple types of users, and implementation effectiveness. Continuous efforts are needed to optimize the effectiveness of policies.

The Importance of Brand in Medical Tourism

Medical tourism, which is becoming more popular every year, represents a significant segment of global tourism. This trend is driven not only by the growing number of patients seeking better, faster, or more affordable healthcare but also by increasing globalisation and the greater availability of information. In the context of the Czech Republic, where the number of international patients has significantly increased over the last decade, it is essential to understand the role that the brand image of healthcare facilities plays in the decision-making process of these patients. Based on the research conducted, it can be concluded that the key factors influencing the choice of a healthcare facility are the quality of services, safety, and modern equipment. Price and speed of service also play an important role, with patients particularly appreciating a good value-for-money ratio. The importance of communication and customer service is also evident, as effective and high-quality communication can significantly strengthen the brand image and patient trust. The research results suggest that although word-of-mouth and personal recommendations are important, their effect is not statistically significantly greater than that of the marketing communication of a given healthcare facility. This indicates that it is important for healthcare providers to address both forms of communication equally. In conclusion, it can be said that a strong brand image of a healthcare facility, built on quality, safety, and effective communication, plays a key role in attracting foreign patients as part of medical tourism. Healthcare providers should actively develop these factors to be able to compete in the ever-growing medical tourism market.

The Promotion and Communication of Occupational Health and Safety at PT Pertamina International (KPI) Refinery Unit Balongan - Indramayu

The Promotion and Communication of Occupational Health and Safety at PT Pertamina International (KPI) Refinery Unit Balongan - Indramayu

Decoding stakeholder priorities of safety culture preferences in the oil and gas industry

Safety culture is a critical determinant of organisational performance, particularly in high-risk industries especially in oil and gas. Understanding stakeholder preferences is essential for developing effective strategies that enhance safety culture. This study utilised the Analytic Hierarchy Process (AHP) to prioritise stakeholder preferences, identifying key elements of safety culture in Malaysia's oil and gas sector. This study employed a structured methodology to evaluate safety culture within the oil and gas industry, focusing on 18 sub-elements across three key domains: psychological, behavioural, and situational factors. A diverse sample of industry experts was recruited using purposeful and snowball sampling to ensure a comprehensive representation of stakeholder views. The AHP framework was applied to analyse the data, utilizing structured questionnaires and multicriteria decision-making techniques to prioritize the identified safety culture elements. The AHP analysis identified distinct priorities among different professional groups within the oil and gas sector. Safety and Health Practitioners emphasized practical elements such as safety rules and management commitment, while academicians prioritized knowledge and training. Management personnel highlighted the importance of safety ownership and communication, whereas policymakers focused on broader, policy-oriented aspects. The findings suggest that safety culture improvement initiatives should be tailored to address the specific needs and priorities of each professional group. A nuanced understanding of stakeholder preferences is crucial for developing comprehensive strategies that integrate observable behaviours, situational conditions, and psychological factors, ultimately fostering a robust safety culture in the oil and gas industry.

A Systematic Approach to Evaluating Instrumental Variable Assumptions: Applied Example of Glucose-lowering Medications and Risk for Hospitalized Heart Failure in Older Adults.

One obstacle to adopting instrumental variable (IV) methods in pharmacoepidemiology is their reliance on strong, unverifiable assumptions. We can falsify IV assumptions by leveraging the causal structure, which can strengthen or refute their plausibility and increase the validity of effect estimates. We illustrate a systematic approach to evaluate calendar time IV assumptions in estimating the known effect of thiazolidinediones on hospitalized heart failure. Using cohort entry time before and after 09/2010, when the U.S. Food and Drug Administration issued a safety communication as a proposed IV, we estimated IV and propensity score-weighted 2-year risk differences (RDs) using Medicare data (2008-2014). We (i) performed inequality tests, (ii) identified the negative control IV/outcome using causal assumptions, (iii) estimated RDs after narrowing the calendar time range and excluding patients likely associated with unmeasured confounding, (iv) derived bounds for RDs, and (v) estimated the proportion of compliers and their characteristics. The findings revealed that IV assumptions were violated and RDs were extreme, but the assumptions became more plausible upon narrowing the calendar time range and restricting the cohort by excluding prevalent heart failure (the strongest measured predictor of outcome). Systematically evaluating IV assumptions could help detect bias in IV estimators and increase their validity.

Anesthesia-Related Closed Claims in Free-Standing Ambulatory Surgery Centers.

As higher acuity procedures continue to move from hospital-based operating rooms (HORs) to free-standing ambulatory surgery centers (ASCs), concerns for patient safety remain high. We conducted a contemporary, descriptive analysis of anesthesia-related liability closed claims to understand risks to patient safety in the free-standing ASC setting, compared to HORs. Free-standing ASC and HOR closed claims between 2015 and 2022 from The Doctors Company that involved an anesthesia provider responsible for the claim were included. We compared the coded data of 212 free-standing ASC claims with 268 HOR claims in terms of severity of injury, major injuries, allegations, comorbidities, contributing factors, and financial value of the claim. Free-standing ASC claims accounted for almost half of all anesthesia-related cases (44%, 212 of 480). Claims with high severity of injury were less frequent in free-standing ASCs (22%) compared to HORs (34%; P = .004). The most common types of injuries in both free-standing ASCs and HORs were dental injury (17% vs 17%) and nerve damage (14% vs 11%). No difference in frequency was noted for types of injuries between claims from free-standing ASCs versus HORs--except that burns appeared more frequently in free-standing ASC claims than in HORs (6% vs 2%; P = .015). Claims with alleged improper management of anesthesia occurred less frequently among free-standing ASC claims than HOR claims (17% vs 29%; P = .01), as well as positioning-related injury (3% vs 8%; P = .025). No difference was seen in frequency of claims regarding alleged improper performance of anesthesia procedures between free-standing ASCs and HORs (25% vs 19%; P = .072). Technical performance of procedures (ie, intubation and nerve block) was the most common contributing factor among free-standing ASC (74%) and HOR (74%) claims. Free-standing ASC claims also had a higher frequency of communication issues between provider and patient/family versus HOR claims (20% vs 10%; P = .004). Most claims were not associated with major comorbidities; however, cardiovascular disease was less prevalent in free-standing ASC claims versus HOR claims (3% vs 11%; P = .002). The mean ± standard deviation total of expenses and payments was lower among free-standing ASC claims ($167,000 ± $295,000) than HOR claims ($332,000 ± $775,000; P = .002). This analysis of medical malpractice claims may indicate higher-than-expected patient and procedural complexity in free-standing ASCs, presenting patient safety concerns and opportunities for improvement. Ambulatory anesthesia practices should consider improving safety culture and communication with families while ensuring that providers have up-to-date training and resources to safely perform routine anesthesia procedures.

Assessing the Influence of Safety Culture to Employee Safety Performance Mediated by Safety Communication in Coal-Fired Power Plant

This study analyzes the effect of safety culture on employee safety performance at a Coal Fired Power Plant (CFPP) in Java, as well as the mediating role of safety communication and moderating role of service years. This study aims to investigate the direct and indirect effects between the variables of safety culture, safety communication and employee safety performance. In addition, the study also explored the moderating role of service year in the relationship between safety culture and employee safety performance. Data was obtained from distributing questionnaires to CFPP employees using a stratified sampling method. SmartPLS SEM. The findings reveal that safety culture does not have a significant direct effect on employee safety performance. However, safety communication significantly mediates the relations between safety culture and employee safety performance. The service year does not moderate the relationship between safety culture and employee safety performance This indicates that other factors such as continuous training, reward system, and work environment may be more influential in this context.

Putting workers’ safety front and center: Employee-organization exchange and employee safety performance

Introduction: The global occupational accident situation remains severe. As enhancing employee safety performance constitutes a crucial part of accident prevention and safety management, the study aims to examine, from an employment relationship perspective, the cognitive, motivational, and behavioral mechanisms through which employee-organization exchange (EOX), as a social exchange type of employment relationship, can affect employee safety performance. Method: Data were collected from 672 subordinates and their immediate 100 supervisors in three large manufacturing firms in Guangdong province, China. Results: The results shows that: (1) EOX has a positive effect on employees’ safety risk perception, psychological ownership of safety promotion, and safety communication; (2) safety risk perception, psychological ownership of safety promotion and safety communication (as cognitive, motivational and behavioral mechanisms) mediate the relationship between EOX and safety performance (both safety compliance and safety participation); and (3) management commitment to safety moderates the direct effect of EOX on safety risk perception, psychological ownership of safety promotion, and safety communication, and its indirect effect on two forms of safety performance via the three mediating mechanisms. The moderating effect and moderated indirect effect are stronger when management commits more to safety. The study contributes to the employee safety literature. Practical Applications: Employers should establish a long-term oriented social exchange relationship with their employees for effective safety management.

One Health Priorities: Advancing Veterinary Public Health in Latin America and the Caribbean.

One Health (OH) is an integrative approach to human, animal, and environmental health and can be used as a comprehensive indicator for comparative purposes. Although an OH index has been proposed for comparing cities, states, and countries, to date, no practical study has compared countries using this approach. Accordingly, this study aimed to assess OH initiatives using a survey with a veterinary public health focus. The questionnaire contained 104 quantitative questions and was sent to representatives of governmental institutions of 32 countries in the Americas. After exclusion criteria were considered, a total of 35 questionnaires from 17 countries were analyzed, with country names remaining undisclosed during the statistical analyses to protect potentially sensitive information. Principal component analysis (PCA) of health parameters in Latin America and the Caribbean (LAC) as a function of country perception (self-vector) showed that food safety was ranked higher than public policies (p = 0.009), and that both (p = 0.003) were ranked higher than institutional routines related to zoonosis programs. National policies in accordance with international standards, regulations, recommendations, and guidelines was considered the standout topic for public policy, with higher-ranking topics including standard. Meanwhile, challenging topics included tools, preparedness, governance, and research. Food safety showed both strengths and challenges in the coordination of its activities with other sectors. Food safety communication was scored as a strength, while foodborne diseases prevention was ranked as a challenge. Institutional routines for zoonosis maintained both strong and challenging topics in the execution and implementation of attributions and daily routine. Thus, the survey showed that topics such as access to and compliance with international guidelines and intercountry integration were ranked higher than in-country articulation, particularly among food safety, zoonoses, and environmental institutions.

Unveiling maritime English communication needs for seafarer: Strategic reformation for classroom instructional design

The significance of onboard maritime English communication has led to the needs of innovation in language teaching strategies and instructional design. Mostly Indonesian seafarers faced serious problems to join ocean-going vessels due to maritime English proficiency. This study attempted to capture the essential demands of Indonesian seafarers joining an ocean-going vessel for their communication techniques using maritime English, with the goal of having a greater impact on the development of instructional design for Indonesian curriculum. Semi-structured interviews were conducted with 14 Indonesian seafarers assigned to different ocean-going vessels of various sorts, sizes, and foreign flags. Semi-structured interview was performed with three maritime English lecturers from different maritime education institutions in Indonesia. This study employed qualitative research by combining theory and using NVivo 12 Plus software as the coding method to understand and analyse data. The first finding indicated that operational maritime communication strategies such as in routine and special-message communication like safety, distress and urgency communications were required to create communication patterns. Second finding denoted challenges faced by Indonesian seafarers in having maritime communication such as unclear meaning resulted from improper word choices, different accents and pronunciations of the different socio-cultural of radio officers they spoke to, and due to sentence construction. The third finding revealed the focus of materials for each language skill for communication onboard. The whole findings implied that maritime-ESP teaching should reform with solemn education packages and instructional design heading toward the communicative competence to prepare cadets with the required needs of their future seafaring job.

Enhancing radiation safety awareness and practices among female radiographers: a comprehensive approach

ObjectiveThis study evaluates the level of radiation safety awareness and adherence to protective practices among pregnant female radiographers in the United Arab Emirates, aiming to identify gaps and develop targeted interventions for enhancing occupational safety.MethodsEmploying a cross-sectional design, the study surveyed 133 female radiographers using a self-developed questionnaire covering demographics, awareness and knowledge, workplace practices, communication, and satisfaction.ResultsThe survey showed high awareness among radiographers, with 97% acknowledging radiation risks during pregnancy, although 42.9% had not received formal training. Concerns over long-term health effects were significant, with 66.2% of participants worried about potential impacts. Despite these concerns, 83.5% had been informed about radiation risks and protective measures, indicating active information provision in many workplaces. However, inconsistencies in information dissemination across different work settings were noted.ConclusionsThe findings highlight the need for standardized radiation safety protocols for pregnant radiographers. The variability in safety training and information dissemination suggests the importance of establishing uniform safety practices. Recommendations include developing comprehensive education and training programs for pregnant radiographers, ensuring open communication for radiation safety and pregnancy-related concerns, and enforcing clear guidelines for workplace accommodations.

Three Shift Simulation: An Interdisciplinary Simulation With a Focus on Communicating for Safety in Managing the Deteriorating Patient

BackgroundSuboptimal communication from one healthcare professional to another can lead to error and patient harm. Effective communication between nurses and other healthcare professionals contributes to a shared understanding of a patient's condition and their management plan. Simulation for health professional education be an effective method to improve communication for patient safety. AimTo implement a simulated communication intervention, as an extracurricular activity among nursing, pharmacy, and medical students from a multicampus Australian university. MethodsA mixed methods questionnaire with open and closed questions was used to evaluate the direct impact of the simulation intervention, utilizing a validated tool: Satisfaction with Simulation Experience (SSE). The tool was adapted to capture experiences related to communication and patient safety. FindingsIt was found that students’ ability to recognize the role of other health professionals in patient safety increased. Participants reported that the intervention enabled them to work together providing routine care and provided experience collaborating within a multidisciplinary team with the deteriorating patient. The results also demonstrated that participants learned to communicate for patient safety. DiscussionThe simulation intervention contributed to better prepare students in communicating with one another in providing safe care for deteriorating patients. However, transfer of learning in practice was not measured and therefore the impact on long -term patient safety outcomes is unknown, and this requires further investigation. ConclusionIncorporating interdisciplinary simulation with a focus on interdisciplinary communication into undergraduate nursing, pharmacy and medicine curricula can support students' knowledge, skills, and attitudes for quality and safe care.

Communication security analysis of fully electronic interlocking systems

Communication security in fully electronic interlocking systems is one of the key factors ensuring the safe and reliable operation of the entire system. EN50159 is an important standard in the European railway communication sector, aimed at ensuring the safety, reliability, and efficiency of railway transportation. According to the communication security standards of EN50159, there are six types of security risks in closed communication: data duplication, deletion, insertion, misordering, delay, and corruption. This paper analyzes and explains the aspects of communication security that need to be considered based on the safety communication standards of China's railway signaling system and the signal safety standards in EN50159, focusing primarily on communication security and reliability.

Breast implant-associated squamous cell carcinoma

Breast implant-associated squamous cell carcinoma (BIA-SCC) is a rare but serious disease that originates from the lining of the breast implant capsule. Alongside BIA-anaplastic large cell lymphoma, the U.S. Food and Drug Administration issued a safety communication in 2022 regarding BIA-SCC to alert healthcare providers and patients. Although only a few cases have been reported, the high mortality and poor prognosis associated with BIA-SCC underscore the severity of the disease. This review discusses the current knowledge of BIA-SCC, including its pathogenesis, diagnostic methods, and treatment options based on reported cases.

Virtual Reality Training of Safety and Social Communication Skills in Children with Autism: An Examination of Acceptability, Usability, and Generalization

Virtual Reality Training of Safety and Social Communication Skills in Children with Autism: An Examination of Acceptability, Usability, and Generalization