Science.gov

Sample records for medication error data-sharing

  1. Medication Errors

    MedlinePlus

    ... to reduce the risk of medication errors to industry and others at FDA. Additionally, DMEPA prospectively reviews ... List of Abbreviations Regulations and Guidances Guidance for Industry: Safety Considerations for Product Design to Minimize Medication ...

  2. Medication Errors

    MedlinePlus

    Medicines cure infectious diseases, prevent problems from chronic diseases, and ease pain. But medicines can also cause harmful reactions if not used ... You can help prevent errors by Knowing your medicines. Keep a list of the names of your ...

  3. [Medical errors in obstetrics].

    PubMed

    Marek, Z

    1984-08-01

    Errors in medicine may fall into 3 main categories: 1) medical errors made only by physicians, 2) technical errors made by physicians and other health care specialists, and 3) organizational errors associated with mismanagement of medical facilities. This classification of medical errors, as well as the definition and treatment of them, fully applies to obstetrics. However, the difference between obstetrics and other fields of medicine stems from the fact that an obstetrician usually deals with healthy women. Conversely, professional risk in obstetrics is very high, as errors and malpractice can lead to very serious complications. Observations show that the most frequent obstetrical errors occur in induced abortions, diagnosis of pregnancy, selection of optimal delivery techniques, treatment of hemorrhages, and other complications. Therefore, the obstetrician should be prepared to use intensive care procedures similar to those used for resuscitation.

  4. [Medical device use errors].

    PubMed

    Friesdorf, Wolfgang; Marsolek, Ingo

    2008-01-01

    Medical devices define our everyday patient treatment processes. But despite the beneficial effect, every use can also lead to damages. Use errors are thus often explained by human failure. But human errors can never be completely extinct, especially in such complex work processes like those in medicine that often involve time pressure. Therefore we need error-tolerant work systems in which potential problems are identified and solved as early as possible. In this context human engineering uses the TOP principle: technological before organisational and then person-related solutions. But especially in everyday medical work we realise that error-prone usability concepts can often only be counterbalanced by organisational or person-related measures. Thus human failure is pre-programmed. In addition, many medical work places represent a somewhat chaotic accumulation of individual devices with totally different user interaction concepts. There is not only a lack of holistic work place concepts, but of holistic process and system concepts as well. However, this can only be achieved through the co-operation of producers, healthcare providers and clinical users, by systematically analyzing and iteratively optimizing the underlying treatment processes from both a technological and organizational perspective. What we need is a joint platform like medilab V of the TU Berlin, in which the entire medical treatment chain can be simulated in order to discuss, experiment and model--a key to a safe and efficient healthcare system of the future. PMID:19213452

  5. Medication Errors in Outpatient Pediatrics.

    PubMed

    Berrier, Kyla

    2016-01-01

    Medication errors may occur during parental administration of prescription and over-the-counter medications in the outpatient pediatric setting. Misinterpretation of medication labels and dosing errors are two types of errors in medication administration. Health literacy may play an important role in parents' ability to safely manage their child's medication regimen. There are several proposed strategies for decreasing these medication administration errors, including using standardized dosing instruments, using strictly metric units for medication dosing, and providing parents and caregivers with picture-based dosing instructions. Pediatric healthcare providers should be aware of these strategies and seek to implement many of them into their practices. PMID:27537086

  6. Sepsis: Medical errors in Poland.

    PubMed

    Rorat, Marta; Jurek, Tomasz

    2016-01-01

    Health, safety and medical errors are currently the subject of worldwide discussion. The authors analysed medico-legal opinions trying to determine types of medical errors and their impact on the course of sepsis. The authors carried out a retrospective analysis of 66 medico-legal opinions issued by the Wroclaw Department of Forensic Medicine between 2004 and 2013 (at the request of the prosecutor or court) in cases examined for medical errors. Medical errors were confirmed in 55 of the 66 medico-legal opinions. The age of victims varied from 2 weeks to 68 years; 49 patients died. The analysis revealed medical errors committed by 113 health-care workers: 98 physicians, 8 nurses and 8 emergency medical dispatchers. In 33 cases, an error was made before hospitalisation. Hospital errors occurred in 35 victims. Diagnostic errors were discovered in 50 patients, including 46 cases of sepsis being incorrectly recognised and insufficient diagnoses in 37 cases. Therapeutic errors occurred in 37 victims, organisational errors in 9 and technical errors in 2. In addition to sepsis, 8 patients also had a severe concomitant disease and 8 had a chronic disease. In 45 cases, the authors observed glaring errors, which could incur criminal liability. There is an urgent need to introduce a system for reporting and analysing medical errors in Poland. The development and popularisation of standards for identifying and treating sepsis across basic medical professions is essential to improve patient safety and survival rates. Procedures should be introduced to prevent health-care workers from administering incorrect treatment in cases.

  7. 20 Tips to Help Prevent Medical Errors

    MedlinePlus

    ... Prevent Medical Errors 20 Tips to Help Prevent Medical Errors: Patient Fact Sheet This information is for ... current information. Select to Download PDF (295 KB). Medical errors can occur anywhere in the health care ...

  8. Medical Error and Moral Luck.

    PubMed

    Hubbeling, Dieneke

    2016-09-01

    This paper addresses the concept of moral luck. Moral luck is discussed in the context of medical error, especially an error of omission that occurs frequently, but only rarely has adverse consequences. As an example, a failure to compare the label on a syringe with the drug chart results in the wrong medication being administered and the patient dies. However, this error may have previously occurred many times with no tragic consequences. Discussions on moral luck can highlight conflicting intuitions. Should perpetrators receive a harsher punishment because of an adverse outcome, or should they be dealt with in the same way as colleagues who have acted similarly, but with no adverse effects? An additional element to the discussion, specifically with medical errors, is that according to the evidence currently available, punishing individual practitioners does not seem to be effective in preventing future errors. The following discussion, using relevant philosophical and empirical evidence, posits a possible solution for the moral luck conundrum in the context of medical error: namely, making a distinction between the duty to make amends and assigning blame. Blame should be assigned on the basis of actual behavior, while the duty to make amends is dependent on the outcome. PMID:26662613

  9. Analysis of Medication Error Reports

    SciTech Connect

    Whitney, Paul D.; Young, Jonathan; Santell, John; Hicks, Rodney; Posse, Christian; Fecht, Barbara A.

    2004-11-15

    In medicine, as in many areas of research, technological innovation and the shift from paper based information to electronic records has created a climate of ever increasing availability of raw data. There has been, however, a corresponding lag in our abilities to analyze this overwhelming mass of data, and classic forms of statistical analysis may not allow researchers to interact with data in the most productive way. This is true in the emerging area of patient safety improvement. Traditionally, a majority of the analysis of error and incident reports has been carried out based on an approach of data comparison, and starts with a specific question which needs to be answered. Newer data analysis tools have been developed which allow the researcher to not only ask specific questions but also to “mine” data: approach an area of interest without preconceived questions, and explore the information dynamically, allowing questions to be formulated based on patterns brought up by the data itself. Since 1991, United States Pharmacopeia (USP) has been collecting data on medication errors through voluntary reporting programs. USP’s MEDMARXsm reporting program is the largest national medication error database and currently contains well over 600,000 records. Traditionally, USP has conducted an annual quantitative analysis of data derived from “pick-lists” (i.e., items selected from a list of items) without an in-depth analysis of free-text fields. In this paper, the application of text analysis and data analysis tools used by Battelle to analyze the medication error reports already analyzed in the traditional way by USP is described. New insights and findings were revealed including the value of language normalization and the distribution of error incidents by day of the week. The motivation for this effort is to gain additional insight into the nature of medication errors to support improvements in medication safety.

  10. Medication errors: definitions and classification.

    PubMed

    Aronson, Jeffrey K

    2009-06-01

    1. To understand medication errors and to identify preventive strategies, we need to classify them and define the terms that describe them. 2. The four main approaches to defining technical terms consider etymology, usage, previous definitions, and the Ramsey-Lewis method (based on an understanding of theory and practice). 3. A medication error is 'a failure in the treatment process that leads to, or has the potential to lead to, harm to the patient'. 4. Prescribing faults, a subset of medication errors, should be distinguished from prescription errors. A prescribing fault is 'a failure in the prescribing [decision-making] process that leads to, or has the potential to lead to, harm to the patient'. The converse of this, 'balanced prescribing' is 'the use of a medicine that is appropriate to the patient's condition and, within the limits created by the uncertainty that attends therapeutic decisions, in a dosage regimen that optimizes the balance of benefit to harm'. This excludes all forms of prescribing faults, such as irrational, inappropriate, and ineffective prescribing, underprescribing and overprescribing. 5. A prescription error is 'a failure in the prescription writing process that results in a wrong instruction about one or more of the normal features of a prescription'. The 'normal features' include the identity of the recipient, the identity of the drug, the formulation, dose, route, timing, frequency, and duration of administration. 6. Medication errors can be classified, invoking psychological theory, as knowledge-based mistakes, rule-based mistakes, action-based slips, and memory-based lapses. This classification informs preventive strategies.

  11. Medication errors: definitions and classification

    PubMed Central

    Aronson, Jeffrey K

    2009-01-01

    To understand medication errors and to identify preventive strategies, we need to classify them and define the terms that describe them. The four main approaches to defining technical terms consider etymology, usage, previous definitions, and the Ramsey–Lewis method (based on an understanding of theory and practice). A medication error is ‘a failure in the treatment process that leads to, or has the potential to lead to, harm to the patient’. Prescribing faults, a subset of medication errors, should be distinguished from prescription errors. A prescribing fault is ‘a failure in the prescribing [decision-making] process that leads to, or has the potential to lead to, harm to the patient’. The converse of this, ‘balanced prescribing’ is ‘the use of a medicine that is appropriate to the patient's condition and, within the limits created by the uncertainty that attends therapeutic decisions, in a dosage regimen that optimizes the balance of benefit to harm’. This excludes all forms of prescribing faults, such as irrational, inappropriate, and ineffective prescribing, underprescribing and overprescribing. A prescription error is ‘a failure in the prescription writing process that results in a wrong instruction about one or more of the normal features of a prescription’. The ‘normal features’ include the identity of the recipient, the identity of the drug, the formulation, dose, route, timing, frequency, and duration of administration. Medication errors can be classified, invoking psychological theory, as knowledge-based mistakes, rule-based mistakes, action-based slips, and memory-based lapses. This classification informs preventive strategies. PMID:19594526

  12. Medical Errors: Tips to Help Prevent Them

    MedlinePlus

    ... to Web version Medical Errors: Tips to Help Prevent Them Medical Errors: Tips to Help Prevent Them Medical errors are one of the nation's ... single most important way you can help to prevent errors is to be an active member of ...

  13. Clinical review: Medication errors in critical care

    PubMed Central

    Moyen, Eric; Camiré, Eric; Stelfox, Henry Thomas

    2008-01-01

    Medication errors in critical care are frequent, serious, and predictable. Critically ill patients are prescribed twice as many medications as patients outside of the intensive care unit (ICU) and nearly all will suffer a potentially life-threatening error at some point during their stay. The aim of this article is to provide a basic review of medication errors in the ICU, identify risk factors for medication errors, and suggest strategies to prevent errors and manage their consequences. PMID:18373883

  14. Reducing medical errors and adverse events.

    PubMed

    Pham, Julius Cuong; Aswani, Monica S; Rosen, Michael; Lee, HeeWon; Huddle, Matthew; Weeks, Kristina; Pronovost, Peter J

    2012-01-01

    Medical errors account for ∼98,000 deaths per year in the United States. They increase disability and costs and decrease confidence in the health care system. We review several important types of medical errors and adverse events. We discuss medication errors, healthcare-acquired infections, falls, handoff errors, diagnostic errors, and surgical errors. We describe the impact of these errors, review causes and contributing factors, and provide an overview of strategies to reduce these events. We also discuss teamwork/safety culture, an important aspect in reducing medical errors.

  15. Why the distribution of medical errors matters.

    PubMed

    McLean, Thomas R

    2015-07-01

    During the last decade, interventions to reduce the number of medical errors have been largely ineffective. Although it is widely assumed that medical errors follow a Gaussian distribution, they may actually follow a Power Rule distribution. This article presents the evidence in favor of a Power Rule distribution for medical errors and then examines the consequences of such a distribution for medical errors. As the distribution of medical errors has real-world implications, further research is needed to determine whether medical errors follow a Gaussian or Power Rule distribution.

  16. Medication Errors - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Are Here: Home → Multiple Languages → All Health Topics → Medication Errors URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Medication Errors - Multiple Languages To use the sharing features on ...

  17. [Medical errors and conflicts in clinical practice].

    PubMed

    Doskin, V A; Dorinova, E A; Kartoeva, R A; Sokolova, M S

    2014-01-01

    The number of medical errors is increasing. Medical errors have negative impact on the professional activities of physicians. Analysis of the causes and incidence of medical errors and conflicts in clinical practice of foreign and domestic doctors is presented based on the author's observations and didactic materials recommended for training doctors to prevent conflict situations in their professional work and for developing a common strategy for the prevention of medical errors.

  18. Content validation of the Medication Error Worksheet.

    PubMed

    Zuzelo, P R; Inverso, T; Linkewich, K M

    2001-11-01

    Clinical nurse specialists use a variety of preexisting instruments to measure and describe health-related concepts. It is important for clinical nurse specialists to know how to evaluate the content validity of potentially useful instruments. This study assessed the content validity of the Institute for Safe Medication Practice's Medication Error Worksheet. The worksheet is used as a questioning framework to guide data collection processes when beginning analysis of a medication error. Although the worksheet has been valuable to the Institute for Safe Medication Practice staff, its content validity has not been determined. Content validity methods included expert validation and a review of the related literature. Results support the validity of the Medication Error Worksheet and suggest that this worksheet is a comprehensive tool that may be helpful when exploring the circumstances of medication errors and when analyzing medication use systems. Results were shared with the Institute for Safe Medication Practice staff to improve the accuracy of the worksheet.

  19. Addressing medical errors in hand surgery.

    PubMed

    Johnson, Shepard P; Adkinson, Joshua M; Chung, Kevin C

    2014-09-01

    Influential think tanks such as the Institute of Medicine have raised awareness about the implications of medical errors. In response, organizations, medical societies, and hospitals have initiated programs to decrease the incidence and prevent adverse effects of these errors. Surgeons deal with the direct implications of adverse events involving patients. In addition to managing the physical consequences, they are confronted with ethical and social issues when caring for a harmed patient. Although there is considerable effort to implement system-wide changes, there is little guidance for hand surgeons on how to address medical errors. Admitting an error by a physician is difficult, but a transparent environment where patients are notified of errors and offered consolation and compensation is essential to maintain physician-patient trust. Furthermore, equipping hand surgeons with a guide for addressing medical errors will help identify system failures, provide learning points for safety improvement, decrease litigation against physicians, and demonstrate a commitment to ethical and compassionate medical care.

  20. Improving medication administration error reporting systems. Why do errors occur?

    PubMed

    Wakefield, B J; Wakefield, D S; Uden-Holman, T

    2000-01-01

    Monitoring medication administration errors (MAE) is often included as part of the hospital's risk management program. While observation of actual medication administration is the most accurate way to identify errors, hospitals typically rely on voluntary incident reporting processes. Although incident reporting systems are more economical than other methods of error detection, incident reporting can also be a time-consuming process depending on the complexity or "user-friendliness" of the reporting system. Accurate incident reporting systems are also dependent on the ability of the practitioner to: 1) recognize an error has actually occurred; 2) believe the error is significant enough to warrant reporting; and 3) overcome the embarrassment of having committed a MAE and the fear of punishment for reporting a mistake (either one's own or another's mistake).

  1. Medication Errors Involving the Intravenous Administration Route: Characteristics of Voluntarily Reported Medication Errors.

    PubMed

    Wolf, Zane Robinson

    2016-01-01

    Characteristics of medication errors involving the intravenous (IV) route of administration were analyzed in reports from 1995 to 2013. This was accomplished through a voluntary medication error reporting program. A retrospective case study design analyzed reports by practitioners or consumers on IV-associated medication errors (N = 975) affecting patients. Patterns in error accounts reflected cultural changes in health care organizations. Equipment, labeling, incorrect route of administration, types of errors, patient outcomes, and causal agents represented major codes. Results point to health care provider and consumer knowledge, the need for ongoing education of nursing staff, and interdisciplinary strategies for preventing IV-associated medication errors. PMID:27379682

  2. Case report of a medication error

    PubMed Central

    Naunton, Mark; Nor, Kowsar; Bartholomaeus, Andrew; Thomas, Jackson; Kosari, Sam

    2016-01-01

    Abstract Introduction: The World Health Organisation recognizes confusing drug names as one of the most common causes of medication errors. Other factors include spelling, phonetic, or packaging similarities. Case presentation: We presented a case report of an inadvertent administration of a non-ocular pharmaceutical product (Novasone® lotion) into the eye of an octogenarian individual, and briefly reviewed the relevant literature. Discussion: We discussed prevention strategies to avoid similar ophthalmic medication errors. PMID:27428216

  3. Physician's error: medical or legal concept?

    PubMed

    Mujovic-Zornic, Hajrija M

    2010-06-01

    This article deals with the common term of different physician's errors that often happen in daily practice of health care. Author begins with the term of medical malpractice, defined broadly as practice of unjustified acts or failures to act upon the part of a physician or other health care professionals, which results in harm to the patient. It is a common term that includes many types of medical errors, especially physician's errors. The author also discusses the concept of physician's error in particular, which is understood no more in traditional way only as classic error in acting something manually wrong without necessary skills (medical concept), but as an error which violates patient's basic rights and which has its final legal consequence (legal concept). In every case the essential element of liability is to establish this error as a breach of the physician's duty. The first point to note is that the standard of procedure and the standard of due care against which the physician will be judged is not going to be that of the ordinary reasonable man who enjoys no medical expertise. The court's decision should give finale answer and legal qualification in each concrete case. The author's conclusion is that higher protection of human rights in the area of health equaly demands broader concept of physician's error with the accent to its legal subject matter.

  4. A Probabilistic Model for Reducing Medication Errors

    PubMed Central

    Nguyen, Phung Anh; Syed-Abdul, Shabbir; Iqbal, Usman; Hsu, Min-Huei; Huang, Chen-Ling; Li, Hsien-Chang; Clinciu, Daniel Livius; Jian, Wen-Shan; Li, Yu-Chuan Jack

    2013-01-01

    Background Medication errors are common, life threatening, costly but preventable. Information technology and automated systems are highly efficient for preventing medication errors and therefore widely employed in hospital settings. The aim of this study was to construct a probabilistic model that can reduce medication errors by identifying uncommon or rare associations between medications and diseases. Methods and Finding(s) Association rules of mining techniques are utilized for 103.5 million prescriptions from Taiwan’s National Health Insurance database. The dataset included 204.5 million diagnoses with ICD9-CM codes and 347.7 million medications by using ATC codes. Disease-Medication (DM) and Medication-Medication (MM) associations were computed by their co-occurrence and associations’ strength were measured by the interestingness or lift values which were being referred as Q values. The DMQs and MMQs were used to develop the AOP model to predict the appropriateness of a given prescription. Validation of this model was done by comparing the results of evaluation performed by the AOP model and verified by human experts. The results showed 96% accuracy for appropriate and 45% accuracy for inappropriate prescriptions, with a sensitivity and specificity of 75.9% and 89.5%, respectively. Conclusions We successfully developed the AOP model as an efficient tool for automatic identification of uncommon or rare associations between disease-medication and medication-medication in prescriptions. The AOP model helps to reduce medication errors by alerting physicians, improving the patients’ safety and the overall quality of care. PMID:24312659

  5. Preventing medication errors in cancer chemotherapy.

    PubMed

    Cohen, M R; Anderson, R W; Attilio, R M; Green, L; Muller, R J; Pruemer, J M

    1996-04-01

    Recommendations for preventing medication errors in cancer chemotherapy are made. Before a health care provider is granted privileges to prescribe, dispense, or administer antineoplastic agents, he or she should undergo a tailored educational program and possibly testing or certification. Appropriate reference materials should be developed. Each institution should develop a dose-verification process with as many independent checks as possible. A detailed checklist covering prescribing, transcribing, dispensing, and administration should be used. Oral orders are not acceptable. All doses should be calculated independently by the physician, the pharmacist, and the nurse. Dosage limits should be established and a review process set up for doses that exceed the limits. These limits should be entered into pharmacy computer systems, listed on preprinted order forms, stated on the product packaging, placed in strategic locations in the institution, and communicated to employees. The prescribing vocabulary must be standardized. Acronyms, abbreviations, and brand names must be avoided and steps taken to avoid other sources of confusion in the written orders, such as trailing zeros. Preprinted antineoplastic drug order forms containing checklists can help avoid errors. Manufacturers should be encouraged to avoid or eliminate ambiguities in drug names and dosing information. Patients must be educated about all aspects of their cancer chemotherapy, as patients represent a last line of defense against errors. An interdisciplinary team at each practice site should review every medication error reported. Pharmacists should be involved at all sites where antineoplastic agents are dispensed. Although it may not be possible to eliminate all medication errors in cancer chemotherapy, the risk can be minimized through specific steps. Because of their training and experience, pharmacists should take the lead in this effort. PMID:8697025

  6. Analgesic medication errors in North Carolina nursing homes.

    PubMed

    Desai, Rishi J; Williams, Charrlotte E; Greene, Sandra B; Pierson, Stephanie; Caprio, Anthony J; Hansen, Richard A

    2013-06-01

    The objective of this study was to characterize analgesic medication errors and to evaluate their association with patient harm. The authors conducted a cross-sectional analysis of individual medication error incidents reported by North Carolina nursing homes to the Medication Error Quality Initiative (MEQI) during fiscal years 2010-2011. Bivariate associations between analgesic medication errors with patient factors, error-related factors, and impact on patients were tested with chi-square tests. A multivariate logistic regression model explored the relationship between type of analgesic medication errors and patient harm, controlling for patient- and error-related factors. A total of 32,176 individual medication error incidents were reported over a 2-year period in North Carolina nursing homes, 12.3% (n = 3949) of which were analgesic medication errors. Of these analgesic medication errors, opioid and nonopioid analgesics were involved in 3105 and 844 errors, respectively. Opioid errors were more likely to be wrong drug errors, wrong dose errors, and administration errors compared with nonopioid errors (P < .0001 for all comparisons). In the multivariate model, opioid errors were found to have higher odds of patient harm compared with nonopioid errors (odds ratio [OR] = 3, 95% confodence interval [CI]: 1.1-7.8). The authors conclude that opioid analgesics represent the majority of analgesic error reports, and these error reports reflect an increased likelihood of patient harm compared with nonopioid analgesics. PMID:23458096

  7. Reducing the risk of medication errors in women.

    PubMed

    Grissinger, Matthew C; Kelly, Kate

    2005-01-01

    We outline some of the causes of medication errors involving women and recommend ways that healthcare practitioners can prevent some of these errors. Patient safety has become a major concern since the November 1999 release of the Institute of Medicine (IOM) report, "To Err Is Human." Errors involving prescription medications are responsible for up to 7000 American deaths per year, and the financial costs of drug-related morbidity and mortality may be nearly $77 billion a year. The Institute for Safe Medication Practices (ISMP) collects and analyzes voluntary confidential medication error reports and makes recommendations on the prevention of such errors. This paper uses the expertise of ISMP in medication error prevention to make recommendations to prevent medication errors involving women. Healthcare practitioners should focus on areas of the medication use process that would have the greatest impact, including obtaining complete patient information, accurately communicating drug information, and properly educating patients. Although medication errors are not more common in women, there are some unique concerns with medications used for treating women. In addition, sharing of information about medication use and compliance with medication regimens have been identified as concerns. Through the sharing of information and improving the patient education process, healthcare practitioners should play a more active role in medication error reduction activities by working together toward the goal of improving medication safety and encouraging women to become active in their own care.

  8. Medication Errors: New EU Good Practice Guide on Risk Minimisation and Error Prevention.

    PubMed

    Goedecke, Thomas; Ord, Kathryn; Newbould, Victoria; Brosch, Sabine; Arlett, Peter

    2016-06-01

    A medication error is an unintended failure in the drug treatment process that leads to, or has the potential to lead to, harm to the patient. Reducing the risk of medication errors is a shared responsibility between patients, healthcare professionals, regulators and the pharmaceutical industry at all levels of healthcare delivery. In 2015, the EU regulatory network released a two-part good practice guide on medication errors to support both the pharmaceutical industry and regulators in the implementation of the changes introduced with the EU pharmacovigilance legislation. These changes included a modification of the 'adverse reaction' definition to include events associated with medication errors, and the requirement for national competent authorities responsible for pharmacovigilance in EU Member States to collaborate and exchange information on medication errors resulting in harm with national patient safety organisations. To facilitate reporting and learning from medication errors, a clear distinction has been made in the guidance between medication errors resulting in adverse reactions, medication errors without harm, intercepted medication errors and potential errors. This distinction is supported by an enhanced MedDRA(®) terminology that allows for coding all stages of the medication use process where the error occurred in addition to any clinical consequences. To better understand the causes and contributing factors, individual case safety reports involving an error should be followed-up with the primary reporter to gather information relevant for the conduct of root cause analysis where this may be appropriate. Such reports should also be summarised in periodic safety update reports and addressed in risk management plans. Any risk minimisation and prevention strategy for medication errors should consider all stages of a medicinal product's life-cycle, particularly the main sources and types of medication errors during product development. This article

  9. The spectrum of medical errors: when patients sue

    PubMed Central

    Kels, Barry D; Grant-Kels, Jane M

    2012-01-01

    Inarguably medical errors constitute a serious, dangerous, and expensive problem for the twenty-first-century US health care system. This review examines the incidence, nature, and complexity of alleged medical negligence and medical malpractice. The authors hope this will constitute a road map to medical providers so that they can better understand the present climate and hopefully avoid the “Scylla and Charybdis” of medical errors and medical malpractice. Despite some documented success in reducing medical errors, adverse events and medical errors continue to represent an indelible stain upon the practice, reputation, and success of the US health care industry. In that regard, what may be required to successfully attack the unacceptably high severity and volume of medical errors is a locally directed and organized initiative sponsored by individual health care organizations that is coordinated, supported, and guided by state and federal governmental and nongovernmental agencies. PMID:22924008

  10. Classifying and Predicting Errors of Inpatient Medication Reconciliation

    PubMed Central

    Pippins, Jennifer R.; Gandhi, Tejal K.; Hamann, Claus; Ndumele, Chima D.; Labonville, Stephanie A.; Diedrichsen, Ellen K.; Carty, Marcy G.; Karson, Andrew S.; Bhan, Ishir; Coley, Christopher M.; Liang, Catherine L.; Turchin, Alexander; McCarthy, Patricia C.

    2008-01-01

    Background Failure to reconcile medications across transitions in care is an important source of potential harm to patients. Little is known about the predictors of unintentional medication discrepancies and how, when, and where they occur. Objective To determine the reasons, timing, and predictors of potentially harmful medication discrepancies. Design Prospective observational study. Patients Admitted general medical patients. Measurements Study pharmacists took gold-standard medication histories and compared them with medical teams’ medication histories, admission and discharge orders. Blinded teams of physicians adjudicated all unexplained discrepancies using a modification of an existing typology. The main outcome was the number of potentially harmful unintentional medication discrepancies per patient (potential adverse drug events or PADEs). Results Among 180 patients, 2066 medication discrepancies were identified, and 257 (12%) were unintentional and had potential for harm (1.4 per patient). Of these, 186 (72%) were due to errors taking the preadmission medication history, while 68 (26%) were due to errors reconciling the medication history with discharge orders. Most PADEs occurred at discharge (75%). In multivariable analyses, low patient understanding of preadmission medications, number of medication changes from preadmission to discharge, and medication history taken by an intern were associated with PADEs. Conclusions Unintentional medication discrepancies are common and more often due to errors taking an accurate medication history than errors reconciling this history with patient orders. Focusing on accurate medication histories, on potential medication errors at discharge, and on identifying high-risk patients for more intensive interventions may improve medication safety during and after hospitalization. PMID:18563493

  11. Avoiding Medication Errors: Reducing Harm in Residents Using Oral Anticoagulants.

    PubMed

    Grissinger, Matthew; Gaunt, Michael J; Rich, Darryl S

    2016-01-01

    Medication errors involving oral anticoagulants have led to serious adverse events, including hemorrhage, treatment failures leading to thromboembolic events, and death. This article will highlight medication errors that may arise during the use of oral anticoagulants and provide risk-reduction strategies to address the potential for error and patient harm. PMID:27250070

  12. Workload and environmental factors in hospital medication errors.

    PubMed

    Roseman, C; Booker, J M

    1995-01-01

    Nine hospital workload factors and seasonal changes in daylight and darkness were examined over a 5-year period in relation to nurse medication errors at a medical center in Anchorage, Alaska. Three workload factors, along with darkness, were found to be significant predictors of the risk of medication error. Errors increased with the number of patient days per month (OR/250 patient days = 1.61) and the number of shifts worked by temporary nursing staff (OR/10 shifts = 1.15); errors decreased with more overtime worked by permanent nursing staff members (OR/10 shifts = .85). Medication errors were 95% more likely in midwinter than in the fall, but the effect of increasing darkness was strongest; a 2-month delay was found between the level of darkness and the rate of errors. More than half of all medication errors occurred during the first 3 months of the year. PMID:7624233

  13. Data sharing in neuroimaging research

    PubMed Central

    Poline, Jean-Baptiste; Breeze, Janis L.; Ghosh, Satrajit; Gorgolewski, Krzysztof; Halchenko, Yaroslav O.; Hanke, Michael; Haselgrove, Christian; Helmer, Karl G.; Keator, David B.; Marcus, Daniel S.; Poldrack, Russell A.; Schwartz, Yannick; Ashburner, John; Kennedy, David N.

    2012-01-01

    Significant resources around the world have been invested in neuroimaging studies of brain function and disease. Easier access to this large body of work should have profound impact on research in cognitive neuroscience and psychiatry, leading to advances in the diagnosis and treatment of psychiatric and neurological disease. A trend toward increased sharing of neuroimaging data has emerged in recent years. Nevertheless, a number of barriers continue to impede momentum. Many researchers and institutions remain uncertain about how to share data or lack the tools and expertise to participate in data sharing. The use of electronic data capture (EDC) methods for neuroimaging greatly simplifies the task of data collection and has the potential to help standardize many aspects of data sharing. We review here the motivations for sharing neuroimaging data, the current data sharing landscape, and the sociological or technical barriers that still need to be addressed. The INCF Task Force on Neuroimaging Datasharing, in conjunction with several collaborative groups around the world, has started work on several tools to ease and eventually automate the practice of data sharing. It is hoped that such tools will allow researchers to easily share raw, processed, and derived neuroimaging data, with appropriate metadata and provenance records, and will improve the reproducibility of neuroimaging studies. By providing seamless integration of data sharing and analysis tools within a commodity research environment, the Task Force seeks to identify and minimize barriers to data sharing in the field of neuroimaging. PMID:22493576

  14. Reducing medication errors in critical care: a multimodal approach

    PubMed Central

    Kruer, Rachel M; Jarrell, Andrew S; Latif, Asad

    2014-01-01

    The Institute of Medicine has reported that medication errors are the single most common type of error in health care, representing 19% of all adverse events, while accounting for over 7,000 deaths annually. The frequency of medication errors in adult intensive care units can be as high as 947 per 1,000 patient-days, with a median of 105.9 per 1,000 patient-days. The formulation of drugs is a potential contributor to medication errors. Challenges related to drug formulation are specific to the various routes of medication administration, though errors associated with medication appearance and labeling occur among all drug formulations and routes of administration. Addressing these multifaceted challenges requires a multimodal approach. Changes in technology, training, systems, and safety culture are all strategies to potentially reduce medication errors related to drug formulation in the intensive care unit. PMID:25210478

  15. Knowledge of healthcare professionals about medication errors in hospitals

    PubMed Central

    Abdel-Latif, Mohamed M. M.

    2016-01-01

    Context: Medication errors are the most common types of medical errors in hospitals and leading cause of morbidity and mortality among patients. Aims: The aim of the present study was to assess the knowledge of healthcare professionals about medication errors in hospitals. Settings and Design: A self-administered questionnaire was distributed to randomly selected healthcare professionals in eight hospitals in Madinah, Saudi Arabia. Subjects and Methods: An 18-item survey was designed and comprised questions on demographic data, knowledge of medication errors, availability of reporting systems in hospitals, attitudes toward error reporting, causes of medication errors. Statistical Analysis Used: Data were analyzed with Statistical Package for the Social Sciences software Version 17. Results: A total of 323 of healthcare professionals completed the questionnaire with 64.6% response rate of 138 (42.72%) physicians, 34 (10.53%) pharmacists, and 151 (46.75%) nurses. A majority of the participants had a good knowledge about medication errors concept and their dangers on patients. Only 68.7% of them were aware of reporting systems in hospitals. Healthcare professionals revealed that there was no clear mechanism available for reporting of errors in most hospitals. Prescribing (46.5%) and administration (29%) errors were the main causes of errors. The most frequently encountered medication errors were anti-hypertensives, antidiabetics, antibiotics, digoxin, and insulin. Conclusions: This study revealed differences in the awareness among healthcare professionals toward medication errors in hospitals. The poor knowledge about medication errors emphasized the urgent necessity to adopt appropriate measures to raise awareness about medication errors in Saudi hospitals. PMID:27330261

  16. Medical error and human factors engineering: where are we now?

    PubMed

    Gawron, Valerie J; Drury, Colin G; Fairbanks, Rollin J; Berger, Roseanne C

    2006-01-01

    The goal of human factors engineering is to optimize the relationship between humans and systems by studying human behavior, abilities, and limitations and using this knowledge to design systems for safe and effective human use. With the assumption that the human component of any system will inevitably produce errors, human factors engineers design systems and human/machine interfaces that are robust enough to reduce error rates and the effect of the inevitable error within the system. In this article, we review the extent and nature of medical error and then discuss human factors engineering tools that have potential applicability. These tools include taxonomies of human and system error and error data collection and analysis methods. Finally, we describe studies that have examined medical error, and on the basis of these studies, present conclusions about how human factors engineering can significantly reduce medical errors and their effects.

  17. Medical error and related factors during internship and residency.

    PubMed

    Ahmadipour, Habibeh; Nahid, Mortazavi

    2015-01-01

    It is difficult to determine the real incidence of medical errors due to the lack of a precise definition of errors, as well as the failure to report them under certain circumstances. We carried out a cross- sectional study in Kerman University of Medical Sciences, Iran in 2013. The participants were selected through the census method. The data were collected using a self-administered questionnaire, which consisted of questions on the participants' demographic data and questions on the medical errors committed. The data were analysed by SPSS 19. It was found that 270 participants had committed medical errors. There was no significant difference in the frequency of errors committed by interns and residents. In the case of residents, the most common error was misdiagnosis and in that of interns, errors related to history-taking and physical examination. Considering that medical errors are common in the clinical setting, the education system should train interns and residents to prevent the occurrence of errors. In addition, the system should develop a positive attitude among them so that they can deal better with medical errors.

  18. The Environmental Context of Patient Safety and Medical Errors

    ERIC Educational Resources Information Center

    Wholey, Douglas; Moscovice, Ira; Hietpas, Terry; Holtzman, Jeremy

    2004-01-01

    The environmental context of patient safety and medical errors was explored with specific interest in rural settings. Special attention was paid to unique features of rural health care organizations and their environment that relate to the patient safety issue and medical errors (including the distribution of patients, types of adverse events…

  19. Characteristics of medication errors with parenteral cytotoxic drugs.

    PubMed

    Fyhr, A; Akselsson, R

    2012-09-01

    Errors involving cytotoxic drugs have the potential of being fatal and should therefore be prevented. The objective of this article is to identify the characteristics of medication errors involving parenteral cytotoxic drugs in Sweden. A total of 60 cases reported to the national error reporting systems from 1996 to 2008 were reviewed. Classification was made to identify cytotoxic drugs involved, type of error, where the error occurred, error detection mechanism, and consequences for the patient. The most commonly involved cytotoxic drugs were fluorouracil, carboplatin, cytarabine and doxorubicin. The platinum-containing drugs often caused serious consequences for the patients. The most common error type were too high doses (45%) followed by wrong drug (30%). Twenty-five of the medication errors (42%) occurred when doctors were prescribing. All of the preparations were delivered to the patient causing temporary or life-threatening harm. Another 25 of the medication errors (42%) started with preparation at the pharmacies. The remaining 10 medication errors (16%) were due to errors during preparation by nurses (5/60) and administration by nurses to the wrong patient (5/60). It is of utmost importance to minimise the potential for errors in the prescribing stage. The identification of drugs and patients should also be improved.

  20. Medication Errors: New EU Good Practice Guide on Risk Minimisation and Error Prevention.

    PubMed

    Goedecke, Thomas; Ord, Kathryn; Newbould, Victoria; Brosch, Sabine; Arlett, Peter

    2016-06-01

    A medication error is an unintended failure in the drug treatment process that leads to, or has the potential to lead to, harm to the patient. Reducing the risk of medication errors is a shared responsibility between patients, healthcare professionals, regulators and the pharmaceutical industry at all levels of healthcare delivery. In 2015, the EU regulatory network released a two-part good practice guide on medication errors to support both the pharmaceutical industry and regulators in the implementation of the changes introduced with the EU pharmacovigilance legislation. These changes included a modification of the 'adverse reaction' definition to include events associated with medication errors, and the requirement for national competent authorities responsible for pharmacovigilance in EU Member States to collaborate and exchange information on medication errors resulting in harm with national patient safety organisations. To facilitate reporting and learning from medication errors, a clear distinction has been made in the guidance between medication errors resulting in adverse reactions, medication errors without harm, intercepted medication errors and potential errors. This distinction is supported by an enhanced MedDRA(®) terminology that allows for coding all stages of the medication use process where the error occurred in addition to any clinical consequences. To better understand the causes and contributing factors, individual case safety reports involving an error should be followed-up with the primary reporter to gather information relevant for the conduct of root cause analysis where this may be appropriate. Such reports should also be summarised in periodic safety update reports and addressed in risk management plans. Any risk minimisation and prevention strategy for medication errors should consider all stages of a medicinal product's life-cycle, particularly the main sources and types of medication errors during product development. This article

  1. Systems Error versus Physicians' Error: Finding the Balance in Medical Education.

    ERIC Educational Resources Information Center

    Casarett, David; Helms, Charles

    1999-01-01

    When physicians ascribe errors to systemic causes, they may be less likely to modify future behaviors and more likely to repeat past errors. Academic medical centers should balance protecting patients from errors that a systems approach can identify against providing optimal education for house officers by teaching them to focus also on personal…

  2. Responses and concerns of healthcare providers to medication errors.

    PubMed

    Wolf, Z R; Serembus, J F; Smetzer, J; Cohen, H; Cohen, M

    2000-11-01

    This descriptive, correlational study examined the responses and concerns of healthcare professionals about making medication errors and estimated patient harm from such errors. A systematic random sample of nurses, pharmacists, and physicians (N = 402) completed a self-report survey about a medication error they judged to be serious. Respondents were guilty, nervous, and worried about the error. They feared for the safety of the patient, disciplinary action, and punishment. A few subjects indicated that they never reported the errors. The most frequent symptoms associated with errors were neurologically based. The injury suffered by patients was not severe overall according to the harm scales. Weak correlations were found for the harm scales and responses and concerns. The authors suggest a supportive environment for the provider following an error and continuous quality improvement efforts to eliminate system-based errors.

  3. Medication errors in primary care in Riyadh City, Saudi Arabia.

    PubMed

    Khoja, T; Neyaz, Y; Qureshi, N A; Magzoub, M A; Haycox, A; Walley, T

    2011-02-01

    Medication errors can cause a variety of adverse drug events but are potentially preventable. This cross-sectional study analysed all medication prescriptions from 5 public and 5 private primary health care clinics in Riyadh city, collected by simple random sampling during 1 working day. Prescriptions for 2463 and 2836 drugs from public and private clinics respectively were examined for errors, which were analysed using Neville et al.'s classification of prescription errors. Prescribing errors were found on 990/5299 (18.7%) prescriptions. Both type B and type C errors (major and minor nuisance) were more often associated with prescriptions from public than private clinics. Type D errors (trivial) were significantly more likely to occur with private health sector prescriptions. Type A errors (potentially serious) were rare (8/5299 drugs; 0.15%) and the rate did not differ significantly between the 2 health sectors. The development of preventive strategies for avoiding prescription errors is crucial. PMID:21735951

  4. Analysis of Medication Errors in Simulated Pediatric Resuscitation by Residents

    PubMed Central

    Porter, Evelyn; Barcega, Besh; Kim, Tommy Y.

    2014-01-01

    Introduction The objective of our study was to estimate the incidence of prescribing medication errors specifically made by a trainee and identify factors associated with these errors during the simulated resuscitation of a critically ill child. Methods The results of the simulated resuscitation are described. We analyzed data from the simulated resuscitation for the occurrence of a prescribing medication error. We compared univariate analysis of each variable to medication error rate and performed a separate multiple logistic regression analysis on the significant univariate variables to assess the association between the selected variables. Results We reviewed 49 simulated resuscitations. The final medication error rate for the simulation was 26.5% (95% CI 13.7% – 39.3%). On univariate analysis, statistically significant findings for decreased prescribing medication error rates included senior residents in charge, presence of a pharmacist, sleeping greater than 8 hours prior to the simulation, and a visual analog scale score showing more confidence in caring for critically ill children. Multiple logistic regression analysis using the above significant variables showed only the presence of a pharmacist to remain significantly associated with decreased medication error, odds ratio of 0.09 (95% CI 0.01 – 0.64). Conclusion Our results indicate that the presence of a clinical pharmacist during the resuscitation of a critically ill child reduces the medication errors made by resident physician trainees. PMID:25035756

  5. Unit of Measurement Used and Parent Medication Dosing Errors

    PubMed Central

    Dreyer, Benard P.; Ugboaja, Donna C.; Sanchez, Dayana C.; Paul, Ian M.; Moreira, Hannah A.; Rodriguez, Luis; Mendelsohn, Alan L.

    2014-01-01

    BACKGROUND AND OBJECTIVES: Adopting the milliliter as the preferred unit of measurement has been suggested as a strategy to improve the clarity of medication instructions; teaspoon and tablespoon units may inadvertently endorse nonstandard kitchen spoon use. We examined the association between unit used and parent medication errors and whether nonstandard instruments mediate this relationship. METHODS: Cross-sectional analysis of baseline data from a larger study of provider communication and medication errors. English- or Spanish-speaking parents (n = 287) whose children were prescribed liquid medications in 2 emergency departments were enrolled. Medication error defined as: error in knowledge of prescribed dose, error in observed dose measurement (compared to intended or prescribed dose); >20% deviation threshold for error. Multiple logistic regression performed adjusting for parent age, language, country, race/ethnicity, socioeconomic status, education, health literacy (Short Test of Functional Health Literacy in Adults); child age, chronic disease; site. RESULTS: Medication errors were common: 39.4% of parents made an error in measurement of the intended dose, 41.1% made an error in the prescribed dose. Furthermore, 16.7% used a nonstandard instrument. Compared with parents who used milliliter-only, parents who used teaspoon or tablespoon units had twice the odds of making an error with the intended (42.5% vs 27.6%, P = .02; adjusted odds ratio=2.3; 95% confidence interval, 1.2–4.4) and prescribed (45.1% vs 31.4%, P = .04; adjusted odds ratio=1.9; 95% confidence interval, 1.03–3.5) dose; associations greater for parents with low health literacy and non–English speakers. Nonstandard instrument use partially mediated teaspoon and tablespoon–associated measurement errors. CONCLUSIONS: Findings support a milliliter-only standard to reduce medication errors. PMID:25022742

  6. Reducing the Risk of Harm From Medication Errors in Children

    PubMed Central

    Neuspiel, Daniel R.; Taylor, Melissa M.

    2013-01-01

    Medication errors affect the pediatric age group in all settings: outpatient, inpatient, emergency department, and at home. Children may be at special risk due to size and physiologic variability, limited communication ability, and treatment by nonpediatric health care providers. Those with chronic illnesses and on multiple medications may be at higher risk of experiencing adverse drug events. Some strategies that have been employed to reduce harm from pediatric medication errors include e-prescribing and computerized provider order entry with decision support, medication reconciliation, barcode systems, clinical pharmacists in medical settings, medical staff training, package changes to reduce look-alike/sound-alike confusion, standardization of labeling and measurement devices for home administration, and quality improvement interventions to promote nonpunitive reporting of medication errors coupled with changes in systems and cultures. Future research is needed to measure the effectiveness of these preventive strategies. PMID:25114560

  7. A review article of the reduce errors in medical laboratories.

    PubMed

    Mohammedsaleh, Zuhair M; Mohammedsaleh, Fayez

    2014-07-29

    The current article examines the modern practices of reducing errors in medical laboratories. The paper sought to examine the methods that different countries are applying to reduce errors in medical laboratories. In addition, the paper examines the relationship between inadequate training of laboratory personnel and error causation in medical laboratories. A total of 17 research articles have been reviewed. The paper has done a comparison of pathology laboratory practices in the US, Canada, the UK and Australia, regarding laboratory staff skills and error reduction. The paper finds out that; although some of the developed countries have employed advanced technology to reduce errors, there is still a great need to use sophisticated medical equipment to reduce errors. In addition, the levels of training for the medical technicians are still low. They are not equipped enough to reduce the errors to the required levels. The article recommends application of advanced technology in the reduction of errors, and training of technicians on the best practices to reduce errors.

  8. Physician assistants and the disclosure of medical error.

    PubMed

    Brock, Douglas M; Quella, Alicia; Lipira, Lauren; Lu, Dave W; Gallagher, Thomas H

    2014-06-01

    Evolving state law, professional societies, and national guidelines, including those of the American Medical Association and Joint Commission, recommend that patients receive transparent communication when a medical error occurs. Recommendations for error disclosure typically consist of an explanation that an error has occurred, delivery of an explicit apology, an explanation of the facts around the event, its medical ramifications and how care will be managed, and a description of how similar errors will be prevented in the future. Although error disclosure is widely endorsed in the medical and nursing literature, there is little discussion of the unique role that the physician assistant (PA) might play in these interactions. PAs are trained in the medical model and technically practice under the supervision of a physician. They are also commonly integrated into interprofessional health care teams in surgical and urgent care settings. PA practice is characterized by widely varying degrees of provider autonomy. How PAs should collaborate with physicians in sensitive error disclosure conversations with patients is unclear. With the number of practicing PAs growing rapidly in nearly all domains of medicine, their role in the error disclosure process warrants exploration. The authors call for educational societies and accrediting agencies to support policy to establish guidelines for PA disclosure of error. They encourage medical and PA researchers to explore and report best-practice disclosure roles for PAs. Finally, they recommend that PA educational programs implement trainings in disclosure skills, and hospitals and supervising physicians provide and support training for practicing PAs. PMID:24871235

  9. The challenges to transparency in reporting medical errors.

    PubMed

    Paterick, Zachary R; Paterick, Barbara B; Waterhouse, Blake E; Paterick, Timothy E

    2009-12-01

    In an ideal health care environment, physicians and health care organizations would acknowledge and factually report all medical errors and "near misses" in an effort to improve future patient safety by better identifying systemic safety lapses. Truth must permeate the health care system to achieve the goal of transparency. The Institute of Medicine has estimated that 44,000 to 98,000 patients die each year as a result of medical errors. Improving the reporting of medical errors and near misses is essential for better prevention of medical errors and thus increasing patient safety. Higher rates of reporting can permit identification of the root causes of errors and create improved processes that can significantly reduce errors in future patient care. Multiple barriers exist with respect to reporting medical errors, despite the ethical and various professional, regulatory, and legislative expectations and requirements generating this obligation. As long as physicians perceive that they are at risk for sanctions, malpractice claims, and unpredictable compensation of injured patients as determined by the United States' tort law system, legislative or regulative reform is unlikely to affect the underreporting of medical errors, and patient safety cannot benefit from the lessons derived from past medical errors and near misses. A new infrastructure for creating patient safety systems, as identified in the Patient Safety and Quality Improvement Act of 2005 is needed. A patient compensation system guided by an administrative health court that includes some form of no-fault insurance must be studied to identify benefits and risks. Most urgent is the development of a reporting system for medical errors and near misses that is transparent and effectively recognizes the legitimate concerns of physicians and health care providers and improves patient safety. PMID:22130212

  10. An intravenous medication safety system: preventing high-risk medication errors at the point of care.

    PubMed

    Hatcher, Irene; Sullivan, Mark; Hutchinson, James; Thurman, Susan; Gaffney, F Andrew

    2004-10-01

    Improving medication safety at the point of care--particularly for high-risk drugs--is a major concern of nursing administrators. The medication errors most likely to cause harm are administration errors related to infusion of high-risk medications. An intravenous medication safety system is designed to prevent high-risk infusion medication errors and to capture continuous quality improvement data for best practice improvement. Initial testing with 50 systems in 2 units at Vanderbilt University Medical Center revealed that, even in the presence of a fully mature computerized prescriber order-entry system, the new safety system averted 99 potential infusion errors in 8 months.

  11. The intention to report medication error.

    PubMed

    Tabak, Nili; Fleishman, Silvia

    2011-09-01

    The aim of this study is to use the Azjen & Madden Theory of Planned Behavior to identify the factors influencing the intention or non-intention of community nurses to report adverse incidents. A convenience sample of community nurses completed a questionnaire. The findings fully or partially confirmed the study's three hypotheses. The factors found to exert most influence on the decision to report adverse incidents or not were the nurse's Perceived Behavioral Control and her perception of her professional and social expectations on this issue. The authors recommend that nursing staff be made aware that reporting error will make them better nurses; that staff who do report errors be given encouragement and support, not punishment; that error-reporting not be regarded as 'informing' or as evidence of personal failure and that nurses need an organizational culture and collegiate environment which supports reporting.

  12. Strategies for reducing medication errors in the emergency department

    PubMed Central

    Weant, Kyle A; Bailey, Abby M; Baker, Stephanie N

    2014-01-01

    Medication errors are an all-too-common occurrence in emergency departments across the nation. This is largely secondary to a multitude of factors that create an almost ideal environment for medication errors to thrive. To limit and mitigate these errors, it is necessary to have a thorough knowledge of the medication-use process in the emergency department and develop strategies targeted at each individual step. Some of these strategies include medication-error analysis, computerized provider-order entry systems, automated dispensing cabinets, bar-coding systems, medication reconciliation, standardizing medication-use processes, education, and emergency-medicine clinical pharmacists. Special consideration also needs to be given to the development of strategies for the pediatric population, as they can be at an elevated risk of harm. Regardless of the strategies implemented, the prevention of medication errors begins and ends with the development of a culture that promotes the reporting of medication errors, and a systematic, nonpunitive approach to their elimination. PMID:27147879

  13. Data sharing for pharmacokinetic studies.

    PubMed

    Anderson, Brian J; Merry, Alan F

    2009-10-01

    Pooling data from different pediatric studies can provide a single robust pharmacokinetic analysis that allows covariate analysis and hypothesis testing. Data sharing should be driven by the altruistic purpose of improving drug understanding to the clinical benefit of children. Electronic communications have rendered the sharing of data relatively easy, and data sharing within the wider scientific community has become commonplace. Data sharing allows verification of results, save costs and time, allows new interpretation of old data, and can fulfill teaching benefits. It may stimulate cooperative competition between researchers and allow individual researchers to concentrate on unique aspects of the scientific puzzle. However, there is occasionally a reluctance to share, in part because of fear of others stealing the hard work of a research group, which may not be recognized in subsequent publications that reuse data. Providing data may require additional effort for presentation in a suitable format. Data may be abused or used for purposes other than those for which they were collected. Propriety claims may limit access to industry-sponsored drug research. The question of who has ownership of data is contentious. Investigators often consider data they have collected to be their own property. Reputations and grants may be hinge on ownership of a data set. However, other team members, institutions, funding agencies, and the public also have a stake. The difficulties identified in the general scientific community also apply to data sharing for pediatric pharmacokinetic studies. There are few clearly established rules at present, and consideration of the issues hinges on ethical and philosophical arguments. The development of databases will depend on collaboration and cooperation and greater clarity and consensus over appropriate processes and procedures. PMID:19558615

  14. What Drives Academic Data Sharing?

    PubMed Central

    Fecher, Benedikt; Friesike, Sascha; Hebing, Marcel

    2015-01-01

    Despite widespread support from policy makers, funding agencies, and scientific journals, academic researchers rarely make their research data available to others. At the same time, data sharing in research is attributed a vast potential for scientific progress. It allows the reproducibility of study results and the reuse of old data for new research questions. Based on a systematic review of 98 scholarly papers and an empirical survey among 603 secondary data users, we develop a conceptual framework that explains the process of data sharing from the primary researcher’s point of view. We show that this process can be divided into six descriptive categories: Data donor, research organization, research community, norms, data infrastructure, and data recipients. Drawing from our findings, we discuss theoretical implications regarding knowledge creation and dissemination as well as research policy measures to foster academic collaboration. We conclude that research data cannot be regarded as knowledge commons, but research policies that better incentivise data sharing are needed to improve the quality of research results and foster scientific progress. PMID:25714752

  15. The Effect of Individual Factors on the Medication Error.

    PubMed

    Zyoud, Amr H; Abdullah, Nor Azimah Chew

    2016-01-01

    Medication error is a major issue in healthcare industry and significant efforts have been taken in recent years to comprehend factors that influence errors in medication. Therefore, the present study aims to examine individual factors that contribute to medication errors as perceived by nurses. 255 registered nurses working in different Jordanian public hospitals have been chosen as samples to collect the study data from. They were asked to complete a questionnaire to assess the perceived individual factors, specifically, on nursing mathematical calculation skills and training as well as knowledge on medication treatment as factors contributing to medication errors. The current study found that the nurses' mathematical calculation skills, training and their knowledge on medication treatment have significant relationship with medication error. This was proven as the study framework is able to explain 45.6% of the total variance. Consequently, it is recommended that healthcare authorities and hospitals in Jordan should focus on nursing knowledge in medication treatment and the nurses' ability to perform drug calculation in order to improve the medication system in Jordan. PMID:27357892

  16. Impact of an electronic medication administration record on medication administration efficiency and errors.

    PubMed

    McComas, Jeffery; Riingen, Michelle; Chae Kim, Son

    2014-12-01

    The study aims were to evaluate the impact of electronic medication administration record implementation on medication administration efficiency and occurrence of medication errors as well as to identify the predictors of medication administration efficiency in an acute care setting. A prospective, observational study utilizing time-and-motion technique was conducted before and after electronic medication administration record implementation in November 2011. A total of 156 cases of medication administration activities (78 pre- and 78 post-electronic medication administration record) involving 38 nurses were observed at the point of care. A separate retrospective review of the hospital Midas+ medication error database was also performed to collect the rates and origin of medication errors for 6 months before and after electronic medication administration record implementation. The mean medication administration time actually increased from 11.3 to 14.4 minutes post-electronic medication administration record (P = .039). In a multivariate analysis, electronic medication administration record was not a predictor of medication administration time, but the distractions/interruptions during medication administration process were significant predictors. The mean hospital-wide medication errors significantly decreased from 11.0 to 5.3 events per month post-electronic medication administration record (P = .034). Although no improvement in medication administration efficiency was observed, electronic medication administration record improved the quality of care with a significant decrease in medication errors.

  17. A classification of errors in lay comprehension of medical documents.

    PubMed

    Keselman, Alla; Smith, Catherine Arnott

    2012-12-01

    Emphasis on participatory medicine requires that patients and consumers participate in tasks traditionally reserved for healthcare providers. This includes reading and comprehending medical documents, often but not necessarily in the context of interacting with Personal Health Records (PHRs). Research suggests that while giving patients access to medical documents has many benefits (e.g., improved patient-provider communication), lay people often have difficulty understanding medical information. Informatics can address the problem by developing tools that support comprehension; this requires in-depth understanding of the nature and causes of errors that lay people make when comprehending clinical documents. The objective of this study was to develop a classification scheme of comprehension errors, based on lay individuals' retellings of two documents containing clinical text: a description of a clinical trial and a typical office visit note. While not comprehensive, the scheme can serve as a foundation of further development of a taxonomy of patients' comprehension errors. Eighty participants, all healthy volunteers, read and retold two medical documents. A data-driven content analysis procedure was used to extract and classify retelling errors. The resulting hierarchical classification scheme contains nine categories and 23 subcategories. The most common error made by the participants involved incorrectly recalling brand names of medications. Other common errors included misunderstanding clinical concepts, misreporting the objective of a clinical research study and physician's findings during a patient's visit, and confusing and misspelling clinical terms. A combination of informatics support and health education is likely to improve the accuracy of lay comprehension of medical documents.

  18. MEADERS: Medication Errors and Adverse Drug Event Reporting system.

    PubMed

    Zafar, Atif

    2007-10-11

    The Agency for Healthcare Research and Quality (AHRQ) recently funded the PBRN Resource Center to develop a system for reporting ambulatory medication errors. Our goal was to develop a usable system that practices could use internally to track errors. We initially performed a comprehensive literature review of what is currently available. Then, using a combination of expert panel meetings and iterative development we designed an instrument for ambulatory medication error reporting and createad a reporting system based both in MS Access 2003 and on the web using MS ASP.NET 2.0 technologies.

  19. Adverse Drug Events caused by Serious Medication Administration Errors

    PubMed Central

    Sawarkar, Abhivyakti; Keohane, Carol A.; Maviglia, Saverio; Gandhi, Tejal K; Poon, Eric G

    2013-01-01

    OBJECTIVE To determine how often serious or life-threatening medication administration errors with the potential to cause patient harm (or potential adverse drug events) result in actual patient harm (or adverse drug events (ADEs)) in the hospital setting. DESIGN Retrospective chart review of clinical events that transpired following observed medication administration errors. BACKGROUND Medication errors are common at the medication administration stage for hospitalized patients. While many of these errors are considered capable of causing patient harm, it is not clear how often patients are actually harmed by these errors. METHODS In a previous study where 14,041 medication administrations in an acute-care hospital were directly observed, investigators discovered 1271 medication administration errors, of which 133 had the potential to cause serious or life-threatening harm to patients and were considered serious or life-threatening potential ADEs. In the current study, clinical reviewers conducted detailed chart reviews of cases where a serious or life-threatening potential ADE occurred to determine if an actual ADE developed following the potential ADE. Reviewers further assessed the severity of the ADE and attribution to the administration error. RESULTS Ten (7.5% [95% C.I. 6.98, 8.01]) actual adverse drug events or ADEs resulted from the 133 serious and life-threatening potential ADEs, of which 6 resulted in significant, three in serious, and one life threatening injury. Therefore 4 (3% [95% C.I. 2.12, 3.6]) serious and life threatening potential ADEs led to serious or life threatening ADEs. Half of the ten actual ADEs were caused by dosage or monitoring errors for anti-hypertensives. The life threatening ADE was caused by an error that was both a transcription and a timing error. CONCLUSION Potential ADEs at the medication administration stage can cause serious patient harm. Given previous estimates of serious or life-threatening potential ADE of 1.33 per 100

  20. The Dash Data Sharing System

    NASA Technical Reports Server (NTRS)

    Hasan, David A.; Slaughter, Brooks

    1994-01-01

    The Data Sharing system (DASH) project was recently undertaken at NASA Johnson Space Center to introduce distributed data sharing into the Mission Control Center (MCC). Although the project focused on MCC communications, the solution is a general one. This paper describes that project. DASH allows applications to share data. It provides callable interfaces for applications wishing to export or import data. The system consists of several processes: publishers make exported data available to subscribers, which provide it to interested importing applications. A network registration service provides network location transparency, allowing the other processes to reside at arbitrary network locations. These processes act as intermediaries between external producing and consuming applications. DASH has been demonstrated in the MCC where it transmits Shuttle electrical bus data from the Bus Loss Smart System to the Configurable Realtime Analysis System. In addition, the Failure Impact and Procedure Analysis system used DASH to transmit Shuttle remote manipulator data from an expert system to a version of CRANS. DASH is currently being used to integrate a knowledge acquisition application and the CLIPS expert system shell.

  1. Do calculation errors by nurses cause medication errors in clinical practice? A literature review.

    PubMed

    Wright, Kerri

    2010-01-01

    This review aims to examine the literature available to ascertain whether medication errors in clinical practice are the result of nurses' miscalculating drug dosages. The research studies highlighting poor calculation skills of nurses and student nurses have been tested using written drug calculation tests in formal classroom settings [Kapborg, I., 1994. Calculation and administration of drug dosage by Swedish nurses, student nurses and physicians. International Journal for Quality in Health Care 6(4): 389 -395; Hutton, M., 1998. Nursing Mathematics: the importance of application Nursing Standard 13(11): 35-38; Weeks, K., Lynne, P., Torrance, C., 2000. Written drug dosage errors made by students: the threat to clinical effectiveness and the need for a new approach. Clinical Effectiveness in Nursing 4, 20-29]; Wright, K., 2004. Investigation to find strategies to improve student nurses' maths skills. British Journal Nursing 13(21) 1280-1287; Wright, K., 2005. An exploration into the most effective way to teach drug calculation skills to nursing students. Nurse Education Today 25, 430-436], but there have been no reviews of the literature on medication errors in practice that specifically look to see whether the medication errors are caused by nurses' poor calculation skills. The databases Medline, CINAHL, British Nursing Index (BNI), Journal of American Medical Association (JAMA) and Archives and Cochrane reviews were searched for research studies or systematic reviews which reported on the incidence or causes of drug errors in clinical practice. In total 33 articles met the criteria for this review. There were no studies that examined nurses' drug calculation errors in practice. As a result studies and systematic reviews that investigated the types and causes of drug errors were examined to establish whether miscalculations by nurses were the causes of errors. The review found insufficient evidence to suggest that medication errors are caused by nurses' poor

  2. What about doctors? The impact of medical errors.

    PubMed

    Abd Elwahab, Sami; Doherty, Eva

    2014-12-01

    Medical error is a distressing event to the patient and the health care providers. The impact of such events has been well studied on patients but poorly on health professionals. These events are still considered as a taboo in the medical culture and hence missed as great learning opportunities. They have negative impact on doctors' emotional wellbeing, general quality of life, and their professional practice and conduct. Medical errors and adverse events also affect the quality and cost of the health service. Health service administrations should provide healthcare professionals involved in such events with professional support and counselling services, and should consider and treat them as second victims.

  3. Preventing medication errors with nimodipine by compounding proper dosage forms.

    PubMed

    McElhiney, Linda F

    2013-01-01

    Pharmacists can play an active role in preventing tragic medication errors by using United States Pharmacopeia standards, as well as other compounding guidelines, by using due diligence, and by following written standard operating procedures. Nimodipine is shown within this article as an example of the importance of proper dosing of a drug because, since the approval of nimodipine capsules in 1988, the U.S. Food and Drug Administration has identified 31 cases of medication errors associated with its use. Pharmacists can compound nimodipine oral suspension and prepare the doses in oral syringes for the nursing and medical staff.

  4. Medication Error Management around the Globe: An Overview.

    PubMed

    Patel, Isha; Balkrishnan, R

    2010-09-01

    Medical mistakes that include medication errors have raised concerns about medication safety. Due to high consumption of medicines and self-treatment by all, especially the aging population, the issue of proper medication use and safety is at the forefront of public health concerns globally. Each country has a different approach towards medication event monitoring that is compliant with its own health care system. This paper focuses on the efforts and endeavors of some of the countries around the world to create an efficient error reporting systems to ensure public safety. Our analysis indicates that there are established and effective medication vigilance systems in many developed countries. The different countries undertake activities which range from collecting information about prescriptions, surveying physicians about adverse drug events, and conducting sophisticated post-marketing surveillance studies. There is still need for such sophisticated system in India; however recent promising developments are occurring towards building a medication vigilance system. Development of these systems may eventually contribute to a global medication vigilance system, which could reduce concern with medication errors and safety. PMID:21694983

  5. Medical errors - a hospital in Nepal searches for answers.

    PubMed

    Hayes, Bruce

    2008-01-01

    Medical errors are recognized as a significant issue in medical practice. Ethical and professional guide-lines emphasize the responsibility of physicians to disclose errors to patients. However, in practice, even in the developed world this often does not happen. This study which involved 12 focus groups formed from 127 members of staff within Patan Hospital in the Kathmandu Valley sought to understand Nepali staff attitudes to medical errors and suggest how they could be handled. Most agreed, for good reasons of honesty and patient autonomy, that admission of errors is important, but the doctors struggled to decide how it should be done. For most of the staff the educational level was a key decider as to what would be disclosed. Most agreed that the socio-legal climate in Nepal, and the possible financial implications, made it difficult to be completely honest. Other strong fears included patient harm, violence from the patient, damage to the hospital's reputation and to the reputation of the doctors and possible loss of jobs for nurses. We recommend that the hospital initiate a clear hospital policy on dealing with errors and that they should: implement the development of incident reporting forms; set up an error investigation team; provide specific training in communicating about errors for the appropriate staff.

  6. The Impact of Medical Interpretation Method on Time and Errors

    PubMed Central

    Kapelusznik, Luciano; Prakash, Kavitha; Gonzalez, Javier; Orta, Lurmag Y.; Tseng, Chi-Hong; Changrani, Jyotsna

    2007-01-01

    Background Twenty-two million Americans have limited English proficiency. Interpreting for limited English proficient patients is intended to enhance communication and delivery of quality medical care. Objective Little is known about the impact of various interpreting methods on interpreting speed and errors. This investigation addresses this important gap. Design Four scripted clinical encounters were used to enable the comparison of equivalent clinical content. These scripts were run across four interpreting methods, including remote simultaneous, remote consecutive, proximate consecutive, and proximate ad hoc interpreting. The first 3 methods utilized professional, trained interpreters, whereas the ad hoc method utilized untrained staff. Measurements Audiotaped transcripts of the encounters were coded, using a prespecified algorithm to determine medical error and linguistic error, by coders blinded to the interpreting method. Encounters were also timed. Results Remote simultaneous medical interpreting (RSMI) encounters averaged 12.72 vs 18.24 minutes for the next fastest mode (proximate ad hoc) (p = 0.002). There were 12 times more medical errors of moderate or greater clinical significance among utterances in non-RSMI encounters compared to RSMI encounters (p = 0.0002). Conclusions Whereas limited by the small number of interpreters involved, our study found that RSMI resulted in fewer medical errors and was faster than non-RSMI methods of interpreting. PMID:17957418

  7. Medical error and systems of signaling: conceptual and linguistic definition.

    PubMed

    Smorti, Andrea; Cappelli, Francesco; Zarantonello, Roberta; Tani, Franca; Gensini, Gian Franco

    2014-09-01

    In recent years the issue of patient safety has been the subject of detailed investigations, particularly as a result of the increasing attention from the patients and the public on the problem of medical error. The purpose of this work is firstly to define the classification of medical errors, which are distinguished between two perspectives: those that are personal, and those that are caused by the system. Furthermore we will briefly review some of the main methods used by healthcare organizations to identify and analyze errors. During this discussion it has been determined that, in order to constitute a practical, coordinated and shared action to counteract the error, it is necessary to promote an analysis that considers all elements (human, technological and organizational) that contribute to the occurrence of a critical event. Therefore, it is essential to create a culture of constructive confrontation that encourages an open and non-punitive debate about the causes that led to error. In conclusion we have thus underlined that in health it is essential to affirm a system discussion that considers the error as a learning source, and as a result of the interaction between the individual and the organization. In this way, one should encourage a non-guilt bearing discussion on evident errors and on those which are not immediately identifiable, in order to create the conditions that recognize and corrects the error even before it produces negative consequences.

  8. Medical error and systems of signaling: conceptual and linguistic definition.

    PubMed

    Smorti, Andrea; Cappelli, Francesco; Zarantonello, Roberta; Tani, Franca; Gensini, Gian Franco

    2014-09-01

    In recent years the issue of patient safety has been the subject of detailed investigations, particularly as a result of the increasing attention from the patients and the public on the problem of medical error. The purpose of this work is firstly to define the classification of medical errors, which are distinguished between two perspectives: those that are personal, and those that are caused by the system. Furthermore we will briefly review some of the main methods used by healthcare organizations to identify and analyze errors. During this discussion it has been determined that, in order to constitute a practical, coordinated and shared action to counteract the error, it is necessary to promote an analysis that considers all elements (human, technological and organizational) that contribute to the occurrence of a critical event. Therefore, it is essential to create a culture of constructive confrontation that encourages an open and non-punitive debate about the causes that led to error. In conclusion we have thus underlined that in health it is essential to affirm a system discussion that considers the error as a learning source, and as a result of the interaction between the individual and the organization. In this way, one should encourage a non-guilt bearing discussion on evident errors and on those which are not immediately identifiable, in order to create the conditions that recognize and corrects the error even before it produces negative consequences. PMID:25034521

  9. Factors effective on medication errors: A nursing view

    PubMed Central

    Shahrokhi, Akram; Ebrahimpour, Fatemeh; Ghodousi, Arash

    2013-01-01

    Objective: Medication errors are the most common medical errors, which may result in some complications for patients. This study was carried out to investigate what influence medication errors by nurses from their viewpoint. Methods: In this descriptive study, 150 nurses who were working in Qazvin Medical University teaching hospitals were selected by proportional random sampling, and data were collected by means of a researcher-made questionnaire including demographic attributes (age, gender, working experience,…), and contributing factors in medication errors (in three categories including nurse-related, management-related, and environment-related factors). Findings: The mean age of the participant nurses was 30.7 ± 6.5 years. Most of them (87.1%) were female with a Bachelor of Sciences degree (86.7%) in nursing. The mean of their overtime working was 64.8 ± 38 h/month. The results showed that the nurse-related factors are the most effective factors (55.44 ± 9.14) while the factors related to the management system (52.84 ± 11.24) and the ward environment (44.0 ± 10.89) are respectively less effective. The difference between these three groups was significant (P = 0.000). In each aforementioned category, the most effective factor on medication error (ranked from the most effective to the least effective) were as follow: The nurse's inadequate attention (98.7%), the errors occurring in the transfer of medication orders from the patient's file to kardex (96.6%) and the ward's heavy workload (86.7%). Conclusion: In this study nurse-related factors were the most effective factors on medication errors, but nurses are one of the members of health-care providing team, so their performance must be considered in the context of the health-care system like work force condition, rules and regulations, drug manufacturing that might impact nurses performance, so it could not be possible to prevent medication errors without paying attention to our health-care system in a

  10. The Impact of Bar Code Medication Administration Technology on Reported Medication Errors

    ERIC Educational Resources Information Center

    Holecek, Andrea

    2011-01-01

    The use of bar-code medication administration technology is on the rise in acute care facilities in the United States. The technology is purported to decrease medication errors that occur at the point of administration. How significantly this technology affects actual rate and severity of error is unknown. This descriptive, longitudinal research…

  11. Evaluation of intravenous medication errors with smart infusion pumps in an academic medical center.

    PubMed

    Ohashi, Kumiko; Dykes, Patricia; McIntosh, Kathleen; Buckley, Elizabeth; Wien, Matt; Bates, David W

    2013-01-01

    While some published research indicates a fairly high frequency of Intravenous (IV) medication errors associated with the use of smart infusion pumps, the generalizability of these results are uncertain. Additionally, the lack of a standardized methodology for measuring these errors is an issue. In this study we iteratively developed a web-based data collection tool to capture IV medication errors using a participatory design approach with interdisciplinary experts. Using the developed tool, a prevalence study was then conducted in an academic medical center. The results showed that the tool was easy to use and effectively captured all IV medication errors. Through the prevalence study, violation errors of hospital policy were found that could potentially place patients at risk, but no critical errors known to contribute to patient harm were noted.

  12. A classification of errors in lay comprehension of medical documents

    PubMed Central

    Keselman, Alla; Smith, Catherine Arnott

    2012-01-01

    Emphasis on participatory medicine requires that patients and consumers participate in tasks traditionally reserved for healthcare providers. This includes reading and comprehending medical documents, often but not necessarily in the context of interacting with Personal Health Records (PHRs). Research suggests that while giving patients access to medical documents has many benefits (e.g., improved patient-provider communication), lay people often have difficulty understanding medical information. Informatics can address the problem by developing tools that support comprehension; this requires in-depth understanding of the nature and causes of errors that lay people make when comprehending clinical documents. The objective of this study was to develop a classification scheme of comprehension errors, based on lay individuals’ retellings of two documents containing clinical text: a description of a clinical trial and a typical office visit note. While not comprehensive, the scheme can serve as a foundation of further development of a taxonomy of patients’ comprehension errors. Eighty participants, all healthy volunteers, read and retold two medical documents. A data-driven content analysis procedure was used to extract and classify retelling errors. The resulting hierarchical classification scheme contains nine categories and twenty-three subcategories. The most common error made by the participants involved incorrectly recalling brand names of medications. Other common errors included misunderstanding clinical concepts, misreporting the objective of a clinical research study and physician’s findings during a patient’s visit, and confusing and misspelling clinical terms. A combination of informatics support and health education is likely to improve the accuracy of lay comprehension of medical documents. PMID:22925723

  13. Characteristics associated with post-discharge medication errors

    PubMed Central

    Mixon, Amanda S.; Myers, Amy P.; Leak, Cardella L.; Mary Lou Jacobsen, J.; Cawthon, Courtney; Goggins, Kathryn M.; Nwosu, Samuel; Schildcrout, Jonathan S.; Schnelle, John F.; Speroff, Theodore; Kripalani, Sunil

    2014-01-01

    Objective To examine the association of patient- and medication-related factors with post-discharge medication errors. Patients and Methods The Vanderbilt Inpatient Cohort Study (VICS) includes adults hospitalized with acute coronary syndromes (ACS) and/or acute decompensated heart failure (ADHF). We measured health literacy, subjective numeracy, marital status, cognition, social support, education, income, depression, global health status, and medication adherence in patients enrolled between October 2011 and August 2012. We used binomial logistic regression to determine predictors of discordance between the discharge medication list and patient-reported list during post-discharge medication review. Results Among 471 patients, mean age was 59 years; mean total number of medications reported was 12; and 17% had inadequate or marginal health literacy. Half (51%) of patients had ≥1 one discordant medication (i.e., appeared either on the discharge or patient-reported list but not both); 27% failed to report a medication on their discharge list; and 36% reported a medication not on their discharge list. Additionally, 59% had a misunderstanding in indication, dose, or frequency in a cardiac medication. In multivariable analyses, higher subjective numeracy (Odds Ratio (OR)=0.81, 95% Confidence Interval (CI) 0.67-0.98) was associated with lower odds of having discordant medications. For cardiac medications, participants with higher health literacy (OR=0.84, CI 0.74-0.95), higher subjective numeracy (OR=0.77, CI 0.63-0.95), and who were female (OR=0.60, CI 0.46-0.78) had lower odds of misunderstandings in indication, dose, or frequency. Conclusion Medication errors are present in approximately half of patients following hospital discharge and are more common among patients with lower numeracy or health literacy. PMID:24998906

  14. Effectiveness of an electronic inpatient medication record in reducing medication errors in Singapore.

    PubMed

    Choo, Janet; Johnston, Linda; Manias, Elizabeth

    2014-06-01

    This study examined the effectiveness of an inpatient electronic medication record system in reducing medication errors in Singaporean hospitals. This pre- and post-intervention study involving a control group was undertaken in two Singaporean acute care hospitals. In one hospital the inpatient electronic medication record system was implemented while in another hospital the paper-based medication record system was used. The mean incidence difference in medication errors of 0.06 between pre-intervention (0.72 per 1000 patient days) and post-intervention (0.78 per 1000 patient days) for the two hospitals was not statistically significant (95%, CI: [0.26, 0.20]). The mean incidence differences in medication errors relating to prescription, dispensing, and administration were also not statistically different. Common system failures involved a lack of medication knowledge by health professionals and a lack of a systematic approach in identifying correct dosages. There was no difference in the incidence of medication errors following the introduction of the electronic medication record system. More work is needed on how this system can reduce medication error rates and improve medication safety.

  15. Effect of an automated bedside dispensing machine on medication errors.

    PubMed

    Barker, K N; Pearson, R E; Hepler, C D; Smith, W E; Pappas, C A

    1984-07-01

    The effect of an automated bedside dispensing machine on medication errors was studied on a 32-bed surgical unit of an 848-bed hospital. The experimental system (McLaughlin Dispensing System) included at each patient's bedside a locked medication cabinet that was electronically programmed to allow the nurse access to doses due at a particular time. The control system was a decentralized unit dose system. A crossover study design with random assignment of subjects and treatments was used. In the 14-day study period, nurses were observed by a pharmacist for 28 five-hour periods as they administered medications on the day and evening shifts. The mean error rates were significantly different--10.6% for the experimental system and 15.9% for the control system. Wrong time errors were the most common type. No significant differences were found between day and evening shifts or workloads of individual nurses. There was no treatment order effect. The error rate was significantly lower for the automated dispensing system than for the system using unit doses dispensed from a satellite pharmacy. Automated dispensing systems may be useful in reducing errors in administration time and dose omissions. PMID:6465150

  16. Medication Errors in the Southeast Asian Countries: A Systematic Review

    PubMed Central

    Salmasi, Shahrzad; Khan, Tahir Mehmood; Hong, Yet Hoi; Ming, Long Chiau; Wong, Tin Wui

    2015-01-01

    Background Medication error (ME) is a worldwide issue, but most studies on ME have been undertaken in developed countries and very little is known about ME in Southeast Asian countries. This study aimed systematically to identify and review research done on ME in Southeast Asian countries in order to identify common types of ME and estimate its prevalence in this region. Methods The literature relating to MEs in Southeast Asian countries was systematically reviewed in December 2014 by using; Embase, Medline, Pubmed, ProQuest Central and the CINAHL. Inclusion criteria were studies (in any languages) that investigated the incidence and the contributing factors of ME in patients of all ages. Results The 17 included studies reported data from six of the eleven Southeast Asian countries: five studies in Singapore, four in Malaysia, three in Thailand, three in Vietnam, one in the Philippines and one in Indonesia. There was no data on MEs in Brunei, Laos, Cambodia, Myanmar and Timor. Of the seventeen included studies, eleven measured administration errors, four focused on prescribing errors, three were done on preparation errors, three on dispensing errors and two on transcribing errors. There was only one study of reconciliation error. Three studies were interventional. Discussion The most frequently reported types of administration error were incorrect time, omission error and incorrect dose. Staff shortages, and hence heavy workload for nurses, doctor/nurse distraction, and misinterpretation of the prescription/medication chart, were identified as contributing factors of ME. There is a serious lack of studies on this topic in this region which needs to be addressed if the issue of ME is to be fully understood and addressed. PMID:26340679

  17. Sensitivity analysis of geometric errors in additive manufacturing medical models.

    PubMed

    Pinto, Jose Miguel; Arrieta, Cristobal; Andia, Marcelo E; Uribe, Sergio; Ramos-Grez, Jorge; Vargas, Alex; Irarrazaval, Pablo; Tejos, Cristian

    2015-03-01

    Additive manufacturing (AM) models are used in medical applications for surgical planning, prosthesis design and teaching. For these applications, the accuracy of the AM models is essential. Unfortunately, this accuracy is compromised due to errors introduced by each of the building steps: image acquisition, segmentation, triangulation, printing and infiltration. However, the contribution of each step to the final error remains unclear. We performed a sensitivity analysis comparing errors obtained from a reference with those obtained modifying parameters of each building step. Our analysis considered global indexes to evaluate the overall error, and local indexes to show how this error is distributed along the surface of the AM models. Our results show that the standard building process tends to overestimate the AM models, i.e. models are larger than the original structures. They also show that the triangulation resolution and the segmentation threshold are critical factors, and that the errors are concentrated at regions with high curvatures. Errors could be reduced choosing better triangulation and printing resolutions, but there is an important need for modifying some of the standard building processes, particularly the segmentation algorithms.

  18. Rate of Medical Errors in Affiliated Hospitals of Mazandaran University of Medical Sciences

    PubMed Central

    Saravi, Benyamin Mohseni; Mardanshahi, Alireza; Ranjbar, Mansour; Siamian, Hasan; Azar, Masoud Shayeste; Asghari, Zolikah; Motamed, Nima

    2015-01-01

    Introduction: Health care organizations are highly specialized and complex. Thus we may expect the adverse events will inevitably occur. Building a medical error reporting system to analyze the reported preventable adverse events and learn from their results can help to prevent the repeat of these events. The medical errors which were reported to the Clinical Governance’s office of Mazandaran University of Medical Sciences (MazUMS) in years 2011-2012 were analyzed. Methods and Materials: This is a descriptive retrospective study in which 18 public hospitals were participated. The instrument of data collection was checklist that was designed by the Ministry of Health of Iran. Variables were type of hospital, unit of hospital, season, severity of event and type of error. The data were analyzed with SPSS software. Results: Of 317966 admissions 182 cases, about 0.06%, medical error reported of which most of the reports (%51.6) were from non- teaching hospitals. Among various units of hospital, the highest frequency of medical error was related to surgical unit (%42.3). The frequency of medical error according to the type of error was also evaluated of which the highest frequency was related to inappropriate and no care (totally 37%) and medication error 28%. We also analyzed the data with respect to the effect of the error on a patient of which the highest frequency was related to minor effect (44.5%). Conclusion: The results showed that a wide variety of errors. Encourage and revision of the reporting process will be result to know more data for prevention of them. PMID:25870528

  19. Risk Factors for Increased Severity of Paediatric Medication Administration Errors

    PubMed Central

    Sears, Kim; Goodman, William M.

    2012-01-01

    Patients' risks from medication errors are widely acknowledged. Yet not all errors, if they occur, have the same risks for severe consequences. Facing resource constraints, policy makers could prioritize factors having the greatest severe–outcome risks. This study assists such prioritization by identifying work-related risk factors most clearly associated with more severe consequences. Data from three Canadian paediatric centres were collected, without identifiers, on actual or potential errors that occurred. Three hundred seventy-two errors were reported, with outcome severities ranging from time delays up to fatalities. Four factors correlated significantly with increased risk for more severe outcomes: insufficient training; overtime; precepting a student; and off-service patient. Factors' impacts on severity also vary with error class: for wrong-time errors, the factors precepting a student or working overtime significantly increase severe-outcomes risk. For other types, caring for an off-service patient has greatest severity risk. To expand such research, better standardization is needed for categorizing outcome severities. PMID:23968607

  20. What have we learned about interventions to reduce medical errors?

    PubMed

    Woodward, Helen I; Mytton, Oliver T; Lemer, Claire; Yardley, Iain E; Ellis, Benjamin M; Rutter, Paul D; Greaves, Felix E C; Noble, Douglas J; Kelley, Edward; Wu, Albert W

    2010-01-01

    Medical errors and adverse events are now recognized as major threats to both individual and public health worldwide. This review provides a broad perspective on major effective, established, or promising strategies to reduce medical errors and harm. Initiatives to improve safety can be conceptualized as a "safety onion" with layers of protection, depending on their degree of remove from the patient. Interventions discussed include those applied at the levels of the patient (patient engagement and disclosure), the caregiver (education, teamwork, and checklists), the local workplace (culture and workplace changes), and the system (information technology and incident reporting systems). Promising interventions include forcing functions, computerized prescriber order entry with decision support, checklists, standardized handoffs and simulation training. Many of the interventions described still lack strong evidence of benefit, but this should not hold back implementation. Rather, it should spur innovation accompanied by evaluation and publication to share the results. PMID:20070203

  1. Developing control charts to review and monitor medication errors.

    PubMed

    Ciminera, J L; Lease, M P

    1992-03-01

    There is a need to monitor reported medication errors in a hospital setting. Because the quantity of errors vary due to external reporting, quantifying the data is extremely difficult. Typically, these errors are reviewed using classification systems that often have wide variations in the numbers per class per month. The authors recommend the use of control charts to review historical data and to monitor future data. The procedure they have adopted is a modification of schemes using absolute (i.e., positive) values of successive differences to estimate the standard deviation when only single incidence values are available in time rather than sample averages, and when many successive differences may be zero. PMID:10116719

  2. Emergency department crowding and risk of preventable medical errors.

    PubMed

    Epstein, Stephen K; Huckins, David S; Liu, Shan W; Pallin, Daniel J; Sullivan, Ashley F; Lipton, Robert I; Camargo, Carlos A

    2012-04-01

    The objective of the study is to determine the association between emergency department (ED) crowding and preventable medical errors (PME). This was a retrospective cohort study of 533 ED patients enrolled in the National ED Safety Study (NEDSS) in four Massachusetts EDs. Individual patients' average exposure to ED crowding during their ED visit was compared with the occurrence of a PME (yes/no) for the three diagnostic categories in NEDSS: acute myocardial infarction, asthma exacerbation, and dislocation requiring procedural sedation. To accommodate site-to-site differences in available administrative data, ED crowding was measured using one of three previously validated crowding metrics (ED Work Index, ED Workscore, and ED Occupancy). At each site, the continuous measure was placed into site-specific quartiles, and these quartiles then were combined across sites. We found that 46 (8.6%; 95% confidence interval, 6.4-11.3%) of the 533 patients experienced a PME. For those seen during higher levels of ED crowding (quartile 4 vs. quartile 1), the occurrence of PMEs was more than twofold higher, both on unadjusted analysis and adjusting for two potential confounders (diagnosis, site). The association appeared non-linear, with most PMEs occurring at the highest crowding level. We identified a direct association between high levels of ED crowding and risk of preventable medical errors. Further study is needed to determine the generalizability of these results. Should such research confirm our findings, we would suggest that mitigating ED crowding may reduce the occurrence of preventable medical errors.

  3. The economics of health care quality and medical errors.

    PubMed

    Andel, Charles; Davidow, Stephen L; Hollander, Mark; Moreno, David A

    2012-01-01

    Hospitals have been looking for ways to improve quality and operational efficiency and cut costs for nearly three decades, using a variety of quality improvement strategies. However, based on recent reports, approximately 200,000 Americans die from preventable medical errors including facility-acquired conditions and millions may experience errors. In 2008, medical errors cost the United States $19.5 billion. About 87 percent or $17 billion were directly associated with additional medical cost, including: ancillary services, prescription drug services, and inpatient and outpatient care, according to a study sponsored by the Society for Actuaries and conducted by Milliman in 2010. Additional costs of $1.4 billion were attributed to increased mortality rates with $1.1 billion or 10 million days of lost productivity from missed work based on short-term disability claims. The authors estimate that the economic impact is much higher, perhaps nearly $1 trillion annually when quality-adjusted life years (QALYs) are applied to those that die. Using the Institute of Medicine's (IOM) estimate of 98,000 deaths due to preventable medical errors annually in its 1998 report, To Err Is Human, and an average of ten lost years of life at $75,000 to $100,000 per year, there is a loss of $73.5 billion to $98 billion in QALYs for those deaths--conservatively. These numbers are much greater than those we cite from studies that explore the direct costs of medical errors. And if the estimate of a recent Health Affairs article is correct-preventable death being ten times the IOM estimate-the cost is $735 billion to $980 billion. Quality care is less expensive care. It is better, more efficient, and by definition, less wasteful. It is the right care, at the right time, every time. It should mean that far fewer patients are harmed or injured. Obviously, quality care is not being delivered consistently throughout U.S. hospitals. Whatever the measure, poor quality is costing payers and

  4. Identifying medication error chains from critical incident reports: a new analytic approach.

    PubMed

    Huckels-Baumgart, Saskia; Manser, Tanja

    2014-10-01

    Research into the distribution of medication errors usually focuses on isolated stages within the medication use process. Our study aimed to provide a novel process-oriented approach to medication incident analysis focusing on medication error chains. Our study was conducted across a 900-bed teaching hospital in Switzerland. All reported 1,591 medication errors 2009-2012 were categorized using the Medication Error Index NCC MERP and the WHO Classification for Patient Safety Methodology. In order to identify medication error chains, each reported medication incident was allocated to the relevant stage of the hospital medication use process. Only 25.8% of the reported medication errors were detected before they propagated through the medication use process. The majority of medication errors (74.2%) formed an error chain encompassing two or more stages. The most frequent error chain comprised preparation up to and including medication administration (45.2%). "Non-consideration of documentation/prescribing" during the drug preparation was the most frequent contributor for "wrong dose" during the administration of medication. Medication error chains provide important insights for detecting and stopping medication errors before they reach the patient. Existing and new safety barriers need to be extended to interrupt error chains and to improve patient safety.

  5. Data Sharing from a Policy Perspective

    ERIC Educational Resources Information Center

    Cheville, R. Alan

    2016-01-01

    This paper addresses questions of data sharing from the perspective of a former NSF program officer. A brief comparison of policy and research perspectives is made to highlight different values in these two communities. Data sharing is framed as one means to support dialog between researchers and those involved in policy. Other uses of data…

  6. An Overview of ISS Human Research Data Sharing

    NASA Technical Reports Server (NTRS)

    Morshedi, Pasha

    2015-01-01

    This presentation is an attempt to clarify several aspects of the current procedures, tools, and challenges of human data sharing for ISS flight activities. There are several binary variables to consider with respect to human spaceflight data sharing: Medical vs. Research, Active Flight vs. Non-Flight, Tactical vs. Supplemental, Prospective vs. Retrospective. This presentation will address each of these variables and how they determine which processes and mechanisms are used both to document and facilitate human data sharing. Some of these variables will likely be so obvious that they induce eye rolls. Please bear with us. We're trying to make these slides fairly rudimentary for a wide, (eventually) international audience. Other distinctions are made if data originated from a NASA vs. IP crewmember. Those distinctions will be made apparent when needed.

  7. Hospital medication errors in a pharmacovigilance system in Colombia.

    PubMed

    Machado Alba, Jorge Enrique; Moreno Gutiérrez, Paula Andrea; Moncada Escobar, Juan Carlos

    2015-11-01

    Objetivos: analizar los errores de medicacion reportados en un sistema de farmacovigilancia en 26 hospitales para pacientes del sistema de salud de Colombia. Métodos: estudio retrospectivo que evaluo las bases de datos sistematizadas de reportes de errores de medicacion entre el 1 de enero de 2008 y el 12 de septiembre de 2013 de los medicamentos dispensados por la empresa Audifarma S.A a hospitales de Colombia. Se utilizo la clasificacion taxonomica del National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). El analisis de los datos se realizo mediante SPSS 22.0 para Windows Se determino como nivel de significacion estadistica una p < 0,05. Resultados: se reportaron 9.062 EM en 45 servicios farmaceuticos hospitalarios. El 51,9% (n = 4.707) de los errores realmente se produjeron, de los cuales el 12,0% (n = 567) afectaron al paciente (categorias C a I) y causaron dano (categorias E a I) a 17 (0,36%). El proceso implicado en los EM ocurridos (categorias B a I) con mayor frecuencia fue la prescripcion (n = 1.758, 37,3%), seguido por la dispensacion (n = 1.737, 36,9%), la transcripcion (n = 970, 20,6%) y, por ultimo, la administracion (n = 242, 5,1%). Los errores relacionados con los procesos de administracion aumentaban 45,2 veces el riesgo de que el medicamento erroneo afectara al paciente (IC 95% 20,2-100,9). Conclusiones: es necesario aumentar la cobertura de los sistemas de reporte de errores de medicacion, y crear estrategias para su prevencion, especialmente en la etapa de administracion del medicamento.

  8. Pediatric medication errors in the postanesthesia care unit: analysis of MEDMARX data.

    PubMed

    Payne, Christopher H; Smith, Christopher R; Newkirk, Laura E; Hicks, Rodney W

    2007-04-01

    Medication errors involving pediatric patients in the postanesthesia care unit may occur as frequently as one in every 20 medication orders and are more likely to cause harm when compared to medication errors in the overall population. Researchers examined six years of records from the MEDMARX database and used consecutive nonprobability sampling and descriptive statistics to compare medication errors in the pediatric data set to those occurring in the total population data set. Nineteen different causes of error involving 28 different products were identified. The results of the study indicate that an organization can focus on causes of errors and products involved in errors to mitigate future error occurrence.

  9. Analysis of errors in medical rapid prototyping models.

    PubMed

    Choi, J Y; Choi, J H; Kim, N K; Kim, Y; Lee, J K; Kim, M K; Lee, J H; Kim, M J

    2002-02-01

    Rapid prototyping (RP) is a relatively new technology that produces physical models by selectively solidifying UV-sensitive liquid resin using a laser beam. The technology has gained a great amount of attention, particularly in oral and maxillofacial surgery. An important issue in RP applications in this field is how to obtain RP models of the required accuracy. We investigated errors generated during the production of medical RP models, and identified the factors that caused dimensional errors in each production phase. The errors were mainly due to the volume-averaging effect, threshold value, and difficulty in the exact replication of landmark locations. We made 16 linear measurements on a dry skull, a replicated three-dimensional (3-D) visual (STL) model, and an RP model. The results showed that the absolute mean deviation between the original dry skull and the RP model over the 16 linear measurements was 0.62 +/- 0.35 mm (0.56 +/- 0.39%), which is smaller than values reported in previous studies. A major emphasis is placed on the dumb-bell effect. Classifying measurements as internal and external measurements, we observed that the effect of an inadequate threshold value differs with the type of measurement.

  10. Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems

    PubMed Central

    Schiff, G D; Amato, M G; Eguale, T; Boehne, J J; Wright, A; Koppel, R; Rashidee, A H; Elson, R B; Whitney, D L; Thach, T-T; Bates, D W; Seger, A C

    2015-01-01

    Importance Medication computerised provider order entry (CPOE) has been shown to decrease errors and is being widely adopted. However, CPOE also has potential for introducing or contributing to errors. Objectives The objectives of this study are to (a) analyse medication error reports where CPOE was reported as a ‘contributing cause’ and (b) develop ‘use cases’ based on these reports to test vulnerability of current CPOE systems to these errors. Methods A review of medication errors reported to United States Pharmacopeia MEDMARX reporting system was made, and a taxonomy was developed for CPOE-related errors. For each error we evaluated what went wrong and why and identified potential prevention strategies and recurring error scenarios. These scenarios were then used to test vulnerability of leading CPOE systems, asking typical users to enter these erroneous orders to assess the degree to which these problematic orders could be entered. Results Between 2003 and 2010, 1.04 million medication errors were reported to MEDMARX, of which 63 040 were reported as CPOE related. A review of 10 060 CPOE-related cases was used to derive 101 codes describing what went wrong, 67 codes describing reasons why errors occurred, 73 codes describing potential prevention strategies and 21 codes describing recurring error scenarios. Ability to enter these erroneous order scenarios was tested on 13 CPOE systems at 16 sites. Overall, 298 (79.5%) of the erroneous orders were able to be entered including 100 (28.0%) being ‘easily’ placed, another 101 (28.3%) with only minor workarounds and no warnings. Conclusions and relevance Medication error reports provide valuable information for understanding CPOE-related errors. Reports were useful for developing taxonomy and identifying recurring errors to which current CPOE systems are vulnerable. Enhanced monitoring, reporting and testing of CPOE systems are important to improve CPOE safety. PMID:25595599

  11. Moderating Effects of Learning Climate on the Impact of RN Staffing on Medication Errors

    PubMed Central

    Chang, YunKyung; Mark, Barbara

    2010-01-01

    Background Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction. Objectives To investigate whether learning climate moderates the relationship between error-producing conditions and medication errors. Method A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses’ expertise), personal factors (nurses’ education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis. Results A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors, and this relationship trended towards significance. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors. Discussion The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors. PMID:21127452

  12. Genomic data-sharing: what will be our legacy?

    PubMed Central

    Callier, Shawneequa; Husain, Rajah; Simpson, Rachel

    2014-01-01

    Prior to 1974, the Tuskegee Syphilis experiments, expansive use of the HeLa cells, and other blatant instances of research abuse pervaded the medical research field. Ongoing challenges to informed consent, privacy and data-sharing will influence the stories that research participants today share with future generations. This has significant implications for the advancement of genomic science, and the public's perception of genomic research. PMID:24634673

  13. Voluntary Electronic Reporting of Medical Errors and Adverse Events

    PubMed Central

    Milch, Catherine E; Salem, Deeb N; Pauker, Stephen G; Lundquist, Thomas G; Kumar, Sanjaya; Chen, Jack

    2006-01-01

    OBJECTIVE To describe the rate and types of events reported in acute care hospitals using an electronic error reporting system (e-ERS). DESIGN Descriptive study of reported events using the same e-ERS between January 1, 2001 and September 30, 2003. SETTING Twenty-six acute care nonfederal hospitals throughout the U.S. that voluntarily implemented a web-based e-ERS for at least 3 months. PARTICIPANTS Hospital employees and staff. INTERVENTION A secure, standardized, commercially available web-based reporting system. RESULTS Median duration of e-ERS use was 21 months (range 3 to 33 months). A total of 92,547 reports were obtained during 2,547,154 patient-days. Reporting rates varied widely across hospitals (9 to 95 reports per 1,000 inpatient-days; median=35). Registered nurses provided nearly half of the reports; physicians contributed less than 2%. Thirty-four percent of reports were classified as nonmedication-related clinical events, 33% as medication/infusion related, 13% were falls, 13% as administrative, and 6% other. Among 80% of reports that identified level of impact, 53% were events that reached a patient (“patient events”), 13% were near misses that did not reach the patient, and 14% were hospital environment problems. Among 49,341 patient events, 67% caused no harm, 32% temporary harm, 0.8% life threatening or permanent harm, and 0.4% contributed to patient deaths. CONCLUSIONS An e-ERS provides an accessible venue for reporting medical errors, adverse events, and near misses. The wide variation in reporting rates among hospitals, and very low reporting rates by physicians, requires investigation. PMID:16390502

  14. Preventing medication errors in neonatology: Is it a dream?

    PubMed Central

    Antonucci, Roberto; Porcella, Annalisa

    2014-01-01

    Since 1999, the problem of patient safety has drawn particular attention, becoming a priority in health care. A “medication error” (ME) is any preventable event occurring at any phase of the pharmacotherapy process (ordering, transcribing, dispensing, administering, and monitoring) that leads to, or can lead to, harm to the patient. Hence, MEs can involve every professional of the clinical team. MEs range from those with severe consequences to those with little or no impact on the patient. Although a high ME rate has been found in neonatal wards, newborn safety issues have not been adequately studied until now. Healthcare professionals working in neonatal wards are particularly susceptible to committing MEs due to the peculiarities of newborn patients and of the neonatal intensive care unit (NICU) environment. Current neonatal prevention strategies for MEs have been borrowed from adult wards, but many factors such as high costs and organizational barriers have hindered their diffusion. In general, two types of strategies have been proposed: the first strategy consists of identifying human factors that result in errors and redesigning the work in the NICU in order to minimize them; the second one suggests to design and implement effective systems for preventing errors or intercepting them before reaching the patient. In the future, prevention strategies for MEs need to be improved and tailored to the special neonatal population and the NICU environment and, at the same time, every effort will have to be made to support their clinical application. PMID:25254183

  15. The Promotion of Data Sharing in Pharmacoepidemiology

    PubMed Central

    Sethi, Nayha

    2014-01-01

    This article addresses the role of pharmacoepidemiology in patient safety and the crucial role of data sharing in ensuring that such activities occur. Against the backdrop of proposed reforms of European data protection legislation, it considers whether the current legislative landscape adequately facilitates this essential data sharing. It is argued that rather than maximising and promoting the benefits of such activities by facilitating data sharing, current and proposed legislative landscapes hamper these vital activities. The article posits that current and proposed data protection approaches to pharmacoepidemiology — and more broadly, re-uses of data — should be reoriented towards enabling these important safety enhancing activities. Two potential solutions are offered: 1) a dedicated working party on data reuse for health research and 2) the introduction of new, dedicated legislation. PMID:25065034

  16. Trust, vulnerable populations, and genetic data sharing

    PubMed Central

    Arias, Jalayne J.; Pham-Kanter, Genevieve; Gonzalez, Rosa; Campbell, Eric G.

    2015-01-01

    Recent policies and proposed regulations, including the Notice of Proposed Rulemaking for the Common Rule and the 2014 NIH Genetic Data Sharing Policy, seek to improve research subject protections. Protections for subjects whose genetic data is shared are critical to reduce risks such as loss of confidentiality, stigma, and discrimination. In the article ‘It depends whose data are being shared: considerations for genomic data sharing policies’, Robinson et al. provide a response to our article, ‘The Growth and Gaps of Genetic Data Sharing Policies’. Robinson et al. highlight the importance of individual and group preferences. In this article, we extend the conversation on models for improving protections which will mitigate consequences for individuals and groups that are vulnerable to stigma and discrimination. PMID:27774227

  17. Armenian Virtual Observatory: Services and Data Sharing

    NASA Astrophysics Data System (ADS)

    Knyazyan, A. V.; Astsatryan, H. V.; Mickaelian, A. M.

    2016-06-01

    The main aim of this article is to introduce the data management and services of the Armenian Virtual Observatory (ArVO), which consists of user friendly data management mechanisms, a new and productive cross-correlation service, and data sharing API based on international standards and protocols.

  18. Interorganizational collaboration in public health data sharing.

    PubMed

    Casey, Colleen; Li, Jianling; Berry, Michele

    2016-09-19

    Purpose The purpose of this paper is to analyze the institutional and social forces that influence collaborative data sharing practices in cross-sector interorganizational networks. The analysis focusses on the data sharing practices between professionals in the transportation and public health sectors, areas prioritized for collaborative action to improve public health. Design/methodology/approach A mixed methods design is utilized. Electronic surveys were sent to 57 public health and 157 transportation professionals in a large major metropolitan area in the USA (response rate 39.7 percent). Focus groups were held with 12 organizational leaders representing professionals in both sectors. Findings The application of the institutional-social capital framework suggests that professional specialization and organizational forces make it challenging for professionals to develop the cross-sector relationships necessary for cross-sector collaborative data sharing. Research limitations/implications The findings suggest that developing the social relationships necessary for cross-sector collaboration may be resource intensive. Investments are necessary at the organizational level to overcome the professional divides that limit the development of cross-sector relationships critical for collaborative data sharing. The results are limited to the data sharing practices of professionals in one metropolitan area. Originality/value Despite mandates and calls for increased cross-sector collaboration to improve public health, such efforts often fail to produce true collaboration. The study's value is that it adds to the theoretical conceptualization of collaboration and provides a deeper understanding as to why collaborative action remains difficult to achieve. Future study of collaboration must consider the interaction between professional specialization and the social relationships necessary for success.

  19. Data Sharing by Scientists: Practices and Perceptions

    PubMed Central

    Tenopir, Carol; Allard, Suzie; Douglass, Kimberly; Aydinoglu, Arsev Umur; Wu, Lei; Read, Eleanor; Manoff, Maribeth; Frame, Mike

    2011-01-01

    Background Scientific research in the 21st century is more data intensive and collaborative than in the past. It is important to study the data practices of researchers – data accessibility, discovery, re-use, preservation and, particularly, data sharing. Data sharing is a valuable part of the scientific method allowing for verification of results and extending research from prior results. Methodology/Principal Findings A total of 1329 scientists participated in this survey exploring current data sharing practices and perceptions of the barriers and enablers of data sharing. Scientists do not make their data electronically available to others for various reasons, including insufficient time and lack of funding. Most respondents are satisfied with their current processes for the initial and short-term parts of the data or research lifecycle (collecting their research data; searching for, describing or cataloging, analyzing, and short-term storage of their data) but are not satisfied with long-term data preservation. Many organizations do not provide support to their researchers for data management both in the short- and long-term. If certain conditions are met (such as formal citation and sharing reprints) respondents agree they are willing to share their data. There are also significant differences and approaches in data management practices based on primary funding agency, subject discipline, age, work focus, and world region. Conclusions/Significance Barriers to effective data sharing and preservation are deeply rooted in the practices and culture of the research process as well as the researchers themselves. New mandates for data management plans from NSF and other federal agencies and world-wide attention to the need to share and preserve data could lead to changes. Large scale programs, such as the NSF-sponsored DataNET (including projects like DataONE) will both bring attention and resources to the issue and make it easier for scientists to apply sound data

  20. Interorganizational collaboration in public health data sharing.

    PubMed

    Casey, Colleen; Li, Jianling; Berry, Michele

    2016-09-19

    Purpose The purpose of this paper is to analyze the institutional and social forces that influence collaborative data sharing practices in cross-sector interorganizational networks. The analysis focusses on the data sharing practices between professionals in the transportation and public health sectors, areas prioritized for collaborative action to improve public health. Design/methodology/approach A mixed methods design is utilized. Electronic surveys were sent to 57 public health and 157 transportation professionals in a large major metropolitan area in the USA (response rate 39.7 percent). Focus groups were held with 12 organizational leaders representing professionals in both sectors. Findings The application of the institutional-social capital framework suggests that professional specialization and organizational forces make it challenging for professionals to develop the cross-sector relationships necessary for cross-sector collaborative data sharing. Research limitations/implications The findings suggest that developing the social relationships necessary for cross-sector collaboration may be resource intensive. Investments are necessary at the organizational level to overcome the professional divides that limit the development of cross-sector relationships critical for collaborative data sharing. The results are limited to the data sharing practices of professionals in one metropolitan area. Originality/value Despite mandates and calls for increased cross-sector collaboration to improve public health, such efforts often fail to produce true collaboration. The study's value is that it adds to the theoretical conceptualization of collaboration and provides a deeper understanding as to why collaborative action remains difficult to achieve. Future study of collaboration must consider the interaction between professional specialization and the social relationships necessary for success. PMID:27681021

  1. Data sharing by scientists: Practices and perceptions

    USGS Publications Warehouse

    Tenopir, C.; Allard, S.; Douglass, K.; Aydinoglu, A.U.; Wu, L.; Read, E.; Manoff, M.; Frame, M.

    2011-01-01

    Background: Scientific research in the 21st century is more data intensive and collaborative than in the past. It is important to study the data practices of researchers - data accessibility, discovery, re-use, preservation and, particularly, data sharing. Data sharing is a valuable part of the scientific method allowing for verification of results and extending research from prior results. Methodology/Principal Findings: A total of 1329 scientists participated in this survey exploring current data sharing practices and perceptions of the barriers and enablers of data sharing. Scientists do not make their data electronically available to others for various reasons, including insufficient time and lack of funding. Most respondents are satisfied with their current processes for the initial and short-term parts of the data or research lifecycle (collecting their research data; searching for, describing or cataloging, analyzing, and short-term storage of their data) but are not satisfied with long-term data preservation. Many organizations do not provide support to their researchers for data management both in the short- and long-term. If certain conditions are met (such as formal citation and sharing reprints) respondents agree they are willing to share their data. There are also significant differences and approaches in data management practices based on primary funding agency, subject discipline, age, work focus, and world region. Conclusions/Significance: Barriers to effective data sharing and preservation are deeply rooted in the practices and culture of the research process as well as the researchers themselves. New mandates for data management plans from NSF and other federal agencies and world-wide attention to the need to share and preserve data could lead to changes. Large scale programs, such as the NSF-sponsored DataNET (including projects like DataONE) will both bring attention and resources to the issue and make it easier for scientists to apply sound

  2. Searching for the Final Answer: Factors Contributing to Medication Administration Errors.

    ERIC Educational Resources Information Center

    Pape, Tess M.

    2001-01-01

    Causal factors contributing to errors in medication administration should be thoroughly investigated, focusing on systems rather than individual nurses. Unless systemic causes are addressed, many errors will go unreported for fear of reprisal. (Contains 42 references.) (SK)

  3. Laboratory Session to Improve First-year Pharmacy Students' Knowledge and Confidence Concerning the Prevention of Medication Errors

    PubMed Central

    Darbishire, Patricia L.; Plake, Kimberly S.; Oswald, Christopher; Walters, Brenda M.

    2009-01-01

    Objectives To implement a laboratory session into the first-year pharmacy curriculum that would provide active-learning experiences in the recognition, resolution, and prevention of medication errors. Design Students participated in medication error-prone prescription processing and counseling simulations, role-played communication strategies after a medication error occurred, and discussed an introductory pharmacy practice experience focused on prescription processing and prevention of medication errors. Assessment Students completed an assessment prior to and after completion of the laboratory on their knowledge of and confidence in identifying medication errors. Students' knowledge and awareness of medication errors improved as did confidence in their ability to (1) recognize and avoid errors, (2) utilize methods to prevent errors, (3) communicate about errors with involved parties, and (4) select and report medication errors on an appropriate form. Conclusion Students' awareness of the pharmacist's role in medication error reduction improved and confidence in their ability to recognize, prevent, and communicate medication errors increased. PMID:19885068

  4. The Importance of Medication Errors Reporting in Improving the Quality of Clinical Care Services

    PubMed Central

    Elden, Nesreen Mohamed Kamal; Ismail, Amira

    2016-01-01

    Introduction: Medication errors have significant implications on patient safety. Error detection through an active management and effective reporting system discloses medication errors and encourages safe practices. Objectives: To improve patient safety through determining and reducing the major causes of medication errors (MEs), after applying tailored preventive strategies. Methodology: A pre-test, post-test study was conducted on all inpatients at a 177 bed hospital where all medication procedures in each ward were monitored by a clinical pharmacist. The patient files were reviewed, as well. Error reports were submitted to a hospital multidisciplinary committee to identify major causes of errors. Accordingly, corrective interventions that consisted of targeted training programs for nurses and physicians were conducted. Results: Medication errors were higher during ordering/prescription stage (38.1%), followed by administration phase (20.9%). About 45% of errors reached the patients: 43.5% were harmless and 1.4% harmful. 7.7% were potential errors and more than 47% could be prevented. After the intervention, error rates decreased from (6.7%) to (3.6%) (P≤0.001). Conclusion: The role of a ward based clinical pharmacist with a hospital multidisciplinary committee was effective in recognizing, designing and implementing tailored interventions for reduction of medication errors. A systematic approach is urgently needed to decrease organizational susceptibility to errors, through providing required resources to monitor, analyze and implement effective interventions. PMID:27045415

  5. Diagnostic Error in Medical Education: Where Wrongs Can Make Rights

    ERIC Educational Resources Information Center

    Eva, Kevin W.

    2009-01-01

    This paper examines diagnostic error from an educational perspective. Rather than addressing the question of how educators in the health professions can help learners avoid error, however, the literature reviewed leads to the conclusion that educators should be working to induce error in learners, leading them to short term pain for long term…

  6. Being a Victim of Medical Error in Brazil: An (Un)Real Dilemma

    PubMed Central

    Mendonça, Vitor Silva; Custódio, Eda Marconi

    2016-01-01

    Medical error stems from inadequate professional conduct that is capable of producing harm to life or exacerbating the health of another, whether through act or omission. This situation has become increasingly common in Brazil and worldwide. In this study, the aim was to understand what being the victim of medical error is like and to investigate the circumstances imposed on this condition of victims in Brazil. A semi-structured interview was conducted with twelve people who had gone through situations of medical error in their lives, creating a space for narratives of their experiences and deep reflection on the phenomenon. The concept of medical error has a negative connotation, often being associated with the incompetence of a medical professional. Medical error in Brazil is demonstrated by low-quality professional performance and represents the current reality of the country because of the common lack of respect and consideration for patients. Victims often remark on their loss of identity, as their social functions have been interrupted and they do not expect to regain such. It was found, however, little assumption of error in the involved doctors’ discourses and attitudes, which felt a need to judge the medical conduct in an attempt to assert their rights. Medical error in Brazil presents a punitive character and is little discussed in medical and scientific circles. The stigma of medical error is closely connected to the value and cultural judgments of the country, making it difficult to accept, both by victims and professionals. PMID:27403461

  7. Being a Victim of Medical Error in Brazil: An (Un)Real Dilemma.

    PubMed

    Mendonça, Vitor Silva; Custódio, Eda Marconi

    2016-06-23

    Medical error stems from inadequate professional conduct that is capable of producing harm to life or exacerbating the health of another, whether through act or omission. This situation has become increasingly common in Brazil and worldwide. In this study, the aim was to understand what being the victim of medical error is like and to investigate the circumstances imposed on this condition of victims in Brazil. A semi-structured interview was conducted with twelve people who had gone through situations of medical error in their lives, creating a space for narratives of their experiences and deep reflection on the phenomenon. The concept of medical error has a negative connotation, often being associated with the incompetence of a medical professional. Medical error in Brazil is demonstrated by low-quality professional performance and represents the current reality of the country because of the common lack of respect and consideration for patients. Victims often remark on their loss of identity, as their social functions have been interrupted and they do not expect to regain such. It was found, however, little assumption of error in the involved doctors' discourses and attitudes, which felt a need to judge the medical conduct in an attempt to assert their rights. Medical error in Brazil presents a punitive character and is little discussed in medical and scientific circles. The stigma of medical error is closely connected to the value and cultural judgments of the country, making it difficult to accept, both by victims and professionals. PMID:27403461

  8. Toward a theoretical approach to medical error reporting system research and design.

    PubMed

    Karsh, Ben-Tzion; Escoto, Kamisha Hamilton; Beasley, John W; Holden, Richard J

    2006-05-01

    The release of the Institute of Medicine (Kohn et al., 2000) report "To Err is Human", brought attention to the problem of medical errors, which led to a concerted effort to study and design medical error reporting systems for the purpose of capturing and analyzing error data so that safety interventions could be designed. However, to make real gains in the efficacy of medical error or event reporting systems, it is necessary to begin developing a theory of reporting systems adoption and use and to understand how existing theories may play a role in explaining adoption and use. This paper presents the results of a 9-month study exploring the barriers and facilitators for the design of a statewide medical error reporting system and discusses how several existing theories of technology acceptance, adoption and implementation fit with many of the results. In addition we present an integrated theoretical model of medical error reporting system design and implementation. PMID:16182233

  9. [On the applied medicolegal significance of the notion of "medical error"].

    PubMed

    Iurasov, V V; Smakhtin, R E

    2014-01-01

    The current practice of expertise of the adequacy of organization of the provision of medical aid introduces a new aspect of the notion of "medical error" that is widely employed in medical profession, among lawyers, patients, and their relatives as well as in mass media. The universally accepted meaning of this notion has not thus far been proposed. The authors consider the medico-legal concept of "medical error" reconciling the contradictory opinions.

  10. Sleep Loss in Resident Physicians: The Cause of Medical Errors?

    PubMed Central

    Kramer, Milton

    2010-01-01

    This review begins with the history of the events starting with the death of Libby Zion that lead to the Bell Commission, that the studied her death and made recommendations for improvement that were codified into law in New York state as the 405 law that the ACGME essentially adopted in putting a cap on work hours and establishing the level of staff supervision that must be available to residents in clinical situations particularly the emergency room and acute care units. A summary is then provided of the findings of the laboratory effects of total sleep deprivation including acute total sleep loss and the consequent widespread physiologic alterations, and of the effects of selective and chronic sleep loss. Generally the sequence of responses to increasing sleep loss goes from mood changes to cognitive effects to performance deficits. In the laboratory situation, deficits resulting from sleep deprivation are clearly and definitively demonstrable. Sleep loss in the clinical situation is usually sleep deprivation superimposed on chronic sleep loss. An examination of questionnaire studies, the literature on reports of sleep loss, studies of the reduction of work hours on performance as well as observational and a few interventional studies have yielded contradictory and often equivocal results. The residents generally find they feel better working fewer hours but improvements in patient care are often not reported or do not occur. A change in the attitude of the resident toward his role and his patient has not been salutary. Decreasing sleep loss should have had a positive effect on patient care in reducing medical error, but this remains to be unequivocally demonstrated. PMID:21188260

  11. Frequency of medication errors in an emergency department of a large teaching hospital in southern Iran.

    PubMed

    Vazin, Afsaneh; Zamani, Zahra; Hatam, Nahid

    2014-01-01

    This study was conducted with the purpose of determining the frequency of medication errors (MEs) occurring in tertiary care emergency department (ED) of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5%) MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2%) and antimicrobial (23.6%) medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6%) and wrong time error (4.4%) were the most frequent administration errors. The less-experienced nurses (P=0.04), higher patient-to-nurse ratio (P=0.017), and the morning shifts (P=0.035) were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction of MEs in EDs. PMID:25525391

  12. Frequency of medication errors in an emergency department of a large teaching hospital in southern Iran

    PubMed Central

    Vazin, Afsaneh; Zamani, Zahra; Hatam, Nahid

    2014-01-01

    This study was conducted with the purpose of determining the frequency of medication errors (MEs) occurring in tertiary care emergency department (ED) of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5%) MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2%) and antimicrobial (23.6%) medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6%) and wrong time error (4.4%) were the most frequent administration errors. The less-experienced nurses (P=0.04), higher patient-to-nurse ratio (P=0.017), and the morning shifts (P=0.035) were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction of MEs in EDs. PMID:25525391

  13. Further characterization of the influence of crowding on medication errors

    PubMed Central

    Watts, Hannah; Nasim, Muhammad Umer; Sweis, Rolla; Sikka, Rishi; Kulstad, Erik

    2013-01-01

    Study Objectives: Our prior analysis suggested that error frequency increases disproportionately with Emergency department (ED) crowding. To further characterize, we measured this association while controlling for the number of charts reviewed and the presence of ambulance diversion status. We hypothesized that errors would occur significantly more frequently as crowding increased, even after controlling for higher patient volumes. Materials and Methods: We performed a prospective, observational study in a large, community hospital ED from May to October of 2009. Our ED has full-time pharmacists who review orders of patients to help identify errors prior to their causing harm. Research volunteers shadowed our ED pharmacists over discrete 4- hour time periods during their reviews of orders on patients in the ED. The total numbers of charts reviewed and errors identified were documented along with details for each error type, severity, and category. We then measured the correlation between error rate (number of errors divided by total number of charts reviewed) and ED occupancy rate while controlling for diversion status during the observational period. We estimated a sample size requirement of at least 45 errors identified to allow detection of an effect size of 0.6 based on our historical data. Results: During 324 hours of surveillance, 1171 charts were reviewed and 87 errors were identified. Median error rate per 4-hour block was 5.8% of charts reviewed (IQR 0-13). No significant change was seen with ED occupancy rate (Spearman's rho = –.08, P = .49). Median error rate during times on ambulance diversion was almost twice as large (11%, IQR 0-17), but this rate did not reach statistical significance in univariate or multivariate analysis. Conclusions: Error frequency appears to remain relatively constant across the range of crowding in our ED when controlling for patient volume via the quantity of orders reviewed. Error quantity therefore increases with crowding

  14. Data Sharing & Publishing at Nature Publishing Group

    NASA Astrophysics Data System (ADS)

    VanDecar, J. C.; Hrynaszkiewicz, I.; Hufton, A. L.

    2015-12-01

    In recent years, the research community has come to recognize that upon-request data sharing has important limitations1,2. The Nature-titled journals feel that researchers have a duty to share data without undue qualifications, in a manner that allows others to replicate and build upon their published findings. Historically, the Nature journals have been strong supporters of data deposition in communities with existing data mandates, and have required data sharing upon request in all other cases. To help address some of the limitations of upon-request data sharing, the Nature titles have strengthened their existing data policies and forged a new partnership with Scientific Data, to promote wider data sharing in discoverable, citeable and reusable forms, and to ensure that scientists get appropriate credit for sharing3. Scientific Data is a new peer-reviewed journal for descriptions of research datasets, which works with a wide of range of public data repositories4. Articles at Scientific Data may either expand on research publications at other journals or may be used to publish new datasets. The Nature Publishing Group has also signed the Joint Declaration of Data Citation Principles5, and Scientific Data is our first journal to include formal data citations. We are currently in the process of adding data citation support to our various journals. 1 Wicherts, J. M., Borsboom, D., Kats, J. & Molenaar, D. The poor availability of psychological research data for reanalysis. Am. Psychol. 61, 726-728, doi:10.1037/0003-066x.61.7.726 (2006). 2 Vines, T. H. et al. Mandated data archiving greatly improves access to research data. FASEB J. 27, 1304-1308, doi:10.1096/fj.12-218164 (2013). 3 Data-access practices strengthened. Nature 515, 312, doi:10.1038/515312a (2014). 4 More bang for your byte. Sci. Data 1, 140010, doi:10.1038/sdata.2014.10 (2014). 5 Data Citation Synthesis Group: Joint Declaration of Data Citation Principles. (FORCE11, San Diego, CA, 2014).

  15. Disclosure of harmful medical errors in out-of-hospital care.

    PubMed

    Lu, Dave W; Guenther, Elisabeth; Wesley, Allen K; Gallagher, Thomas H

    2013-02-01

    Safety experts and national guidelines recommend disclosing harmful medical errors to patients. Communicating with patients and families about errors respects their autonomy, supports informed decisionmaking, may decrease malpractice costs, and can enhance patient safety. Yet existing disclosure guidelines may not account for the difficulty in discussing out-of-hospital errors with patients. Emergency medical services (EMS) providers operate in unpredictable environments that require rapid interventions for patients with whom they have only brief relationships. EMS providers also have limited access to patient medical data and risk management resources, which can make conducting disclosure conversations even more difficult. In addition, out-of-hospital errors may be discovered only after the transition of care to the inpatient setting, further complicating the question of who should disclose the error. EMS organizations should support the disclosure of out-of-hospital errors by fostering a nonpunitive culture of error reporting and disclosure, as well as developing guidelines for use by EMS systems.

  16. "You Never Forget Your First Mistake": Nursing Socialization, Memorable Messages, and Communication About Medical Errors.

    PubMed

    Noland, Carey M; Carmack, Heather J

    2015-01-01

    As nurses' communication is essential to prevent, intercept, and resolve medical mistakes, it is important to understand how they learn to communicate about medical errors. In this study, we identify memorable messages about communicating about mistakes that nursing students receive during their training and how they make sense of these messages. Data were acquired through individual interviews with 68 nursing students. The data were analyzed using a thematic constant comparative method. While open and honest communication about medical errors was the overarching message participants formally and informally learned, for nursing students, communicating about medical errors is a much more complex process than using open and honest communication. When dealing with medical errors, nursing students relied on three major memorable messages to guide their communication: (a) Not everyone hears about errors, (b) hierarchy matters, and

  17. Medication administration errors for older people in long-term residential care

    PubMed Central

    2011-01-01

    Background Older people in long-term residential care are at increased risk of medication prescribing and administration errors. The main aim of this study was to measure the incidence of medication administration errors in nursing and residential homes using a barcode medication administration (BCMA) system. Methods A prospective study was conducted in 13 care homes (9 residential and 4 nursing). Data on all medication administrations for a cohort of 345 older residents were recorded in real-time using a disguised observation technique. Every attempt by social care and nursing staff to administer medication over a 3-month observation period was analysed using BCMA records to determine the incidence and types of potential medication administration errors (MAEs) and whether errors were averted. Error classifications included attempts to administer medication at the wrong time, to the wrong person or discontinued medication. Further analysis compared data for residential and nursing homes. In addition, staff were surveyed prior to BCMA system implementation to assess their awareness of administration errors. Results A total of 188,249 medication administration attempts were analysed using BCMA data. Typically each resident was receiving nine different drugs and was exposed to 206 medication administration episodes every month. During the observation period, 2,289 potential MAEs were recorded for the 345 residents; 90% of residents were exposed to at least one error. The most common (n = 1,021, 45% of errors) was attempting to give medication at the wrong time. Over the 3-month observation period, half (52%) of residents were exposed to a serious error such as attempting to give medication to the wrong resident. Error incidence rates were 1.43 as high (95% CI 1.32-1.56 p < 0.001) in nursing homes as in residential homes. The level of non-compliance with system alerts was very low in both settings (0.075% of administrations). The pre-study survey revealed that only 12

  18. The approach of Bayesian model indicates media awareness of medical errors

    NASA Astrophysics Data System (ADS)

    Ravichandran, K.; Arulchelvan, S.

    2016-06-01

    This research study brings out the factors behind the increase in medical malpractices in the Indian subcontinent in the present day environment and impacts of television media awareness towards it. Increased media reporting of medical malpractices and errors lead to hospitals taking corrective action and improve the quality of medical services that they provide. The model of Cultivation Theory can be used to measure the influence of media in creating awareness of medical errors. The patient's perceptions of various errors rendered by the medical industry from different parts of India were taken up for this study. Bayesian method was used for data analysis and it gives absolute values to indicate satisfaction of the recommended values. To find out the impact of maintaining medical records of a family online by the family doctor in reducing medical malpractices which creates the importance of service quality in medical industry through the ICT.

  19. Voluntary Medical Incident Reporting Tool to Improve Physician Reporting of Medical Errors in an Emergency Department

    PubMed Central

    Okafor, Nnaemeka G.; Doshi, Pratik B.; Miller, Sara K.; McCarthy, James J.; Hoot, Nathan R.; Darger, Bryan F.; Benitez, Roberto C.; Chathampally, Yashwant G.

    2015-01-01

    Introduction Medical errors are frequently under-reported, yet their appropriate analysis, coupled with remediation, is essential for continuous quality improvement. The emergency department (ED) is recognized as a complex and chaotic environment prone to errors. In this paper, we describe the design and implementation of a web-based ED-specific incident reporting system using an iterative process. Methods A web-based, password-protected tool was developed by members of a quality assurance committee for ED providers to report incidents that they believe could impact patient safety. Results The utilization of this system in one residency program with two academic sites resulted in an increase from 81 reported incidents in 2009, the first year of use, to 561 reported incidents in 2012. This is an increase in rate of reported events from 0.07% of all ED visits to 0.44% of all ED visits. In 2012, faculty reported 60% of all incidents, while residents and midlevel providers reported 24% and 16% respectively. The most commonly reported incidents were delays in care and management concerns. Conclusion Error reporting frequency can be dramatically improved by using a web-based, user-friendly, voluntary, and non-punitive reporting system. PMID:26759657

  20. Obligation towards medical errors disclosure at a tertiary care hospital in Dubai, UAE

    PubMed Central

    Zaghloul, Ashraf Ahmad; Rahman, Syed Azizur; Abou El-Enein, Nagwa Younes

    2016-01-01

    OBJECTIVE: The study aimed to identify healthcare providers’ obligation towards medical errors disclosure as well as to study the association between the severity of the medical error and the intention to disclose the error to the patients and their families. DESIGN: A cross-sectional study design was followed to identify the magnitude of disclosure among healthcare providers in different departments at a randomly selected tertiary care hospital in Dubai. SETTING AND PARTICIPANTS: The total sample size accounted for 106 respondents. Data were collected using a questionnaire composed of two sections namely; demographic variables of the respondents and a section which included variables relevant to medical error disclosure. RESULTS: Statistical analysis yielded significant association between the obligation to disclose medical errors with male healthcare providers (X2 = 5.1), and being a physician (X2 = 19.3). Obligation towards medical errors disclosure was significantly associated with those healthcare providers who had not committed any medical errors during the past year (X2 = 9.8), and any type of medical error regardless the cause, extent of harm (X2 = 8.7). Variables included in the binary logistic regression model were; status (Exp β (Physician) = 0.39, 95% CI 0.16–0.97), gender (Exp β (Male) = 4.81, 95% CI 1.84–12.54), and medical errors during the last year (Exp β (None) = 2.11, 95% CI 0.6–2.3). CONCLUSION: Education and training of physicians about disclosure conversations needs to start as early as medical school. Like the training in other competencies required of physicians, education in communicating about medical errors could help reduce physicians’ apprehension and make them more comfortable with disclosure conversations. PMID:27567766

  1. Data sharing in the Undiagnosed Diseases Network

    PubMed Central

    Brownstein, Catherine A.; Holm, Ingrid A.; Ramoni, Rachel; Goldstein, David B.

    2015-01-01

    The Undiagnosed Diseases Network (UDN), builds on the successes of the Undiagnosed Diseases Program at the National Institutes of Health (NIH UDP). Through support from the NIH Common Fund, a coordinating center, six additional clinical sites, and two sequencing cores comprise the UDN. The objectives of the UDN are to: (1) improve the level of diagnosis and care for patients with undiagnosed diseases through the development of common protocols designed by an enlarged community of investigators across the Network; (2) facilitate research into the etiology of undiagnosed diseases, by collecting and sharing standardized, high-quality clinical and laboratory data including genotyping, phenotyping, and environmental exposure data; and (3) create an integrated and collaborative research community across multiple clinical sites, and among laboratory and clinical investigators, to investigate the pathophysiology of these rare diseases and to identify options for patient management. Broad-based data sharing is at the core of achieving these objectives, and the UDN is establishing the policies and governance structure to support broad data sharing. PMID:26220576

  2. Reduced error signalling in medication-naive children with ADHD: associations with behavioural variability and post-error adaptations

    PubMed Central

    Plessen, Kerstin J.; Allen, Elena A.; Eichele, Heike; van Wageningen, Heidi; Høvik, Marie Farstad; Sørensen, Lin; Worren, Marius Kalsås; Hugdahl, Kenneth; Eichele, Tom

    2016-01-01

    Background We examined the blood-oxygen level–dependent (BOLD) activation in brain regions that signal errors and their association with intraindividual behavioural variability and adaptation to errors in children with attention-deficit/hyperactivity disorder (ADHD). Methods We acquired functional MRI data during a Flanker task in medication-naive children with ADHD and healthy controls aged 8–12 years and analyzed the data using independent component analysis. For components corresponding to performance monitoring networks, we compared activations across groups and conditions and correlated them with reaction times (RT). Additionally, we analyzed post-error adaptations in behaviour and motor component activations. Results We included 25 children with ADHD and 29 controls in our analysis. Children with ADHD displayed reduced activation to errors in cingulo-opercular regions and higher RT variability, but no differences of interference control. Larger BOLD amplitude to error trials significantly predicted reduced RT variability across all participants. Neither group showed evidence of post-error response slowing; however, post-error adaptation in motor networks was significantly reduced in children with ADHD. This adaptation was inversely related to activation of the right-lateralized ventral attention network (VAN) on error trials and to task-driven connectivity between the cingulo-opercular system and the VAN. Limitations Our study was limited by the modest sample size and imperfect matching across groups. Conclusion Our findings show a deficit in cingulo-opercular activation in children with ADHD that could relate to reduced signalling for errors. Moreover, the reduced orienting of the VAN signal may mediate deficient post-error motor adaptions. Pinpointing general performance monitoring problems to specific brain regions and operations in error processing may help to guide the targets of future treatments for ADHD. PMID:26441332

  3. [The alliance of the parent, child and the nurse to challenge medical error].

    PubMed

    Davous, D; Seigneur, E; Auvrignon, A; Kerjosse, B; Asselain, B; Brugières, L; Cerny, C; Corroyez, F; Desdouits, F; Heard, M; Souyri, V; Vialle, G; Velter, N; Bourdeaut, F

    2010-12-01

    A group composed of parents, nurses, and physicians involved in pediatric cancerology has reflected on medical errors within the Espace Éthique de l'Assistance publique-Hôpitaux de Paris. Based on narratives and qualitative analysis of histories and testimonies, this discussion aimed at exploring the causes, circumstances, and impacts of medical errors on the relations between these individuals. The study demonstrated that some circumstances actually promote medical errors, such as hard working conditions, mistrust, unreliable control procedures, not listening to parents, and caring for children in extreme situations of pain and suffering. Errors almost always result from the accumulation of several shortcomings. The tensions raised by a medical error can be overcome, provided that parents and caregivers trust each other from the onset of disease and that the medical errors are disclosed in a sincere way, whatever the medical consequences. The feelings raised by the painful experience of a medical error do not solely depend on the severity of the consequences, since seemingly benign errors may lead to long-term trauma, whereas severe errors, even those leading to death, do not necessarily breach trust. The keyword here is permanent vigilance. The capacity of caregivers to question their practice, from both a technical and ethical point of view, will determine their ability to learn from an error for the future. The depth and quality of this questioning, in the best of times encouraged by the institution, may also help children affected by a medical error and their family to move forward in their personal history, beyond such painful experiences.

  4. Medication Errors Among Geriatrics at the Outpatient Pharmacy in a Teaching Hospital in Kelantan

    PubMed Central

    Abdullah, Dellemin Che; Ibrahim, Noor Shufiza; Ibrahim, Mohamed Izham Mohamed

    2004-01-01

    The main aim of this study was to determine the medication errors among geriatrics at the outpatient pharmacy in a teaching hospital in Kelantan and the strategies to minimize the prevalence. A retrospective study was conducted that involved screening of prescription for a one-month period (March 2001). Only 15.35% (1601 prescription) of a total 10,429 prescriptions were for geriatrics. The prescriptions that were found to have medication errors was 403. Therefore, the prevalence of medication errors per day was approximately 20 cases. Generally, the errors between both genders were found to be comparable and to be the highest for Malays and at the age of 60–64 years old. Administrative errors was recorded to be the highest which included patient’s particulars and validity of the prescriptions (70.22%) and drugs that available in HUSM (16.13%). Whereas the total of prescribing errors were low. Under prescribing errors were pharmaceutical error (0.99%) and clinical error (8.68%). Sixteen cases or 3.98% had more than 1 error. The highest prevalence went to geriatrics who received more than nine drugs (32.16%), geriatrics with more than 3 clinical diagnosis (10.06%), geriatrics who visited specialist clinics (37.52%) and treated by the specialists (31.07%). The estimated cost for the 403 medication errors in March was RM9,327 or RM301 per day that included the cost of drugs and humanistic cost. The projected cost of medication errors per year was RM 111,924. In conclusion, it is very clear that the role of pharmacist is very great in preventing and minimizing the medication errors beside the needs of correct prescription writing and other strategies by all of the heath care components. PMID:22973127

  5. Understanding the Nature of Medication Errors in an ICU with a Computerized Physician Order Entry System

    PubMed Central

    Cho, Insook; Park, Hyeok; Choi, Youn Jeong; Hwang, Mi Heui; Bates, David W.

    2014-01-01

    Objectives We investigated incidence rates to understand the nature of medication errors potentially introduced by utilizing a computerized physician order entry (CPOE) system in the three clinical phases of the medication process: prescription, administration, and documentation. Methods Overt observations and chart reviews were employed at two surgical intensive care units of a 950-bed tertiary teaching hospital. Ten categories of high-risk drugs prescribed over a four-month period were noted and reviewed. Error definition and classifications were adapted from previous studies for use in the present research. Incidences of medication errors in the three phases of the medication process were analyzed. In addition, nurses' responses to prescription errors were also assessed. Results Of the 534 prescriptions issued, 286 (53.6%) included at least one error. The proportion of errors was 19.0% (58) of the 306 drug administrations, of which two-thirds were verbal orders classified as errors due to incorrectly entered prescriptions. Documentation errors occurred in 205 (82.7%) of 248 correctly performed administrations. When tracking incorrectly entered prescriptions, 93% of the errors were intercepted by nurses, but two-thirds of them were recorded as prescribed rather than administered. Conclusion The number of errors occurring at each phase of the medication process was relatively high, despite long experience with a CPOE system. The main causes of administration errors and documentation errors were prescription errors and verbal order processes. To reduce these errors, hospital-level and unit-level efforts toward a better system are needed. PMID:25526059

  6. Nursing student medication errors: a snapshot view from a school of nursing's quality and safety officer.

    PubMed

    Cooper, Elizabeth

    2014-03-01

    Medication errors are one of the most common types of errors in the health care arena. For more than a decade, health care providers have been challenged to improve patient safety outcomes, including medication administration issues. Nurse educators are challenged to provide didactic content and clinical experiences that will ensure students gain the knowledge necessary to administer medications in a safe manner. The aim of this article is to discuss nursing student medication errors identified at a university school of nursing, looking to categorize the errors into three areas: administration rights, system issues, and knowledge and understanding. Introducing nursing students to a reporting system early in their educational process can lead to increased transparency in error reporting and increased patient safety.

  7. The $17.1 billion problem: the annual cost of measurable medical errors.

    PubMed

    Van Den Bos, Jill; Rustagi, Karan; Gray, Travis; Halford, Michael; Ziemkiewicz, Eva; Shreve, Jonathan

    2011-04-01

    At a minimum, high-quality health care is care that does not harm patients, particularly through medical errors. The first step in reducing the large number of harmful medical errors that occur today is to analyze them. We used an actuarial approach to measure the frequency and costs of measurable US medical errors, identified through medical claims data. This method focuses on the analysis of comparative rates of illness, using mathematical models to assess the risk of occurrence and to project costs to the total population. We estimate that the annual cost of measurable medical errors that harm patients was $17.1 billion in 2008. Pressure ulcers were the most common measurable medical error, followed by postoperative infections and by postlaminectomy syndrome, a condition characterized by persistent pain following back surgery. A total of ten types of errors account for more than two-thirds of the total cost of errors, and these errors should be the first targets of prevention efforts.

  8. Medication prescribing errors and associated factors at the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia

    PubMed Central

    2014-01-01

    Background Medication error is common and preventable cause of medical errors and occurs as a result of either human error or a system flaw. The consequences of such errors are more harmful and frequent among pediatric patients. Objective To assess medication prescribing errors and associated factors in the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia. Methods A cross-sectional study was carried out in the pediatric wards of Dessie Referral Hospital from February 17 to March 17, 2012. Data on the prescribed drugs were collected from patient charts and prescription papers among all patients who were admitted during the study period. Descriptive statistics was used to determine frequency, prevalence, means, and standard deviations. The relationship between dependent and independent variables were computed using logistic regression (with significance declared at p-value of 0.05 and 95% confidence interval). Results Out of the 384 Medication order s identified during the study, a total of 223 prescribing errors were identified. This corresponds to an overall medication prescribing error rate of 58.07%. Incomplete prescriptions and dosing errors were the two most common types of prescribing errors. Antibiotics (54.26%) were the most common classes of drugs subjected to prescribing error. Day of the week and route of administration were factors significantly associated with increased prescribing error. Conclusions Medication prescribing errors are common in the pediatric wards of Dessie Referral Hospital. Improving quick access to up to date reference materials, providing regular refresher trainings and possibly including a clinical pharmacist in the healthcare team are recommended. PMID:24826198

  9. Database Maintenance, Data Sharing Policy, Collaboration

    SciTech Connect

    Papale, D.; Agarwal, D. A; Baldocchi, D. D.; Cook, Robert B; Fisher, J. B.; van Ingen, C.

    2012-01-01

    Scientific questions of today are now more global than ever before. The answers to these questions are buried within multiple disciplines and across a diverse range of scientists and institutions. The expanse and complexity of data required by researchers often exceed the means of a single scientist. Data sharing in the form of its distributed collection and analysis is increasingly common. Collective research now takes place in what may be called 'collaboratories' or in 'centers without walls' (Clery 2006). Creating effective artifacts, which enable scientists to collaborate on data analyses, continues to be a significant challenge for today's science activities. It is rare that providing a file system abstraction on distributed data enables acceleration of scientific discoveries. By explicitly identifying and addressing the different requirements for data contributors, data curators, and data consumers, we can create a data management architecture which enables the creation of datasets that evolve over time with growing and changing data, data annotations, participants, and use rules. This involves also a crucial contribution by the teams and people collecting the data, that in addition to carefully acquire and process the measurements and to be ready to share their measurements within the scientific community, need to follow general rules that help to make their data well documented and safely stored and to maximize visibility to their works and sites. In this chapter, we provide examples of the types of functions and capabilities typically provided within the data management systems, focusing in particular on databases structures and characteristics, data practices, and data user services. Finally, the importance and advantages of collective efforts like data sharing for synthesis activities and the relative data policy options are discussed and analyzed.

  10. Disclosure of "nonharmful" medical errors and other events: duty to disclose.

    PubMed

    Chamberlain, Catherine J; Koniaris, Leonidas G; Wu, Albert W; Pawlik, Timothy M

    2012-03-01

    An estimated 98 000 patients die in the United States each year because of medical errors. One million or more total medical errors are estimated to occur annually, which is far greater than the actual number of reported "harmful" mistakes. Although it is generally agreed that harmful errors must be disclosed to patients, when the error is deemed to have not resulted in a harmful event, physicians are less inclined to disclose it. Little has been written about the handling of near misses or "nonharmful" errors, and the issues related to disclosure of such events have rarely been discussed in medicine, although they are routinely addressed within the aviation industry. Herein, we elucidate the arguments for reporting nonharmful medical errors to patients and to reporting systems. A definition of what constitutes harm is explored, as well as the ethical issues underpinning disclosure of nonharmful errors. In addition, systematic institutional implications of reporting nonharmful errors are highlighted. Full disclosure of nonharmful errors is advocated, and recommendations on how to discuss errors with patients are provided. An argument that full error disclosure may improve future patient care is also outlined.

  11. Eleven-year descriptive analysis of closed court verdicts on medical errors in Spain and Massachusetts

    PubMed Central

    Giraldo, Priscila; Sato, Luke; Martínez-Sánchez, Jose M; Comas, Mercè; Dwyer, Kathy; Sala, Maria; Castells, Xavier

    2016-01-01

    Objectives To evaluate and compare the characteristics of court verdicts on medical errors allegedly harming patients in Spain and Massachusetts from 2002 to 2012. Design, setting and participants We reviewed 1041 closed court verdicts obtained from data on litigation in the Thomson Reuters Aranzadi Westlaw databases in Spain (Europe), and 370 closed court verdicts obtained from the Controlled Risk and Risk Management Foundation of Harvard Medical Institutions (CRICO/RMF) in Massachusetts (USA). We included closed court verdicts on medical errors. The definition of medical errors was based on that of the Institute of Medicine (USA). We excluded any agreements between parties before a judgement. Results Medical errors were involved in 25.9% of court verdicts in Spain and in 74% of those in Massachusetts. The most frequent cause of medical errors was a diagnosis-related problem (25.1%; 95% CI 20.7% to 31.1% in Spain; 35%; 95% CI 29.4% to 40.7% in Massachusetts). The proportion of medical errors classified as high severity was 34% higher in Spain than in Massachusetts (p=0.001). The most frequent factors contributing to medical errors in Spain were surgical and medical treatment (p=0.001). In Spain, 98.5% of medical errors resulted in compensation awards compared with only 6.9% in Massachusetts. Conclusions This study reveals wide differences in litigation rates and the award of indemnity payments in Spain and Massachusetts; however, common features of both locations are the high rates of diagnosis-related problems and the long time interval until resolution. PMID:27577585

  12. Patient disclosure of medical errors in paediatrics: A systematic literature review.

    PubMed

    Koller, Donna; Rummens, Anneke; Le Pouesard, Morgane; Espin, Sherry; Friedman, Jeremy; Coffey, Maitreya; Kenneally, Noah

    2016-05-01

    Medical errors are common within paediatrics; however, little research has examined the process of disclosing medical errors in paediatric settings. The present systematic review of current research and policy initiatives examined evidence regarding the disclosure of medical errors involving paediatric patients. Peer-reviewed research from a range of scientific journals from the past 10 years is presented, and an overview of Canadian and international policies regarding disclosure in paediatric settings are provided. The purpose of the present review was to scope the existing literature and policy, and to synthesize findings into an integrated and accessible report. Future research priorities and policy implications are then identified.

  13. The effectiveness of risk management program on pediatric nurses’ medication error

    PubMed Central

    Dehghan-Nayeri, Nahid; Bayat, Fariba; Salehi, Tahmineh; Faghihzadeh, Soghrat

    2013-01-01

    Background: Medication therapy is one of the most complex and high-risk clinical processes that nurses deal with. Medication error is the most common type of error that brings about damage and death to patients, especially pediatric ones. However, these errors are preventable. Identifying and preventing undesirable events leading to medication errors are the main risk management activities. The aim of this study was to investigate the effectiveness of a risk management program on the pediatric nurses’ medication error rate. Materials and Methods: This study is a quasi-experimental one with a comparison group. In this study, 200 nurses were recruited from two main pediatric hospitals in Tehran. In the experimental hospital, we applied the risk management program for a period of 6 months. Nurses of the control hospital did the hospital routine schedule. A pre- and post-test was performed to measure the frequency of the medication error events. SPSS software, t-test, and regression analysis were used for data analysis. Results: After the intervention, the medication error rate of nurses at the experimental hospital was significantly lower (P < 0.001) and the error-reporting rate was higher (P < 0.007) compared to before the intervention and also in comparison to the nurses of the control hospital. Conclusions: Based on the results of this study and taking into account the high-risk nature of the medical environment, applying the quality-control programs such as risk management can effectively prevent the occurrence of the hospital undesirable events. Nursing mangers can reduce the medication error rate by applying risk management programs. However, this program cannot succeed without nurses’ cooperation. PMID:24403939

  14. Justifying a pediatric critical-care satellite pharmacy by medication-error reporting.

    PubMed

    Tisdale, J E

    1986-02-01

    As a part of an evaluation of the need for a satellite pharmacy to serve two pediatric critical-care units, an observational study was conducted to determine the incidence of medication errors in the units. A pharmacist observed nurses preparing and administering medications in 18 12-hour shifts. Of the nine shifts observed in each unit, five were day shifts and four were night shifts. Five nurses were observed per shift in the intensive-care nursery (ICN) and three nurses per shift in the pediatric intensive-care unit (PICU). The classification of errors was based on the definitions established by the American Society of Hospital Pharmacists. The total error rate was 17.4% in the ICN and 38.0% in the PICU. When the error rates were calculated excluding wrong-time errors, they were 7.1% in the ICN and 11.7% in the PICU. Of 147 errors, 124 (84.4%) occurred with medications with a high potential for serious consequences. The error rates were similar on the day and night shifts in the PICU (42.1% and 31.3%, respectively), but they were significantly higher on the day shifts than the night shifts in the ICN (24.5% and 8.4%, respectively). The number of medication errors in the two units was substantial, and steps were taken to implement a 24-hour pediatric critical-care satellite pharmacy with unit dose drug distribution to reduce the incidence of errors.

  15. Perspective of midwives working at hospitals affiliated to the Isfahan University of Medical Sciences regarding medical errors

    PubMed Central

    Valiani, Mahboubeh; Majidi, Jamileh; Beigi, Marjan

    2015-01-01

    Background: Committing an error is part of the human nature. No health care provider, despite the mastery of their skills, is immune from committing it. Medical error in the labor and obstetrics wards as well as other health units is inevitable and reduces the quality of health care, leading to accident. Sometimes these events, like the death of mother, fetus, and newborn, would be beyond repair. The purpose of this study was to investigate the perspective of gynecological ward providers about medical errors. Materials and Methods: This was a descriptive–analytical study. Sample size was 94 participants selected using census sampling. The study population included all midwives of four hospitals (Al-Zahra, Beheshti, Isa Ben Maryam, and Amin). Data were collected by a self-administered questionnaire and analyzed using SPSS software. Results: This study shows that three factors (human, structural, and managerial) have affected medical errors in the labor and obstetrics wards. From the midwifery perspective, human factors were the most important factors with an average score of 73.26% and the lowest score was related to structural factors with an average score of 65.36%. Intervention strategies to reduce errors, service training program tailored to the needs of the service provider, distribution of the tasks at different levels, and attempts to reform the system instead of punishing the wrongdoer were set in priority list. Conclusions: Based on the results of this study on the perspectives of participants, among the three factors of medical errors (human factors, structural factors, and management factors), human factors are the biggest threat in committing medical errors. Modification in the pattern of teaching by the midwifery professors and their presence in the hospitals, creating a no-blame culture, and sharing of alerts in medical errors are among appropriate actions in the dimensions of human, structural, and managerial factors. PMID:26457089

  16. Data Sharing in P2P Systems

    NASA Astrophysics Data System (ADS)

    Hayek, Rabab; Raschia, Guillaume; Valduriez, Patrick; Mouaddib, Noureddine

    In this chapter, we survey P2P data sharing systems. All along, we focus on the evolution from simple file-sharing systems, with limited functionalities, to Peer Data Management Systems (PDMS) that support advanced applications with more sophisticated data management techniques. Advanced P2P applications are dealing with semantically rich data (e.g., XML documents, relational tables), using a high-level SQL-like query language. We start our survey with an overview over the existing P2P network architectures, and the associated routing protocols. Then, we discuss data indexing techniques based on their distribution degree and the semantics they can capture from the underlying data. We also discuss schema management techniques which allow integrating heterogeneous data. We conclude by discussing the techniques proposed for processing complex queries (e.g., range and join queries). Complex query facilities are necessary for advanced applications which require a high level of search expressiveness. This last part shows the lack of querying techniques that allow for an approximate query answering.

  17. Social Media, Education and Data Sharing

    NASA Astrophysics Data System (ADS)

    King, T. A.; Walker, R. J.; Masters, A.

    2011-12-01

    Social media is a blending of technology and social interactions which allows for the creation and exchange of user-generated content. Social media started as conversations between groups of people, now companies are using social media to communicate with customers and politicians use it to communicate with their constituents. Social media is now finding uses in the science communities. This adoption is driven by the expectation of students that technology will be an integral part of their research and that it will match the technology they use in their social lifes. Students are using social media to keep informed and collaborate with others. They have also replaced notepads with smart mobile devices. We have been introducing social media components into Virtual Observatories as a way to quickly access and exchange information with a tap or a click. We discuss the use of Quick Response (QR) codes, Digital Object Identifiers (DOIs), unique identifiers, Twitter, Facebook and tiny URL redirects as ways to enable easier sharing of data and information. We also discuss what services and features are needed in a Virtual Observatory to make data sharing with social media possible.

  18. Reducing Medical Errors in Primary Care Using a Pragmatic Complex Intervention.

    PubMed

    Khoo, Ee Ming; Sararaks, Sondi; Lee, Wai Khew; Liew, Su May; Cheong, Ai Theng; Abdul Samad, Azah; Maskon, Kalsom; Hamid, Maimunah A

    2015-09-01

    This study aimed to develop an intervention to reduce medical errors and to determine if the intervention can reduce medical errors in public funded primary care clinics. A controlled interventional trial was conducted in 12 conveniently selected primary care clinics. Random samples of outpatient medical records were selected and reviewed by family physicians for documentation, diagnostic, and management errors at baseline and 3 months post intervention. The intervention package comprised educational training, structured process change, review methods, and patient education. A significant reduction was found in overall documentation error rates between intervention (Pre 98.3% [CI 97.1-99.6]; Post 76.1% [CI 68.1-84.1]) and control groups (Pre 97.4% [CI 95.1-99.8]; Post 89.5% [85.3-93.6]). Within the intervention group, overall management errors reduced from 54.0% (CI 49.9-58.0) to 36.6% (CI 30.2-43.1) and medication error from 43.2% (CI 39.2-47.1) to 25.2% (CI 19.9-30.5). This low-cost intervention was useful to reduce medical errors in resource-constrained settings.

  19. Description of medication errors detected at a drug information centre in Southern Brazil

    PubMed Central

    Dos Santos, Luciana; Winkler, Natália; Dos Santos, Marlise A.; Martinbiancho, Jacqueline K.

    2014-01-01

    Objective: To identify and describe actual or potential medication errors related to drug information inquiries made by staff members of a teaching hospital to a Drug Information Centre from January 2012 to December 2013. Methods: Data were collected from the records of inquiries made by health care professionals to the Drug Information Centre throughout this period. Results: During the study period, the Drug Information Centre received 3,500 inquiries. Of these, 114 inquiries had medication errors. Most errors were related to prescribing, preparation, and administration and were classified according to severity as category B (57%) (potential errors) and categories C (26.3%) and D (15.8%) (actual errors that did not result in harm to the patient). Error causes included overdose (13.2%), wrong route of administration (11.4%), inadequate drug storage (11.4%), and wrong dosage form (8.8%). The drugs most frequently involved in errors were vitamin K (4.4%), vancomycin (3.5%), and meropenem (3.5%). Conclusion: In this study, it was not possible to measure the reduction in error rate involving medication use because of the lack of previous data on this process in the institution. However, our findings indicate that the Drug Information Centre may be used as a strategy to seek improvements in processes involving medication use. PMID:25883691

  20. Indication Alerts Intercept Drug Name Confusion Errors during Computerized Entry of Medication Orders

    PubMed Central

    Galanter, William L.; Bryson, Michelle L.; Falck, Suzanne; Rosenfield, Rachel; Laragh, Marci; Shrestha, Neeha; Schiff, Gordon D.; Lambert, Bruce L.

    2014-01-01

    Background Confusion between similar drug names is a common cause of potentially harmful medication errors. Interventions to prevent these errors at the point of prescribing have had limited success. The purpose of this study is to measure whether indication alerts at the time of computerized physician order entry (CPOE) can intercept drug name confusion errors. Methods and Findings A retrospective observational study of alerts provided to prescribers in a public, tertiary hospital and ambulatory practice with medication orders placed using CPOE. Consecutive patients seen from April 2006 through February 2012 were eligible if a clinician received an indication alert during ordering. A total of 54,499 unique patients were included. The computerized decision support system prompted prescribers to enter indications when certain medications were ordered without a coded indication in the electronic problem list. Alerts required prescribers either to ignore them by clicking OK, to place a problem in the problem list, or to cancel the order. Main outcome was the proportion of indication alerts resulting in the interception of drug name confusion errors. Error interception was determined using an algorithm to identify instances in which an alert triggered, the initial medication order was not completed, and the same prescriber ordered a similar-sounding medication on the same patient within 5 minutes. Similarity was defined using standard text similarity measures. Two clinicians performed chart review of all cases to determine whether the first, non-completed medication order had a documented or non-documented, plausible indication for use. If either reviewer found a plausible indication, the case was not considered an error. We analyzed 127,458 alerts and identified 176 intercepted drug name confusion errors, an interception rate of 0.14±.01%. Conclusions Indication alerts intercepted 1.4 drug name confusion errors per 1000 alerts. Institutions with CPOE should consider

  1. Clinical research data sharing: what an open science world means for researchers involved in evidence synthesis.

    PubMed

    Ross, Joseph S

    2016-09-20

    The International Committee of Medical Journal Editors (ICMJE) recently announced a bold step forward to require data generated by interventional clinical trials that are published in its member journals to be responsibly shared with external investigators. The movement toward a clinical research culture that supports data sharing has important implications for the design, conduct, and reporting of systematic reviews and meta-analyses. While data sharing is likely to enhance the science of evidence synthesis, facilitating the identification and inclusion of all relevant research, it will also pose key challenges, such as requiring broader search strategies and more thorough scrutiny of identified research. Furthermore, the adoption of data sharing initiatives by the clinical research community should challenge the community of researchers involved in evidence synthesis to follow suit, including the widespread adoption of systematic review registration, results reporting, and data sharing, to promote transparency and enhance the integrity of the research process.

  2. Clinical research data sharing: what an open science world means for researchers involved in evidence synthesis.

    PubMed

    Ross, Joseph S

    2016-01-01

    The International Committee of Medical Journal Editors (ICMJE) recently announced a bold step forward to require data generated by interventional clinical trials that are published in its member journals to be responsibly shared with external investigators. The movement toward a clinical research culture that supports data sharing has important implications for the design, conduct, and reporting of systematic reviews and meta-analyses. While data sharing is likely to enhance the science of evidence synthesis, facilitating the identification and inclusion of all relevant research, it will also pose key challenges, such as requiring broader search strategies and more thorough scrutiny of identified research. Furthermore, the adoption of data sharing initiatives by the clinical research community should challenge the community of researchers involved in evidence synthesis to follow suit, including the widespread adoption of systematic review registration, results reporting, and data sharing, to promote transparency and enhance the integrity of the research process. PMID:27649796

  3. A simple tool for neuroimaging data sharing.

    PubMed

    Haselgrove, Christian; Poline, Jean-Baptiste; Kennedy, David N

    2014-01-01

    Data sharing is becoming increasingly common, but despite encouragement and facilitation by funding agencies, journals, and some research efforts, most neuroimaging data acquired today is still not shared due to political, financial, social, and technical barriers to sharing data that remain. In particular, technical solutions are few for researchers that are not a part of larger efforts with dedicated sharing infrastructures, and social barriers such as the time commitment required to share can keep data from becoming publicly available. We present a system for sharing neuroimaging data, designed to be simple to use and to provide benefit to the data provider. The system consists of a server at the International Neuroinformatics Coordinating Facility (INCF) and user tools for uploading data to the server. The primary design principle for the user tools is ease of use: the user identifies a directory containing Digital Imaging and Communications in Medicine (DICOM) data, provides their INCF Portal authentication, and provides identifiers for the subject and imaging session. The user tool anonymizes the data and sends it to the server. The server then runs quality control routines on the data, and the data and the quality control reports are made public. The user retains control of the data and may change the sharing policy as they need. The result is that in a few minutes of the user's time, DICOM data can be anonymized and made publicly available, and an initial quality control assessment can be performed on the data. The system is currently functional, and user tools and access to the public image database are available at http://xnat.incf.org/. PMID:24904398

  4. A simple tool for neuroimaging data sharing

    PubMed Central

    Haselgrove, Christian; Poline, Jean-Baptiste; Kennedy, David N.

    2014-01-01

    Data sharing is becoming increasingly common, but despite encouragement and facilitation by funding agencies, journals, and some research efforts, most neuroimaging data acquired today is still not shared due to political, financial, social, and technical barriers to sharing data that remain. In particular, technical solutions are few for researchers that are not a part of larger efforts with dedicated sharing infrastructures, and social barriers such as the time commitment required to share can keep data from becoming publicly available. We present a system for sharing neuroimaging data, designed to be simple to use and to provide benefit to the data provider. The system consists of a server at the International Neuroinformatics Coordinating Facility (INCF) and user tools for uploading data to the server. The primary design principle for the user tools is ease of use: the user identifies a directory containing Digital Imaging and Communications in Medicine (DICOM) data, provides their INCF Portal authentication, and provides identifiers for the subject and imaging session. The user tool anonymizes the data and sends it to the server. The server then runs quality control routines on the data, and the data and the quality control reports are made public. The user retains control of the data and may change the sharing policy as they need. The result is that in a few minutes of the user’s time, DICOM data can be anonymized and made publicly available, and an initial quality control assessment can be performed on the data. The system is currently functional, and user tools and access to the public image database are available at http://xnat.incf.org/. PMID:24904398

  5. Nurses' perceptions of how physical environment affects medication errors in acute care settings.

    PubMed

    Mahmood, Atiya; Chaudhury, Habib; Valente, Maria

    2011-11-01

    The work that nurses perform in hospital environments is physically and psychologically intense, with the potential for burnout and stress. This issue is compounded by crowded and poorly designed work spaces in nursing units that can contribute to medical mistakes, including medication errors. This article is based on a study that examined the nurses' perception of how the physical environment in hospitals affects medication errors. Literature suggests that reduction of staff stress can be achieved through physical environmental considerations, such as improved air quality, acoustics, and lighting. However, there is no empirical study specifically exploring the relationship between aspects of the physical environment and medication errors. In this study, a cross-sectional survey was conducted with nursing staff (N = 84) in four hospitals in the Pacific Northwest region of the United States. The survey included questions on nursing unit design, medication room configurations, perceived incidence of errors, and adverse events. Respondents noted several physical environmental factors that are potentially problematic in the nursing station area and can lead to medication, documentation, and other types of nursing errors. These factors include inadequate space in charting and documentation area, lengthy walking distances to patient rooms, insufficient patient surveillance opportunity/lack of visibility to all parts of the nursing unit, small size of the medication room, inappropriate organization of medical supplies, high noise levels in nursing unit, poor lighting, and lack of privacy in the nursing stations. As administrators in acute care facilities consider strategies for organizational and staff interventions to reduce medication errors, it is important to consider physical environmental factors to have a comprehensive understanding of the issue.

  6. The effect of a safe zone on nurse interruptions, distractions, and medication administration errors.

    PubMed

    Yoder, Mindy; Schadewald, Diane; Dietrich, Kim

    2015-01-01

    Patient safety is a health care priority. Yet medical errors are ranked the eighth leading cause of death. Medication administration errors (MAEs) often result from multiple environmental and individual factors. This quality improvement initiative adapted a protocol based on airline industry safety measures to decrease nurse distractions and interruptions during medication administration, with the goal of decreasing MAEs. Sources of distractions, interruptions, and MAEs were measured pre and post intervention. Patient satisfaction scores were measured concurrently. Results of this initiative differ from previous studies in which similar interventions reduced both distractions and MAEs. An unexpected finding was dramatically increased patient satisfaction. PMID:25723837

  7. The alarming reality of medication error: a patient case and review of Pennsylvania and National data

    PubMed Central

    da Silva, Brianna A.; Krishnamurthy, Mahesh

    2016-01-01

    Case description A 71-year-old female accidentally received thiothixene (Navane), an antipsychotic, instead of her anti-hypertensive medication amlodipine (Norvasc) for 3 months. She sustained physical and psychological harm including ambulatory dysfunction, tremors, mood swings, and personality changes. Despite the many opportunities for intervention, multiple health care providers overlooked her symptoms. Discussion Errors occurred at multiple care levels, including prescribing, initial pharmacy dispensation, hospitalization, and subsequent outpatient follow-up. This exemplifies the Swiss Cheese Model of how errors can occur within a system. Adverse drug events (ADEs) account for more than 3.5 million physician office visits and 1 million emergency department visits each year. It is believed that preventable medication errors impact more than 7 million patients and cost almost $21 billion annually across all care settings. About 30% of hospitalized patients have at least one discrepancy on discharge medication reconciliation. Medication errors and ADEs are an underreported burden that adversely affects patients, providers, and the economy. Conclusion Medication reconciliation including an ‘indication review’ for each prescription is an important aspect of patient safety. The decreasing frequency of pill bottle reviews, suboptimal patient education, and poor communication between healthcare providers are factors that threaten patient safety. Medication error and ADEs cost billions of health care dollars and are detrimental to the provider–patient relationship. PMID:27609720

  8. [Prevention of medication errors in healthcare transition of patients treated with apomorphine].

    PubMed

    Ucha Sanmartin, M; Martín Vila, A; López Vidal, C; Caaamaño Barreiro, M; Piñeiro Corrales, G

    2014-05-01

    The transition of patients between different levels of care process is a particular risk in the production of medication errors. The aim of this paper is to analyze the role of the pharmacist in preventing errors transition care to ensure a safe and cross pharmacotherapy of patients.Transversal, observational and descriptive study in a University Hospital that has a pharmacy service that integrates specialized inpatient care and health centers. Transition of care a patient treated with Apormorfina was analyzed to determine the keypoints of action of the pharmacist. Demographics, disease and medication history, and care transition episodes were collected through the pharmacy program and electronics history.The pharmacist did tasks adapting, reconciliation, management and reporting of medication to the health care team to prevent medication errors in care transition of patients treated with drugs requiring special handling .In conclusion, this work represents perfectly the key role of the pharmacist as coordinator of safe and transverse pharmacotherapy of patients.

  9. Maths anxiety and medication dosage calculation errors: A scoping review.

    PubMed

    Williams, Brett; Davis, Samantha

    2016-09-01

    A student's accuracy on drug calculation tests may be influenced by maths anxiety, which can impede one's ability to understand and complete mathematic problems. It is important for healthcare students to overcome this barrier when calculating drug dosages in order to avoid administering the incorrect dose to a patient when in the clinical setting. The aim of this study was to examine the effects of maths anxiety on healthcare students' ability to accurately calculate drug dosages by performing a scoping review of the existing literature. This review utilised a six-stage methodology using the following databases; CINAHL, Embase, Medline, Scopus, PsycINFO, Google Scholar, Trip database (http://www.tripdatabase.com/) and Grey Literature report (http://www.greylit.org/). After an initial title/abstract review of relevant papers, and then full text review of the remaining papers, six articles were selected for inclusion in this study. Of the six articles included, there were three experimental studies, two quantitative studies and one mixed method study. All studies addressed nursing students and the presence of maths anxiety. No relevant studies from other disciplines were identified in the existing literature. Three studies took place in the U.S, the remainder in Canada, Australia and United Kingdom. Upon analysis of these studies, four factors including maths anxiety were identified as having an influence on a student's drug dosage calculation abilities. Ultimately, the results from this review suggest more research is required in nursing and other relevant healthcare disciplines regarding the effects of maths anxiety on drug dosage calculations. This additional knowledge will be important to further inform development of strategies to decrease the potentially serious effects of errors in drug dosage calculation to patient safety.

  10. Maths anxiety and medication dosage calculation errors: A scoping review.

    PubMed

    Williams, Brett; Davis, Samantha

    2016-09-01

    A student's accuracy on drug calculation tests may be influenced by maths anxiety, which can impede one's ability to understand and complete mathematic problems. It is important for healthcare students to overcome this barrier when calculating drug dosages in order to avoid administering the incorrect dose to a patient when in the clinical setting. The aim of this study was to examine the effects of maths anxiety on healthcare students' ability to accurately calculate drug dosages by performing a scoping review of the existing literature. This review utilised a six-stage methodology using the following databases; CINAHL, Embase, Medline, Scopus, PsycINFO, Google Scholar, Trip database (http://www.tripdatabase.com/) and Grey Literature report (http://www.greylit.org/). After an initial title/abstract review of relevant papers, and then full text review of the remaining papers, six articles were selected for inclusion in this study. Of the six articles included, there were three experimental studies, two quantitative studies and one mixed method study. All studies addressed nursing students and the presence of maths anxiety. No relevant studies from other disciplines were identified in the existing literature. Three studies took place in the U.S, the remainder in Canada, Australia and United Kingdom. Upon analysis of these studies, four factors including maths anxiety were identified as having an influence on a student's drug dosage calculation abilities. Ultimately, the results from this review suggest more research is required in nursing and other relevant healthcare disciplines regarding the effects of maths anxiety on drug dosage calculations. This additional knowledge will be important to further inform development of strategies to decrease the potentially serious effects of errors in drug dosage calculation to patient safety. PMID:27589091

  11. Designing an Algorithm to Preserve Privacy for Medical Record Linkage With Error-Prone Data

    PubMed Central

    Pal, Doyel; Chen, Tingting; Khethavath, Praveen

    2014-01-01

    Background Linking medical records across different medical service providers is important to the enhancement of health care quality and public health surveillance. In records linkage, protecting the patients’ privacy is a primary requirement. In real-world health care databases, records may well contain errors due to various reasons such as typos. Linking the error-prone data and preserving data privacy at the same time are very difficult. Existing privacy preserving solutions for this problem are only restricted to textual data. Objective To enable different medical service providers to link their error-prone data in a private way, our aim was to provide a holistic solution by designing and developing a medical record linkage system for medical service providers. Methods To initiate a record linkage, one provider selects one of its collaborators in the Connection Management Module, chooses some attributes of the database to be matched, and establishes the connection with the collaborator after the negotiation. In the Data Matching Module, for error-free data, our solution offered two different choices for cryptographic schemes. For error-prone numerical data, we proposed a newly designed privacy preserving linking algorithm named the Error-Tolerant Linking Algorithm, that allows the error-prone data to be correctly matched if the distance between the two records is below a threshold. Results We designed and developed a comprehensive and user-friendly software system that provides privacy preserving record linkage functions for medical service providers, which meets the regulation of Health Insurance Portability and Accountability Act. It does not require a third party and it is secure in that neither entity can learn the records in the other’s database. Moreover, our novel Error-Tolerant Linking Algorithm implemented in this software can work well with error-prone numerical data. We theoretically proved the correctness and security of our Error

  12. Medical error disclosure and patient safety: legal aspects.

    PubMed

    Guillod, Olivier

    2013-12-01

    Reducing the number of preventable adverse events has become a public health issue. The paper discusses in which ways the law can contribute to that goal, especially by encouraging a culture of safety among healthcare professionals. It assesses the need or the usefulness to pass so-called disclosure laws and apology laws, to adopt mandatory but strictly confidential Critical Incidents Reporting Systems in hospitals, to change the fault-based system of medical liability or to amend the rules on criminal liability. The paper eventually calls for adding the law to the present agenda of patient safety. Significance for public healthThe extent of preventable adverse events and the correlative need to improve patient safety are recognized today as a public health issue. In order to lower the toll associated with preventable adverse events, the former culture of professionalism (based on the premise that a good physician doesn't make mistakes) must be replaced by a culture of safety, which requires a multi-pronged approach that includes all the main stakeholders within the healthcare system. A number of legal reforms could help in prompting such a change. This contribution stresses the need to include legal aspects when trying to find appropriate responses to public health issues.

  13. Medical Error Disclosure and Patient Safety: Legal Aspects

    PubMed Central

    Guillod, Olivier

    2013-01-01

    Reducing the number of preventable adverse events has become a public health issue. The paper discusses in which ways the law can contribute to that goal, especially by encouraging a culture of safety among healthcare professionals. It assesses the need or the usefulness to pass so-called disclosure laws and apology laws, to adopt mandatory but strictly confidential Critical Incidents Reporting Systems in hospitals, to change the fault-based system of medical liability or to amend the rules on criminal liability. The paper eventually calls for adding the law to the present agenda of patient safety. Significance for public health The extent of preventable adverse events and the correlative need to improve patient safety are recognized today as a public health issue. In order to lower the toll associated with preventable adverse events, the former culture of professionalism (based on the premise that a good physician doesn’t make mistakes) must be replaced by a culture of safety, which requires a multi-pronged approach that includes all the main stakeholders within the healthcare system. A number of legal reforms could help in prompting such a change. This contribution stresses the need to include legal aspects when trying to find appropriate responses to public health issues. PMID:25170502

  14. Estimated Cost Savings from Reducing Errors in the Preparation of Sterile Doses of Medications

    PubMed Central

    Schneider, Philip J.

    2014-01-01

    Abstract Background: Preventing intravenous (IV) preparation errors will improve patient safety and reduce costs by an unknown amount. Objective: To estimate the financial benefit of robotic preparation of sterile medication doses compared to traditional manual preparation techniques. Methods: A probability pathway model based on published rates of errors in the preparation of sterile doses of medications was developed. Literature reports of adverse events were used to project the array of medical outcomes that might result from these errors. These parameters were used as inputs to a customized simulation model that generated a distribution of possible outcomes, their probability, and associated costs. Results: By varying the important parameters across ranges found in published studies, the simulation model produced a range of outcomes for all likely possibilities. Thus it provided a reliable projection of the errors avoided and the cost savings of an automated sterile preparation technology. The average of 1,000 simulations resulted in the prevention of 5,420 medication errors and associated savings of $288,350 per year. The simulation results can be narrowed to specific scenarios by fixing model parameters that are known and allowing the unknown parameters to range across values found in previously published studies. Conclusions: The use of a robotic device can reduce health care costs by preventing errors that can cause adverse drug events. PMID:25477598

  15. Mitigating errors caused by interruptions during medication verification and administration: interventions in a simulated ambulatory chemotherapy setting

    PubMed Central

    Prakash, Varuna; Koczmara, Christine; Savage, Pamela; Trip, Katherine; Stewart, Janice; McCurdie, Tara; Cafazzo, Joseph A; Trbovich, Patricia

    2014-01-01

    Background Nurses are frequently interrupted during medication verification and administration; however, few interventions exist to mitigate resulting errors, and the impact of these interventions on medication safety is poorly understood. Objective The study objectives were to (A) assess the effects of interruptions on medication verification and administration errors, and (B) design and test the effectiveness of targeted interventions at reducing these errors. Methods The study focused on medication verification and administration in an ambulatory chemotherapy setting. A simulation laboratory experiment was conducted to determine interruption-related error rates during specific medication verification and administration tasks. Interventions to reduce these errors were developed through a participatory design process, and their error reduction effectiveness was assessed through a postintervention experiment. Results Significantly more nurses committed medication errors when interrupted than when uninterrupted. With use of interventions when interrupted, significantly fewer nurses made errors in verifying medication volumes contained in syringes (16/18; 89% preintervention error rate vs 11/19; 58% postintervention error rate; p=0.038; Fisher's exact test) and programmed in ambulatory pumps (17/18; 94% preintervention vs 11/19; 58% postintervention; p=0.012). The rate of error commission significantly decreased with use of interventions when interrupted during intravenous push (16/18; 89% preintervention vs 6/19; 32% postintervention; p=0.017) and pump programming (7/18; 39% preintervention vs 1/19; 5% postintervention; p=0.017). No statistically significant differences were observed for other medication verification tasks. Conclusions Interruptions can lead to medication verification and administration errors. Interventions were highly effective at reducing unanticipated errors of commission in medication administration tasks, but showed mixed effectiveness at

  16. Errors Related to Medication Reconciliation: A Prospective Study in Patients Admitted to the Post CCU

    PubMed Central

    Haji Aghajani, Mohammad; Ghazaeian, Monireh; Mehrazin, Hamid Reza; Sistanizad, Mohammad; Miri, Mirmohammad

    2016-01-01

    Medication errors are one of the important factors that increase fatal injuries to the patients and burden significant economic costs to the health care. An appropriate medical history could reduce errors related to omission of the previous drugs at the time of hospitalization. The aim of this study, as first one in Iran, was evaluating the discrepancies between medication histories obtained by pharmacists and physicians/nurses and first order of physician. From September 2012 until March 2013, patients admitted to the post CCU of a 550 bed university hospital, were recruited in the study. As a part of medication reconciliation on admission, the physicians/nurses obtained medication history from all admitted patients. For patients included in the study, medication history was obtained by both physician/nurse and a pharmacy student (after training by a faculty clinical pharmacist) during the first 24 h of admission. 250 patients met inclusion criteria. The mean age of patients was 61.19 ± 14.41 years. Comparing pharmacy student drug history with medication lists obtained by nurses/physicians revealed 3036 discrepancies. On average, 12.14 discrepancies, ranged from 0 to 68, were identified per patient. Only in 20 patients (8%) there was 100 % agreement among medication lists obtained by pharmacist and physician/nurse. Comparing the medications by list of drugs ordered by physician at first visit showed 12.1 discrepancies on average ranging 0 to 72. According to the results, omission errors in our setting are higher than other countries. Pharmacy-based medication reconciliation could be recommended to decrease this type of error. PMID:27642331

  17. Errors Related to Medication Reconciliation: A Prospective Study in Patients Admitted to the Post CCU.

    PubMed

    Haji Aghajani, Mohammad; Ghazaeian, Monireh; Mehrazin, Hamid Reza; Sistanizad, Mohammad; Miri, Mirmohammad

    2016-01-01

    Medication errors are one of the important factors that increase fatal injuries to the patients and burden significant economic costs to the health care. An appropriate medical history could reduce errors related to omission of the previous drugs at the time of hospitalization. The aim of this study, as first one in Iran, was evaluating the discrepancies between medication histories obtained by pharmacists and physicians/nurses and first order of physician. From September 2012 until March 2013, patients admitted to the post CCU of a 550 bed university hospital, were recruited in the study. As a part of medication reconciliation on admission, the physicians/nurses obtained medication history from all admitted patients. For patients included in the study, medication history was obtained by both physician/nurse and a pharmacy student (after training by a faculty clinical pharmacist) during the first 24 h of admission. 250 patients met inclusion criteria. The mean age of patients was 61.19 ± 14.41 years. Comparing pharmacy student drug history with medication lists obtained by nurses/physicians revealed 3036 discrepancies. On average, 12.14 discrepancies, ranged from 0 to 68, were identified per patient. Only in 20 patients (8%) there was 100 % agreement among medication lists obtained by pharmacist and physician/nurse. Comparing the medications by list of drugs ordered by physician at first visit showed 12.1 discrepancies on average ranging 0 to 72. According to the results, omission errors in our setting are higher than other countries. Pharmacy-based medication reconciliation could be recommended to decrease this type of error. PMID:27642331

  18. Female residents experiencing medical errors in general internal medicine: a qualitative study

    PubMed Central

    2014-01-01

    Background Doctors, especially doctors-in-training such as residents, make errors. They have to face the consequences even though today’s approach to errors emphasizes systemic factors. Doctors’ individual characteristics play a role in how medical errors are experienced and dealt with. The role of gender has previously been examined in a few quantitative studies that have yielded conflicting results. In the present study, we sought to qualitatively explore the experience of female residents with respect to medical errors. In particular, we explored the coping mechanisms displayed after an error. This study took place in the internal medicine department of a Swiss university hospital. Methods Within a phenomenological framework, semi-structured interviews were conducted with eight female residents in general internal medicine. All interviews were audiotaped, fully transcribed, and thereafter analyzed. Results Seven main themes emerged from the interviews: (1) A perception that there is an insufficient culture of safety and error; (2) The perceived main causes of errors, which included fatigue, work overload, inadequate level of competences in relation to assigned tasks, and dysfunctional communication; (3) Negative feelings in response to errors, which included different forms of psychological distress; (4) Variable attitudes of the hierarchy toward residents involved in an error; (5) Talking about the error, as the core coping mechanism; (6) Defensive and constructive attitudes toward one’s own errors; and (7) Gender-specific experiences in relation to errors. Such experiences consisted in (a) perceptions that male residents were more confident and therefore less affected by errors than their female counterparts and (b) perceptions that sexist attitudes among male supervisors can occur and worsen an already painful experience. Conclusions This study offers an in-depth account of how female residents specifically experience and cope with medical errors. Our

  19. Iatrogenic disease management: moderating medication errors and risks in a pharmacy benefit management environment.

    PubMed

    Nair, Vinit; Salmon, J Warren; Kaul, Alan F

    2007-12-01

    Disease Management (DM) programs have advanced to address costly chronic disease patterns in populations. This is in part due to the programs' significant clinical and economical value, coupled with interest by pharmaceutical manufacturers, managed care organizations, and pharmacy benefit management firms. While cost containment realizations for many such interventions have been less than anticipated, this article explores potentials in marrying Medication Error Risk Reduction into DM programs within managed care environments. Medication errors are an emergent serious problem now gaining attention in US health policy. They represent a failure within population-based health programs because they remain significant cost drivers. Therefore, medication errors should be addressed in an organized fashion, with DM being a worthy candidate for piggybacking such programs to achieve the best synergistic effects.

  20. Hope modified the association between distress and incidence of self-perceived medical errors among practicing physicians: prospective cohort study.

    PubMed

    Hayashino, Yasuaki; Utsugi-Ozaki, Makiko; Feldman, Mitchell D; Fukuhara, Shunichi

    2012-01-01

    The presence of hope has been found to influence an individual's ability to cope with stressful situations. The objective of this study is to evaluate the relationship between medical errors, hope and burnout among practicing physicians using validated metrics. Prospective cohort study was conducted among hospital based physicians practicing in Japan (N = 836). Measures included the validated Burnout Scale, self-assessment of medical errors and Herth Hope Index (HHI). The main outcome measure was the frequency of self-perceived medical errors, and Poisson regression analysis was used to evaluate the association between hope and medical error. A total of 361 errors were reported in 836 physician-years. We observed a significant association between hope and self-report of medical errors. Compared with the lowest tertile category of HHI, incidence rate ratios (IRRs) of self-perceived medical errors of physicians in the highest category were 0.44 (95%CI, 0.34 to 0.58) and 0.54 (95%CI, 0.42 to 0.70) respectively, for the 2(nd) and 3(rd) tertile. In stratified analysis by hope score, among physicians with a low hope score, those who experienced higher burnout reported higher incidence of errors; physicians with high hope scores did not report high incidences of errors, even if they experienced high burnout. Self-perceived medical errors showed a strong association with physicians' hope, and hope modified the association between physicians' burnout and self-perceived medical errors.

  1. What is the measure of a safe hospital? Medication errors missed by risk management, clinical staff, and surveyors.

    PubMed

    Grasso, Benjamin C; Rothschild, Jeffrey M; Jordan, Constance W; Jayaram, Geetha

    2005-07-01

    Research in the last decade has identified medication errors as a more frequent cause of unintended harm than was previously thought. Inpatient medication errors and error-prone medication usage are detected internally by medication error reporting and externally through hospital licensing and accreditation surveys. A hospital's rate of medication errors is one of several measures of patient safety available to staff. However, prospective patients and other interested parties must rely upon licensing and accreditation scores, along with varying access to outcome data, as their sole measures of patient safety. We have previously reported that much higher rates of medication errors were found when an independent audit was used compared with rates determined by the usual process of self-report. In this study, we summarize these earlier findings and then compare the error detection sensitivity of licensing and accreditation surveys with that of an independent audit. When experienced surveyors fail to detect a highly error prone medication usage system, it raises questions about the validity of survey scores as a measure of safety (i.e., lack of medication errors). Replication of our findings in other hospital settings is needed. We also recommend measures for improving patient safety by reducing error rates and increasing error detection. PMID:16041238

  2. Building a data sharing model for global genomic research.

    PubMed

    Kosseim, Patricia; Dove, Edward S; Baggaley, Carman; Meslin, Eric M; Cate, Fred H; Kaye, Jane; Harris, Jennifer R; Knoppers, Bartha M

    2014-01-01

    Data sharing models designed to facilitate global business provide insights for improving transborder genomic data sharing. We argue that a flexible, externally endorsed, multilateral arrangement, combined with an objective third-party assurance mechanism, can effectively balance privacy with the need to share genomic data globally.

  3. Transforming Education Research through Open Video Data Sharing

    ERIC Educational Resources Information Center

    Gilmore, Rick O.; Adolph, Karen E.; Millman, David S.; Gordon, Andrew

    2016-01-01

    Open data sharing promises to accelerate the pace of discovery in the developmental and learning sciences, but significant technical, policy, and cultural barriers have limited its adoption. As a result, most research on learning and development remains shrouded in a culture of isolation. Data sharing is the rare exception (Gilmore, 2016). Many…

  4. Perceptions and Practices of Data Sharing in Engineering Education

    ERIC Educational Resources Information Center

    Johri, Aditya; Yang, Seungwon; Vorvoreanu, Mihaela; Madhavan, Krishna

    2016-01-01

    As part of our NSF funded collaborative project on Data Sharing within Engineering Education Community, we conducted an empirical study to better understand the current climate of data sharing and participants' future expectations of the field. We present findings of this mixed method study and discuss implications. Overall, we found strong…

  5. Identifying Modifiable Barriers to Medication Error Reporting in the Nursing Home Setting

    PubMed Central

    Handler, Steven M.; Perera, Subashan; Olshansky, Ellen F.; Studenski, Stephanie A.; Nace, David A.; Fridsma, Douglas B.; Hanlon, Joseph T.

    2007-01-01

    Objectives To have healthcare professionals in nursing homes identify organizational-level and individual-level modifiable barriers to medication error reporting. Design Nominal group technique sessions to identify potential barriers, followed by development and administration of a 20-item cross-sectional mailed survey. Participants and Setting Representatives of 4 professions (physicians, pharmacists, advanced practitioners, and nurses) from 4 independently owned, nonprofit nursing homes that had an average bed size of 150, were affiliated with an academic medical center, and were located in urban and suburban areas. Measurements Barriers identified in the nominal group technique sessions were used to design a 20-item survey. Survey respondents used 5-point Likert scales to score factors in terms of their likelihood of posing a barrier (“very unlikely” to “very likely”) and their modifiability (“not modifiable” to “very modifiable”). Immediate action factors were identified as factors with mean scores of <3.0 on the likelihood and modifiability scales, and represent barriers that should be addressed to increase medication error reporting frequency. Results In 4 nominal group technique sessions, 28 professionals identified factors to include in the survey. The survey was mailed to all 154 professionals in the 4 nursing homes, and 104 (67.5%) responded. Response rates by facility ranged from 55.8% to 92.9%, and rates by profession ranged from 52.0% for physicians to 100% for pharmacists. Most respondents (75.0%) were women. Respondents had worked for a mean of 9.8 years in nursing homes and 5.4 years in their current facility. Of 20 survey items, 14 (70%) had scores that categorized them as immediate action factors, 9 (64%) of which were organizational barriers. Of these factors, the 3 considered most modifiable were (1) lack of a readily available medication error reporting system or forms, (2) lack of information on how to report a medication error

  6. Medication errors in paediatric care: a systematic review of epidemiology and an evaluation of evidence supporting reduction strategy recommendations

    PubMed Central

    Miller, Marlene R; Robinson, Karen A; Lubomski, Lisa H; Rinke, Michael L; Pronovost, Peter J

    2007-01-01

    Background Although children are at the greatest risk for medication errors, little is known about the overall epidemiology of these errors, where the gaps are in our knowledge, and to what extent national medication error reduction strategies focus on children. Objective To synthesise peer reviewed knowledge on children's medication errors and on recommendations to improve paediatric medication safety by a systematic literature review. Data sources PubMed, Embase and Cinahl from 1 January 2000 to 30 April 2005, and 11 national entities that have disseminated recommendations to improve medication safety. Study selection Inclusion criteria were peer reviewed original data in English language. Studies that did not separately report paediatric data were excluded. Data extraction Two reviewers screened articles for eligibility and for data extraction, and screened all national medication error reduction strategies for relevance to children. Data synthesis From 358 articles identified, 31 were included for data extraction. The definition of medication error was non‐uniform across the studies. Dispensing and administering errors were the most poorly and non‐uniformly evaluated. Overall, the distributional epidemiological estimates of the relative percentages of paediatric error types were: prescribing 3–37%, dispensing 5–58%, administering 72–75%, and documentation 17–21%. 26 unique recommendations for strategies to reduce medication errors were identified; none were based on paediatric evidence. Conclusions Medication errors occur across the entire spectrum of prescribing, dispensing, and administering, are common, and have a myriad of non‐evidence based potential reduction strategies. Further research in this area needs a firmer standardisation for items such as dose ranges and definitions of medication errors, broader scope beyond inpatient prescribing errors, and prioritisation of implementation of medication error reduction strategies. PMID:17403758

  7. Information partnerships--shared data, shared scale.

    PubMed

    Konsynski, B R; McFarlan, F W

    1990-01-01

    How can one company gain access to another's resources or customers without merging ownership, management, or plotting a takeover? The answer is found in new information partnerships, enabling diverse companies to develop strategic coalitions through the sharing of data. The key to cooperation is a quantum improvement in the hardware and software supporting relational databases: new computer speeds, cheaper mass-storage devices, the proliferation of fiber-optic networks, and networking architectures. Information partnerships mean that companies can distribute the technological and financial exposure that comes with huge investments. For the customer's part, partnerships inevitably lead to greater simplification on the desktop and more common standards around which vendors have to compete. The most common types of partnership are: joint marketing partnerships, such as American Airline's award of frequent flyer miles to customers who use Citibank's credit card; intraindustry partnerships, such as the insurance value-added network service (which links insurance and casualty companies to independent agents); customer-supplier partnerships, such as Baxter Healthcare's electronic channel to hospitals for medical and other equipment; and IT vendor-driven partnerships, exemplified by ESAB (a European welding supplies and equipment company), whose expansion strategy was premised on a technology platform offered by an IT vendor. Partnerships that succeed have shared vision at the top, reciprocal skills in information technology, concrete plans for an early success, persistence in the development of usable information for all partners, coordination on business policy, and a new and imaginative business architecture.

  8. Facilitating Health Data Sharing Across Diverse Practices and Communities

    PubMed Central

    Lin, Ching-Ping; Black, Robert A.; LaPlante, Jay; Keppel, Gina A.; Tuzzio, Leah; Berg, Alfred O.; Whitener, Ron J.; Buchwald, Dedra S.; Baldwin, Laura-Mae; Fishman, Paul A.; Greene, Sarah M.; Gennari, John H.; Tarczy-Hornoch, Peter; Stephens, Kari A.

    2010-01-01

    Health data sharing with and among practices is a method for engaging rural and underserved populations, often with strong histories of marginalization, in health research. The Institute of Translational Health Sciences, funded by a National Institutes of Health Clinical and Translational Science Award, is engaged in the LC Data QUEST project to build practice and community based research networks with the ability to share semantically aligned electronic health data. We visited ten practices and communities to assess the feasibility of and barriers to developing data sharing networks. We found that these sites had very different approaches and expectations for data sharing. In order to support practices and communities and foster the acceptance of data sharing in these settings, informaticists must take these diverse views into account. Based on these findings, we discuss system design implications and the need for flexibility in the development of community-based data sharing networks. PMID:21347138

  9. Facilitating health data sharing across diverse practices and communities.

    PubMed

    Lin, Ching-Ping; Black, Robert A; Laplante, Jay; Keppel, Gina A; Tuzzio, Leah; Berg, Alfred O; Whitener, Ron J; Buchwald, Dedra S; Baldwin, Laura-Mae; Fishman, Paul A; Greene, Sarah M; Gennari, John H; Tarczy-Hornoch, Peter; Stephens, Kari A

    2010-03-01

    Health data sharing with and among practices is a method for engaging rural and underserved populations, often with strong histories of marginalization, in health research. The Institute of Translational Health Sciences, funded by a National Institutes of Health Clinical and Translational Science Award, is engaged in the LC Data QUEST project to build practice and community based research networks with the ability to share semantically aligned electronic health data. We visited ten practices and communities to assess the feasibility of and barriers to developing data sharing networks. We found that these sites had very different approaches and expectations for data sharing. In order to support practices and communities and foster the acceptance of data sharing in these settings, informaticists must take these diverse views into account. Based on these findings, we discuss system design implications and the need for flexibility in the development of community-based data sharing networks.

  10. Effects of Crew Resource Management Training on Medical Errors in a Simulated Prehospital Setting

    ERIC Educational Resources Information Center

    Carhart, Elliot D.

    2012-01-01

    This applied dissertation investigated the effect of crew resource management (CRM) training on medical errors in a simulated prehospital setting. Specific areas addressed by this program included situational awareness, decision making, task management, teamwork, and communication. This study is believed to be the first investigation of CRM…

  11. Designing a national combined reporting form for adverse drug reactions and medication errors.

    PubMed

    Tanti, A; Serracino-Inglott, A; Borg, J J

    2015-06-09

    The Maltese Medicines Authority was tasked with developing a reporting form that captures high-quality case information on adverse drug reactions (ADRs) and medication errors in order to fulfil its public-health obligations set by the European Union (EU) legislation on pharmacovigilance. This paper describes the process of introducing the first combined ADR/medication error reporting form in the EU for health-care professionals, the analysis of reports generated by it and the promotion of the system. A review of existing ADR forms was carried out and recommendations from the European Medicines Agency and World Health Organization audits integrated. A new, combined ADR/medication error reporting form was developed and pilot tested based on case studies. The Authority's quality system (ISO 9001 certified) was redesigned and a promotion strategy was deployed. The process used in Malta can be useful for countries that need to develop systems relative to ADR/medication error reporting and to improve the quality of data capture within their systems.

  12. The Selection of Critical Errors on a Medical School Certifying Examination.

    ERIC Educational Resources Information Center

    Juul, Dorthea; Loewy, Erich H.

    This study analyzed the relationship between selecting critical errors (choices that would be dangerous to patients) and conventional test scores on a medical school certifying examination that included three item formats: regular and weighted multiple-choice questions and patient management problems. Data from a Clinical Certifying Examination…

  13. Translating Research Into Practice: Voluntary Reporting of Medication Errors in Critical Access Hospitals

    ERIC Educational Resources Information Center

    Jones, Katherine J.; Cochran, Gary; Hicks, Rodney W.; Mueller, Keith J.

    2004-01-01

    Context:Low service volume, insufficient information technology, and limited human resources are barriers to learning about and correcting system failures in small rural hospitals. This paper describes the implementation of and initial findings from a voluntary medication error reporting program developed by the Nebraska Center for Rural Health…

  14. A multifacited approach to improve patient safety, prevent medical errors and resolve the professional liability crisis.

    PubMed

    Weinstein, Louis

    2006-04-01

    The current professional liability crisis is the third in the last 30 years. Similarities of the 3 crises are the rising cost of professional liability insurance and a diminishing number of sources available to purchase coverage. Proposed tort reform with caps on noneconomic damages and attorney contingency fees is a back end approach and will do little to solve this crisis or prevent future ones. The current situation can only be solved by placing an increased emphasis on improving patient safety and elimination of all preventable medical errors. A national electronic medical record must be developed and rapid response teams need to be available in most hospitals. The protective devices of privileged communication and peer review are counterproductive and must be eliminated. Full and prompt disclosure of any medical error or injury needs to be made. Physicians must be taught proper communication skills and the importance of teamwork. Providers with frequent patient, nursing or medical staff complaints must be critically reviewed. The present system of risk management needs to move from a reactive position to a role of being proactive for both patient and physician. Claims management should offer the patient early compensation when appropriate and pursue a vigorous defense when medical care is adequate. Experts should be identified who will render fair, unbiased reviews of medical care with all of their findings being disclosed. Similar experts need to devise clear, concise, evidenced based standards of care for common medical conditions.

  15. Recent Literature on Medication Errors and Adverse Drug Events in Older Adults

    PubMed Central

    Naples, Jennifer G.; Hanlon, Joseph T.; Schmader, Kenneth E.; Semla, Todd P.

    2015-01-01

    Medication errors and adverse drug events are common in older adults, but locating literature addressing these issues is often challenging. The objective of this article was to summarize recent studies addressing medication errors and adverse drug events in a single location to improve accessibility for individuals working with older adults. The authors conducted a comprehensive literature search for studies published in 2014 and identified 51 potential articles. After critical review, 17 studies were selected for inclusion based on innovation, rigorous observational or experimental study designs, and use of reliable, valid measures. Four articles characterizing potentially inappropriate prescribing and interventions to optimize medication regimens were annotated and critiqued in detail. We hope that health policy makers and clinicians find this information helpful in improving the quality of care for older adults. PMID:26804210

  16. Modern Palliative Radiation Treatment: Do Complexity and Workload Contribute to Medical Errors?

    SciTech Connect

    D'Souza, Neil; Holden, Lori; Robson, Sheila; Mah, Kathy; Di Prospero, Lisa; Wong, C. Shun; Chow, Edward; Spayne, Jacqueline

    2012-09-01

    Purpose: To examine whether treatment workload and complexity associated with palliative radiation therapy contribute to medical errors. Methods and Materials: In the setting of a large academic health sciences center, patient scheduling and record and verification systems were used to identify patients starting radiation therapy. All records of radiation treatment courses delivered during a 3-month period were retrieved and divided into radical and palliative intent. 'Same day consultation, planning and treatment' was used as a proxy for workload and 'previous treatment' and 'multiple sites' as surrogates for complexity. In addition, all planning and treatment discrepancies (errors and 'near-misses') recorded during the same time frame were reviewed and analyzed. Results: There were 365 new patients treated with 485 courses of palliative radiation therapy. Of those patients, 128 (35%) were same-day consultation, simulation, and treatment patients; 166 (45%) patients had previous treatment; and 94 (26%) patients had treatment to multiple sites. Four near-misses and 4 errors occurred during the audit period, giving an error per course rate of 0.82%. In comparison, there were 10 near-misses and 5 errors associated with 1100 courses of radical treatment during the audit period. This translated into an error rate of 0.45% per course. An association was found between workload and complexity and increased palliative therapy error rates. Conclusions: Increased complexity and workload may have an impact on palliative radiation treatment discrepancies. This information may help guide the necessary recommendations for process improvement for patients who require palliative radiation therapy.

  17. The SHEL model: a useful tool for analyzing and teaching the contribution of Human Factors to medical error.

    PubMed

    Molloy, Gerard J; O'Boyle, Ciarán A

    2005-02-01

    Recent reports on the problem of medical error pointed to a discipline that has been until recently, largely disregarded by the medical profession. The interdisciplinary science of Human Factors, the reports argue, provides a pragmatic framework for analyzing and assessing risk and reducing error in health care. The argument for applying Human Factors analysis to health care is increasingly accepted, and the application of Human Factors systems models for understanding medical error in particular have proved to be especially illuminating. The authors present a conceptual model of Human Factors--the SHEL model (named after the initial letters of its components' names, Software, Hardware, Environment, and Liveware)--that has been used in investigations of error in aviation. The authors use this simple model to examine and elucidate the Human Factors issues in a specific real-life example of medical error. The SHEL model is particularly useful in examining Human Factors issues in microsystems in health care such as the emergency room or the operating theatre; it argues that mismatches at the interface between the components in these health care microsystems are often conducive to medical errors. The authors propose that the SHEL model may have some unexploited potential in analyzing error and in training medical professionals about the science of Human Factors and its application to medical error. Empirical studies are needed, however, to ascertain the optimal amount of training needed to make clinically significant reductions in the occurrence of medical error.

  18. Selected Medication Safety Risks to Manage in 2016-Part II; Methylergonovine Errors in Obstetrics.

    PubMed

    Cohen, Michael R; Smetzer, Judy L

    2016-06-01

    These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications. PMID:27354742

  19. The strategic role of education in the prevention of medication errors in nursing: part 2.

    PubMed

    Cleary-Holdforth, Joanne; Leufer, Therese

    2013-05-01

    It has been established that medication errors are a significant cause for concern in healthcare settings. In Part 1 of this paper the gravity of this problem in addition to the some of the contributing factors were discussed. The shared nature of the problem across disciplines was highlighted in addition to the potential benefits of multi-disciplinary collaboration in resolution of the problem. The contribution that education can make in this regard is unquestionable both at pre-registration (undergraduate) and post-registration level. A variety of pragmatic proposals will be presented for consideration. In addition, clinical and educational measures that have been shown to reduce medication errors will also be proffered and the way(s) forward to ensure optimal medication management and patient safety will be explored from a nursing perspective. The specific aim of this paper is to illuminate the significant role that education, in both academic and clinical settings, can play in the preparation of nurses for their roles in medication management and the marked reduction in errors and improved patient outcomes in this area of practice that they can yield.

  20. Data sharing in international transboundary contexts: The Vietnamese perspective on data sharing in the Lower Mekong Basin

    NASA Astrophysics Data System (ADS)

    Thu, Hang Ngo; Wehn, Uta

    2016-05-01

    Transboundary data sharing is widely recognised as a necessary element in the successful handling of water-related climate change issues, as it is a means towards integrated water resources management (IWRM). However, in practice it is often a challenge to achieve it. The Mekong River Commission (MRC), an inter-governmental agency established by Cambodia, Lao PDR, Thailand and Vietnam, has adopted IWRM in its water strategy plan in order to properly manage the transboundary waters of the Mekong River. In this context, data sharing procedures were institutionalised and have been officially implemented by the four member countries since 2001. This paper uses a systematic approach to identify the extent of data sharing and the factors influencing the willingness of key individuals in the Vietnam National Mekong Committee and its Primary Custodians to share data. We find that the initial objectives of the Procedures for Data and Information Exchange and Sharing (PDIES) have not been fully achieved and, further, that Vietnam has much to gain and little to lose by engaging in data sharing in the MRC context. The primary motivation for data sharing stems from the desire to protect national benefits and to prevent upstream countries from overexploiting the shared water resources. However, data sharing is hindered by a lack of national regulations in the Vietnam context concerning data sharing between state agencies and outdated information management systems.

  1. Privacy Risks from Genomic Data-Sharing Beacons.

    PubMed

    Shringarpure, Suyash S; Bustamante, Carlos D

    2015-11-01

    The human genetics community needs robust protocols that enable secure sharing of genomic data from participants in genetic research. Beacons are web servers that answer allele-presence queries--such as "Do you have a genome that has a specific nucleotide (e.g., A) at a specific genomic position (e.g., position 11,272 on chromosome 1)?"--with either "yes" or "no." Here, we show that individuals in a beacon are susceptible to re-identification even if the only data shared include presence or absence information about alleles in a beacon. Specifically, we propose a likelihood-ratio test of whether a given individual is present in a given genetic beacon. Our test is not dependent on allele frequencies and is the most powerful test for a specified false-positive rate. Through simulations, we showed that in a beacon with 1,000 individuals, re-identification is possible with just 5,000 queries. Relatives can also be identified in the beacon. Re-identification is possible even in the presence of sequencing errors and variant-calling differences. In a beacon constructed with 65 European individuals from the 1000 Genomes Project, we demonstrated that it is possible to detect membership in the beacon with just 250 SNPs. With just 1,000 SNP queries, we were able to detect the presence of an individual genome from the Personal Genome Project in an existing beacon. Our results show that beacons can disclose membership and implied phenotypic information about participants and do not protect privacy a priori. We discuss risk mitigation through policies and standards such as not allowing anonymous pings of genetic beacons and requiring minimum beacon sizes.

  2. Privacy Risks from Genomic Data-Sharing Beacons

    PubMed Central

    Shringarpure, Suyash S.; Bustamante, Carlos D.

    2015-01-01

    The human genetics community needs robust protocols that enable secure sharing of genomic data from participants in genetic research. Beacons are web servers that answer allele-presence queries—such as “Do you have a genome that has a specific nucleotide (e.g., A) at a specific genomic position (e.g., position 11,272 on chromosome 1)?”—with either “yes” or “no.” Here, we show that individuals in a beacon are susceptible to re-identification even if the only data shared include presence or absence information about alleles in a beacon. Specifically, we propose a likelihood-ratio test of whether a given individual is present in a given genetic beacon. Our test is not dependent on allele frequencies and is the most powerful test for a specified false-positive rate. Through simulations, we showed that in a beacon with 1,000 individuals, re-identification is possible with just 5,000 queries. Relatives can also be identified in the beacon. Re-identification is possible even in the presence of sequencing errors and variant-calling differences. In a beacon constructed with 65 European individuals from the 1000 Genomes Project, we demonstrated that it is possible to detect membership in the beacon with just 250 SNPs. With just 1,000 SNP queries, we were able to detect the presence of an individual genome from the Personal Genome Project in an existing beacon. Our results show that beacons can disclose membership and implied phenotypic information about participants and do not protect privacy a priori. We discuss risk mitigation through policies and standards such as not allowing anonymous pings of genetic beacons and requiring minimum beacon sizes. PMID:26522470

  3. The successful application of business coaching to decrease preventable medical errors.

    PubMed

    Cassatly, Michael G; Mitsch, Darelyn

    2011-01-01

    The number and cost of preventable medical injuries and deaths continue to rise in the U.S. healthcare system despite many attempts to avert such occurrences. The Centers for Medicare & Medicaid Services has prudently decided to deny claims for the healthcare costs incurred in treating certain preventable injuries. With the passage of a the Patient Protection and Affordable Care Act, the list of denied healthcare procedures to correct preventable medical injuries will grow, resulting in a further squeezing of the profit margins of medical institutions and providers. In this article, we show that business coaching of the healthcare team is successful in reversing the alarming growth rate of medical errors, thus ensuring the financial success of healthcare institutions adopting business coaching practices.

  4. Risk factors for medication errors in the electronic and manual prescription 1

    PubMed Central

    Volpe, Cris Renata Grou; de Melo, Eveline Maria Magalhães; de Aguiar, Lucas Barbosa; Pinho, Diana Lúcia Moura; Stival, Marina Morato

    2016-01-01

    ABSTRACT Objective: to compare electronic and manual prescriptions of a public hospital of Brasilia, identifying risk factors for the occurrence of medication errors. Method: descriptive-exploratory, comparative and retrospective study. Data collection occurred from July 2012 to January 2013, using an instrument for the review of the information contained in medical records related to the medication process. A total of 190 manual and 199 electronic records composed the sample, with 2027 prescriptions each. Results: compared to the manual prescription, a significant reduction was observed in the risk factors after implantation of the electronic prescription, in items such as "lack of the form of dilution" (71.1% to 22.3%) and "prescription with brand name" (99.5% to 31.5%). Conversely, the risk factors "no check" and "lack of CRM of the prescriber" increased. The lack of the allergy registration and the occurrences related to medication were the same for both groups. Conclusion: generally, the use of the electronic prescription system was associated with a significant reduction in risk factors for medication errors, concerning the following aspects: illegibility, prescription with brand name and presence of essential items that provide a safe and effective prescription. PMID:27508913

  5. Using Simulation to Improve First-Year Pharmacy Students’ Ability to Identify Medication Errors Involving the Top 100 Prescription Medications

    PubMed Central

    Awdishu, Linda; Namba, Jennifer

    2016-01-01

    Objective. To evaluate first-year pharmacy students’ ability to identify medication errors involving the top 100 prescription medications. Design. In the first quarter of a 3-quarter pharmacy self-care course, a didactic lecture on the most common prescribing and dispensing prescription errors was presented to first-year pharmacy students (P1) in preparation for a prescription review simulation done individually and as a group. In the following quarter, they were given a formal prescription review workshop before a second simulation involving individual and group review of a different set of prescriptions. Students were evaluated based on the number of correctly checked prescriptions and a self-assessment of their confidence in reviewing prescriptions. Assessment. All 63 P1 students completed the prescription review simulations. The individual scores did not significantly change, but group scores improved from 79 (16.2%) in the fall quarter to 98.6 (4.7%) in the winter quarter. Students perceived improvement of their prescription checking skills, specifically in their ability to fill a prescription on their own, identify prescribing and dispensing errors, and perform pharmaceutical calculations. Conclusion. A prescription review module consisting of a didactic lecture, workshop and simulation-based methods to teach prescription analysis was successful at improving first year pharmacy students’ knowledge, confidence, and application of these skills. PMID:27402989

  6. Improving end of life care: an information systems approach to reducing medical errors.

    PubMed

    Tamang, S; Kopec, D; Shagas, G; Levy, K

    2005-01-01

    Chronic and terminally ill patients are disproportionately affected by medical errors. In addition, the elderly suffer more preventable adverse events than younger patients. Targeting system wide "error-reducing" reforms to vulnerable populations can significantly reduce the incidence and prevalence of human error in medical practice. Recent developments in health informatics, particularly the application of artificial intelligence (AI) techniques such as data mining, neural networks, and case-based reasoning (CBR), presents tremendous opportunities for mitigating error in disease diagnosis and patient management. Additionally, the ubiquity of the Internet creates the possibility of an almost ideal network for the dissemination of medical information. We explore the capacity and limitations of web-based palliative information systems (IS) to transform the delivery of care, streamline processes and improve the efficiency and appropriateness of medical treatment. As a result, medical error(s) that occur with patients dealing with severe, chronic illness and the frail elderly can be reduced.The palliative model grew out of the need for pain relief and comfort measures for patients diagnosed with cancer. Applied definitions of palliative care extend this convention, but there is no widely accepted definition. This research will discuss the development life cycle of two palliative information systems: the CONFER QOLP management information system (MIS), currently used by a community-based palliative care program in Brooklyn, New York, and the CAREN case-based reasoning prototype. CONFER is a web platform based on the idea of "eCare". CONFER uses XML (extensible mark-up language), a W3C-endorced standard mark up to define systems data. The second system, CAREN, is a CBR prototype designed for palliative care patients in the cancer trajectory. CBR is a technique, which tries to exploit the similarities of two situations and match decision-making to the best

  7. How to minimize perceptual error and maximize expertise in medical imaging

    NASA Astrophysics Data System (ADS)

    Kundel, Harold L.

    2007-03-01

    Visual perception is such an intimate part of human experience that we assume that it is entirely accurate. Yet, perception accounts for about half of the errors made by radiologists using adequate imaging technology. The true incidence of errors that directly affect patient well being is not known but it is probably at the lower end of the reported values of 3 to 25%. Errors in screening for lung and breast cancer are somewhat better characterized than errors in routine diagnosis. About 25% of cancers actually recorded on the images are missed and cancer is falsely reported in about 5% of normal people. Radiologists must strive to decrease error not only because of the potential impact on patient care but also because substantial variation among observers undermines confidence in the reliability of imaging diagnosis. Observer variation also has a major impact on technology evaluation because the variation between observers is frequently greater than the difference in the technologies being evaluated. This has become particularly important in the evaluation of computer aided diagnosis (CAD). Understanding the basic principles that govern the perception of medical images can provide a rational basis for making recommendations for minimizing perceptual error. It is convenient to organize thinking about perceptual error into five steps. 1) The initial acquisition of the image by the eye-brain (contrast and detail perception). 2) The organization of the retinal image into logical components to produce a literal perception (bottom-up, global, holistic). 3) Conversion of the literal perception into a preferred perception by resolving ambiguities in the literal perception (top-down, simulation, synthesis). 4) Selective visual scanning to acquire details that update the preferred perception. 5) Apply decision criteria to the preferred perception. The five steps are illustrated with examples from radiology with suggestions for minimizing error. The role of perceptual

  8. Identifying the Latent Failures Underpinning Medication Administration Errors: An Exploratory Study

    PubMed Central

    Lawton, Rebecca; Carruthers, Sam; Gardner, Peter; Wright, John; McEachan, Rosie R C

    2012-01-01

    Objectives The primary aim of this article was to identify the latent failures that are perceived to underpin medication errors. Study Setting The study was conducted within three medical wards in a hospital in the United Kingdom. Study Design The study employed a cross-sectional qualitative design. Data Collection Methods Interviews were conducted with 12 nurses and eight managers. Interviews were transcribed and subject to thematic content analysis. A two-step inter-rater comparison tested the reliability of the themes. Principal Findings Ten latent failures were identified based on the analysis of the interviews. These were ward climate, local working environment, workload, human resources, team communication, routine procedures, bed management, written policies and procedures, supervision and leadership, and training. The discussion focuses on ward climate, the most prevalent theme, which is conceptualized here as interacting with failures in the nine other organizational structures and processes. Conclusions This study is the first of its kind to identify the latent failures perceived to underpin medication errors in a systematic way. The findings can be used as a platform for researchers to test the impact of organization-level patient safety interventions and to design proactive error management tools and incident reporting systems in hospitals. PMID:22375850

  9. Low cost RFID real lightweight binding proof protocol for medication errors and patient safety.

    PubMed

    Yu, Yao-Chang; Hou, Ting-Wei; Chiang, Tzu-Chiang

    2012-04-01

    An Institute of Medicine Report stated there are 98,000 people annually who die due to medication related errors in the United States, and hospitals and other medical institutions are thus being pressed to use technologies to reduce such errors. One approach is to provide a suitable protocol that can cooperate with low cost RFID tags in order to identify patients. However, existing low cost RFID tags lack computational power and it is almost impossible to equip them with security functions, such as keyed hash function. To address this issue, a so a real lightweight binding proof protocol is proposed in this paper. The proposed protocol uses only logic gates (e.g. AND, XOR, ADD) to achieve the goal of proving that two tags exist in the field simultaneously, without the need for any complicated security algorithms. In addition, various scenarios are provider to explain the process of adopting this binding proof protocol with regard to guarding patient safety and preventing medication errors.

  10. The adolescent with an inborn error of metabolism: medical issues and transition to adulthood.

    PubMed

    Enns, Gregory M; Packman, Wendy

    2002-06-01

    As patients with inborn errors of metabolism survive longer, understanding of potential medical and psychiatric complications adolescence and adulthood has increased. In general, detailed therapeutic guidelines for specific metabolic disorders are not available, and medical management must be tailored to the individual patient. Close interaction between the biochemical genetics clinic staff, primary care physician, mental health professional, and other specialists is necessary to formulate an integrated care plan. The education of the patient and family is a critical function of the biochemical genetics clinic, and transition from dependence on parents or other care providers to full independence is gradual. The ultimate goal is for the patient to have the essential knowledge and motivation required to cope responsibly with dietary and medical therapeutic regimens by adolescence or early adulthood. Specific illustrative inborn errors of metabolism are discussed (aminoacidemias, urea cycle defects, organic acidemias, fatty acid oxidation defects, disorders of carbohydrate metabolism, lysosomal storage disorders) in light of potential problems encountered in adolescence and adulthood, including issues involving pregnancy and long-term medical, psychosocial, and psychiatric complications.

  11. Medical error reduction and tort reform through private, contractually-based quality medicine societies.

    PubMed

    MacCourt, Duncan; Bernstein, Joseph

    2009-01-01

    The current medical malpractice system is broken. Many patients injured by malpractice are not compensated, whereas some patients who recover in tort have not suffered medical negligence; furthermore, the system's failures demoralize patients and physicians. But most importantly, the system perpetuates medical error because the adversarial nature of litigation induces a so-called "Culture of Silence" in physicians eager to shield themselves from liability. This silence leads to the pointless repetition of error, as the open discussion and analysis of the root causes of medical mistakes does not take place as fully as it should. In 1993, President Clinton's Task Force on National Health Care Reform considered a solution characterized by Enterprise Medical Liability (EML), Alternative Dispute Resolution (ADR), some limits on recovery for non-pecuniary damages (Caps), and offsets for collateral source recovery. Yet this list of ingredients did not include a strategy to surmount the difficulties associated with each element. Specifically, EML might be efficient, but none of the enterprises contemplated to assume responsibility, i.e., hospitals and payers, control physician behavior enough so that it would be fair to foist liability on them. Likewise, although ADR might be efficient, it will be resisted by individual litigants who perceive themselves as harmed by it. Finally, while limitations on collateral source recovery and damages might effectively reduce costs, patients and trial lawyers likely would not accept them without recompense. The task force also did not place error reduction at the center of malpractice tort reform -a logical and strategic error, in our view. In response, we propose a new system that employs the ingredients suggested by the task force but also addresses the problems with each. We also explicitly consider steps to rebuff the Culture of Silence and promote error reduction. We assert that patients would be better off with a system where

  12. Medical error reduction and tort reform through private, contractually-based quality medicine societies.

    PubMed

    MacCourt, Duncan; Bernstein, Joseph

    2009-01-01

    The current medical malpractice system is broken. Many patients injured by malpractice are not compensated, whereas some patients who recover in tort have not suffered medical negligence; furthermore, the system's failures demoralize patients and physicians. But most importantly, the system perpetuates medical error because the adversarial nature of litigation induces a so-called "Culture of Silence" in physicians eager to shield themselves from liability. This silence leads to the pointless repetition of error, as the open discussion and analysis of the root causes of medical mistakes does not take place as fully as it should. In 1993, President Clinton's Task Force on National Health Care Reform considered a solution characterized by Enterprise Medical Liability (EML), Alternative Dispute Resolution (ADR), some limits on recovery for non-pecuniary damages (Caps), and offsets for collateral source recovery. Yet this list of ingredients did not include a strategy to surmount the difficulties associated with each element. Specifically, EML might be efficient, but none of the enterprises contemplated to assume responsibility, i.e., hospitals and payers, control physician behavior enough so that it would be fair to foist liability on them. Likewise, although ADR might be efficient, it will be resisted by individual litigants who perceive themselves as harmed by it. Finally, while limitations on collateral source recovery and damages might effectively reduce costs, patients and trial lawyers likely would not accept them without recompense. The task force also did not place error reduction at the center of malpractice tort reform -a logical and strategic error, in our view. In response, we propose a new system that employs the ingredients suggested by the task force but also addresses the problems with each. We also explicitly consider steps to rebuff the Culture of Silence and promote error reduction. We assert that patients would be better off with a system where

  13. Data sharing: not as simple as it seems.

    PubMed

    Pearce, Neil; Smith, Allan H

    2011-01-01

    In recent years there has been a major change on the part of funders, particularly in North America, so that data sharing is now considered to be the norm rather than the exception. We believe that data sharing is a good idea. However, we also believe that it is inappropriate to prescribe exactly when or how researchers should preserve and share data, since these issues are highly specific to each study, the nature of the data collected, who is requesting it, and what they intend to do with it. The level of ethical concern will vary according to the nature of the information, and the way in which it is collected - analyses of anonymised hospital admission records may carry a quite different ethical burden than analyses of potentially identifiable health information collected directly from the study participants. It is striking that most discussions about data sharing focus almost exclusively on issues of ownership (by the researchers or the funders) and efficiency (on the part of the funders). There is usually little discussion of the ethical issues involved in data sharing, and its implications for the study participants. Obtaining prior informed consent from the participants does not solve this problem, unless the informed consent process makes it completely clear what is being proposed, in which case most study participants would not agree. Thus, the undoubted benefits of data sharing does not remove the obligations and responsibilities that the original investigators hold for the people they invited to participate in the study.

  14. Challenges of web-based personal genomic data sharing.

    PubMed

    Shabani, Mahsa; Borry, Pascal

    2015-01-01

    In order to study the relationship between genes and diseases, the increasing availability and sharing of phenotypic and genotypic data have been promoted as an imperative within the scientific community. In parallel with data sharing practices by clinicians and researchers, recent initiatives have been observed in which individuals are sharing personal genomic data. The involvement of individuals in such initiatives is facilitated by the increased accessibility of personal genomic data, offered by private test providers along with availability of online networks. Personal webpages and on-line data sharing platforms such as Consent to Research (Portable Legal Consent), Free the Data, and Genomes Unzipped are being utilized to host and share genotypes, electronic health records and family history uploaded by individuals. Although personal genomic data sharing initiatives vary in nature, the emphasis on the individuals' control on their data in order to benefit research and ultimately health care has seen as a key theme across these initiatives. In line with the growing practice of personal genomic data sharing, this paper aims to shed light on the potential challenges surrounding these initiatives. As in the course of these initiatives individuals are solicited to individually balance the risks and benefits of sharing their genomic data, their awareness of the implications of personal genomic data sharing for themselves and their family members is a necessity. Furthermore, given the sensitivity of genomic data and the controversies around their complete de-identifiability, potential privacy risks and harms originating from unintended uses of data have to be taken into consideration.

  15. Physicians' medication prescribing in primary care . in Riyadh City, Saudi Arabia. Literature review, part 3: prescribing errors.

    PubMed

    Qureshi, N A; Neyaz, Y; Khoja, T; Magzoub, M A; Haycox, A; Walley, T

    2011-02-01

    Medication errors are globally huge in magnitude and associated with high morbidity and mortality together with high costs and legal problems. Medication errors are caused by multiple factors related to health providers, consumers and health system, but most prescribing errors are preventable. This paper is the third of 3 review articles that form the background for a series of 5 interconnected studies of prescribing patterns and medication errors in the public and private primary health care sectors of Saudi Arabia. A MEDLINE search was conducted to identify papers published in peer-reviewed journals over the previous 3 decades. The paper reviews the etiology, prevention strategies, reporting mechanisms and the myriad consequences of medication errors. PMID:21735949

  16. [Can new technologies reduce the rate of medications errors in adult intensive care?].

    PubMed

    Benoit, E; Beney, J

    2011-09-01

    In the intensive care environment, technology is omnipresent to ensure the monitoring and the administration of critical drugs to unstable patients. Since the early 2000's computerized physician order entry (CPOE), bar code assisted medication administration (BCMA), "smart" infusion pumps (SIP), electronic medication administration record (eMAR) and automated dispensing systems (ADS) have been recommended to reduce medication errors. About ten years later, their implementation rises but remains modest. The objective of this study is to determine the impact of these technologies on the rate of medication errors (ME) in adult intensive care. CPOE allows a strong and significant reduction of ME, especially the least critical ones. Only when adding a clinical decision support system (CDSS), CPOE could allow a reduction of serious errors. Used alone, it could even increase them. The available studies do not have the sufficient power to demonstrate the benefits of SIP or BCMA on ME. However, these devices, reveal practices, such as overriding of alerts. Power or methodology problems and conflicting results do not allow to determine the ability of ADS to reduce the incidence of ME in the intensive care. The studies, investigating these technologies, are not very recent, of limited number and present lacks in their methodology, which does not allow to determine whether they can reduce the incidence of MEs in the adult intensive care. Currently, the benefits appear to be limited which may be explained by the complexity of their integration into the care process. Special attention should be given to the communication between caregivers, the human-computer interface and the caregivers' training.

  17. Errors and pitfalls: Briefing and accusation of medical malpractice - the second victim.

    PubMed

    Wienke, Albrecht

    2013-01-01

    In June 2012, the German Medical Association (Bundesärztekammer) published the statistics of medical malpractice for 2011 (published at http://www.bundesaerztekammer.de). Still ENT-specific accusations of medical malpractice are by far the fewest in the field of hospitals and actually even in the outpatient context. Clearly most of the unforeseen incidents still occur in the disciplines of trauma surgery and orthopedics. In total, however, an increasing number of errors in treatment can be noticed on the multidisciplinary level: in 25.5% of the registered cases, an error in treatment was found to be the origin of damage to health justifying a claim for compensation of the patient. In the year before, it was only 24.7%. The reasons may be manifold, but the medical system itself certainly plays a major role in this context: the recent developments related to health policy lead to a continuous economisation of medical care. Rationing and limited remuneration more and more result in the fact that therapeutic decision are not exclusively made for the benefit of the patient but that they are oriented at economic or bureaucratic aspects. Thus, in the long term, practising medicine undergoes a change. According to the §§ 1, 3 of the professional code of conduct for doctors (Musterberufsordnung für Ärzte; MBO-Ä) medical practice as liberal profession is principally incompatible with the pursuit of profit, however, even doctors have to earn money which more and more makes him play the role of a businessman. Lack of personnel and staff savings lead to excessive workloads of physicians, caregivers, and nurses, which also favour errors. The quality and even the confidential relationship between doctor and patient, which is important for the treatment success, are necessarily affected by the cost pressure. The victims in this context are not only the patients but also the physicians find themselves in the continuous conflict between ethical requirements of their profession

  18. Errors and pitfalls: Briefing and accusation of medical malpractice – the second victim

    PubMed Central

    Wienke, Albrecht

    2013-01-01

    In June 2012, the German Medical Association (Bundesärztekammer) published the statistics of medical malpractice for 2011 (published at http://www.bundesaerztekammer.de). Still ENT-specific accusations of medical malpractice are by far the fewest in the field of hospitals and actually even in the outpatient context. Clearly most of the unforeseen incidents still occur in the disciplines of trauma surgery and orthopedics. In total, however, an increasing number of errors in treatment can be noticed on the multidisciplinary level: in 25.5% of the registered cases, an error in treatment was found to be the origin of damage to health justifying a claim for compensation of the patient. In the year before, it was only 24.7%. The reasons may be manifold, but the medical system itself certainly plays a major role in this context: the recent developments related to health policy lead to a continuous economisation of medical care. Rationing and limited remuneration more and more result in the fact that therapeutic decision are not exclusively made for the benefit of the patient but that they are oriented at economic or bureaucratic aspects. Thus, in the long term, practising medicine undergoes a change. According to the §§ 1, 3 of the professional code of conduct for doctors (Musterberufsordnung für Ärzte; MBO-Ä) medical practice as liberal profession is principally incompatible with the pursuit of profit, however, even doctors have to earn money which more and more makes him play the role of a businessman. Lack of personnel and staff savings lead to excessive workloads of physicians, caregivers, and nurses, which also favour errors. The quality and even the confidential relationship between doctor and patient, which is important for the treatment success, are necessarily affected by the cost pressure. The victims in this context are not only the patients but also the physicians find themselves in the continuous conflict between ethical requirements of their profession

  19. Balancing data sharing requirements for analyses with data sensitivity

    USGS Publications Warehouse

    Jarnevich, C.S.; Graham, J.J.; Newman, G.J.; Crall, A.W.; Stohlgren, T.J.

    2007-01-01

    Data sensitivity can pose a formidable barrier to data sharing. Knowledge of species current distributions from data sharing is critical for the creation of watch lists and an early warning/rapid response system and for model generation for the spread of invasive species. We have created an on-line system to synthesize disparate datasets of non-native species locations that includes a mechanism to account for data sensitivity. Data contributors are able to mark their data as sensitive. This data is then 'fuzzed' in mapping applications and downloaded files to quarter-quadrangle grid cells, but the actual locations are available for analyses. We propose that this system overcomes the hurdles to data sharing posed by sensitive data. ?? 2006 Springer Science+Business Media B.V.

  20. Data Sharing of Mechanical Design Formulas Using Semantic Web Technology

    NASA Astrophysics Data System (ADS)

    Zhou, Jun; Watanuki, Keiichi

    Speed and efficiency are necessary in the field of mechanical design. CAD/CAM/CAE technologies have advanced and attention has also been paid to increasing the efficiency of data sharing and agent processes in the web environment. In this paper, Semantic Web technology is used to enable the sharing of metadata. The metadata consists of design documents and design formulas, with additional semantic information inserted. Mathematical information is expressed by adding metadata into conventional mechanical design formulas using a Resource Description Framework (RDF). The design formulas are later written in MathML (Mathematical Markup Language) for the sake of data sharing. In this way, data sharing and advanced searching is made easy, because the relevant information is made machine readable in the web environment. The calculation of design formulas is made possible using a mathematical processing system, thus increasing the efficiency of mechanical design.

  1. Medical error disclosure: from the therapeutic alliance to risk management: the vision of the new Italian code of medical ethics

    PubMed Central

    2014-01-01

    Background The Italian code of medical deontology recently approved stipulates that physicians have the duty to inform the patient of each unwanted event and its causes, and to identify, report and evaluate adverse events and errors. Thus the obligation to supply information continues to widen, in some way extending beyond the doctor-patient relationship to become an essential tool for improving the quality of professional services. Discussion The new deontological precepts intersect two areas in which the figure of the physician is paramount. On the one hand is the need for maximum integrity towards the patient, in the name of the doctor’s own, and the other’s (the patient’s) dignity and liberty; on the other is the physician’s developing role in the strategies of the health system to achieve efficacy, quality, reliability and efficiency, to reduce errors and adverse events and to manage clinical risk. Summary In Italy, due to guidelines issued by the Ministry of Health and to the new code of medical deontology, the role of physicians becomes a part of a complex strategy of risk management based on a system focused approach in which increasing transparency regarding adverse outcomes and full disclosure of health- related negative events represent a key factor. PMID:25023339

  2. [Witch trials in the Salem as a medical error. Witch hunts in the XVII century and the medical art].

    PubMed

    Werner, Wiktor

    2005-01-01

    That article concerns with the influences of medical practitioners in witch hunts in the Salem (1692). Witch trials in England and English colonies in the XVII century were mainly criminal trials. Witchcraft had been there considered principally as a crime-tool rather then the crime itself. Witches were usually accused of crimes such as the murder and the disease sending. Physicians normally played in that situations the role of court experts. They decided if analyzed disease had normal or abnormal, artificial origin. In the Salem an medical practitioner judged that an illness which touched some children had come from the acts of sorcery. That was the beginning of a long and bloody witch hunt. Death sentences in the Salem trial were also justified with applying medical and physical categories to show the objectivity of a witchcraft. Salem judges were sure that by using "objective" categories they had been able to proof the existence of material relations between the witch and bewitched persons without the possibility of error. PMID:17144196

  3. [Witch trials in the Salem as a medical error. Witch hunts in the XVII century and the medical art].

    PubMed

    Werner, Wiktor

    2005-01-01

    That article concerns with the influences of medical practitioners in witch hunts in the Salem (1692). Witch trials in England and English colonies in the XVII century were mainly criminal trials. Witchcraft had been there considered principally as a crime-tool rather then the crime itself. Witches were usually accused of crimes such as the murder and the disease sending. Physicians normally played in that situations the role of court experts. They decided if analyzed disease had normal or abnormal, artificial origin. In the Salem an medical practitioner judged that an illness which touched some children had come from the acts of sorcery. That was the beginning of a long and bloody witch hunt. Death sentences in the Salem trial were also justified with applying medical and physical categories to show the objectivity of a witchcraft. Salem judges were sure that by using "objective" categories they had been able to proof the existence of material relations between the witch and bewitched persons without the possibility of error.

  4. Task and error analysis balancing benefits over business of electronic medical records.

    PubMed

    Carstens, Deborah Sater; Rodriguez, Walter; Wood, Michael B

    2014-01-01

    Task and error analysis research was performed to identify: a) the process for healthcare organisations in managing healthcare for patients with mental illness or substance abuse; b) how the process can be enhanced and; c) if electronic medical records (EMRs) have a role in this process from a business and safety perspective. The research question is if EMRs have a role in enhancing the healthcare for patients with mental illness or substance abuse. A discussion on the business of EMRs is addressed to understand the balancing act between the safety and business aspects of an EMR.

  5. Designing for Global Data Sharing, Designing for Educational Transformation

    ERIC Educational Resources Information Center

    Adams, Robin S.; Radcliffe, David; Fosmire, Michael

    2016-01-01

    This paper provides an example of a global data sharing project with an educational transformation agenda. This agenda shaped both the design of the shared dataset and the experience of sharing the common dataset to support multiple perspective inquiry and enable integrative and critically reflexive research-to-practice dialogue. The shared…

  6. Data Sharing: Academic Libraries and the Scholarly Enterprise

    ERIC Educational Resources Information Center

    Nicholson, Shawn W.; Bennett, Terrence B.

    2011-01-01

    Technological advances have raised expectations for data sharing; and financial exigencies have brought the issue into sharper focus, especially as grant-funding institutions are beginning to require shared access to research results and the data that support them. These data are increasingly linked to publications and related resources, thereby…

  7. Data Sharing to Inform School-Based Asthma Services

    ERIC Educational Resources Information Center

    Portwood, Sharon G.; Nelson, Elissa B.

    2013-01-01

    Background: This article examines results and lessons learned from a collaborative project involving a large urban school district, its county health department, multiple community partners, and the local university to establish an effective system for data sharing to inform monitoring and evaluation of the Charlotte Mecklenburg Schools (CMS)…

  8. Adaptative Peer to Peer Data Sharing for Technology Enhanced Learning

    NASA Astrophysics Data System (ADS)

    Angelaccio, Michele; Buttarazzi, Berta

    Starting from the hypothesis that P2P Data Sharing in a direct teaching scenario (e.g.: a classroom lesson) may lead to relevant benefits, this paper explores the features of EduSHARE a Collaborative Learning System useful for Enhanced Learning Process.

  9. Using Simulation to Address Hierarchy-Related Errors in Medical Practice

    PubMed Central

    Calhoun, Aaron William; Boone, Megan C; Porter, Melissa B; Miller, Karen H

    2014-01-01

    Objective: Hierarchy, the unavoidable authority gradients that exist within and between clinical disciplines, can lead to significant patient harm in high-risk situations if not mitigated. High-fidelity simulation is a powerful means of addressing this issue in a reproducible manner, but participant psychological safety must be assured. Our institution experienced a hierarchy-related medication error that we subsequently addressed using simulation. The purpose of this article is to discuss the implementation and outcome of these simulations. Methods: Script and simulation flowcharts were developed to replicate the case. Each session included the use of faculty misdirection to precipitate the error. Care was taken to assure psychological safety via carefully conducted briefing and debriefing periods. Case outcomes were assessed using the validated Team Performance During Simulated Crises Instrument. Gap analysis was used to quantify team self-insight. Session content was analyzed via video review. Results: Five sessions were conducted (3 in the pediatric intensive care unit and 2 in the Pediatric Emergency Department). The team was unsuccessful at addressing the error in 4 (80%) of 5 cases. Trends toward lower communication scores (3.4/5 vs 2.3/5), as well as poor team self-assessment of communicative ability, were noted in unsuccessful sessions. Learners had a positive impression of the case. Conclusions: Simulation is a useful means to replicate hierarchy error in an educational environment. This methodology was viewed positively by learner teams, suggesting that psychological safety was maintained. Teams that did not address the error successfully may have impaired self-assessment ability in the communication skill domain. PMID:24867545

  10. Challenges of web-based personal genomic data sharing.

    PubMed

    Shabani, Mahsa; Borry, Pascal

    2015-01-01

    In order to study the relationship between genes and diseases, the increasing availability and sharing of phenotypic and genotypic data have been promoted as an imperative within the scientific community. In parallel with data sharing practices by clinicians and researchers, recent initiatives have been observed in which individuals are sharing personal genomic data. The involvement of individuals in such initiatives is facilitated by the increased accessibility of personal genomic data, offered by private test providers along with availability of online networks. Personal webpages and on-line data sharing platforms such as Consent to Research (Portable Legal Consent), Free the Data, and Genomes Unzipped are being utilized to host and share genotypes, electronic health records and family history uploaded by individuals. Although personal genomic data sharing initiatives vary in nature, the emphasis on the individuals' control on their data in order to benefit research and ultimately health care has seen as a key theme across these initiatives. In line with the growing practice of personal genomic data sharing, this paper aims to shed light on the potential challenges surrounding these initiatives. As in the course of these initiatives individuals are solicited to individually balance the risks and benefits of sharing their genomic data, their awareness of the implications of personal genomic data sharing for themselves and their family members is a necessity. Furthermore, given the sensitivity of genomic data and the controversies around their complete de-identifiability, potential privacy risks and harms originating from unintended uses of data have to be taken into consideration. PMID:26085313

  11. MERIS (Medical Error Reporting Information System) as an innovative patient safety intervention: a health policy perspective.

    PubMed

    Riga, Marina; Vozikis, Athanassios; Pollalis, Yannis; Souliotis, Kyriakos

    2015-04-01

    The economic crisis in Greece poses the necessity to resolve problems concerning both the spiralling cost and the quality assurance in the health system. The detection and the analysis of patient adverse events and medical errors are considered crucial elements of this course. The implementation of MERIS embodies a mandatory module, which adopts the trigger tool methodology for measuring adverse events and medical errors an intensive care unit [ICU] environment, and a voluntary one with web-based public reporting methodology. A pilot implementation of MERIS running in a public hospital identified 35 adverse events, with approx. 12 additional hospital days and an extra healthcare cost of €12,000 per adverse event or of about €312,000 per annum for ICU costs only. At the same time, the voluntary module unveiled 510 reports on adverse events submitted by citizens or patients. MERIS has been evaluated as a comprehensive and effective system; it succeeded in detecting the main factors that cause adverse events and discloses severe omissions of the Greek health system. MERIS may be incorporated and run efficiently nationally, adapted to the needs and peculiarities of each hospital or clinic.

  12. A systematic approach of tracking and reporting medication errors at a tertiary care university hospital, Karachi, Pakistan

    PubMed Central

    Khowaja, Khurshid; Nizar, Rozmin; Merchant, Rashida J; Dias, Jacqueline; Bustamante-Gavino, Irma; Malik, Amina

    2008-01-01

    Introduction: Administering medication is one of the high risk areas for any health professional. It is a multidisciplinary process, which begins with the doctor’s prescription, followed by review and provision by a pharmacist, and ends with preparation and administration by a nurse. Several studies have highlighted a high medication incident rate at several healthcare institutions. Methods: Our study design was exploratory and evaluative and used methodological triangulation. Sample size was of two types. First, a convenient sample of 1000 medication dosages to estimate the medication error (95% CI). We took another sample from subjects involved in medication usage processes such as physicians, nurses, pharmacists, and patients. Two sets of instruments were designed via extensive literature review: a medication tracking error form and a focus group interview questionnaire. Results: Our study findings revealed 100% compliance with a computerized physician order entry (CPOE) system by physicians, nurses, and pharmacists. The main error rate was 5.5% and pharmacists contributed an higher error rate of 2.6% followed by nurses (1.1%) and physicians (1%). Major areas for improvement in error rates were identified: delay in medication delivery, lab results reviewed electronically before prescription, dispension, and administration. PMID:19209247

  13. Development of case-based medication alerting and recommender system: a new approach to prevention for medication error.

    PubMed

    Miyo, Kengo; Nittami, Yuki S; Kitagawa, Yoichiro; Ohe, Kazuhiko

    2007-01-01

    The purpose of this study was to develop a new alerting and recommender system for preventing medication errors. In recent years, alerting systems have been widely implemented, but because these systems apply a same static threshold for all patients in all cases, they produce excessive alerts and subject physicians to "alert fatigue". We believe that the most commonly-written prescription for a patient's status is the safest one. From this standpoint, we developed a real-time case-based medication alerting and recommender system linked to a database of past prescriptions. When a physician issues his or her prescription, our system dynamically compares it with past ones for similar patients in the database. An analysis of the 10 most frequently-used drugs in the University of Tokyo Hospital revealed that our system reduced the number of false alerts compared to the traditional static alert method. Our system contributes to the creation of alerts that are appropriate for patients' clinical conditions and based on physicians' empirical discretion.

  14. Investigating the Causes of Medication Errors and Strategies to Prevention of Them from Nurses and Nursing Student Viewpoint

    PubMed Central

    Gorgich, Enam Alhagh Charkhat; Barfroshan, Sanam; Ghoreishi, Gholamreza; Yaghoobi, Maryam

    2016-01-01

    Introduction and Aim: Medication errors as a serious problem in world and one of the most common medical errors that threaten patient safety and may lead to even death of them. The purpose of this study was to investigate the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. Materials & Methods: This cross-sectional descriptive study was conducted on 327 nursing staff of khatam-al-anbia hospital and 62 intern nursing students in nursing and midwifery school of Zahedan, Iran, enrolled through the availability sampling in 2015. The data were collected by the valid and reliable questionnaire. To analyze the data, descriptive statistics, T-test and ANOVA were applied by use of SPSS16 software. Findings: The results showed that the most common causes of medications errors in nursing were tiredness due increased workload (97.8%), and in nursing students were drug calculation, (77.4%). The most important way for prevention in nurses and nursing student opinion, was reducing the work pressure by increasing the personnel, proportional to the number and condition of patients and also creating a unit as medication calculation. Also there was a significant relationship between the type of ward and the mean of medication errors in two groups. Conclusion: Based on the results it is recommended that nurse-managers resolve the human resources problem, provide workshops and in-service education about preparing medications, side-effects of drugs and pharmacological knowledge. Using electronic medications cards is a measure which reduces medications errors. PMID:27045413

  15. Best Practices for Data Sharing in Phylogenetic Research

    PubMed Central

    Cranston, Karen; Harmon, Luke J.; O'Leary, Maureen A.; Lisle, Curtis

    2014-01-01

    As phylogenetic data becomes increasingly available, along with associated data on species’ genomes, traits, and geographic distributions, the need to ensure data availability and reuse become more and more acute. In this paper, we provide ten “simple rules” that we view as best practices for data sharing in phylogenetic research. These rules will help lead towards a future phylogenetics where data can easily be archived, shared, reused, and repurposed across a wide variety of projects. PMID:24987572

  16. Exploring Pathways to Trust: A Tribal Perspective on Data Sharing

    PubMed Central

    James, Rosalina; Tsosie, Rebecca; Sahota, Puneet; Parker, Myra; Dillard, Denise; Sylvester, Ileen; Lewis, John; Klejka, Joseph; Muzquiz, LeeAnna; Olsen, Polly; Whitener, Ron; Burke, Wylie

    2014-01-01

    National Institutes of Health data-sharing policies aim to maximize public benefit derived from genetic studies by increasing research efficiency and the use of a pooled data resource for future studies. While broad access to data may lead to benefits for populations underrepresented in genetic studies, such as indigenous groups, tribes have ownership interest in their data. The Northwest-Alaska Pharmacogenetic Research Network, a partnership involving tribal organizations and universities conducting basic and translational pharmacogenetic research, convened a meeting to discuss the collection, management, and secondary use of research data, and of the processes surrounding access to data stored in federal repositories. This article reports on tribal perspectives that emerged from the dialogue and discusses the implications of tribal government sovereign status on research agreements and data-sharing negotiations. There is strong tribal support for efficient research processes that expedite the benefits from collaborative research, but there is also a need for data sharing procedures that take into account tribal sovereignty and appropriate oversight of research ¬ such as tribally-based research review processes and review of draft manuscripts. We also note specific ways in which accountability could be encouraged by National Institutes of Health as part of the research process. PMID:24830328

  17. Exploring pathways to trust: a tribal perspective on data sharing.

    PubMed

    James, Rosalina; Tsosie, Rebecca; Sahota, Puneet; Parker, Myra; Dillard, Denise; Sylvester, Ileen; Lewis, John; Klejka, Joseph; Muzquiz, LeeAnna; Olsen, Polly; Whitener, Ron; Burke, Wylie

    2014-11-01

    The data-sharing policies of the National Institutes of Health aim to maximize public benefit derived from genetic studies by increasing research efficiency and use of a pooled data resource for future studies. Although broad access to data may lead to benefits for populations underrepresented in genetic studies, such as indigenous groups, tribes have ownership interest in their data. The Northwest-Alaska Pharmacogenetic Research Network, a partnership involving tribal organizations and universities conducting basic and translational pharmacogenetic research, convened a meeting to discuss the collection, management, and secondary use of research data, and of the processes surrounding access to data stored in federal repositories. This article reports the tribal perspectives that emerged from the dialogue and discusses the implications of tribal government sovereign status on research agreements and data-sharing negotiations. There is strong tribal support for efficient research processes that expedite the benefits from collaborative research, but there is also a need for data-sharing procedures that take into account tribal sovereignty and appropriate oversight of research--such as tribally based research review processes and review of draft manuscripts. We also note specific ways in which accountability could be encouraged by the National Institutes of Health as part of the research process. PMID:24830328

  18. Advancing Science Through Collaborative Data Sharing and Synthesis.

    PubMed

    Perrino, Tatiana; Howe, George; Sperling, Anne; Beardslee, William; Sandler, Irwin; Shern, David; Pantin, Hilda; Kaupert, Sheila; Cano, Nicole; Cruden, Gracelyn; Bandiera, Frank; Brown, C Hendricks

    2013-07-01

    The demand for researchers to share their data has increased dramatically in recent years. There is a need to replicate and confirm scientific findings to bolster confidence in many research areas. Data sharing also serves the critical function of allowing synthesis of findings across trials. As innovative statistical methods have helped resolve barriers to synthesis analyses, data sharing and synthesis can help answer research questions that cannot be answered by individual trials alone. However, the sharing of data among researchers remains challenging and infrequent. This article aims to (a) increase support for data sharing and synthesis collaborations among researchers to advance scientific knowledge and (b) provide a model for establishing these collaborations using the example of the ongoing National Institute of Mental Health's Collaborative Data Synthesis on Adolescent Depression Trials. This study brings together datasets from existing prevention and treatment trials in adolescent depression, as well as researchers and stakeholders, to answer questions about "for whom interventions work" and "by what pathways interventions have their effects." This is critical to improving interventions, including increasing knowledge about intervention efficacy among minority populations, or what we call "scientific equity." The collaborative model described is relevant to fields with research questions that can only be addressed by synthesizing individual-level data.

  19. Water, Water, Everywhere: Defining and Assessing Data Sharing in Academia.

    PubMed

    Van Tuyl, Steven; Whitmire, Amanda L

    2016-01-01

    Sharing of research data has begun to gain traction in many areas of the sciences in the past few years because of changing expectations from the scientific community, funding agencies, and academic journals. National Science Foundation (NSF) requirements for a data management plan (DMP) went into effect in 2011, with the intent of facilitating the dissemination and sharing of research results. Many projects that were funded during 2011 and 2012 should now have implemented the elements of the data management plans required for their grant proposals. In this paper we define 'data sharing' and present a protocol for assessing whether data have been shared and how effective the sharing was. We then evaluate the data sharing practices of researchers funded by the NSF at Oregon State University in two ways: by attempting to discover project-level research data using the associated DMP as a starting point, and by examining data sharing associated with journal articles that acknowledge NSF support. Sharing at both the project level and the journal article level was not carried out in the majority of cases, and when sharing was accomplished, the shared data were often of questionable usability due to access, documentation, and formatting issues. We close the article by offering recommendations for how data producers, journal publishers, data repositories, and funding agencies can facilitate the process of sharing data in a meaningful way.

  20. Exploring pathways to trust: a tribal perspective on data sharing.

    PubMed

    James, Rosalina; Tsosie, Rebecca; Sahota, Puneet; Parker, Myra; Dillard, Denise; Sylvester, Ileen; Lewis, John; Klejka, Joseph; Muzquiz, LeeAnna; Olsen, Polly; Whitener, Ron; Burke, Wylie

    2014-11-01

    The data-sharing policies of the National Institutes of Health aim to maximize public benefit derived from genetic studies by increasing research efficiency and use of a pooled data resource for future studies. Although broad access to data may lead to benefits for populations underrepresented in genetic studies, such as indigenous groups, tribes have ownership interest in their data. The Northwest-Alaska Pharmacogenetic Research Network, a partnership involving tribal organizations and universities conducting basic and translational pharmacogenetic research, convened a meeting to discuss the collection, management, and secondary use of research data, and of the processes surrounding access to data stored in federal repositories. This article reports the tribal perspectives that emerged from the dialogue and discusses the implications of tribal government sovereign status on research agreements and data-sharing negotiations. There is strong tribal support for efficient research processes that expedite the benefits from collaborative research, but there is also a need for data-sharing procedures that take into account tribal sovereignty and appropriate oversight of research--such as tribally based research review processes and review of draft manuscripts. We also note specific ways in which accountability could be encouraged by the National Institutes of Health as part of the research process.

  1. Building and Sustaining International Scientific Partnerships Through Data Sharing

    NASA Astrophysics Data System (ADS)

    Ramamurthy, M. K.; Yoksas, T.; Miller, L.

    2007-05-01

    Understanding global environmental processes and their regional linkages has heightened the importance of full, open, and timely access to earth system science data and strong international scientific partnerships. To that end, the Unidata Program at the University Corporation for Atmospheric Research has developed a growing portfolio of international outreach activities, conducted in close collaboration with academic, research and operational institutions on several continents. The overarching goals of Unidata's international activities include: - democratization of access-to and use-of data that describe the dynamic earth system - building capacity and empowering geoscientists and educators worldwide - strengthening international science partnerships for exchanging knowledge and expertise - effectuating sustainable cultural changes that recognize the benefits of data sharing, and - helping to build regional and global communities around specific geoscientific themes Using an Internet-based data sharing network, Unidata has made great strides in establishing the underpinnings of a worldwide data sharing network. To date, over 160 institutions of higher education worldwide are participating in this data sharing effort. The Internet Data Distribution (IDD) system, as it is known, was originally developed for sharing mostly atmospheric science data among U.S. institutions. It has now been extended beyond North America into a system of interconnected regional data networks encompassing Latin America, the Caribbean, Antarctica, Asia, Europe, and most recently Africa. The adoption of the IDD concept in Brazil has been so successful that Brazil now ranks second behind the U. S. in the number of institutions participating in their own regionally customized and managed data sharing network, which is dubbed the IDD-Brazil. Another noteworthy data distribution network, Antarctic IDD, is leveraging the IDD system for the benefit of the Antarctic meteorological research

  2. The science of medical decision making: neurosurgery, errors, and personal cognitive strategies for improving quality of care.

    PubMed

    Fargen, Kyle M; Friedman, William A

    2014-01-01

    During the last 2 decades, there has been a shift in the U.S. health care system towards improving the quality of health care provided by enhancing patient safety and reducing medical errors. Unfortunately, surgical complications, patient harm events, and malpractice claims remain common in the field of neurosurgery. Many of these events are potentially avoidable. There are an increasing number of publications in the medical literature in which authors address cognitive errors in diagnosis and treatment and strategies for reducing such errors, but these are for the most part absent in the neurosurgical literature. The purpose of this article is to highlight the complexities of medical decision making to a neurosurgical audience, with the hope of providing insight into the biases that lead us towards error and strategies to overcome our innate cognitive deficiencies. To accomplish this goal, we review the current literature on medical errors and just culture, explain the dual process theory of cognition, identify common cognitive errors affecting neurosurgeons in practice, review cognitive debiasing strategies, and finally provide simple methods that can be easily assimilated into neurosurgical practice to improve clinical decision making.

  3. IMPACT Observatory: tracking the evolution of clinical trial data sharing and research integrity

    PubMed Central

    Krleža-Jerić, Karmela; Gabelica, Mirko; Banzi, Rita; Martinić, Marina Krnić; Pulido, Bibiana; Mahmić-Kaknjo, Mersiha; Reveiz, Ludovic; Šimić, Josip; Utrobičić, Ana; Hrgović, Irena

    2016-01-01

    Introduction The opening of research data is emerging thanks to the increasing possibilities of digital technology. The opening of clinical trial (CT) data is a part of this process, expected to have positive scientific, ethical, health, and economic impacts thus contributing to research integrity. The January 2016 proposal by the International Council of Medical Journal Editors triggered ample discussion about CT data sharing and reconfirmed the need for an ongoing assessment of its dynamics. The IMProving Access to Clinical Trials data (IMPACT) Observatory aims to play such a role, and assess the data sharing culture, policies, and practices of key players, the impact of their interventions on CTs, and contribute to a transformation of research. The objective of this paper is to present the IMPACT Observatory as well as share some of its preliminary findings. Materials and methods Methods include a scoping study of research, surveys, interviews, and an environmental scan of research data repositories. Results Our preliminary findings indicate that although opening of CT data has not yet been achieved, its evolution is encouraging. Initiatives by key players contribute to increasing of CT data sharing, and many barriers are shrinking or disappearing. Conclusions The major barrier is the lack of data sharing standards, from preparing data for public sharing to its curatorship, findability and access. However, experiences accumulated by sharing CT data according to “upon request” or “open” mechanisms could inform the development of such standards. The Vivli, CORBEL-ECRIN and Open Trials projects are currently working in this direction. PMID:27812300

  4. Comparison of consumers’ views on electronic data sharing for healthcare and research

    PubMed Central

    Joseph, Jill G; Ohno-Machado, Lucila

    2015-01-01

    New models of healthcare delivery such as accountable care organizations and patient-centered medical homes seek to improve quality, access, and cost. They rely on a robust, secure technology infrastructure provided by health information exchanges (HIEs) and distributed research networks and the willingness of patients to share their data. There are few large, in-depth studies of US consumers’ views on privacy, security, and consent in electronic data sharing for healthcare and research together. Objective This paper addresses this gap, reporting on a survey which asks about California consumers’ views of data sharing for healthcare and research together. Materials and Methods The survey conducted was a representative, random-digit dial telephone survey of 800 Californians, performed in Spanish and English. Results There is a great deal of concern that HIEs will worsen privacy (40.3%) and security (42.5%). Consumers are in favor of electronic data sharing but elements of transparency are important: individual control, who has access, and the purpose for use of data. Respondents were more likely to agree to share deidentified information for research than to share identified information for healthcare (76.2% vs 57.3%, p < .001). Discussion While consumers show willingness to share health information electronically, they value individual control and privacy. Responsiveness to these needs, rather than mere reliance on Health Insurance Portability and Accountability Act (HIPAA), may improve support of data networks. Conclusion Responsiveness to the public’s concerns regarding their health information is a pre-requisite for patient-centeredness. This is one of the first in-depth studies of attitudes about electronic data sharing that compares attitudes of the same individual towards healthcare and research. PMID:25829461

  5. Understanding the causes of intravenous medication administration errors in hospitals: a qualitative critical incident study

    PubMed Central

    Keers, Richard N; Williams, Steven D; Cooke, Jonathan; Ashcroft, Darren M

    2015-01-01

    Objectives To investigate the underlying causes of intravenous medication administration errors (MAEs) in National Health Service (NHS) hospitals. Setting Two NHS teaching hospitals in the North West of England. Participants Twenty nurses working in a range of inpatient clinical environments were identified and recruited using purposive sampling at each study site. Primary outcome measures Semistructured interviews were conducted with nurse participants using the critical incident technique, where they were asked to discuss perceived causes of intravenous MAEs that they had been directly involved with. Transcribed interviews were analysed using the Framework approach and emerging themes were categorised according to Reason's model of accident causation. Results In total, 21 intravenous MAEs were discussed containing 23 individual active failures which included slips and lapses (n=11), mistakes (n=8) and deliberate violations of policy (n=4). Each active failure was associated with a range of error and violation provoking conditions. The working environment was implicated when nurses lacked healthcare team support and/or were exposed to a perceived increased workload during ward rounds, shift changes or emergencies. Nurses frequently reported that the quality of intravenous dose-checking activities was compromised due to high perceived workload and working relationships. Nurses described using approaches such as subconscious functioning and prioritising to manage their duties, which at times contributed to errors. Conclusions Complex interactions between active and latent failures can lead to intravenous MAEs in hospitals. Future interventions may need to be multimodal in design in order to mitigate these risks and reduce the burden of intravenous MAEs. PMID:25770226

  6. [Medical errors and iatrogenic injury--results of 173 Schlichtungsstellen proceedings in general practice].

    PubMed

    Scheppokat, K D

    2004-09-01

    The Schlichtungsstelle (expert panel for alternative dispute resolution) of Northern Germany receives and decides on large numbers of malpractice claims. We report on 173 panel decisions on claims involving general practitioners: Medical negligence was found in 40%, and patient-injuries due to negligence in 28% of these cases. Treatment-caused injuries of the patient were also found in several of the cases decided against the claimant. In proceedings on the grounds of injections, 26 of 30 claimants concerned had suffered iatrogenic injuries. Treatment-caused injuries were severe in 40 of the 173 patients, fatal in 7. Injury rated and margins of error are much lower in industry than in medicine. Reviews of hospital records identified adverse events in 3-4% of hospitalized patients. Autopsy studies revealed that in 10-50% of cases the diagnosis verified postmortem had been missed clinically. Effective risk-management should be based on a trustful relationship among the persons working together: so that errors and adverse events might be discussed openly and the roles of persons, organization or system can be laid open. PMID:15527195

  7. Integrating Six Sigma with total quality management: a case example for measuring medication errors.

    PubMed

    Revere, Lee; Black, Ken

    2003-01-01

    Six Sigma is a new management philosophy that seeks a nonexistent error rate. It is ripe for healthcare because many healthcare processes require a near-zero tolerance for mistakes. For most organizations, establishing a Six Sigma program requires significant resources and produces considerable stress. However, in healthcare, management can piggyback Six Sigma onto current total quality management (TQM) efforts so that minimal disruption occurs in the organization. Six Sigma is an extension of the Failure Mode and Effects Analysis that is required by JCAHO; it can easily be integrated into existing quality management efforts. Integrating Six Sigma into the existing TQM program facilitates process improvement through detailed data analysis. A drilled-down approach to root-cause analysis greatly enhances the existing TQM approach. Using the Six Sigma metrics, internal project comparisons facilitate resource allocation while external project comparisons allow for benchmarking. Thus, the application of Six Sigma makes TQM efforts more successful. This article presents a framework for including Six Sigma in an organization's TQM plan while providing a concrete example using medication errors. Using the process defined in this article, healthcare executives can integrate Six Sigma into all of their TQM projects.

  8. Identification and assessment of medical errors in the triage area of an educational hospital using the SHERPA technique in Iran.

    PubMed

    Ghasemi, Mohammad; Khoshakhlagh, Amir Hossein; Mahmudi, Sadrollah; Fesharaki, Mohammad Gholami

    2015-01-01

    Accidents caused by human error are prominent in the medical field. The present study identified medical errors in the emergency triage area by assessing the tasks of all healthcare workers employed in the triage area of an educational hospital in Tehran, Iran in 2014. Data were collected using the systematic human error reduction and prediction approach (SHERPA). The tasks and sub-tasks were determined and analyzed using hierarchical analysis and the errors were extracted. A total of 199 human errors were identified in the different tasks. The rate of error for action was 46.8%, checking was 25.6%, retrieval was 8.5%, communication was 12.1% and selection was 7%. Rate of unacceptable and unfavorable risks were 21.1% and 38.6%, respectively. SHERPA was shown to be an appropriate technique for detecting medical errors. The establishment of control programs should be a high priority in the management and implementation of health facilities in triage areas.

  9. Investigating the epidemiology of medication errors and error-related adverse drug events (ADEs) in primary care, ambulatory care and home settings: a systematic review protocol

    PubMed Central

    Assiri, Ghadah Asaad; Grant, Liz; Aljadhey, Hisham; Sheikh, Aziz

    2016-01-01

    Introduction There is a need to better understand the epidemiology of medication errors and error-related adverse events in community care contexts. Methods and analysis We will systematically search the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Eastern Mediterranean Regional Office of the WHO (EMRO), MEDLINE, PsycINFO and Web of Science. In addition, we will search Google Scholar and contact an international panel of experts to search for unpublished and in progress work. The searches will cover the time period January 1990–December 2015 and will yield data on the incidence or prevalence of and risk factors for medication errors and error-related adverse drug events in adults living in community settings (ie, primary care, ambulatory and home). Study quality will be assessed using the Critical Appraisal Skills Program quality assessment tool for cohort and case–control studies, and cross-sectional studies will be assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Descriptive Studies. Meta-analyses will be undertaken using random-effects modelling using STATA (V.14) statistical software. Ethics and dissemination This protocol will be registered with PROSPERO, an international prospective register of systematic reviews, and the systematic review will be reported in the peer-reviewed literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses. PMID:27580826

  10. Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events?

    PubMed

    Charles, Krista; Cannon, Margaret; Hall, Robert; Coustasse, Alberto

    2014-01-01

    Computerized provider order entry (CPOE) systems allow physicians to prescribe patient services electronically. In hospitals, CPOE essentially eliminates the need for handwritten paper orders and achieves cost savings through increased efficiency. The purpose of this research study was to examine the benefits of and barriers to CPOE adoption in hospitals to determine the effects on medical errors and adverse drug events (ADEs) and examine cost and savings associated with the implementation of this newly mandated technology. This study followed a methodology using the basic principles of a systematic review and referenced 50 sources. CPOE systems in hospitals were found to be capable of reducing medical errors and ADEs, especially when CPOE systems are bundled with clinical decision support systems designed to alert physicians and other healthcare providers of pending lab or medical errors. However, CPOE systems face major barriers associated with adoption in a hospital system, mainly high implementation costs and physicians' resistance to change.

  11. How to perform a root cause analysis for workup and future prevention of medical errors: a review.

    PubMed

    Charles, Ryan; Hood, Brandon; Derosier, Joseph M; Gosbee, John W; Li, Ying; Caird, Michelle S; Biermann, J Sybil; Hake, Mark E

    2016-01-01

    Providing quality patient care is a basic tenant of medical and surgical practice. Multiple orthopaedic programs, including The Patient Safety Committee of the American Academy of Orthopaedic Surgeons (AAOS), have been implemented to measure quality of surgical care, as well as reduce the incidence of medical errors. Structured Root Cause Analysis (RCA) has become a recent area of interest and, if performed thoroughly, has been shown to reduce surgical errors across many subspecialties. There is a paucity of literature on how the process of a RCA can be effectively implemented. The current review was designed to provide a structured approach on how to conduct a formal root cause analysis. Utilization of this methodology may be effective in the prevention of medical errors.

  12. How to perform a root cause analysis for workup and future prevention of medical errors: a review.

    PubMed

    Charles, Ryan; Hood, Brandon; Derosier, Joseph M; Gosbee, John W; Li, Ying; Caird, Michelle S; Biermann, J Sybil; Hake, Mark E

    2016-01-01

    Providing quality patient care is a basic tenant of medical and surgical practice. Multiple orthopaedic programs, including The Patient Safety Committee of the American Academy of Orthopaedic Surgeons (AAOS), have been implemented to measure quality of surgical care, as well as reduce the incidence of medical errors. Structured Root Cause Analysis (RCA) has become a recent area of interest and, if performed thoroughly, has been shown to reduce surgical errors across many subspecialties. There is a paucity of literature on how the process of a RCA can be effectively implemented. The current review was designed to provide a structured approach on how to conduct a formal root cause analysis. Utilization of this methodology may be effective in the prevention of medical errors. PMID:27688807

  13. Can Utilizing a Computerized Provider Order Entry (CPOE) System Prevent Hospital Medical Errors and Adverse Drug Events?

    PubMed Central

    Charles, Krista; Cannon, Margaret; Hall, Robert; Coustasse, Alberto

    2014-01-01

    Computerized provider order entry (CPOE) systems allow physicians to prescribe patient services electronically. In hospitals, CPOE essentially eliminates the need for handwritten paper orders and achieves cost savings through increased efficiency. The purpose of this research study was to examine the benefits of and barriers to CPOE adoption in hospitals to determine the effects on medical errors and adverse drug events (ADEs) and examine cost and savings associated with the implementation of this newly mandated technology. This study followed a methodology using the basic principles of a systematic review and referenced 50 sources. CPOE systems in hospitals were found to be capable of reducing medical errors and ADEs, especially when CPOE systems are bundled with clinical decision support systems designed to alert physicians and other healthcare providers of pending lab or medical errors. However, CPOE systems face major barriers associated with adoption in a hospital system, mainly high implementation costs and physicians’ resistance to change. PMID:25593568

  14. Water, Water, Everywhere: Defining and Assessing Data Sharing in Academia

    PubMed Central

    2016-01-01

    Sharing of research data has begun to gain traction in many areas of the sciences in the past few years because of changing expectations from the scientific community, funding agencies, and academic journals. National Science Foundation (NSF) requirements for a data management plan (DMP) went into effect in 2011, with the intent of facilitating the dissemination and sharing of research results. Many projects that were funded during 2011 and 2012 should now have implemented the elements of the data management plans required for their grant proposals. In this paper we define ‘data sharing’ and present a protocol for assessing whether data have been shared and how effective the sharing was. We then evaluate the data sharing practices of researchers funded by the NSF at Oregon State University in two ways: by attempting to discover project-level research data using the associated DMP as a starting point, and by examining data sharing associated with journal articles that acknowledge NSF support. Sharing at both the project level and the journal article level was not carried out in the majority of cases, and when sharing was accomplished, the shared data were often of questionable usability due to access, documentation, and formatting issues. We close the article by offering recommendations for how data producers, journal publishers, data repositories, and funding agencies can facilitate the process of sharing data in a meaningful way. PMID:26886581

  15. Enabling public data sharing: encouraging scientific discovery and education.

    PubMed

    Fennema-Notestine, Christine

    2009-01-01

    To promote scientific discovery and education, the federated Biomedical Informatics Research Network (BIRN) Data Repository (BDR) supports data storage, sharing, querying, and downloading for the biomedical community, enabling the integration of multiple data resources from a single entry point. The BDR encourages data sharing both for investigators requesting assistance with databasing and informatics infrastructure, and for those wishing to extend the reach of existing data resources to be registered with the BDR. Both approaches rely heavily on data integration and knowledge management techniques, ensuring capabilities for intelligent exploration of diverse data resources that make up the BDR's shared environment. Although the development of the BDR has been driven by BIRN testbeds in the fields of neuroscience and neuroimaging, the infrastructure is flexible and extendable to serve a broad array of disciplines, fueling interdisciplinary studies. For a welcoming environment, the BDR provides simple, straightforward policies and procedures for contributing data and for using available data. Contributing investigators provide information through the BDR Gridsphere-based Portal environment to allow meaningful sharing of their data, and, when relevant, supply documentation for human subjects' protection. The BDR aims to provide a common resource to increase the availability of, and access to, rare data; complex, sizable data; and existing data sharing structures in support of research and education in the scientific and clinical communities. PMID:19623484

  16. Reducing emergency department charting and ordering errors with a room number watermark on the electronic medical record display.

    PubMed

    Yamamoto, Loren G

    2014-10-01

    A survey of Emergency Department (ED) clinicians (ie, physicians, nurses and clinical assistants) at a single hospital in Honolulu, Hawai'i was conducted to assess the frequency of errors in charting, and entering orders on the wrong patient's chart in the electronic medical record (EMR), and clinician opinion was sought on whether a simple watermark of the patient's room number might help reduce the number of these EMR "wrong patient errors." ED clinicians (68 total surveys) were asked if and how often they charted in the wrong patient's chart or entered an order (physicians only) in the wrong patient's chart. Physicians had a combined self-reported average error rate of 1.3%. Mean rate of patient charting errors occurred at 0.5 errors and 0.4 errors per 100 hours, for nurses and clinical assistants, respectively. The majority (81%) of the 68 clinicians surveyed felt that a room number watermark would eliminate most of the wrong patient errors. In conclusion, charting on the wrong patient and order entry on the wrong patient type errors occur with varying frequencies amongst ED clinicians. Nearly all the clinicians believe that a room number watermark might be an effective strategy to reduce these errors.

  17. Nucleoside reverse-transcriptase inhibitor dosing errors in an outpatient HIV clinic in the electronic medical record era.

    PubMed

    Willig, James H; Westfall, Andrew O; Allison, Jeroan; Van Wagoner, Nicholas; Chang, Pei-Wen; Raper, James; Saag, Michael S; Mugavero, Michael J

    2007-09-01

    Information on antiretroviral dosing errors among health care providers for outpatient human immunodeficiency virus (HIV)-infected patients is lacking. We evaluated factors associated with nucleoside reverse-transcriptase inhibitor dosing errors in a university-based HIV clinic using an electronic medical record. Overall, older age, minority race or ethnicity, and didanosine use were related to such errors. Impaired renal function was more common in older patients and racial or ethnic minorities and, in conjunction with fixed-dose combination drugs, contributed to the higher rates of errors in nucleoside reverse-transcriptase inhibitor dosing. Understanding the factors related to nucleoside reverse-transcriptase inhibitor dosing errors is an important step in the building of preventive tools.

  18. Information And Data-Sharing Plan of IPY China Activity

    NASA Astrophysics Data System (ADS)

    Zhang, X.; Cheng, W.

    2007-12-01

    Polar Data-Sharing is an effective resolution to global system and polar science problems and to interdisciplinary and sustainable study, as well as an important means to deal with IPY scientific heritages and realize IPY goals. Corresponding to IPY Data-Sharing policies, Information and Data-Sharing Plan was listed in five sub-plans of IPY Chinese Programme launched in March, 2007,they are Scientific research program of the Prydz Bay, Amery Ice Shelf and Dome A transects(short title:'PANDA'), the Arctic Scientific Research Expedition Plan, International Cooperation Plan, Information and Data-Sharing Plan, Education and Outreach. China, since the foundation of Antarctic Zhongshan Station in 1989, has carried out systematic scientific expeditions and researches in Larsemann Hills, Prydz Bay and the neighbouring sea areas, organized 14 Prydz Bay oceanographic investigations, 3 Amery Ice Shelf expeditions, 4 Grove Mountains expeditions and 5 inland ice cap scientific expeditions. 2 comprehensive oceanographic investigations in the Arctic Ocean were conducted in 1999 and 2003, acquired a large amount of data and samples in PANDA section and fan areas of Pacific Ocean in the Arctic Ocean. A mechanism of basic data submitting ,sharing and archiving has been gradually set up since 2000. Presently, Polar Science Database and Polar Sample Resource Sharing Platform of China with the aim of sharing polar data and samples has been initially established and began to provide sharing service to domestic and oversea users. According to IPY Chinese Activity, 2 scientific expeditions in the Arctic Ocean, 3 in the South Ocean, 2 at Amery Ice Shelf, 1 on Grove Mountains and 2 inland ice cap expeditions on Dome A will be carried out during IPY period. According to the experiences accumulated in the past and the jobs in the future, the Information and Data- Sharing Plan, during 2007-2010, will save, archive, and provide exchange and sharing services upon the data obtained by scientific

  19. Error-correction learning for artificial neural networks using the Bayesian paradigm. Application to automated medical diagnosis.

    PubMed

    Belciug, Smaranda; Gorunescu, Florin

    2014-12-01

    Automated medical diagnosis models are now ubiquitous, and research for developing new ones is constantly growing. They play an important role in medical decision-making, helping physicians to provide a fast and accurate diagnosis. Due to their adaptive learning and nonlinear mapping properties, the artificial neural networks are widely used to support the human decision capabilities, avoiding variability in practice and errors based on lack of experience. Among the most common learning approaches, one can mention either the classical back-propagation algorithm based on the partial derivatives of the error function with respect to the weights, or the Bayesian learning method based on posterior probability distribution of weights, given training data. This paper proposes a novel training technique gathering together the error-correction learning, the posterior probability distribution of weights given the error function, and the Goodman-Kruskal Gamma rank correlation to assembly them in a Bayesian learning strategy. This study had two main purposes; firstly, to develop anovel learning technique based on both the Bayesian paradigm and the error back-propagation, and secondly,to assess its effectiveness. The proposed model performance is compared with those obtained by traditional machine learning algorithms using real-life breast and lung cancer, diabetes, and heart attack medical databases. Overall, the statistical comparison results indicate that thenovellearning approach outperforms the conventional techniques in almost all respects.

  20. CalSWIM: A Wiki-Based Data Sharing Platform

    NASA Astrophysics Data System (ADS)

    Ganjisaffar, Yasser; Javanmardi, Sara; Grant, Stanley; Lopes, Cristina Videira

    Organizations increasingly create massive internal digital data repositories and are looking for technical advances in managing, exchanging and integrating explicit knowledge. While most of the enabling technologies for knowledge management have been used around for several years, the ability to cost effective data sharing, integration and analysis into a cohesive infrastructure evaded organizations until the advent of Web 2.0 applications. In this paper, we discuss our investigations into using a Wiki as a web-based interactive knowledge management system, which is integrated with some features for easy data access, data integration and analysis. Using the enhanced wiki, it possible to make organizational knowledge sustainable, expandable, outreaching and continually up-to-date. The wiki is currently under use as California Sustainable Watershed Information Manager. We evaluate our work according to the requirements of knowledge management systems. The result shows that our solution satisfies more requirements compared to other tools.

  1. P2P proteomics -- data sharing for enhanced protein identification

    PubMed Central

    2012-01-01

    Background In order to tackle the important and challenging problem in proteomics of identifying known and new protein sequences using high-throughput methods, we propose a data-sharing platform that uses fully distributed P2P technologies to share specifications of peer-interaction protocols and service components. By using such a platform, information to be searched is no longer centralised in a few repositories but gathered from experiments in peer proteomics laboratories, which can subsequently be searched by fellow researchers. Methods The system distributively runs a data-sharing protocol specified in the Lightweight Communication Calculus underlying the system through which researchers interact via message passing. For this, researchers interact with the system through particular components that link to database querying systems based on BLAST and/or OMSSA and GUI-based visualisation environments. We have tested the proposed platform with data drawn from preexisting MS/MS data reservoirs from the 2006 ABRF (Association of Biomolecular Resource Facilities) test sample, which was extensively tested during the ABRF Proteomics Standards Research Group 2006 worldwide survey. In particular we have taken the data available from a subset of proteomics laboratories of Spain's National Institute for Proteomics, ProteoRed, a network for the coordination, integration and development of the Spanish proteomics facilities. Results and Discussion We performed queries against nine databases including seven ProteoRed proteomics laboratories, the NCBI Swiss-Prot database and the local database of the CSIC/UAB Proteomics Laboratory. A detailed analysis of the results indicated the presence of a protein that was supported by other NCBI matches and highly scored matches in several proteomics labs. The analysis clearly indicated that the protein was a relatively high concentrated contaminant that could be present in the ABRF sample. This fact is evident from the information that

  2. When data sharing gets close to 100%: what human paleogenetics can teach the open science movement.

    PubMed

    Anagnostou, Paolo; Capocasa, Marco; Milia, Nicola; Sanna, Emanuele; Battaggia, Cinzia; Luzi, Daniela; Destro Bisol, Giovanni

    2015-01-01

    This study analyzes data sharing regarding mitochondrial, Y chromosomal and autosomal polymorphisms in a total of 162 papers on ancient human DNA published between 1988 and 2013. The estimated sharing rate was not far from totality (97.6% ± 2.1%) and substantially higher than observed in other fields of genetic research (evolutionary, medical and forensic genetics). Both a questionnaire-based survey and the examination of Journals' editorial policies suggest that this high sharing rate cannot be simply explained by the need to comply with stakeholders requests. Most data were made available through body text, but the use of primary databases increased in coincidence with the introduction of complete mitochondrial and next-generation sequencing methods. Our study highlights three important aspects. First, our results imply that researchers' awareness of the importance of openness and transparency for scientific progress may complement stakeholders' policies in achieving very high sharing rates. Second, widespread data sharing does not necessarily coincide with a prevalent use of practices which maximize data findability, accessibility, useability and preservation. A detailed look at the different ways in which data are released can be very useful to detect failures to adopt the best sharing modalities and understand how to correct them. Third and finally, the case of human paleogenetics tells us that a widespread awareness of the importance of Open Science may be important to build reliable scientific practices even in the presence of complex experimental challenges.

  3. When Data Sharing Gets Close to 100%: What Human Paleogenetics Can Teach the Open Science Movement

    PubMed Central

    Anagnostou, Paolo; Capocasa, Marco; Milia, Nicola; Sanna, Emanuele; Battaggia, Cinzia; Luzi, Daniela; Destro Bisol, Giovanni

    2015-01-01

    This study analyzes data sharing regarding mitochondrial, Y chromosomal and autosomal polymorphisms in a total of 162 papers on ancient human DNA published between 1988 and 2013. The estimated sharing rate was not far from totality (97.6% ± 2.1%) and substantially higher than observed in other fields of genetic research (evolutionary, medical and forensic genetics). Both a questionnaire-based survey and the examination of Journals’ editorial policies suggest that this high sharing rate cannot be simply explained by the need to comply with stakeholders requests. Most data were made available through body text, but the use of primary databases increased in coincidence with the introduction of complete mitochondrial and next-generation sequencing methods. Our study highlights three important aspects. First, our results imply that researchers’ awareness of the importance of openness and transparency for scientific progress may complement stakeholders’ policies in achieving very high sharing rates. Second, widespread data sharing does not necessarily coincide with a prevalent use of practices which maximize data findability, accessibility, useability and preservation. A detailed look at the different ways in which data are released can be very useful to detect failures to adopt the best sharing modalities and understand how to correct them. Third and finally, the case of human paleogenetics tells us that a widespread awareness of the importance of Open Science may be important to build reliable scientific practices even in the presence of complex experimental challenges. PMID:25799293

  4. A SOA-based approach to geographical data sharing

    NASA Astrophysics Data System (ADS)

    Li, Zonghua; Peng, Mingjun; Fan, Wei

    2009-10-01

    In the last few years, large volumes of spatial data have been available in different government departments in China, but these data are mainly used within these departments. With the e-government project initiated, spatial data sharing become more and more necessary. Currently, the Web has been used not only for document searching but also for the provision and use of services, known as Web services, which are published in a directory and may be automatically discovered by software agents. Particularly in the spatial domain, the possibility of accessing these large spatial datasets via Web services has motivated research into the new field of Spatial Data Infrastructure (SDI) implemented using service-oriented architecture. In this paper a Service-Oriented Architecture (SOA) based Geographical Information Systems (GIS) is proposed, and a prototype system is deployed based on Open Geospatial Consortium (OGC) standard in Wuhan, China, thus that all the departments authorized can access the spatial data within the government intranet, and also these spatial data can be easily integrated into kinds of applications.

  5. Institutional and Individual Influences on Scientists' Data Sharing Behaviors

    ERIC Educational Resources Information Center

    Kim, Youngseek

    2013-01-01

    In modern research activities, scientific data sharing is essential, especially in terms of data-intensive science and scholarly communication. Scientific communities are making ongoing endeavors to promote scientific data sharing. Currently, however, data sharing is not always well-deployed throughout diverse science and engineering disciplines.…

  6. [Longer working hours of pharmacists in the ward resulted in lower medication-related errors--survey of national university hospitals in Japan].

    PubMed

    Matsubara, Kazuo; Toyama, Akira; Satoh, Hiroshi; Suzuki, Hiroshi; Awaya, Toshio; Tasaki, Yoshikazu; Yasuoka, Toshiaki; Horiuchi, Ryuya

    2011-04-01

    It is obvious that pharmacists play a critical role as risk managers in the healthcare system, especially in medication treatment. Hitherto, there is not a single multicenter-survey report describing the effectiveness of clinical pharmacists in preventing medical errors from occurring in the wards in Japan. Thus, we conducted a 1-month survey to elucidate the relationship between the number of errors and working hours of pharmacists in the ward, and verified whether the assignment of clinical pharmacists to the ward would prevent medical errors between October 1-31, 2009. Questionnaire items for the pharmacists at 42 national university hospitals and a medical institute included the total and the respective numbers of medication-related errors, beds and working hours of pharmacist in 2 internal medicine and 2 surgical departments in each hospital. Regardless of severity, errors were consecutively reported to the Medical Security and Safety Management Section in each hospital. The analysis of errors revealed that longer working hours of pharmacists in the ward resulted in less medication-related errors; this was especially significant in the internal medicine ward (where a variety of drugs were used) compared with the surgical ward. However, the nurse assignment mode (nurse/inpatients ratio: 1 : 7-10) did not influence the error frequency. The results of this survey strongly indicate that assignment of clinical pharmacists to the ward is critically essential in promoting medication safety and efficacy. PMID:21467804

  7. Family Perceptions of Medication Administration at School: Errors, Risk Factors, and Consequences

    ERIC Educational Resources Information Center

    Clay, Daniel; Farris, Karen; McCarthy, Ann Marie; Kelly, Michael W.; Howarth, Robyn

    2008-01-01

    Medications are administered every day in schools across the country. Researchers and clinicians have studied school nurses' and educators' experiences with medication administration, but not the experiences of children or their parents. This study examined medication administration from the child and parent perspectives to (a) determine problems…

  8. DeID - a data sharing tool for neuroimaging studies.

    PubMed

    Song, Xuebo; Wang, James; Wang, Anlin; Meng, Qingping; Prescott, Christian; Tsu, Loretta; Eckert, Mark A

    2015-01-01

    Funding institutions and researchers increasingly expect that data will be shared to increase scientific integrity and provide other scientists with the opportunity to use the data with novel methods that may advance understanding in a particular field of study. In practice, sharing human subject data can be complicated because data must be de-identified prior to sharing. Moreover, integrating varied data types collected in a study can be challenging and time consuming. For example, sharing data from structural imaging studies of a complex disorder requires the integration of imaging, demographic and/or behavioral data in a way that no subject identifiers are included in the de-identified dataset and with new subject labels or identification values that cannot be tracked back to the original ones. We have developed a Java program that users can use to remove identifying information in neuroimaging datasets, while still maintaining the association among different data types from the same subject for further studies. This software provides a series of user interaction wizards to allow users to select data variables to be de-identified, implements functions for auditing and validation of de-identified data, and enables the user to share the de-identified data in a single compressed package through various communication protocols, such as FTPS and SFTP. DeID runs with Windows, Linux, and Mac operating systems and its open architecture allows it to be easily adapted to support a broader array of data types, with the goal of facilitating data sharing. DeID can be obtained at http://www.nitrc.org/projects/deid. PMID:26441500

  9. How to make medication error reporting systems work--Factors associated with their successful development and implementation.

    PubMed

    Holmström, Anna-Riia; Laaksonen, Raisa; Airaksinen, Marja

    2015-08-01

    This study explored factors associated with successful development and implementation of medication error reporting (MER) systems in different healthcare contexts. A descriptive online questionnaire comprising of structured and open-ended questions was responded to by 16 medication safety experts in 16 countries. The present paper describes the rich and multidimensional qualitative data from the experts' narratives from open-ended questions. Several factors related to the national context of MER systems, i.e., the operational environment, were identified to impact successful development and implementation of these systems. The factors were: awareness of deficiencies in medication safety at local and national levels to justify the need for MER systems; gaining political will for the development and implementation actions together with international and governmental support; creating or reforming legislation and national regulations, guidelines and strategies to support MER; allocation of adequate human and financial resources; establishment of an organisation or centre to coordinate and lead MER; and extending systems approach and safety culture to all parts of the operational environment to facilitate openness on and learning from medication errors. In conclusion, operational environments of MER systems must be constructed to support functionality of these systems, and need to be improved in many countries.

  10. Pattern and Predictors of Medication Dosing Errors in Chronic Kidney Disease Patients in Pakistan: A Single Center Retrospective Analysis

    PubMed Central

    Saleem, Ahsan; Masood, Imran

    2016-01-01

    Background Chronic kidney disease (CKD) alters the pharmacokinetic and pharmacodynamic response of various drugs and increases the risk of toxicity. The data regarding the pattern and predictors of medication dosing errors is scare from the developing countries. Therefore, the present study was conducted to assess the pattern and predictors of medication dosing errors in CKD patients in a tertiary care setting in Pakistan. Methods A retrospective study design was employed and medical charts of all those CKD patients who had an eGFR ≤60ml/min/1.73m2, hospitalization ≥24 hours, and admitted in the nephrology unit during January 2013 to December 2014 were assessed. Descriptive statistics and the logistic regression analysis were done using IBM SPSS version 20. Results In total, 205 medical charts were assessed. The mean age of patients was 38.64 (±16.82) years. Overall, 1534 drugs were prescribed to CKD patients, of which, nearly 34.0% drugs required dose adjustment. Among those drugs, only 41.8% were properly adjusted, and the remaining 58.2% were unadjusted. The logistic regression analysis revealed that the medication dosing errors were significantly associated with the CKD stages, i.e. stage 4 (OR 0.054; 95% CI [0.017–0.177]; p <0.001) and stage 5 (OR 0.098; 95% CI [0.040–0.241]; p <0.001), the number of prescribed medicines ≥ 5 (OR 0.306; 95% CI [0.133–0.704]; p 0.005), and the presence of a comorbidity (OR 0.455; 95% CI [0.226–0.916]; p 0.027) such as the hypertension (OR 0.453; 95% CI [0.231–0.887]; p 0.021). Conclusions It is concluded that more than half drugs prescribed to CKD patients requiring dose adjustment were unadjusted. The predictors of medication dosing errors were the severe-to-end stages of chronic kidney disease, the presence of a comorbidity such as hypertension, and a higher number of prescribed medicines. Therefore, attention should be paid to these risk factors. PMID:27367594

  11. A System of Analyzing Medical Errors To Improve GME Curricula and Programs.

    ERIC Educational Resources Information Center

    Battles, James B.; Shea, Christine E.

    2001-01-01

    Performed an analysis of the root causes of events involving graduate medical trainees that were recorded in hospital-based near-miss reporting systems. Classified root causes using the Eindhoven Classification Model, medical version. Found lack of knowledge and organizational causes at root of near-miss incidents. Concluded that root cause…

  12. Cooperative Data Sharing: Simple Support for Clusters of SMP Nodes

    NASA Technical Reports Server (NTRS)

    DiNucci, David C.; Balley, David H. (Technical Monitor)

    1997-01-01

    Libraries like PVM and MPI send typed messages to allow for heterogeneous cluster computing. Lower-level libraries, such as GAM, provide more efficient access to communication by removing the need to copy messages between the interface and user space in some cases. still lower-level interfaces, such as UNET, get right down to the hardware level to provide maximum performance. However, these are all still interfaces for passing messages from one process to another, and have limited utility in a shared-memory environment, due primarily to the fact that message passing is just another term for copying. This drawback is made more pertinent by today's hybrid architectures (e.g. clusters of SMPs), where it is difficult to know beforehand whether two communicating processes will share memory. As a result, even portable language tools (like HPF compilers) must either map all interprocess communication, into message passing with the accompanying performance degradation in shared memory environments, or they must check each communication at run-time and implement the shared-memory case separately for efficiency. Cooperative Data Sharing (CDS) is a single user-level API which abstracts all communication between processes into the sharing and access coordination of memory regions, in a model which might be described as "distributed shared messages" or "large-grain distributed shared memory". As a result, the user programs to a simple latency-tolerant abstract communication specification which can be mapped efficiently to either a shared-memory or message-passing based run-time system, depending upon the available architecture. Unlike some distributed shared memory interfaces, the user still has complete control over the assignment of data to processors, the forwarding of data to its next likely destination, and the queuing of data until it is needed, so even the relatively high latency present in clusters can be accomodated. CDS does not require special use of an MMU, which

  13. Development of a patient positioning error compensation tool for Korea Heavy-Ion Medical Accelerator Treatment Center

    NASA Astrophysics Data System (ADS)

    Kim, Min-Joo; Suh, Tae-Suk; Cho, Woong; Jung, Won-Gyun

    2015-07-01

    In this study, a potential validation tool for compensating for the patient positioning error was developed by using 2D/3D and 3D/3D image registration. For 2D/3D registration, digitallyreconstructed radiography (DRR) and three-dimensional computed tomography (3D-CT) images were applied. The ray-casting algorithm is the most straightforward method for generating DRR, so we adopted the traditional ray-casting method, which finds the intersections of a ray with all objects, voxels of the 3D-CT volume in the scene. The similarity between the extracted DRR and the orthogonal image was measured by using a normalized mutual information method. Two orthogonal images were acquired from a Cyber-knife system from the anterior-posterior (AP) and right lateral (RL) views. The 3D-CT and the two orthogonal images of an anthropomorphic phantom and of the head and neck of a cancer patient were used in this study. For 3D/3D registration, planning CT and in-room CT images were applied. After registration, the translation and the rotation factors were calculated to position a couch to be movable in six dimensions. Registration accuracies and average errors of 2.12 mm ± 0.50 mm for transformations and 1.23 ° ± 0.40 ° for rotations were acquired by using 2D/3D registration with the anthropomorphic Alderson-Rando phantom. In addition, registration accuracies and average errors of 0.90 mm ± 0.30 mm for transformations and 1.00 ° ± 0.2 ° for rotations were acquired by using CT image sets. We demonstrated that this validation tool could compensate for patient positioning errors. In addition, this research could be a fundamental step in compensating for patient positioning errors at the Korea Heavy-ion Medical Accelerator Treatment Center.

  14. Pitfalls of Counterfactual Thinking in Medical Practice: Preventing Errors by Using More Functional Reference Points

    PubMed Central

    Petrocelli, John V.

    2013-01-01

    Background Counterfactual thinking involves mentally simulating alternatives to reality. The current article reviews literature pertaining to the relevance counterfactual thinking has for the quality of medical decision making. Although earlier counterfactual thought research concluded that counterfactuals have important benefits for the individual, there are reasons to believe that counterfactual thinking is also associated with dysfunctional consequences. Of particular focus is whether or not medical experience, and its influence on counterfactual thinking, actually informs or improves medical practice. It is hypothesized that relatively more probable decision alternatives, followed by undesirable outcomes and counterfactual thought responses, can be abandoned for relatively less probable decision alternatives. Design and Methods Building on earlier research demonstrating that counterfactual thinking can impede memory and learning in a decision paradigm with undergraduate students, the current study examines the extent to which earlier findings can be generalized to practicing physicians (N=10). Participants were asked to complete 60 trials of a computerized Monty Hall Problem simulation. Learning by experience was operationalized as the frequency of switch-decisions. Results Although some learning was evidenced by a general increase in switch-decision frequency across block trials, the extent of learning demonstrated was not ideal, nor practical. Conclusions A simple, multiple-trial, decision paradigm demonstrated that doctors fail to learn basic decision-outcome associations through experience. An agenda for future research, which tests the functionality of reference points (other than counterfactual alternatives) for the purposes of medical decision making, is proposed. Significance for public health The quality of healthcare depends heavily on the judgments and decisions made by doctors and other medical professionals. Findings from this research indicate

  15. Estimation of immunization providers' activities cost, medication cost, and immunization dose errors cost in Iraq.

    PubMed

    Al-lela, Omer Qutaiba B; Bahari, Mohd Baidi; Al-abbassi, Mustafa G; Salih, Muhannad R M; Basher, Amena Y

    2012-06-01

    The immunization status of children is improved by interventions that increase community demand for compulsory and non-compulsory vaccines, one of the most important interventions related to immunization providers. The aim of this study is to evaluate the activities of immunization providers in terms of activities time and cost, to calculate the immunization doses cost, and to determine the immunization dose errors cost. Time-motion and cost analysis study design was used. Five public health clinics in Mosul-Iraq participated in the study. Fifty (50) vaccine doses were required to estimate activities time and cost. Micro-costing method was used; time and cost data were collected for each immunization-related activity performed by the clinic staff. A stopwatch was used to measure the duration of activity interactions between the parents and clinic staff. The immunization service cost was calculated by multiplying the average salary/min by activity time per minute. 528 immunization cards of Iraqi children were scanned to determine the number and the cost of immunization doses errors (extraimmunization doses and invalid doses). The average time for child registration was 6.7 min per each immunization dose, and the physician spent more than 10 min per dose. Nurses needed more than 5 min to complete child vaccination. The total cost of immunization activities was 1.67 US$ per each immunization dose. Measles vaccine (fifth dose) has a lower price (0.42 US$) than all other immunization doses. The cost of a total of 288 invalid doses was 744.55 US$ and the cost of a total of 195 extra immunization doses was 503.85 US$. The time spent on physicians' activities was longer than that spent on registrars' and nurses' activities. Physician total cost was higher than registrar cost and nurse cost. The total immunization cost will increase by about 13.3% owing to dose errors.

  16. Parsing error correction of medical phrases for semantic annotation of clinical radiology reports.

    PubMed

    Nishimoto, Naoki; Terae, Satoshi; Uesugi, Masahito; Tanikawa, Takumi; Endou, Akira; Endoh, Akira; Ogasawara, Katsuhiko; Sakurai, Tsunetaro

    2008-01-01

    The purpose of this study is to develop a module for correcting errors in the product of a natural language parser. When tested with 300 CT reports, a total of 604 patterns were generated. The recall and precision was improved to 90.7% and 74.1% after processed by the module from initial 80.5% and 42.8% respectively. This rule-based module will help health care personnel reduce the cost of manual tagging correction for corpus building. PMID:18998948

  17. Connection error in the delivery of medical gases to a surgical unit.

    PubMed

    Dangoisse, M J; Lalot, M; Lechat, J P

    2010-01-01

    Whilst anesthetic incidents due to problems with the delivery of medical gases to a surgical unit are exceptional, their consequences are potentially drastic. With the growing of modern hospitals, every anesthetist may one day find himself confronted with such events, which are new to him, partly because they are infrequent, but mainly because they are due to causes outside his immediate environment. A simple mistake in the labelling and identification of medical gas lines resulted in a cross-connection of the oxygen and air, causing perioperative hypoxemia following the administration of a mixture poor in oxygen. The questions of training, responsibility and procedures in regard to these types of incidents are discussed below. PMID:20593642

  18. Codifying Collegiality: Recent Developments in Data Sharing Policy in the Life Sciences

    PubMed Central

    Pham-Kanter, Genevieve; Zinner, Darren E.; Campbell, Eric G.

    2014-01-01

    Over the last decade, there have been significant changes in data sharing policies and in the data sharing environment faced by life science researchers. Using data from a 2013 survey of over 1600 life science researchers, we analyze the effects of sharing policies of funding agencies and journals. We also examine the effects of new sharing infrastructure and tools (i.e., third party repositories and online supplements). We find that recently enacted data sharing policies and new sharing infrastructure and tools have had a sizable effect on encouraging data sharing. In particular, third party repositories and online supplements as well as data sharing requirements of funding agencies, particularly the NIH and the National Human Genome Research Institute, were perceived by scientists to have had a large effect on facilitating data sharing. In addition, we found a high degree of compliance with these new policies, although noncompliance resulted in few formal or informal sanctions. Despite the overall effectiveness of data sharing policies, some significant gaps remain: about one third of grant reviewers placed no weight on data sharing plans in their reviews, and a similar percentage ignored the requirements of material transfer agreements. These patterns suggest that although most of these new policies have been effective, there is still room for policy improvement. PMID:25259842

  19. Assessing the privacy risks of data sharing in genomics.

    PubMed

    Heeney, C; Hawkins, N; de Vries, J; Boddington, P; Kaye, J

    2011-01-01

    The protection of identity of participants in medical research has traditionally been guaranteed by the maintenance of the confidentiality of health information through mechanisms such as only releasing data in an aggregated form or after identifying variables have been removed. This protection of privacy is regarded as a fundamental principle of research ethics, through which the support of research participants and the public is maintained. Whilst this traditional model was adopted for genetics and genomics research, and was generally considered broadly fit for purpose, we argue that this approach is increasingly untenable in genomics. Privacy risk assessments need to have regard to the whole data environment, not merely the quality of the dataset to be released in isolation. As sources of data proliferate, issues of privacy protection are increasingly problematic in relation to the release of genomic data. However, we conclude that, by paying careful attention to potential pitfalls, scientific funders and researchers can take an important part in attempts to safeguard the public and ensure the continuation of potentially important scientific research.

  20. Changes in Data Sharing and Data Reuse Practices and Perceptions among Scientists Worldwide

    PubMed Central

    Tenopir, Carol; Dalton, Elizabeth D.; Allard, Suzie; Frame, Mike; Pjesivac, Ivanka; Birch, Ben; Pollock, Danielle; Dorsett, Kristina

    2015-01-01

    The incorporation of data sharing into the research lifecycle is an important part of modern scholarly debate. In this study, the DataONE Usability and Assessment working group addresses two primary goals: To examine the current state of data sharing and reuse perceptions and practices among research scientists as they compare to the 2009/2010 baseline study, and to examine differences in practices and perceptions across age groups, geographic regions, and subject disciplines. We distributed surveys to a multinational sample of scientific researchers at two different time periods (October 2009 to July 2010 and October 2013 to March 2014) to observe current states of data sharing and to see what, if any, changes have occurred in the past 3–4 years. We also looked at differences across age, geographic, and discipline-based groups as they currently exist in the 2013/2014 survey. Results point to increased acceptance of and willingness to engage in data sharing, as well as an increase in actual data sharing behaviors. However, there is also increased perceived risk associated with data sharing, and specific barriers to data sharing persist. There are also differences across age groups, with younger respondents feeling more favorably toward data sharing and reuse, yet making less of their data available than older respondents. Geographic differences exist as well, which can in part be understood in terms of collectivist and individualist cultural differences. An examination of subject disciplines shows that the constraints and enablers of data sharing and reuse manifest differently across disciplines. Implications of these findings include the continued need to build infrastructure that promotes data sharing while recognizing the needs of different research communities. Moving into the future, organizations such as DataONE will continue to assess, monitor, educate, and provide the infrastructure necessary to support such complex grand science challenges. PMID:26308551

  1. Changes in Data Sharing and Data Reuse Practices and Perceptions among Scientists Worldwide.

    PubMed

    Tenopir, Carol; Dalton, Elizabeth D; Allard, Suzie; Frame, Mike; Pjesivac, Ivanka; Birch, Ben; Pollock, Danielle; Dorsett, Kristina

    2015-01-01

    The incorporation of data sharing into the research lifecycle is an important part of modern scholarly debate. In this study, the DataONE Usability and Assessment working group addresses two primary goals: To examine the current state of data sharing and reuse perceptions and practices among research scientists as they compare to the 2009/2010 baseline study, and to examine differences in practices and perceptions across age groups, geographic regions, and subject disciplines. We distributed surveys to a multinational sample of scientific researchers at two different time periods (October 2009 to July 2010 and October 2013 to March 2014) to observe current states of data sharing and to see what, if any, changes have occurred in the past 3-4 years. We also looked at differences across age, geographic, and discipline-based groups as they currently exist in the 2013/2014 survey. Results point to increased acceptance of and willingness to engage in data sharing, as well as an increase in actual data sharing behaviors. However, there is also increased perceived risk associated with data sharing, and specific barriers to data sharing persist. There are also differences across age groups, with younger respondents feeling more favorably toward data sharing and reuse, yet making less of their data available than older respondents. Geographic differences exist as well, which can in part be understood in terms of collectivist and individualist cultural differences. An examination of subject disciplines shows that the constraints and enablers of data sharing and reuse manifest differently across disciplines. Implications of these findings include the continued need to build infrastructure that promotes data sharing while recognizing the needs of different research communities. Moving into the future, organizations such as DataONE will continue to assess, monitor, educate, and provide the infrastructure necessary to support such complex grand science challenges. PMID:26308551

  2. Changes in data sharing and data reuse practices and perceptions among scientists worldwide

    USGS Publications Warehouse

    Tenopir, Carol; Dalton, Elizabeth D.; Allard, Suzie; Frame, Mike; Pjesivac, Ivanka; Birch, Ben; Pollock, Danielle; Dorsett, Kristina

    2015-01-01

    The incorporation of data sharing into the research lifecycle is an important part of modern scholarly debate. In this study, the DataONE Usability and Assessment working group addresses two primary goals: To examine the current state of data sharing and reuse perceptions and practices among research scientists as they compare to the 2009/2010 baseline study, and to examine differences in practices and perceptions across age groups, geographic regions, and subject disciplines. We distributed surveys to a multinational sample of scientific researchers at two different time periods (October 2009 to July 2010 and October 2013 to March 2014) to observe current states of data sharing and to see what, if any, changes have occurred in the past 3–4 years. We also looked at differences across age, geographic, and discipline-based groups as they currently exist in the 2013/2014 survey. Results point to increased acceptance of and willingness to engage in data sharing, as well as an increase in actual data sharing behaviors. However, there is also increased perceived risk associated with data sharing, and specific barriers to data sharing persist. There are also differences across age groups, with younger respondents feeling more favorably toward data sharing and reuse, yet making less of their data available than older respondents. Geographic differences exist as well, which can in part be understood in terms of collectivist and individualist cultural differences. An examination of subject disciplines shows that the constraints and enablers of data sharing and reuse manifest differently across disciplines. Implications of these findings include the continued need to build infrastructure that promotes data sharing while recognizing the needs of different research communities. Moving into the future, organizations such as DataONE will continue to assess, monitor, educate, and provide the infrastructure necessary to support such complex grand science challenges.

  3. Changes in Data Sharing and Data Reuse Practices and Perceptions among Scientists Worldwide.

    PubMed

    Tenopir, Carol; Dalton, Elizabeth D; Allard, Suzie; Frame, Mike; Pjesivac, Ivanka; Birch, Ben; Pollock, Danielle; Dorsett, Kristina

    2015-01-01

    The incorporation of data sharing into the research lifecycle is an important part of modern scholarly debate. In this study, the DataONE Usability and Assessment working group addresses two primary goals: To examine the current state of data sharing and reuse perceptions and practices among research scientists as they compare to the 2009/2010 baseline study, and to examine differences in practices and perceptions across age groups, geographic regions, and subject disciplines. We distributed surveys to a multinational sample of scientific researchers at two different time periods (October 2009 to July 2010 and October 2013 to March 2014) to observe current states of data sharing and to see what, if any, changes have occurred in the past 3-4 years. We also looked at differences across age, geographic, and discipline-based groups as they currently exist in the 2013/2014 survey. Results point to increased acceptance of and willingness to engage in data sharing, as well as an increase in actual data sharing behaviors. However, there is also increased perceived risk associated with data sharing, and specific barriers to data sharing persist. There are also differences across age groups, with younger respondents feeling more favorably toward data sharing and reuse, yet making less of their data available than older respondents. Geographic differences exist as well, which can in part be understood in terms of collectivist and individualist cultural differences. An examination of subject disciplines shows that the constraints and enablers of data sharing and reuse manifest differently across disciplines. Implications of these findings include the continued need to build infrastructure that promotes data sharing while recognizing the needs of different research communities. Moving into the future, organizations such as DataONE will continue to assess, monitor, educate, and provide the infrastructure necessary to support such complex grand science challenges.

  4. Benzodiazepine Use During Hospitalization: Automated Identification of Potential Medication Errors and Systematic Assessment of Preventable Adverse Events

    PubMed Central

    Niedrig, David Franklin; Hoppe, Liesa; Mächler, Sarah; Russmann, Heike; Russmann, Stefan

    2016-01-01

    Objective Benzodiazepines and “Z-drug” GABA-receptor modulators (BDZ) are among the most frequently used drugs in hospitals. Adverse drug events (ADE) associated with BDZ can be the result of preventable medication errors (ME) related to dosing, drug interactions and comorbidities. The present study evaluated inpatient use of BDZ and related ME and ADE. Methods We conducted an observational study within a pharmacoepidemiological database derived from the clinical information system of a tertiary care hospital. We developed algorithms that identified dosing errors and interacting comedication for all administered BDZ. Associated ADE and risk factors were validated in medical records. Results Among 53,081 patients contributing 495,813 patient-days BDZ were administered to 25,626 patients (48.3%) on 115,150 patient-days (23.2%). We identified 3,372 patient-days (2.9%) with comedication that inhibits BDZ metabolism, and 1,197 (1.0%) with lorazepam administration in severe renal impairment. After validation we classified 134, 56, 12, and 3 cases involving lorazepam, zolpidem, midazolam and triazolam, respectively, as clinically relevant ME. Among those there were 23 cases with associated adverse drug events, including severe CNS-depression, falls with subsequent injuries and severe dyspnea. Causality for BDZ was formally assessed as ‘possible’ or ‘probable’ in 20 of those cases. Four cases with ME and associated severe ADE required administration of the BDZ antagonist flumazenil. Conclusions BDZ use was remarkably high in the studied setting, frequently involved potential ME related to dosing, co-medication and comorbidities, and rarely cases with associated ADE. We propose the implementation of automated ME screening and validation for the prevention of BDZ-related ADE. PMID:27711224

  5. Towards more reliable automated multi-dose dispensing: retrospective follow-up study on medication dose errors and product defects.

    PubMed

    Palttala, Iida; Heinämäki, Jyrki; Honkanen, Outi; Suominen, Risto; Antikainen, Osmo; Hirvonen, Jouni; Yliruusi, Jouko

    2013-03-01

    To date, little is known on applicability of different types of pharmaceutical dosage forms in an automated high-speed multi-dose dispensing process. The purpose of the present study was to identify and further investigate various process-induced and/or product-related limitations associated with multi-dose dispensing process. The rates of product defects and dose dispensing errors in automated multi-dose dispensing were retrospectively investigated during a 6-months follow-up period. The study was based on the analysis of process data of totally nine automated high-speed multi-dose dispensing systems. Special attention was paid to the dependence of multi-dose dispensing errors/product defects and pharmaceutical tablet properties (such as shape, dimensions, weight, scored lines, coatings, etc.) to profile the most suitable forms of tablets for automated dose dispensing systems. The relationship between the risk of errors in dose dispensing and tablet characteristics were visualized by creating a principal component analysis (PCA) model for the outcome of dispensed tablets. The two most common process-induced failures identified in the multi-dose dispensing are predisposal of tablet defects and unexpected product transitions in the medication cassette (dose dispensing error). The tablet defects are product-dependent failures, while the tablet transitions are dependent on automated multi-dose dispensing systems used. The occurrence of tablet defects is approximately twice as common as tablet transitions. Optimal tablet preparation for the high-speed multi-dose dispensing would be a round-shaped, relatively small/middle-sized, film-coated tablet without any scored line. Commercial tablet products can be profiled and classified based on their suitability to a high-speed multi-dose dispensing process. PMID:22458299

  6. The Effect of an Intervention Aimed at Reducing Errors when Administering Medication through Enteral Feeding Tubes in an Institution for Individuals with Intellectual Disability

    ERIC Educational Resources Information Center

    Idzinga, J. C.; de Jong, A. L.; van den Bemt, P. M. L. A.

    2009-01-01

    Background: Previous studies, both in hospitals and in institutions for clients with an intellectual disability (ID), have shown that medication errors at the administration stage are frequent, especially when medication has to be administered through an enteral feeding tube. In hospitals a specially designed intervention programme has proven to…

  7. Differences in medical error risk among nurses working two- and three-shift systems at teaching hospitals: a six-month prospective study.

    PubMed

    Tanaka, Katsutoshi; Takahashi, Masaya; Hiro, Hisanori; Kakinuma, Mitsuru; Tanaka, Mika; Kamata, Naoki; Miyaoka, Hitoshi

    2010-01-01

    Shift work, including night work, has been regarded as a risk factor for medical safety. However, few studies have investigated the difference in medical error risk between two- and three-shift systems. A total of 1,506 registered nurses working shifts at teaching hospitals participated in this study to evaluate the difference in medical error risk between two- and three-shift systems. After adjustment for potential confounding factors using a log Poisson generalized estimating equation model, the results showed significantly higher frequencies of perceived adverse events over 6 months in the three-shift than in the two-shift system, with estimated mean numbers of adverse events of 1.05 and 0.74, respectively. Shorter intervals after night shifts and greater frequency of night shifts in three-shift systems, which reduce the recovery time from night shift work, may be linked to increased medical errors by nurses.

  8. Confidentiality and data sharing: vulnerabilities of the Mexican Genomics Sovereignty Act.

    PubMed

    Rojas-Martínez, Augusto

    2015-07-01

    A law known as "Genomic Sovereignty Act", instituted in 2011, regulates research on the human genome in Mexico. This law establishes Government regulations for the exportation of DNA samples from Mexican nationals for population genetics studies. The Genomic Sovereignty Act protects fundamental human values, as confidentiality and non-discrimination based on personal genetic information. It also supports the development of the genome-based medical biotechnology and the bio-economy. Current laws for the protection of the genomic confidentiality, however, are inexplicit and insufficient, and the legal and technological instruments are primitive and insufficient to safeguard this bioethical principle. In addition, this law may undermine efforts of the national and international scientific communities to cooperate with big-data analysis for the development of the genome-based biomedical sciences. The argument of this article is that deficiencies in the protection of the confidentiality of genomic information and limitations in data sharing severely weaken the objectives and scope of the Genomic Sovereignty Act. In addition, the Act may compromise the national biomedical development and the international cooperation for research and development in the field of human genomics.

  9. Confidentiality and data sharing: vulnerabilities of the Mexican Genomics Sovereignty Act.

    PubMed

    Rojas-Martínez, Augusto

    2015-07-01

    A law known as "Genomic Sovereignty Act", instituted in 2011, regulates research on the human genome in Mexico. This law establishes Government regulations for the exportation of DNA samples from Mexican nationals for population genetics studies. The Genomic Sovereignty Act protects fundamental human values, as confidentiality and non-discrimination based on personal genetic information. It also supports the development of the genome-based medical biotechnology and the bio-economy. Current laws for the protection of the genomic confidentiality, however, are inexplicit and insufficient, and the legal and technological instruments are primitive and insufficient to safeguard this bioethical principle. In addition, this law may undermine efforts of the national and international scientific communities to cooperate with big-data analysis for the development of the genome-based biomedical sciences. The argument of this article is that deficiencies in the protection of the confidentiality of genomic information and limitations in data sharing severely weaken the objectives and scope of the Genomic Sovereignty Act. In addition, the Act may compromise the national biomedical development and the international cooperation for research and development in the field of human genomics. PMID:25990230

  10. [Errors in medical records as the cause of negative expert decisions regarding disability pensions].

    PubMed

    Zyss, Tomasz

    2007-01-01

    Psychiatric disorders frequently make the patient unable to perform their work. It is estimated that psychiatric disorders are the third most frequent reason for an expert's decision concerning long-term inability to work justifying the granting of a disability pension. Unfortunately, not all patients are certified positively, i.e. are granted disability pension or receive disability benefits in the expected amount; usually, they are lower than those they applied for. The paper discusses the premises applied by the Social Insurance Institution (ZUS) physicians and court appointed experts in their examination of patients applying for disability benefits. Some patients are positively certified already at the time of the initial contact. Their mode of behavior, functioning and patterns of speech leave no doubt as to the significant exacerbation of their mental disturbances. Another group of patients manifests situational "exacerbation" connected with the stressful nature of a meeting with an expert physician. In such cases, the patient's medical records are of great importance. Evaluation of medical records takes into account regular and systematic character of treatment, as well as the kind of pharmacotherapy applied in the treatment. The patient's discontinuation of treatment just after having been granted disability benefits and restarting it a short time before check-up examination is regarded rather critically. Rare appointments taking place once or twice a year are not recognized as corresponding with the existence of intense and debilitating mental disorders. Duration of treatment before applying for disability pension is also evaluated. The author discusses particular cases in the context of ethical and deontological principles.

  11. It depends whose data are being shared: considerations for genomic data sharing policies

    PubMed Central

    Robinson, Jill O.; Slashinski, Melody J.; Chiao, Elizabeth; McGuire, Amy L.

    2015-01-01

    There is an urgent need for consistent data sharing policies that promote the advancement of science while respecting the values and interests of those providing their genetic data for research. Responding to the article of Jalayne J. Arias, Genevieve Pham-Kanter, and Eric G. Campbell, ‘The Growth and Gaps of Genetic Data Sharing Policies in the United States’, this commentary further explores the challenges of human subjects’ protection in existing data sharing policies. We will elaborate on the need for data sharing policies to accommodate variation in individual and group preferences around data sharing and privacy concerns by comparing our previously published data on patients’ and parents’ consent to data sharing and attitudes about privacy to data from focus groups with HIV-positive, underserved individuals who were asked about their willingness to participate in genetic research and share their data broadly. These studies support the observation of Arias, Pham-Kanter, and Campbell that researchers, and funding agencies will need to balance the privacy interests of groups as well as individuals in future genomic data sharing policies. PMID:27774218

  12. The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis

    PubMed Central

    2014-01-01

    Background The Health Information Technology for Economic and Clinical Health (HITECH) Act subsidizes implementation by hospitals of electronic health records with computerized provider order entry (CPOE), which may reduce patient injuries caused by medication errors (preventable adverse drug events, pADEs). Effects on pADEs have not been rigorously quantified, and effects on medication errors have been variable. The objectives of this analysis were to assess the effectiveness of CPOE at reducing pADEs in hospital-related settings, and examine reasons for heterogeneous effects on medication errors. Methods Articles were identified using MEDLINE, Cochrane Library, Econlit, web-based databases, and bibliographies of previous systematic reviews (September 2013). Eligible studies compared CPOE with paper-order entry in acute care hospitals, and examined diverse pADEs or medication errors. Studies on children or with limited event-detection methods were excluded. Two investigators extracted data on events and factors potentially associated with effectiveness. We used random effects models to pool data. Results Sixteen studies addressing medication errors met pooling criteria; six also addressed pADEs. Thirteen studies used pre-post designs. Compared with paper-order entry, CPOE was associated with half as many pADEs (pooled risk ratio (RR) = 0.47, 95% CI 0.31 to 0.71) and medication errors (RR = 0.46, 95% CI 0.35 to 0.60). Regarding reasons for heterogeneous effects on medication errors, five intervention factors and two contextual factors were sufficiently reported to support subgroup analyses or meta-regression. Differences between commercial versus homegrown systems, presence and sophistication of clinical decision support, hospital-wide versus limited implementation, and US versus non-US studies were not significant, nor was timing of publication. Higher baseline rates of medication errors predicted greater reductions (P < 0.001). Other context and

  13. Safety in numbers 2: Competency modelling and diagnostic error assessment in medication dosage calculation problem-solving.

    PubMed

    Weeks, Keith W; Hutton, B Meriel; Young, Simon; Coben, Diana; Clochesy, John M; Pontin, David

    2013-03-01

    Accurately defining and modelling competence in medication dosage calculation problem-solving (MDC-PS) is a fundamental pre-requisite to measuring competence, diagnosing errors and determining the necessary design and content of professional education programmes. In this paper we advance an MDC-PS competence model that illustrates the relationship between conceptual competence (dosage problem-understanding), calculation competence (dosage-computation) and technical measurement competence (dosage-measurement). To facilitate bridging of the theory-practice gap it is critical that such models are operationalised within a wider education framework that supports the learning, assessment and synthesis of cognitive competence (the knowing that and knowing why of MDC-PS) and functional competence (the know-how and skills associated with the professional practice of MDC-PS in clinical settings). Within the context of supporting the learning and diagnostic assessment of MDC-PS we explore PhD fieldwork that challenges the value of pedagogical approaches that focus solely on abstract information, that isolate the process of knowledge construction from its application in practice settings and contribute to the generation of conceptual errors. We consider misconceptions theory and the concept of mathematical 'dropped stitches' and offer an assessment model and program designed to diagnose flawed arithmetical operation and computation constructs.

  14. Developing Ethical Practices for Public Health Research Data Sharing in South Africa

    PubMed Central

    Denny, Spencer G.; Silaigwana, Blessing; Bull, Susan; Parker, Michael

    2015-01-01

    The abundance of South African clinical and public health research data has the potential to unlock important and valuable future advances in biomedical science. Amid increasing calls for more effective sharing of individual-level data, commitment to promote access to research data is evident within South Africa’s public research sector, but national guidance and regulation are absent. This qualitative study examined the perceptions, experiences and concerns of 32 research stakeholders about data-sharing practices. There was consensus about the utility of data sharing in publicly funded health research. However, disparate views emerged about the possible harms and benefits of sharing data and how these should be weighed. The relative dearth of policies governing data-sharing practices needs to be addressed and a framework of support developed that incentivizes data-sharing practices for researchers that are both ethical and effective. PMID:26297750

  15. Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: A randomized crossover trial☆, ☆

    PubMed Central

    Stevens, Allen D.; Hernandez, Caleb; Jones, Seth; Moreira, Maria E.; Blumen, Jason R.; Hopkins, Emily; Sande, Margaret; Bakes, Katherine; Haukoos, Jason S.

    2016-01-01

    Background Medication dosing errors remain commonplace and may result in potentially life-threatening outcomes, particularly for pediatric patients where dosing often requires weight-based calculations. Novel medication delivery systems that may reduce dosing errors resonate with national healthcare priorities. Our goal was to evaluate novel, prefilled medication syringes labeled with color-coded volumes corresponding to the weight-based dosing of the Broselow Tape, compared to conventional medication administration, in simulated prehospital pediatric resuscitation scenarios. Methods We performed a prospective, block-randomized, cross-over study, where 10 full-time paramedics each managed two simulated pediatric arrests in situ using either prefilled, color-coded-syringes (intervention) or their own medication kits stocked with conventional ampoules (control). Each paramedic was paired with two emergency medical technicians to provide ventilations and compressions as directed. The ambulance patient compartment and the intravenous medication port were video recorded. Data were extracted from video review by blinded, independent reviewers. Results Median time to delivery of all doses for the intervention and control groups was 34 (95% CI: 28–39) seconds and 42 (95% CI: 36–51) seconds, respectively (difference = 9 [95% CI: 4–14] seconds). Using the conventional method, 62 doses were administered with 24 (39%) critical dosing errors; using the prefilled, color-coded syringe method, 59 doses were administered with 0 (0%) critical dosing errors (difference = 39%, 95% CI: 13–61%). Conclusions A novel color-coded, prefilled syringe decreased time to medication administration and significantly reduced critical dosing errors by paramedics during simulated prehospital pediatric resuscitations. PMID:26247145

  16. The Precise Observation System for the Safe Use of Medicines (POSSUM): An Approach for Studying Medication Administration Errors in the Field.

    PubMed

    Westbrook, Johanna I; Raban, Magdalena Z; Lehnbom, Elin C; Li, Ling

    2016-01-01

    Medication administration errors (MAEs) in hospital are frequent and significantly more likely to result in serious harm to patients than other medication error types. Many interventions have been proposed in order reduce MAEs and the amount of harm associated with these errors. A major limitation in assessing the effectiveness of these interventions has been the lack of robust measures for assessing changes in MAEs and associated harms. Drawing upon extensive foundational research we have developed a robust approach and data collection software to be applied in direct observational studies of nurses to allow measurement of changes in MAE rates. We report how this approach is being applied in a large stepped-wedge cluster randomised controlled trial to assess the effectiveness of an electronic medication management system to reduce MAEs in a paediatric hospital. PMID:27577460

  17. An Observational Study of the Impact of a Computerized Physician Order Entry System on the Rate of Medication Errors in an Orthopaedic Surgery Unit

    PubMed Central

    Hernandez, Fabien; Majoul, Elyes; Montes-Palacios, Carlota; Antignac, Marie; Cherrier, Bertrand; Doursounian, Levon; Feron, Jean-Marc; Robert, Cyrille; Hejblum, Gilles; Fernandez, Christine; Hindlet, Patrick

    2015-01-01

    Aim To assess the impact of the implementation of a Computerized Physician Order Entry (CPOE) associated with a pharmaceutical checking of medication orders on medication errors in the 3 stages of drug management (i.e. prescription, dispensing and administration) in an orthopaedic surgery unit. Methods A before-after observational study was conducted in the 66-bed orthopaedic surgery unit of a teaching hospital (700 beds) in Paris France. Direct disguised observation was used to detect errors in prescription, dispensing and administration of drugs, before and after the introduction of computerized prescriptions. Compliance between dispensing and administration on the one hand and the medical prescription on the other hand was studied. The frequencies and types of errors in prescribing, dispensing and administration were investigated. Results During the pre and post-CPOE period (two days for each period) 111 and 86 patients were observed, respectively, with corresponding 1,593 and 1,388 prescribed drugs. The use of electronic prescribing led to a significant 92% decrease in prescribing errors (479/1593 prescribed drugs (30.1%) vs 33/1388 (2.4%), p < 0.0001) and to a 17.5% significant decrease in administration errors (209/1222 opportunities (17.1%) vs 200/1413 (14.2%), p < 0.05). No significant difference was found in regards to dispensing errors (430/1219 opportunities (35.3%) vs 449/1407 (31.9%), p = 0.07). Conclusion The use of CPOE and a pharmacist checking medication orders in an orthopaedic surgery unit reduced the incidence of medication errors in the prescribing and administration stages. The study results suggest that CPOE is a convenient system for improving the quality and safety of drug management. PMID:26207363

  18. Patient-Controlled Analgesia Basal Infusion Overdose; Life-threatening Errors with Flecainide Suspension in Children; Medical Product Error-Prevention Efforts Need to Be Shared and Harmonized Internationally.

    PubMed

    Cohen, Michael R; Smetzer, Judy L

    2015-09-01

    These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications. PMID:26715797

  19. Patient-Controlled Analgesia Basal Infusion Overdose; Life-threatening Errors with Flecainide Suspension in Children; Medical Product Error-Prevention Efforts Need to Be Shared and Harmonized Internationally

    PubMed Central

    Cohen, Michael R.; Smetzer, Judy L.

    2015-01-01

    These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers’ names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters’ wishes as to the level of detail included in publications. PMID:26715797

  20. [Medico-legal assessment of selected cases of perinatal complications resulting in death of the woman during childbirth. Medical error or therapeutic failure?].

    PubMed

    Chowaniec, Małgorzata; Chowaniec, Czesław; Jabłoński, Christian; Nowak, Agnieszka

    2005-01-01

    Medico-legal estimation of therapeutic management in cases of perinatal complications, especially those resulting in death of the women during childbirth is usually very difficult. The authors have investigated medical documentation supported by the results of autopsies of cases chosen from the casuistry of the Forensic Medicine Department, Medical University of Silesia, Katowice. Considering the limits of professional liability and legal responsibility of physicians, close attention was paid to standard therapeutic management and increased risk in treatment with regard to that relating to typical salubrious complications. The presented cases of deaths of women during childbirth can be the succeeding opinion in broad discussion on medical errors as well as an attempt to standardise and differentiate the medical error from therapeutic failure which occurred within the reach of risk in the undertaken treatment.

  1. Learning without Borders: A Review of the Implementation of Medical Error Reporting in Médecins Sans Frontières

    PubMed Central

    Shanks, Leslie; Bil, Karla; Fernhout, Jena

    2015-01-01

    Objective To analyse the results from the first 3 years of implementation of a medical error reporting system in Médecins Sans Frontières-Operational Centre Amsterdam (MSF) programs. Methodology A medical error reporting policy was developed with input from frontline workers and introduced to the organisation in June 2010. The definition of medical error used was “the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim.” All confirmed error reports were entered into a database without the use of personal identifiers. Results 179 errors were reported from 38 projects in 18 countries over the period of June 2010 to May 2013. The rate of reporting was 31, 42, and 106 incidents/year for reporting year 1, 2 and 3 respectively. The majority of errors were categorized as dispensing errors (62 cases or 34.6%), errors or delays in diagnosis (24 cases or 13.4%) and inappropriate treatment (19 cases or 10.6%). The impact of the error was categorized as no harm (58, 32.4%), harm (70, 39.1%), death (42, 23.5%) and unknown in 9 (5.0%) reports. Disclosure to the patient took place in 34 cases (19.0%), did not take place in 46 (25.7%), was not applicable for 5 (2.8%) cases and not reported for 94 (52.5%). Remedial actions introduced at headquarters level included guideline revisions and changes to medical supply procedures. At field level improvements included increased training and supervision, adjustments in staffing levels, and adaptations to the organization of the pharmacy. Conclusion It was feasible to implement a voluntary reporting system for medical errors despite the complex contexts in which MSF intervenes. The reporting policy led to system changes that improved patient safety and accountability to patients. Challenges remain in achieving widespread acceptance of the policy as evidenced by the low reporting and disclosure rates. PMID:26381622

  2. Physician Order Entry Or Nurse Order Entry? Comparison of Two Implementation Strategies for a Computerized Order Entry System Aimed at Reducing Dosing Medication Errors

    PubMed Central

    Fors, Uno GH; Tofighi, Shahram; Tessma, Mesfin; Ellenius, Johan

    2010-01-01

    Background Despite the significant effect of computerized physician order entry (CPOE) in reducing nonintercepted medication errors among neonatal inpatients, only a minority of hospitals have successfully implemented such systems. Physicians' resistance and users' frustration seem to be two of the most important barriers. One solution might be to involve nurses in the order entry process to reduce physicians’ data entry workload and resistance. However, the effect of this collaborative order entry method in reducing medication errors should be compared with a strictly physician order entry method. Objective To investigate whether a collaborative order entry method consisting of nurse order entry (NOE) followed by physician verification and countersignature is as effective as a strictly physician order entry (POE) method in reducing nonintercepted dose and frequency medication errors in the neonatal ward of an Iranian teaching hospital. Methods A four-month prospective study was designed with two equal periods. During the first period POE was used and during the second period NOE was used. In both methods, a warning appeared when the dose or frequency of the prescribed medication was incorrect that suggested the appropriate dosage to the physicians. Physicians’ responses to the warnings were recorded in a database and subsequently analyzed. Relevant paper-based and electronic medical records were reviewed to increase credibility. Results Medication prescribing for 158 neonates was studied. The rate of nonintercepted medication errors during the NOE period was 40% lower than during the POE period (rate ratio 0.60; 95% confidence interval [CI] .50, .71;P < .001). During the POE period, 80% of nonintercepted errors occurred at the prescription stage, while during the NOE period, 60% of nonintercepted errors occurred in that stage. Prescription errors decreased from 10.3% during the POE period to 4.6% during the NOE period (P < .001), and the number of warnings

  3. The growth and gaps of genetic data sharing policies in the United States

    PubMed Central

    Arias, Jalayne J.; Pham-Kanter, Genevieve; Campbell, Eric G.

    2014-01-01

    The 1996 Bermuda Principles launched a new era in data sharing, reflecting a growing belief that the rapid public dissemination of research data was crucial to scientific progress in genetics. A historical review of data sharing policies in the field of genetics and genomics reflects changing scientific norms and evolving views of genomic data, particularly related to human subjects’ protections and privacy concerns. The 2013 NIH Draft Genomic Data Sharing (GDS) Policy incorporates the most significant protections and guidelines to date. The GDS Policy, however, will face difficult challenges ahead as geneticists seek to balance the very real concerns of research participants and the scientific norms that propel research forward. This article provides a novel evaluation of genetic and GDS policies’ treatment of human subjects’ protections. The article examines not only the policies, but also some of the most pertinent scientific, legal, and regulatory developments that occurred alongside data sharing policies. This historical perspective highlights the challenges that future data sharing policies, including the recently disseminated NIH GDS Draft Policy, will encounter. PMID:27774180

  4. Privacy Technology to Support Data Sharing for Comparative Effectiveness Research: A SYSTEMATIC REVIEW

    PubMed Central

    Jiang, Xiaoqian; Sarwate, Anand D.; Ohno-Machado, Lucila

    2013-01-01

    Objective Effective data sharing is critical for comparative effectiveness research (CER), but there are significant concerns about inappropriate disclosure of patient data. These concerns have spurred the development of new technologies for privacy preserving data sharing and data mining. Our goal is to review existing and emerging techniques that may be appropriate for data sharing related to CER. Material and methods We adapted a systematic review methodology to comprehensively search the research literature. We searched 7 databases and applied three stages of filtering based on titles, abstracts, and full text to identify those works most relevant to CER. Results Based on agreement and using the arbitrage of a third party expert, we selected 97 articles for meta-analysis. Our findings are organized along major types of data sharing in CER applications (i.e., institution-to-institution, institution-hosted, and public release). We made recommendations based on specific scenarios. Limitation We limited the scope of our study to methods that demonstrated practical impact, eliminating many theoretical studies of privacy that have been surveyed elsewhere. We further limited our study to data sharing for data tables, rather than complex genomic, set-valued, time series, text, image, or network data. Conclusion State-of-the-art privacy preserving technologies can guide the development of practical tools that will scale up the CER studies of the future. However, many challenges remain in this fast moving field in terms of practical evaluations as well as applications to a wider range of data types. PMID:23774511

  5. Persistence of Hemorrhage and Hypertensive Disorders of Pregnancy (HDP) as the Main Causes of Maternal Mortality: Emergence of Medical Errors in Iranian Healthcare System

    PubMed Central

    FARROKH-ESLAMLOU, Hamidreza; AGHLMAND, Siamak; OSHNOUEI, Sima

    2014-01-01

    Abstract Background This study aimed to assess factors affecting substandard care and probable medical errors associated with obstetric hemorrhage and HDP at a Northwestern Iranian health care system. Methods In a community-based descriptive cross-sectional study, data on all maternal deaths occurred at West Azerbaijan Province, Iran during a period of 10 years from March 21, 2002 to March 20, 2011 was analyzed. The principal cause of death, main contributory factors, nature of care, main responsible staff for sub-standard care and medical error were determined. The data on maternal deaths was obtained from the national Maternal Mortality Surveillance System (MMSS) which were covered all maternal deaths. The “Three delays model” was used to recognize contributing factors of maternal deaths due to obstetric hemorrhage and HDP. Results There were 183 maternal deaths, therefore the Mean Maternal Mortality Ratio (MMR) in the province was 32.8 per 100 000 live births (95% CI, 32.64—32.88). The most common causes of maternal deaths were obstetric hemorrhage in 36.6% of cases and HDP in 25.7%. The factors that most contributed to the deaths were all types of medical errors and substandard care with different proportions in management of obstetric hemorrhage and HDP. Conclusion A substandard care and medical error was the major contributing factor in both obstetric hemorrhage and HDP leading to maternal mortality, therefore, it is necessary to improve the quality of health care at all levels especially hospitals. PMID:26060702

  6. The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education – A Position Statement of the Committee for Patient Safety and Error Management of the German Association for Medical Education

    PubMed Central

    Kiesewetter, Jan; Gutmann, Johanna; Drossard, Sabine; Gurrea Salas, David; Prodinger, Wolfgang; Mc Dermott, Fiona; Urban, Bert; Staender, Sven; Baschnegger, Heiko; Hoffmann, Gordon; Hübsch, Grit; Scholz, Christoph; Meier, Anke; Wegscheider, Mirko; Hoffmann, Nicolas; Ohlenbusch-Harke, Theda; Keil, Stephanie; Schirlo, Christian; Kühne-Eversmann, Lisa; Heitzmann, Nicole; Busemann, Alexandra; Koechel, Ansgar; Manser, Tanja; Welbergen, Lena; Kiesewetter, Isabel

    2016-01-01

    Background: Since the report “To err is human” was published by the Institute of Medicine in the year 2000, topics regarding patient safety and error management are in the focal point of interest of science and politics. Despite international attention, a structured and comprehensive medical education regarding these topics remains to be missing. Goals: The Learning Objective Catalogue for Patient Safety described below the Committee for Patient Safety and Error Management of the German Association for Medical Education (GMA) has aimed to establish a common foundation for the structured implementation of patient safety curricula at the medical faculties in German-speaking countries. Methods: The development the Learning Objective Catalogue resulted via the participation of 13 faculties in two committee meetings, two multi-day workshops, and additional judgments of external specialists. Results: The Committee of Patient Safety and Error Management of GMA developed the present Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education, structured in three chapters: Basics, Recognize Causes as Foundation for Proactive Behavior, and Approaches for Solutions. The learning objectives within the chapters are organized on three levels with a hierarchical organization of the topics. Overall, the Learning Objective Catalogue consists of 38 learning objectives. All learning objectives are referenced with the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education. Discussion: The Learning Objective Catalogue for Patient Safety in Undergraduate Medical Education is a product that was developed through collaboration of members from 13 medical faculties. In the German-speaking countries, the Learning Objective Catalogue should advance discussion regarding the topics of patient safety and error management and help develop subsequent educational structures. The Learning Objective Catalogue for Patient Safety can

  7. Implementation of a health data-sharing infrastructure across diverse primary care organizations.

    PubMed

    Cole, Allison M; Stephens, Kari A; Keppel, Gina A; Lin, Ching-Ping; Baldwin, Laura-Mae

    2014-01-01

    Practice-based research networks bring together academic researchers and primary care clinicians to conduct research that improves health outcomes in real-world settings. The Washington, Wyoming, Alaska, Montana, and Idaho region Practice and Research Network implemented a health data-sharing infrastructure across 9 clinics in 3 primary care organizations. Following implementation, we identified challenges and solutions. Challenges included working with diverse primary care organizations, adoption of health information data-sharing technology in a rapidly changing local and national landscape, and limited resources for implementation. Overarching solutions included working with a multidisciplinary academic implementation team, maintaining flexibility, and starting with an established network for primary care organizations. Approaches outlined may generalize to similar initiatives and facilitate adoption of health data sharing in other practice-based research networks. PMID:24594564

  8. Data Rights and Responsibilities: A Human Rights Perspective on Data Sharing.

    PubMed

    Harris, Theresa L; Wyndham, Jessica M

    2015-07-01

    A human-rights-based analysis can be a useful tool for the scientific community and policy makers as they develop codes of conduct, harmonized standards, and national policies for data sharing. The human rights framework provides a shared set of values and norms across borders, defines rights and responsibilities of various actors involved in data sharing, addresses the potential harms as well as the benefits of data sharing, and offers a framework for balancing competing values. The right to enjoy the benefits of scientific progress and its applications offers a particularly helpful lens through which to view data as both a tool of scientific inquiry to which access is vital and as a product of science from which everyone should benefit.

  9. From the principles of genomic data sharing to the practices of data access committees.

    PubMed

    Shabani, Mahsa; Knoppers, Bartha Maria; Borry, Pascal

    2015-05-01

    Sharing genomic research data through controlled-access databases has increased in recent years. Policymakers and funding organizations endorse genomic data sharing in order to optimize the use of public funds and to increase the statistical power of databases. Well-established data access arrangements and data access committees (DACs)-responsible for reviewing and managing requests for access to genomic databases-are therefore central for implementing the policies and principles of data sharing. This article aims to investigate the functionality of DACs through the perspective of existing practices.

  10. From the principles of genomic data sharing to the practices of data access committees

    PubMed Central

    Shabani, Mahsa; Knoppers, Bartha Maria; Borry, Pascal

    2015-01-01

    Sharing genomic research data through controlled-access databases has increased in recent years. Policymakers and funding organizations endorse genomic data sharing in order to optimize the use of public funds and to increase the statistical power of databases. Well-established data access arrangements and data access committees (DACs)—responsible for reviewing and managing requests for access to genomic databases—are therefore central for implementing the policies and principles of data sharing. This article aims to investigate the functionality of DACs through the perspective of existing practices. PMID:25759363

  11. Addressing medical coding and billing part II: a strategy for achieving compliance. A risk management approach for reducing coding and billing errors.

    PubMed Central

    Adams, Diane L.; Norman, Helen; Burroughs, Valentine J.

    2002-01-01

    Medical practice today, more than ever before, places greater demands on physicians to see more patients, provide more complex medical services and adhere to stricter regulatory rules, leaving little time for coding and billing. Yet, the need to adequately document medical records, appropriately apply billing codes and accurately charge insurers for medical services is essential to the medical practice's financial condition. Many physicians rely on office staff and billing companies to process their medical bills without ever reviewing the bills before they are submitted for payment. Some physicians may not be receiving the payment they deserve when they do not sufficiently oversee the medical practice's coding and billing patterns. This article emphasizes the importance of monitoring and auditing medical record documentation and coding application as a strategy for achieving compliance and reducing billing errors. When medical bills are submitted with missing and incorrect information, they may result in unpaid claims and loss of revenue to physicians. Addressing Medical Audits, Part I--A Strategy for Achieving Compliance--CMS, JCAHO, NCQA, published January 2002 in the Journal of the National Medical Association, stressed the importance of preparing the medical practice for audits. The article highlighted steps the medical practice can take to prepare for audits and presented examples of guidelines used by regulatory agencies to conduct both medical and financial audits. The Medicare Integrity Program was cited as an example of guidelines used by regulators to identify coding errors during an audit and deny payment to providers when improper billing occurs. For each denied claim, payments owed to the medical practice are are also denied. Health care is, no doubt, a costly endeavor for health care providers, consumers and insurers. The potential risk to physicians for improper billing may include loss of revenue, fraud investigations, financial sanction

  12. Mortality as an indicator of patient safety in orthopaedics: lessons from qualitative analysis of a database of medical errors

    PubMed Central

    2012-01-01

    Background Orthopaedic surgery is a high-risk specialty in which errors will undoubtedly occur. Patient safety incidents can yield valuable information to generate solutions and prevent future cases of avoidable harm. The aim of this study was to understand the causative factors leading to all unnecessary deaths in orthopaedics and trauma surgery reported to the National Patient Safety Agency (NPSA) over a four-year period (2005–2009), using a qualitative approach. Methods Reports made to the NPSA are categorised and stored in the database as free-text data. A search was undertaken to identify the cases of all-cause mortality in orthopaedic and trauma surgery, and the free-text elements were used for thematic analysis. Descriptive statistics were calculated based on the incidents reported. This included presenting the number of times categories of incidents had the same or similar response. Superordinate and subordinate categories were created. Results A total of 257 incident reports were analysed. Four main thematic categories emerged. These were: (1) stages of the surgical journey – 118/191 (62%) of deaths occurred in the post-operative phase; (2) causes of patient deaths – 32% were related to severe infections; (3) reported quality of medical interventions – 65% of patients experienced minimal or delayed treatment; (4) skills of healthcare professionals – 44% of deaths had a failure in non-technical skills. Conclusions Most complications in orthopaedic surgery can be dealt with adequately, provided they are anticipated and that risk-reduction strategies are instituted. Surgeons take pride in the precision of operative techniques; perhaps it is time to enshrine the multimodal tools available to ensure safer patient care. PMID:22682470

  13. Propylene Glycol Toxicity with Stoss Therapy; State Drug Tracking Database Helps Prevent an Error; Where Did That Medication Come From?; Expiration Date Difficult to Read.

    PubMed

    Cohen, Michael R; Smetzer, Judy L

    2015-04-01

    These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications. PMID:26448654

  14. Propylene Glycol Toxicity with Stoss Therapy; State Drug Tracking Database Helps Prevent an Error; Where Did That Medication Come From?; Expiration Date Difficult to Read.

    PubMed

    Cohen, Michael R; Smetzer, Judy L

    2015-04-01

    These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (www.ismp.org), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org. ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.

  15. A human rights approach to an international code of conduct for genomic and clinical data sharing.

    PubMed

    Knoppers, Bartha M; Harris, Jennifer R; Budin-Ljøsne, Isabelle; Dove, Edward S

    2014-07-01

    Fostering data sharing is a scientific and ethical imperative. Health gains can be achieved more comprehensively and quickly by combining large, information-rich datasets from across conventionally siloed disciplines and geographic areas. While collaboration for data sharing is increasingly embraced by policymakers and the international biomedical community, we lack a common ethical and legal framework to connect regulators, funders, consortia, and research projects so as to facilitate genomic and clinical data linkage, global science collaboration, and responsible research conduct. Governance tools can be used to responsibly steer the sharing of data for proper stewardship of research discovery, genomics research resources, and their clinical applications. In this article, we propose that an international code of conduct be designed to enable global genomic and clinical data sharing for biomedical research. To give this proposed code universal application and accountability, however, we propose to position it within a human rights framework. This proposition is not without precedent: international treaties have long recognized that everyone has a right to the benefits of scientific progress and its applications, and a right to the protection of the moral and material interests resulting from scientific productions. It is time to apply these twin rights to internationally collaborative genomic and clinical data sharing.

  16. Big Heart Data: Advancing Health Informatics through Data Sharing in Cardiovascular Imaging

    PubMed Central

    Suinesiaputra, Avan; Medrano-Gracia, Pau; Cowan, Brett R.; Young, Alistair A.

    2015-01-01

    The burden of heart disease is rapidly worsening due to increasing prevalence of obesity and diabetes. Data sharing and open database resources for heart health informatics are important for advancing our understanding of cardiovascular function, disease progression and therapeutics. Data sharing enables valuable information, often obtained at considerable expense and effort, to be re-used beyond the specific objectives of the original study. Many government funding agencies and journal publishers are requiring data re-use, and are providing mechanisms for data curation and archival. Tools and infrastructure are available to archive anonymous data from a wide range of studies, from descriptive epidemiological data to gigabytes of imaging data. Meta-analyses can be performed to combine raw data from disparate studies to obtain unique comparisons or to enhance statistical power. Open benchmark datasets are invaluable for validating data analysis algorithms and objectively comparing results. This review provides a rationale for increased data sharing and surveys recent progress in the cardiovascular domain. We also highlight the potential of recent large cardiovascular epidemiological studies enabling collaborative efforts to facilitate data sharing, algorithms benchmarking, disease modeling and statistical atlases. PMID:25415993

  17. Data Standards for Omics Data: the Basis of Data Sharing and Reuse.

    SciTech Connect

    Chervitz, Stephen A.; Deutsch, Eric W.; Field, Dawn; Parkinson, Helen E.; Quackenbush, John; Rocca-Serra, Philippe; Sansone, Susanna A.; Stoeckert, Christian Jr. J.; Taylor, Chris F.; Taylor, Ronald C.; Ball, Catherine A.

    2011-11-01

    To facilitate sharing of Omics data, many groups of scientists have been working to establish the relevant data standards. The main components of data sharing standards are experiment description standards, data exchange standards, terminology standards, and experiment execution standards. Here we provide a survey of existing and emerging standards that are intended to assist the free and open exchange of large-format data.

  18. A human rights approach to an international code of conduct for genomic and clinical data sharing.

    PubMed

    Knoppers, Bartha M; Harris, Jennifer R; Budin-Ljøsne, Isabelle; Dove, Edward S

    2014-07-01

    Fostering data sharing is a scientific and ethical imperative. Health gains can be achieved more comprehensively and quickly by combining large, information-rich datasets from across conventionally siloed disciplines and geographic areas. While collaboration for data sharing is increasingly embraced by policymakers and the international biomedical community, we lack a common ethical and legal framework to connect regulators, funders, consortia, and research projects so as to facilitate genomic and clinical data linkage, global science collaboration, and responsible research conduct. Governance tools can be used to responsibly steer the sharing of data for proper stewardship of research discovery, genomics research resources, and their clinical applications. In this article, we propose that an international code of conduct be designed to enable global genomic and clinical data sharing for biomedical research. To give this proposed code universal application and accountability, however, we propose to position it within a human rights framework. This proposition is not without precedent: international treaties have long recognized that everyone has a right to the benefits of scientific progress and its applications, and a right to the protection of the moral and material interests resulting from scientific productions. It is time to apply these twin rights to internationally collaborative genomic and clinical data sharing. PMID:24573176

  19. Big heart data: advancing health informatics through data sharing in cardiovascular imaging.

    PubMed

    Suinesiaputra, Avan; Medrano-Gracia, Pau; Cowan, Brett R; Young, Alistair A

    2015-07-01

    The burden of heart disease is rapidly worsening due to the increasing prevalence of obesity and diabetes. Data sharing and open database resources for heart health informatics are important for advancing our understanding of cardiovascular function, disease progression and therapeutics. Data sharing enables valuable information, often obtained at considerable expense and effort, to be reused beyond the specific objectives of the original study. Many government funding agencies and journal publishers are requiring data reuse, and are providing mechanisms for data curation and archival. Tools and infrastructure are available to archive anonymous data from a wide range of studies, from descriptive epidemiological data to gigabytes of imaging data. Meta-analyses can be performed to combine raw data from disparate studies to obtain unique comparisons or to enhance statistical power. Open benchmark datasets are invaluable for validating data analysis algorithms and objectively comparing results. This review provides a rationale for increased data sharing and surveys recent progress in the cardiovascular domain. We also highlight the potential of recent large cardiovascular epidemiological studies enabling collaborative efforts to facilitate data sharing, algorithms benchmarking, disease modeling and statistical atlases. PMID:25415993

  20. Data Sharing Agreement Checklist for IDEA Part C and Part B 619 Agencies and Programs

    ERIC Educational Resources Information Center

    Center for IDEA Early Childhood Data Systems (DaSy), 2014

    2014-01-01

    This 2014 document is an adaptation of the 2012 release of "Data Sharing Agreement Checklist" intended for K-12 audiences. Presented as a checklist, the document summarizes the requirements for the written agreements under the audit or evaluation exception that is specified in FERPA and that also applies to the IDEA for Part C early…

  1. Phenotyping for patient safety: algorithm development for electronic health record based automated adverse event and medical error detection in neonatal intensive care

    PubMed Central

    Li, Qi; Melton, Kristin; Lingren, Todd; Kirkendall, Eric S; Hall, Eric; Zhai, Haijun; Ni, Yizhao; Kaiser, Megan; Stoutenborough, Laura; Solti, Imre

    2014-01-01

    Background Although electronic health records (EHRs) have the potential to provide a foundation for quality and safety algorithms, few studies have measured their impact on automated adverse event (AE) and medical error (ME) detection within the neonatal intensive care unit (NICU) environment. Objective This paper presents two phenotyping AE and ME detection algorithms (ie, IV infiltrations, narcotic medication oversedation and dosing errors) and describes manual annotation of airway management and medication/fluid AEs from NICU EHRs. Methods From 753 NICU patient EHRs from 2011, we developed two automatic AE/ME detection algorithms, and manually annotated 11 classes of AEs in 3263 clinical notes. Performance of the automatic AE/ME detection algorithms was compared to trigger tool and voluntary incident reporting results. AEs in clinical notes were double annotated and consensus achieved under neonatologist supervision. Sensitivity, positive predictive value (PPV), and specificity are reported. Results Twelve severe IV infiltrates were detected. The algorithm identified one more infiltrate than the trigger tool and eight more than incident reporting. One narcotic oversedation was detected demonstrating 100% agreement with the trigger tool. Additionally, 17 narcotic medication MEs were detected, an increase of 16 cases over voluntary incident reporting. Conclusions Automated AE/ME detection algorithms provide higher sensitivity and PPV than currently used trigger tools or voluntary incident-reporting systems, including identification of potential dosing and frequency errors that current methods are unequipped to detect. PMID:24401171

  2. Compliance and Cognitive Function: A Methodological Approach to Measuring Unintentional Errors in Medication Compliance in the Elderly.

    ERIC Educational Resources Information Center

    Isaac, Lisa M.; And Others

    1993-01-01

    Assessed multiple aspects of cognitive performance, medication planning ability, and medication compliance in 20 elderly outpatients. Findings suggest that aspects of attention/concentration, visual and verbal memory, and motor function which are untapped by simple mental status assessment are related to medication access, planning, and compliance…

  3. Multilateral Biomedical Data Sharing in the One-year Joint US-Russian Mission on the International Space Station

    NASA Technical Reports Server (NTRS)

    Charles, John B.; Haven, C.; Johnson-Throop, K.; Van Baalen, M.; McFather, J.

    2014-01-01

    presentation will describe the overarching principles for multilateral data collection, analysis and sharing and for data security for medical and research data shared between ISS partners prior to release in public forums.

  4. Integrating GIS with Distributed Applications Using Dynamic Data-Sharing Mechanisms

    SciTech Connect

    Burnett, Robert A. ); Tzemos, Spyridon ); Stoops, LaMar R. )

    2002-08-21

    Effective integration of a stand-alone GIS (e.g., ArcView 3.x) into a complex distributed software application requires an efficient, reliable mechanism for passing data and function requests to and from the GIS component. This paper describes the use of dynamic data-sharing and inter-process communication mechanisms to integrate GIS capability into a multi-jurisdictional distributed emergency management information system. These mechanisms include dynamic layer updates from spatial and attribute information shared via a distributed relational database across multiple sites; storage of private and shared ViewMarks to facilitate consistent GIS views; and asynchronous inter-process communication using function queuing and a data sharing library.

  5. An International Framework for Data Sharing: Moving Forward with the Global Alliance for Genomics and Health.

    PubMed

    Rahimzadeh, Vasiliki; Dyke, Stephanie O M; Knoppers, Bartha M

    2016-06-01

    The Global Alliance for Genomics and Health is marshaling expertise in biomedical research and data sharing policy to propel bench-to-bedside translation of genomics in parallel with many of the BioSHaRE-EU initiatives described at length in this Issue. Worldwide representation of institutions, funders, researchers, and patient advocacy groups at the Global Alliance is testament to a shared ideal that sees maximizing the public good as a chief priority of genomic innovation in health. The Global Alliance has made a critical stride in this regard with the development of its Framework for Responsible Sharing of Genomic and Health-related Data.(1) This article first discusses the human rights pillars that underlie the Framework and mission of the Global Alliance. Second, it outlines the Global Alliance's use of data governance policies through a number of demonstration projects. Finally, the authors describe how the Global Alliance envisions international data sharing moving forward in the postgenomic era. PMID:27082668

  6. Trust, Respect, and Reciprocity: Informing Culturally Appropriate Data-Sharing Practice in Vietnam.

    PubMed

    Merson, Laura; Phong, Tran Viet; Nhan, Le Nguyen Thanh; Dung, Nguyen Thanh; Ngan, Ta Thi Dieu; Kinh, Nguyen Van; Parker, Michael; Bull, Susan

    2015-07-01

    International science funders and publishers are driving a growing trend in data sharing. There is mounting pressure on researchers in low- and middle-income settings to conform to new sharing policies, despite minimal empirically grounded accounts of the ethical challenges of implementing the policies in these settings. This study used in-depth interviews and focus group discussions with 48 stakeholders in Vietnam to explore the experiences, attitudes, and expectations that inform ethical and effective approaches to sharing clinical research data. Distinct views on the role of trust, respect, and reciprocity were among those that emerged to inform culturally appropriate best practices. We conclude by discussing the challenges that authors of data-sharing policies should consider in this unique context.

  7. The Tension Between Data Sharing and the Protection of Privacy in Genomics Research

    PubMed Central

    Kaye, Jane

    2014-01-01

    Next-generation sequencing and global data sharing challenge many of the governance mechanisms currently in place to protect the privacy of research participants. These challenges will make it more difficult to guarantee anonymity for participants, provide information to satisfy the requirements of informed consent, and ensure complete withdrawal from research when requested. To move forward, we need to improve the current governance systems for research so that they are responsive to individual privacy concerns but can also be effective at a global level. We need to develop a system of e-governance that can complement existing governance systems but that places greater reliance on the use of technology to ensure compliance with ethical and legal requirements. These new governance structures must be able to address the concerns of research participants while at the same time ensuring effective data sharing that promotes public trust in genomics research. PMID:22404490

  8. The tension between data sharing and the protection of privacy in genomics research.

    PubMed

    Kaye, Jane

    2012-01-01

    Next-generation sequencing and global data sharing challenge many of the governance mechanisms currently in place to protect the privacy of research participants. These challenges will make it more difficult to guarantee anonymity for participants, provide information to satisfy the requirements of informed consent, and ensure complete withdrawal from research when requested. To move forward, we need to improve the current governance systems for research so that they are responsive to individual privacy concerns but can also be effective at a global level. We need to develop a system of e-governance that can complement existing governance systems but that places greater reliance on the use of technology to ensure compliance with ethical and legal requirements. These new governance structures must be able to address the concerns of research participants while at the same time ensuring effective data sharing that promotes public trust in genomics research.

  9. LC Data QUEST: A Technical Architecture for Community Federated Clinical Data Sharing.

    PubMed

    Stephens, Kari A; Lin, Ching-Ping; Baldwin, Laura-Mae; Echo-Hawk, Abigail; Keppel, Gina A; Buchwald, Dedra; Whitener, Ron J; Korngiebel, Diane M; Berg, Alfred O; Black, Robert A; Tarczy-Hornoch, Peter

    2012-01-01

    The University of Washington Institute of Translational Health Sciences is engaged in a project, LC Data QUEST, building data sharing capacity in primary care practices serving rural and tribal populations in the Washington, Wyoming, Alaska, Montana, Idaho region to build research infrastructure. We report on the iterative process of developing the technical architecture for semantically aligning electronic health data in primary care settings across our pilot sites and tools that will facilitate linkages between the research and practice communities. Our architecture emphasizes sustainable technical solutions for addressing data extraction, alignment, quality, and metadata management. The architecture provides immediate benefits to participating partners via a clinical decision support tool and data querying functionality to support local quality improvement efforts. The FInDiT tool catalogues type, quantity, and quality of the data that are available across the LC Data QUEST data sharing architecture. These tools facilitate the bi-directional process of translational research.

  10. Data Standards for Omics Data: The Basis of Data Sharing and Reuse

    PubMed Central

    Chervitz, Stephen A.; Deutsch, Eric W.; Field, Dawn; Parkinson, Helen; Quackenbush, John; Rocca-Serra, Phillipe; Sansone, Susanna-Assunta; Stoeckert, Christian J.; Taylor, Chris F.; Taylor, Ronald; Ball, Catherine A.

    2014-01-01

    To facilitate sharing of Omics data, many groups of scientists have been working to establish the relevant data standards. The main components of data sharing standards are experiment description standards, data exchange standards, terminology standards, and experiment execution standards. Here we provide a survey of existing and emerging standards that are intended to assist the free and open exchange of large-format data. PMID:21370078

  11. Perspectives on Open Science and scientific data sharing:an interdisciplinary workshop.

    PubMed

    Destro Bisol, Giovanni; Anagnostou, Paolo; Capocasa, Marco; Bencivelli, Silvia; Cerroni, Andrea; Contreras, Jorge; Enke, Neela; Fantini, Bernardino; Greco, Pietro; Heeney, Catherine; Luzi, Daniela; Manghi, Paolo; Mascalzoni, Deborah; Molloy, Jennifer; Parenti, Fabio; Wicherts, Jelte; Boulton, Geoffrey

    2014-01-01

    Looking at Open Science and Open Data from a broad perspective. This is the idea behind "Scientific data sharing: an interdisciplinary workshop", an initiative designed to foster dialogue between scholars from different scientific domains which was organized by the Istituto Italiano di Antropologia in Anagni, Italy, 2-4 September 2013.We here report summaries of the presentations and discussions at the meeting. They deal with four sets of issues: (i) setting a common framework, a general discussion of open data principles, values and opportunities; (ii) insights into scientific practices, a view of the way in which the open data movement is developing in a variety of scientific domains (biology, psychology, epidemiology and archaeology); (iii) a case study of human genomics, which was a trail-blazer in data sharing, and which encapsulates the tension that can occur between large-scale data sharing and one of the boundaries of openness, the protection of individual data; (iv) open science and the public, based on a round table discussion about the public communication of science and the societal implications of open science. There were three proposals for the planning of further interdisciplinary initiatives on open science. Firstly, there is a need to integrate top-down initiatives by governments, institutions and journals with bottom-up approaches from the scientific community. Secondly, more should be done to popularize the societal benefits of open science, not only in providing the evidence needed by citizens to draw their own conclusions on scientific issues that are of concern to them, but also explaining the direct benefits of data sharing in areas such as the control of infectious disease. Finally, introducing arguments from social sciences and humanities in the educational dissemination of open data may help students become more profoundly engaged with Open Science and look at science from a broader perspective.

  12. The Mason Water Data Information System (MWDIS): Enabling data sharing and discovery at George Mason University

    NASA Astrophysics Data System (ADS)

    Ferreira, C.; Da Silva, A. L.; Nunes, A.; Haddad, J.; Lawler, S.

    2014-12-01

    Enabling effective data use and re-use in scientific investigations relies heavily not only on data availability but also on efficient data sharing discovery. The CUAHSI led Hydrological Information Systems (HIS) and supporting products have paved the way to efficient data sharing and discovery in the hydrological sciences. Based on the CUAHSI-HIS framework concepts for hydrologic data sharing we developed a unique system devoted to the George Mason University scientific community to support university wide data sharing and discovery as well as real time data access for extreme events situational awareness. The internet-based system will provide an interface where the researchers will input data collected from the measurement stations and present them to the public in form of charts, tables, maps, and documents. Moreover, the system is developed in ASP.NET MVC 4 using as Database Management System, Microsoft SQL Server 2008 R2, and hosted by Amazon Web Services. Currently the system is supporting the Mason Watershed Project providing historical hydrological, atmospheric and water quality data for the campus watershed and real time flood conditions in the campus. The system is also a gateway for unprecedented data collection of hurricane storm surge hydrodynamics in coastal wetlands in the Chesapeake Bay providing not only access to historical data but recent storms such as Hurricane Arthur. Future research includes coupling the system to a real-time flood alert system on campus, and besides providing data on the World Wide Web, to foment and provide a venue for interdisciplinary collaboration within the water scientists in the region.

  13. Factors Related to Public Health Data Sharing between Local and State Health Departments

    PubMed Central

    Vest, Joshua R; Issel, L Michele

    2014-01-01

    Objective Public health organizations increasingly face the need to be able to share data among themselves and ultimately with other providers. We examined what factors contribute to public health organizations’ data exchange capabilities. Data Sources National Association of County and City Health Officials’ 2008 National Profile of Local Health Departments survey was linked to the Association of State and Territorial Health Official’s 2007 Profile of State Public Health Survey. Study Design We conducted a cross-sectional analysis of organizational factors associated with gaps in data sharing between state health agencies (SHAs) and local health departments (LHDs) in the areas of childhood immunizations, vital records, and reportable conditions. Data Collection Based on reported information system (IS) capabilities, we created a binary variable that measured whether bidirectional data sharing was structurally possible between an LHD and its respective SHA. Principal Findings The proportion of LHDs experiencing a data sharing gap was 34.0 percent for immunizations, 69.8 percent for vital records, and 81.8 percent for reportable conditions. Increased SHA technological capacity and size reduced the odds of gaps. Conclusions Improving the IS capabilities of public health agencies may be the key to their remaining relevant in the currently evolving health care system. PMID:24359636

  14. Capturing and Supporting Contexts for Scientific Data Sharing via the Biological Sciences Collaboratory

    SciTech Connect

    Chin, George; Lansing, Carina S.

    2004-11-10

    Scientific collaboration is largely focused on the sharing and joint analysis of scientific data and results. Today, a movement is afoot within the scientific computing community to shift “collaboratory” development from traditional tool-centric approaches to more data-centric ones. Yet, to effectively support data sharing means more than providing a common repository for storing and retrieving shared data sets. In order to reasonably comprehend and apply another researcher’s data set, the scientist must grasp the various contexts of the data as it relates to the overall data space, applications, experiments, projects, and the scientific community. Under development at the Pacific Northwest National Laboratory, the Biological Sciences Collaboratory (BSC) enables the sharing of biological data and analyses through diverse capabilities such as metadata capture, electronic laboratory notebooks, data organization views, data provenance tracking, analysis notes, task management, and scientific workflow management. Overall, BSC strives to identify and capture the various social and scientific contexts in which data sharing collaborations in biology take place and to provide collaboration tools and capabilities that can effectively support and facilitate these important data sharing contexts.

  15. Biobanks, Data Sharing, and the Drive for a Global Privacy Governance Framework.

    PubMed

    Dove, Edward S

    2015-01-01

    Biobanks are a key emerging biomedical research infrastructure. They manifest the turn towards greater global sharing of genomic and health-related data, which is considered by many to be an ethical and scientific imperative. Our collective interests lie in improving the health and welfare of individuals, communities, and populations; improving health and welfare requires access to, and use of, widely dispersed quality data. But sharing these individual and familial data requires in turn that due thought be given to the ethical and legal interests at stake. Most critically, data sharing must occur in an environment whereby privacy interests are safeguarded throughout the lifecycle of biobank initiatives, and regardless of the locations where the data are stored, to which they are sent, and where they are ultimately processed. In this article, I outline the complex dimensions of data privacy regulation that challenge data sharing within the biobanking context. I discuss how harmonization may be a remedy for the gaps and marked differences of approach in data privacy regulation. Finally, I encourage the development of foundational responsible data sharing principles set within an overarching governance framework that provides assurance that reasonable expectations of privacy will be met.

  16. Participants' recall and understanding of genomic research and large-scale data sharing.

    PubMed

    Robinson, Jill Oliver; Slashinski, Melody J; Wang, Tao; Hilsenbeck, Susan G; McGuire, Amy L

    2013-10-01

    As genomic researchers are urged to openly share generated sequence data with other researchers, it is important to examine the utility of informed consent documents and processes, particularly as these relate to participants' engagement with and recall of the information presented to them, their objective or subjective understanding of the key elements of genomic research (e.g., data sharing), as well as how these factors influence or mediate the decisions they make. We conducted a randomized trial of three experimental informed consent documents (ICDs) with participants (n = 229) being recruited to genomic research studies; each document afforded varying control over breadth of release of genetic information. Recall and understanding, their impact on data sharing decisions, and comfort in decision making were assessed in a follow-up structured interview. Over 25% did not remember signing an ICD to participate in a genomic study, and the majority (54%) could not correctly identify with whom they had agreed to share their genomic data. However, participants felt that they understood enough to make an informed decision, and lack of recall did not impact final data sharing decisions or satisfaction with participation. These findings raise questions about the types of information participants need in order to provide valid informed consent, and whether subjective understanding and comfort with decision making are sufficient to satisfy the ethical principle of respect for persons.

  17. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era

    PubMed Central

    Wang, Hua-fen; Jin, Jing-fen; Feng, Xiu-qin; Huang, Xin; Zhu, Ling-ling; Zhao, Xiao-ying; Zhou, Quan

    2015-01-01

    Background Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs) are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI) advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. Methods An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People’s Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014). Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. Results The number of MAEs continuously decreased from 143 (first half-year of 2012) to 64 (first half-year of 2014), with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, P<0.05). The number of MAEs related to high-alert medications decreased from 32 (the second half-year of 2011) to 16 (the first half-year of 2014), with a decrease in occurrence rate by 57.9% (0.0787% versus 0.0331%, P<0.05). Omission was the top type of MAE during the first half-year of 2011 to the first half-year of 2014, with a decrease by 50% (40 cases versus 20 cases). Intravenous administration error was the top type of error regarding administration route, but it continuously decreased from 64 (first half-year of 2012) to 27 (first half-year of 2014). More experienced registered nurses made fewer medication errors. The number of MAEs in surgical wards was twice that in medicinal wards. Compared with non-intensive care units, the intensive care units exhibited higher occurrence rates of MAEs

  18. Eight reasons payer interoperability and data sharing are essential in ACOs. Interoperability standards could be a prerequisite to measuring care.

    PubMed

    Mookencherry, Shefali

    2012-01-01

    It makes strategic and business sense for payers and providers to collaborate on how to take substantial cost out of the healthcare delivery system. Acting independently, neither medical groups, hospitals nor health plans have the optimal mix of resources and incentives to significantly reduce costs. Payers have core assets such as marketing, claims data, claims processing, reimbursement systems and capital. It would be cost prohibitive for all but the largest providers to develop these capabilities in order to compete directly with insurers. Likewise, medical groups and hospitals are positioned to foster financial interdependence among providers and coordinate the continuum of patient illnesses and care settings. Payers and providers should commit to reasonable clinical and cost goals, and share resources to minimize expenses and financial risks. It is in the interest of payers to work closely with providers on risk-management strategies because insurers need synergy with ACOs to remain cost competitive. It is in the interest of ACOs to work collaboratively with payers early on to develop reasonable and effective performance benchmarks. Hence, it is essential to have payer interoperability and data sharing integrated in an ACO model. PMID:22352172

  19. High-resolution, low-delay, and error-resilient medical ultrasound video communication using H.264/AVC over mobile WiMAX networks.

    PubMed

    Panayides, Andreas; Antoniou, Zinonas C; Mylonas, Yiannos; Pattichis, Marios S; Pitsillides, Andreas; Pattichis, Constantinos S

    2013-05-01

    In this study, we describe an effective video communication framework for the wireless transmission of H.264/AVC medical ultrasound video over mobile WiMAX networks. Medical ultrasound video is encoded using diagnostically-driven, error resilient encoding, where quantization levels are varied as a function of the diagnostic significance of each image region. We demonstrate how our proposed system allows for the transmission of high-resolution clinical video that is encoded at the clinical acquisition resolution and can then be decoded with low-delay. To validate performance, we perform OPNET simulations of mobile WiMAX Medium Access Control (MAC) and Physical (PHY) layers characteristics that include service prioritization classes, different modulation and coding schemes, fading channels conditions, and mobility. We encode the medical ultrasound videos at the 4CIF (704 × 576) resolution that can accommodate clinical acquisition that is typically performed at lower resolutions. Video quality assessment is based on both clinical (subjective) and objective evaluations.

  20. Impact of a Drug Shortage on Medication Errors and Clinical Outcomes in the Pediatric Intensive Care Unit

    PubMed Central

    Goswami, Elizabeth S.; Morris, Jennifer L.

    2015-01-01

    OBJECTIVES: The purpose of this study was to assess the rate of prescribing errors, resulting adverse events, and patient outcomes associated with sedation and analgesia in the pediatric intensive care unit (PICU) before and during a national shortage of fentanyl and injectable benzodiazepines. METHODS: A retrospective chart review was performed of patients admitted to the PICU with at least 1 prescribed order for a sedative or analgesic agent during the time periods of January to February of 2011 and 2012. Initial orders for sedative and analgesic agents were identified and investigated for appropriateness of dose and were assessed for error-associated adverse events. Orders were stratified by timing in regard to clinical pharmacist on-site availability. Demographic and outcome information, including unintended extubations, ventilator days, and PICU length of stay, were gathered. RESULTS: One hundred sixty-nine orders representing 72 patients and 179 orders representing 75 patients in 2011 and 2012, respectively, were included in analysis. No differences were found in the rate of prescribing errors in 2011 and 2012 (33 errors in 169 orders vs. 39 errors in 179 orders, respectively, p=0.603). No differences were found in rates of prescribing errors in regard to clinical pharmacist on-site availability. A significant increase was seen in unintended extubations per 100 ventilator days, with 0.15 in 2011 vs. 1.13 in 2012, respectively (p<0.001). A significant decrease was seen in ventilator days per patient (p<0.001) and PICU length of stay per patient (p=0.019). CONCLUSIONS: There were no differences in rates of prescribing errors before versus during the fentanyl and benzodiazepine shortage. PMID:26766934

  1. Data Sharing Interviews with Crop Sciences Faculty: Why They Share Data and How the Library Can Help

    ERIC Educational Resources Information Center

    Williams, Sarah C.

    2013-01-01

    This study was designed to generate a deeper understanding of data sharing by targeting faculty members who had already made data publicly available. During interviews, crop scientists at the University of Illinois at Urbana-Champaign were asked why they decided to share data, why they chose a data sharing method (e. g., supplementary file,…

  2. Drug Errors in Anaesthesiology

    PubMed Central

    Jain, Rajnish Kumar; Katiyar, Sarika

    2009-01-01

    Summary Medication errors are a leading cause of morbidity and mortality in hospitalized patients. The incidence of these drug errors during anaesthesia is not certain. They impose a considerable financial burden to health care systems apart from the patient losses. Common causes of these errors and their prevention is discussed. PMID:20640103

  3. Technical and Policy Approaches to Balancing Patient Privacy and Data Sharing in Clinical and Translational Research

    PubMed Central

    Malin, Bradley; Karp, David; Scheuermann, Richard H.

    2010-01-01

    Clinical researchers need to share data to support scientific validation and information reuse, and to comply with a host of regulations and directives from funders. Various organizations are constructing informatics resources in the form of centralized databases to ensure widespread availability of data derived from sponsored research. The widespread use of such open databases is contingent on the protection of patient privacy. In this paper, we review several aspects of the privacy-related problems associated with data sharing for clinical research from technical and policy perspectives. We begin with a review of existing policies for secondary data sharing and privacy requirements in the context of data derived from research and clinical settings. In particular, we focus on policies specified by the U.S. National Institutes of Health and the Health Insurance Portability and Accountability Act and touch upon how these policies are related to current, as well as future, use of data stored in public database archives. Next, we address aspects of data privacy and “identifiability” from a more technical perspective, and review how biomedical databanks can be exploited and seemingly anonymous records can be “re-identified” using various resources without compromising or hacking into secure computer systems. We highlight which data features specified in clinical research data models are potentially vulnerable or exploitable. In the process, we recount a recent privacy-related concern associated with the publication of aggregate statistics from pooled genome-wide association studies that has had a significant impact on the data sharing policies of NIH-sponsored databanks. Finally, we conclude with a list of recommendations that cover various technical, legal, and policy mechanisms that open clinical databases can adopt to strengthen data privacy protections as they move toward wider deployment and adoption. PMID:20051768

  4. German critical incident reporting system database of prehospital emergency medicine: Analysis of reported communication and medication errors between 2005–2015

    PubMed Central

    Hohenstein, Christian; Fleischmann, Thomas; Rupp, Peter; Hempel, Dorothea; Wilk, Sophia; Winning, Johannes

    2016-01-01

    BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors. METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all. RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classification resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure. CONCLUSION: Communication deficits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety. PMID:27313802

  5. Democratization of genetic data: connecting government approval of clinical tests with data sharing.

    PubMed

    Ross, Theodora S

    2015-10-01

    When a doctor orders a genetic test, patients assume that the test will yield a useful result to guide how their physicians take care of them. That assumption is frequently correct, but not always. Until recently, a genetic test only interrogated the sequence of one or two genes. Now, DNA-sequencing technologies are so fast and cheap that they have enabled clinicians to sequence panels of genes that may or may not be relevant to the patient's condition. The technology has outpaced our ability to interpret the results. Connecting approval of clinical tests to data sharing could help close this gap.

  6. Research Update: The materials genome initiative: Data sharing and the impact of collaborative ab initio databases

    NASA Astrophysics Data System (ADS)

    Jain, Anubhav; Persson, Kristin A.; Ceder, Gerbrand

    2016-05-01

    Materials innovations enable new technological capabilities and drive major societal advancements but have historically required long and costly development cycles. The Materials Genome Initiative (MGI) aims to greatly reduce this time and cost. In this paper, we focus on data reuse in the MGI and, in particular, discuss the impact of three different computational databases based on density functional theory methods to the research community. We also discuss and provide recommendations on technical aspects of data reuse, outline remaining fundamental challenges, and present an outlook on the future of MGI's vision of data sharing.

  7. Optimal Care Mother-Baby and Outcomes through Community-wide Data Sharing, Interoperability and Connectivity.

    PubMed

    Shaha, Steven H; Gilbert-Bradley, Diane

    2015-01-01

    The power of interoperable systems with data/information integration, central to achieving the goals of Telehealth, is illustrated through mutually beneficial sharing between Labor & Delivery (L&D) and Obstetrics (OBs) Clinics. Data shared between L&D and OB brought improved practice patterns and outcomes, and increased satisfaction at both. Staffing and skillsets were significantly improved by knowing complications arriving and anticipated volumes. OBs increased clinic efficiencies and improved patient-direct care time with improved clinical and cost outcomes. PMID:25980718

  8. Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls

    PubMed Central

    Maben, Jill; Murrells, Trevor; Griffiths, Peter

    2016-01-01

    Objectives A wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. However, studies have been limited to the US with limited evidence from elsewhere. The aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital. Methods A natural experiment investigating the move to 100% single room accommodation in acute assessment, surgical and older people’s wards. Move to 100% single room accommodation compared to ‘steady state’ and ‘new build’ control hospitals. Falls, pressure ulcer, medication error, meticillin-resistant Staphylococcus aureus and Clostridium difficile rates from routine data sources were measured over 36 months. Results Five of 15 time series in the wards that moved to single room accommodation revealed changes that coincided with the move to the new all single room hospital: specifically, increased fall, pressure ulcer and Clostridium difficile rates in the older people’s ward, and temporary increases in falls and medication errors in the acute assessment unit. However, because the case mix of the older people’s ward changed, and because the increase in falls and medication errors on the acute assessment ward did not last longer than six months, no clear effect of single rooms on the safety outcomes was demonstrated. There were no changes to safety events coinciding with the move at the new build control site. Conclusion For all changes in patient safety events that coincided with the move to single rooms, we found plausible alternative explanations such as case-mix change or disruption as a result of the re-organization of services after the move. The results provide no evidence of either benefit or harm from all single room accommodation in terms of safety-related outcomes, although there may be short-term risks associated with a move to single rooms. PMID:26811373

  9. Error patterns on the continuous performance test in non-medicated and medicated samples of children with and without ADHD: a meta-analytic review.

    PubMed

    Losier, B J; McGrath, P J; Klein, R M

    1996-11-01

    We systematically reviewed the patterns of Continuous Performance Test (CPT) errors of omission and commission exhibited by normal children and children with Attention Deficit and Hyperactivity Disorder (ADHD) under no drug, placebo and methylphenidate drug conditions. Findings from 26 studies were submitted to a meta-analytic procedure. In contrast to the contradictory findings of individual reports, our results revealed that children with ADHD made significantly more errors of omission and commission than normal children. As well, in children with ADHD and treated with methylphenidate, statistically significant reductions in the rate of both error types were noted. The effects of methylphenidate on the percentage of hits (i.e. 1 - omissions) were greater in experiments using shorter stimulus duration, smaller number of trials and higher probability of a target. Using Signal Detection Theory (SDT) parameters, we found that children with ADHD were less sensitive to the difference between targets and non-targets than their normal counterparts, while showing a comparable response bias. Similarly, the effects of methylphenidate were restricted to improving the sensitivity, while not affecting response bias, in both normal children and those with ADHD.

  10. Conducting Research with Tribal Communities: Sovereignty, Ethics, and Data-Sharing Issues

    PubMed Central

    Harper, Barbara; Stone, Dave; O’Neill, Catherine; Berger, Patricia; Harris, Stuart; Donatuto, Jamie

    2011-01-01

    Background: When conducting research with American Indian tribes, informed consent beyond conventional institutional review board (IRB) review is needed because of the potential for adverse consequences at a community or governmental level that are unrecognized by academic researchers. Objectives: In this article, we review sovereignty, research ethics, and data-sharing considerations when doing community-based participatory health–related or natural-resource–related research with American Indian nations and present a model material and data-sharing agreement that meets tribal and university requirements. Discussion: Only tribal nations themselves can identify potential adverse outcomes, and they can do this only if they understand the assumptions and methods of the proposed research. Tribes must be truly equal partners in study design, data collection, interpretation, and publication. Advances in protection of intellectual property rights (IPR) are also applicable to IRB reviews, as are principles of sovereignty and indigenous rights, all of which affect data ownership and control. Conclusions: Academic researchers engaged in tribal projects should become familiar with all three areas: sovereignty, ethics and informed consent, and IPR. We recommend developing an agreement with tribal partners that reflects both health-related IRB and natural-resource–related IPR considerations. PMID:21890450

  11. A Requirement Engineering Framework for Electronic Data Sharing of Health Care Data Between Organizations

    NASA Astrophysics Data System (ADS)

    Liu, Xia; Peyton, Liam; Kuziemsky, Craig

    Health care is increasingly provided to citizens by a network of collaboration that includes multiple providers and locations. Typically, that collaboration is on an ad-hoc basis via phone calls, faxes, and paper based documentation. Internet and wireless technologies provide an opportunity to improve this situation via electronic data sharing. These new technologies make possible new ways of working and collaboration but it can be difficult for health care organizations to understand how to use the new technologies while still ensuring that their policies and objectives are being met. It is also important to have a systematic approach to validate that e-health processes deliver the performance improvements that are expected. Using a case study of a palliative care patient receiving home care from a team of collaborating health organizations, we introduce a framework based on requirements engineering. Key concerns and objectives are identified and modeled (privacy, security, quality of care, and timeliness of service). And, then, proposed business processes which use new technologies are modeled in terms of these concerns and objectives to assess their impact and ensure that electronic data sharing is well regulated.

  12. The European Union's Adequacy Approach to Privacy and International Data Sharing in Health Research.

    PubMed

    Stoddart, Jennifer; Chan, Benny; Joly, Yann

    2016-03-01

    The European Union (EU) approach to data protection consists of assessing the adequacy of the data protection offered by the laws of a particular jurisdiction against a set of principles that includes purpose limitation, transparency, quality, proportionality, security, access, and rectification. The EU's Data Protection Directive sets conditions on the transfer of data to third countries by prohibiting Member States from transferring to such countries as have been deemed inadequate in terms of the data protection regimes. In theory, each jurisdiction is evaluated similarly and must be found fully compliant with the EU's data protection principles to be considered adequate. In practice, the inconsistency with which these evaluations are made presents a hurdle to international data-sharing and makes difficult the integration of different data-sharing approaches; in the 20 years since the Directive was first adopted, the laws of only five countries from outside of the EU, Economic Area, or the European Free Trade Agreement have been deemed adequate to engage in data transfers without the need for further administrative safeguards. PMID:27256130

  13. Big data from small data: data-sharing in the ‘long tail’ of neuroscience

    PubMed Central

    Ferguson, Adam R; Nielson, Jessica L; Cragin, Melissa H; Bandrowski, Anita E; Martone, Maryann E

    2016-01-01

    The launch of the US BRAIN and European Human Brain Projects coincides with growing international efforts toward transparency and increased access to publicly funded research in the neurosciences. The need for data-sharing standards and neuroinformatics infrastructure is more pressing than ever. However, ‘big science’ efforts are not the only drivers of data-sharing needs, as neuroscientists across the full spectrum of research grapple with the overwhelming volume of data being generated daily and a scientific environment that is increasingly focused on collaboration. In this commentary, we consider the issue of sharing of the richly diverse and heterogeneous small data sets produced by individual neuroscientists, so-called long-tail data. We consider the utility of these data, the diversity of repositories and options available for sharing such data, and emerging best practices. We provide use cases in which aggregating and mining diverse long-tail data convert numerous small data sources into big data for improved knowledge about neuroscience-related disorders. PMID:25349910

  14. OpenSlice: Quantitative data sharing from HyperPeaks to global ion chromatograms (GICs).

    PubMed

    Askenazi, Manor; Fenyö, David

    2016-09-01

    Data sharing in the field of MS has advanced greatly thanks to innovations such as the standardized formats, data repositories, and publications guidelines. However, there is currently no data sharing mechanism that enables real-time data browsing and deep linking on a large scale: unrestricted data access (particularly at the quantitative level) ultimately requires the user to download a local copy of the relevant data files (e.g., in order to generate extracted ion chromatograms [XICs]). In this technical resource, we present a set of technologies (collectively termed OpenSlice) that enable the user to quantitatively query hundreds of hours of proteomics discovery data (i.e., nontargeted acquisition) in real time: the user is able to effectively generate XICs for arbitrary masses on the fly and across the entire dataset (so-called global ion chromatograms), interacting with the results through a very intuitive browser-based interface. A key design consideration underlying the OpenSlice approach is the notion that every aspect of the acquired data must be accessible through a RESTful uniform resource locator based application programming interface, up to and including individual chromatographic peaks (hence HyperPeaks). A publicly accessible demonstration of this technology based on the Clinical Proteomics Tumor Analysis Consortium CompRef dataset is made available at http://compref.fenyolab.org.

  15. Data Democratization - Promoting Real-Time Data Sharing and Use Worldwide

    NASA Astrophysics Data System (ADS)

    Yoksas, T. C.; Almeida, W. G.; Leon, V. C.

    2007-05-01

    The Unidata Program Center (Unidata) of the University Corporation of Atmospheric Research (UCAR) is actively involved in international collaborations whose goals are the free-and-open sharing of hydro-meteorological data; the distribution of analysis and visualization tools for those data; the establishment of server technologies that provide easy-to-use, programmatic remote-access to a wide variety of datasets, and in the building of a community where data, tools, and best practices in education and research are shared. The tools and services provided by Unidata are available to the research and education community free-of-charge. Data sharing capabilities are being provided by Unidata's Internet Data Distribution (IDD) system, a community-based effort that has been the primary source of real-time meteorological data in the US university community for over a decade. A collaboration among Unidata, Brazil's Centro de Previso de Tempo e Estudos Climaticos (CPTEC), the Universidad Federal do Rio de Janeiro (UFRJ), and the Universidade de Sao Paulo (USP) has resulted in the creation of a Brazilian peer of the North American IDD, the IDD-Brasil. Collaboration between Unidata and the Universidad de Costa Rica (UCR) seeks to extend IDD data sharing throughout Central America and the Caribbean in an IDD-Caribe. Efforts aimed at creating a data sharing network for researchers on the Antarctic continent have resulted in the establishment of the Antarctic-IDD. Most recently, explorations of data sharing between UCAR and select countries in Africa have begun. Data analysis and visualization capabilities are available through Unidata in a suite of freely-available applications: the National Centers for Environmental Prediction (NCEP) GEneral Meteorology PAcKage (GEMPAK); the Unidata Integrated Data Viewer (IDV); and University of Wisconsin, Space Science and Engineering Center (SSEC) Man-computer Interactive Data Access System (McIDAS). Remote data access capabilities are

  16. Medication Error When Switching from Warfarin to Rivaroxaban Leading to Spontaneous Large Ecchymosis of the Abdominal and Chest Wall

    PubMed Central

    Egger, Flavio; Targa, Federica; Unterholzner, Ivan; Grant, Russell P.; Herrmann, Markus; Wiedermann, Christian J.

    2016-01-01

    Non-vitamin K oral anticoagulant (NOAC) therapy may be inappropriate if prescription was incorrect, the patient’s physiological parameters change, or interacting concomitant medications are erroneously added. The aim of this report was to illustrate inappropriate NOAC prescription in a 78-year-old woman with non-valvular atrial fibrillation and borderline renal dysfunction who was switched from warfarin to rivaroxaban and subsequently developed bruising with hemorrhagic shock and acute on chronic renal failure. Administration of 4-factor prothrombin complex concentrate effectively reversed coagulopathy and stopped bleeding. Retrospective determination of circulating plasma levels of rivaroxaban and warfarin confirmed that excessive anticoagulation was likely due to warfarin that the patient probably continued to take although rivaroxaban was initiated. Pharmacodynamic interaction between rivaroxaban and warfarin may not only be additive but synergistic. In patients at high risk of complications, judicious prescribing and dosing of NOACs, and regular monitoring of concomitant medications and renal function are highly recommended. PMID:27777713

  17. A pharmacist-led information technology intervention for medication errors (PINCER): a multicentre, cluster randomised, controlled trial and cost-effectiveness analysis

    PubMed Central

    Avery, Anthony J; Rodgers, Sarah; Cantrill, Judith A; Armstrong, Sarah; Cresswell, Kathrin; Eden, Martin; Elliott, Rachel A; Howard, Rachel; Kendrick, Denise; Morris, Caroline J; Prescott, Robin J; Swanwick, Glen; Franklin, Matthew; Putman, Koen; Boyd, Matthew; Sheikh, Aziz

    2012-01-01

    Summary Background Medication errors are common in primary care and are associated with considerable risk of patient harm. We tested whether a pharmacist-led, information technology-based intervention was more effective than simple feedback in reducing the number of patients at risk of measures related to hazardous prescribing and inadequate blood-test monitoring of medicines 6 months after the intervention. Methods In this pragmatic, cluster randomised trial general practices in the UK were stratified by research site and list size, and randomly assigned by a web-based randomisation service in block sizes of two or four to one of two groups. The practices were allocated to either computer-generated simple feedback for at-risk patients (control) or a pharmacist-led information technology intervention (PINCER), composed of feedback, educational outreach, and dedicated support. The allocation was masked to general practices, patients, pharmacists, researchers, and statisticians. Primary outcomes were the proportions of patients at 6 months after the intervention who had had any of three clinically important errors: non-selective non-steroidal anti-inflammatory drugs (NSAIDs) prescribed to those with a history of peptic ulcer without co-prescription of a proton-pump inhibitor; β blockers prescribed to those with a history of asthma; long-term prescription of angiotensin converting enzyme (ACE) inhibitor or loop diuretics to those 75 years or older without assessment of urea and electrolytes in the preceding 15 months. The cost per error avoided was estimated by incremental cost-effectiveness analysis. This study is registered with Controlled-Trials.com, number ISRCTN21785299. Findings 72 general practices with a combined list size of 480 942 patients were randomised. At 6 months' follow-up, patients in the PINCER group were significantly less likely to have been prescribed a non-selective NSAID if they had a history of peptic ulcer without gastroprotection (OR 0

  18. caNanoLab: data sharing to expedite the use of nanotechnology in biomedicine.

    PubMed

    Gaheen, Sharon; Hinkal, George W; Morris, Stephanie A; Lijowski, Michal; Heiskanen, Mervi; Klemm, Juli D

    2013-11-21

    The use of nanotechnology in biomedicine involves the engineering of nanomaterials to act as therapeutic carriers, targeting agents and diagnostic imaging devices. The application of nanotechnology in cancer aims to transform early detection, targeted therapeutics and cancer prevention and control. To assist in expediting and validating the use of nanomaterials in biomedicine, the National Cancer Institute (NCI) Center for Biomedical Informatics and Information Technology, in collaboration with the NCI Alliance for Nanotechnology in Cancer (Alliance), has developed a data sharing portal called caNanoLab. caNanoLab provides access to experimental and literature curated data from the NCI Nanotechnology Characterization Laboratory, the Alliance and the greater cancer nanotechnology community. PMID:25364375

  19. The need to redefine genomic data sharing: A focus on data accessibility.

    PubMed

    van Schaik, Tempest A; Kovalevskaya, Nadezda V; Protopapas, Elena; Wahid, Hamza; Nielsen, Fiona G G

    2014-12-01

    DNAdigest's mission is to investigate and address the issues hindering efficient and ethical genomic data sharing in the human genomics research community. We conducted contextual interviews with human genomics researchers in clinical, academic or industrial R&D settings about their experience with accessing and sharing human genomic data. The qualitative interviews were followed by an online survey which provided quantitative support for our findings. Here we present the generalised workflow for accessing human genomic data through both public and restricted-access repositories and discuss reported points of frustration and their possible improvements. We discuss how data discoverability and accessibility are lacking in current mechanisms and how these are the prerequisites for adoption of best practices in the research community. We summarise current initiatives related to genomic data discovery and present a new data discovery platform available at http://nucleobase.co.uk.

  20. The need to redefine genomic data sharing: A focus on data accessibility.

    PubMed

    van Schaik, Tempest A; Kovalevskaya, Nadezda V; Protopapas, Elena; Wahid, Hamza; Nielsen, Fiona G G

    2014-12-01

    DNAdigest's mission is to investigate and address the issues hindering efficient and ethical genomic data sharing in the human genomics research community. We conducted contextual interviews with human genomics researchers in clinical, academic or industrial R&D settings about their experience with accessing and sharing human genomic data. The qualitative interviews were followed by an online survey which provided quantitative support for our findings. Here we present the generalised workflow for accessing human genomic data through both public and restricted-access repositories and discuss reported points of frustration and their possible improvements. We discuss how data discoverability and accessibility are lacking in current mechanisms and how these are the prerequisites for adoption of best practices in the research community. We summarise current initiatives related to genomic data discovery and present a new data discovery platform available at http://nucleobase.co.uk. PMID:27294022

  1. Data sharing between home care professionals: a feasibility study using the RAI Home Care instrument

    PubMed Central

    2014-01-01

    Background Across Ontario, home care professionals collect standardized information on each client using the Resident Assessment for Home Care (RAI-HC). However, this information is not consistently shared with those professionals who provide services in the client’s home. In this pilot study, we examined the feasibility of sharing data, from the RAI-HC, between care coordinators and service providers. Methods All participants were involved in a one-day training session on the RAI-HC. The care coordinators shared specific outputs from the RAI-HC, including the embedded health index scales, with their contracted physiotherapy and occupational therapy service providers. Two focus groups were held, one with care coordinators (n = 4) and one with contracted service providers (n = 6). They were asked for their opinions on the positive aspects of the project and areas for improvement. Results The focus groups revealed a number of positive outcomes related to the project including the use of a falls prevention brochure and an increased level of communication between professionals. The participants also cited multiple areas for improvement related to data sharing (e.g., time constraints, data being sent in a timely fashion) and to their standard practices in the community (e.g., busy workloads, difficulties in data sharing, duplication of assessments between professionals). Conclusions Home care professionals were able to share select pieces of information generated from the RAI-HC system and this project enhanced the level of communication between the two groups of professionals. However, a single information session was not adequate training for the rehabilitation professionals, who do not use the RAI-HC as part of normal practice. Better education, ongoing support and timely access to the RAI-HC data are some ways to improve the usefulness of this information for busy home care providers. PMID:24975375

  2. Nutritional treatment for inborn errors of metabolism: indications, regulations, and availability of medical foods and dietary supplements using phenylketonuria as an example.

    PubMed

    Camp, Kathryn M; Lloyd-Puryear, Michele A; Huntington, Kathleen L

    2012-09-01

    Medical foods and dietary supplements are used to treat rare inborn errors of metabolism (IEM) identified through state-based universal newborn screening. These products are regulated under Food and Drug Administration (FDA) food and dietary supplement statutes. The lack of harmony in terminology used to refer to medical foods and dietary supplements and the misuse of words that imply that FDA regulates these products as drugs have led to confusion. These products are expensive and, although they are used for medical treatment of IEM, third-party payer coverage of these products is inconsistent across the United States. Clinicians and families report termination of coverage in late adolescence, failure to cover treatment during pregnancy, coverage for select conditions only, or no coverage. We describe the indications for specific nutritional treatment products for IEM and their regulation, availability, and categorization. We conclude with a discussion of the problems that have contributed to the paradox of identifying individuals with IEM through newborn screening but not guaranteeing that they receive optimal treatment. Throughout the paper, we use the nutritional treatment of phenylketonuria as an example of IEM treatment.

  3. High-resolution, low-delay, and error-resilient medical ultrasound video communication using H.264/AVC over mobile WiMAX networks.

    PubMed

    Panayides, Andreas; Antoniou, Zinonas C; Mylonas, Yiannos; Pattichis, Marios S; Pitsillides, Andreas; Pattichis, Constantinos S

    2013-05-01

    In this study, we describe an effective video communication framework for the wireless transmission of H.264/AVC medical ultrasound video over mobile WiMAX networks. Medical ultrasound video is encoded using diagnostically-driven, error resilient encoding, where quantization levels are varied as a function of the diagnostic significance of each image region. We demonstrate how our proposed system allows for the transmission of high-resolution clinical video that is encoded at the clinical acquisition resolution and can then be decoded with low-delay. To validate performance, we perform OPNET simulations of mobile WiMAX Medium Access Control (MAC) and Physical (PHY) layers characteristics that include service prioritization classes, different modulation and coding schemes, fading channels conditions, and mobility. We encode the medical ultrasound videos at the 4CIF (704 × 576) resolution that can accommodate clinical acquisition that is typically performed at lower resolutions. Video quality assessment is based on both clinical (subjective) and objective evaluations. PMID:23232416

  4. Nutritional Treatment for Inborn Errors of Metabolism: Indications, Regulations, and Availability of Medical Foods and Dietary Supplements Using Phenylketonuria as an Example

    PubMed Central

    Camp, Kathryn M.; Lloyd-Puryear, Michele A.; Huntington, Kathleen L.

    2012-01-01

    Medical foods and dietary supplements are used to treat rare inborn errors of metabolism (IEM) identified through state-based universal newborn screening. These products are regulated under Food and Drug Administration (FDA) food and dietary supplement statutes. The lack of harmony in terminology used to refer to medical foods and dietary supplements and the misuse of words that imply that FDA regulates these products as drugs have led to confusion. These products are expensive and, although they are used for medical treatment of IEM, third-party payer coverage of these products is inconsistent across the United States. Clinicians and families report termination of coverage in late adolescence, failure to cover treatment during pregnancy, coverage for select conditions only, or no coverage. We describe the indications for specific nutritional treatment products for IEM and their regulation, availability, and categorization. We conclude with a discussion of the problems that have contributed to the paradox of identifying individuals with IEM through newborn screening but not guaranteeing that they receive optimal treatment. Throughout the paper, we use the nutritional treatment of phenylketonuria as an example of IEM treatment. PMID:22854513

  5. [Advance Directives - Not a Lot of Margin for Error - The Surgeon's View of a Complex Medical-Legal Topic].

    PubMed

    Slotta, J E; Schilling, M K; Ghadimi, M; Kollmar, O

    2015-08-01

    Since September 1st, 2009, the most recent version of the German "Betreuungsrechtsänderungsgesetz" has been validated by the legislators. It precisely sets out how physicians and nursing staff have to deal with a written declaration of a patient's will. This new law focuses in a special way on advance directives, describes the precise rules for the authors of an advance directive and shows both its sphere of action and its limitations. This article aims to give an overview on the legal scope of advance directives, and to illustrate potential limitations and conflicts. Furthermore, it shows the commitments and rights of the medical team against the background of an existing advance directive.

  6. Data Citation Standard: A Means to Support Data Sharing, Attribution, and Traceability

    NASA Astrophysics Data System (ADS)

    McCallum, I.; Plag, H. P.; Fritz, S.

    2012-04-01

    Geo-referenced data are crucial for addressing many of the burning societal problems and to support related interdisciplinary research. Data sharing is hampered by the lack of a widely accepted method for giving credit to those who make their data freely available and for tracking the use of data throughout it's life-cycle. Particularly in the scientific community, recognition and renown are important currencies. Providing means for data citation would be a strong incentive for data sharing. Recently, a number of organizations and projects have started to address the concept of data citation (e.g., PANGAEA, NASA DAACS, USGS, NOAA National Data Centers, ESIP, US National Academy of Sciences, and EGIDA). A number of proposals for data citation guidelines have emerged and a better understanding of the many issues at hand is evolving, but to date, no standard has been accepted. This is not surprising, as data citation is far more complicated than citation of scientific publication. Data sets differ in many aspects from standard scientific publications. For example, data sets generally are not locatable and attributable in the same way as scientific publications. Data sets often are not static (introducing versioning), and they are mostly not peer-reviewed (requiring quality control). There is a consensus that the implementation of a standard would reveal new issues that are not obvious today. With the Global Earth Observation System of Systems (GEOSS), the Group on Earth Observations (GEO) is in a unique position to provide the testbed for the implementation of a draft standard. The GEO Plenary supports the implementation of a draft standard developed by the Science and Technology Committee (STC) of GEO with support of the EGIDA Project. This draft is based on guidelines developed by international groups. Currently, users of the GEO-Portal are not obliged or encouraged to cite data accessed through GEOSS - if at all, citation requirements come from the individual data

  7. Dataworks for GNSS: Software for Supporting Data Sharing and Federation of Geodetic Networks

    NASA Astrophysics Data System (ADS)

    Boler, F. M.; Meertens, C. M.; Miller, M. M.; Wier, S.; Rost, M.; Matykiewicz, J.

    2015-12-01

    Continuously-operating Global Navigation Satellite System (GNSS) networks are increasingly being installed globally for a wide variety of science and societal applications. GNSS enables Earth science research in areas including tectonic plate interactions, crustal deformation in response to loading by tectonics, magmatism, water and ice, and the dynamics of water - and thereby energy transfer - in the atmosphere at regional scale. The many individual scientists and organizations that set up GNSS stations globally are often open to sharing data, but lack the resources or expertise to deploy systems and software to manage and curate data and metadata and provide user tools that would support data sharing. UNAVCO previously gained experience in facilitating data sharing through the NASA-supported development of the Geodesy Seamless Archive Centers (GSAC) open source software. GSAC provides web interfaces and simple web services for data and metadata discovery and access, supports federation of multiple data centers, and simplifies transfer of data and metadata to long-term archives. The NSF supported the dissemination of GSAC to multiple European data centers forming the European Plate Observing System. To expand upon GSAC to provide end-to-end, instrument-to-distribution capability, UNAVCO developed Dataworks for GNSS with NSF funding to the COCONet project, and deployed this software on systems that are now operating as Regional GNSS Data Centers as part of the NSF-funded TLALOCNet and COCONet projects. Dataworks consists of software modules written in Python and Java for data acquisition, management and sharing. There are modules for GNSS receiver control and data download, a database schema for metadata, tools for metadata handling, ingest software to manage file metadata, data file management scripts, GSAC, scripts for mirroring station data and metadata from partner GSACs, and extensive software and operator documentation. UNAVCO plans to provide a cloud VM

  8. Biomedical Data Sharing and Reuse: Attitudes and Practices of Clinical and Scientific Research Staff

    PubMed Central

    Federer, Lisa M.; Lu, Ya-Ling; Joubert, Douglas J.; Welsh, Judith; Brandys, Barbara

    2015-01-01

    Background Significant efforts are underway within the biomedical research community to encourage sharing and reuse of research data in order to enhance research reproducibility and enable scientific discovery. While some technological challenges do exist, many of the barriers to sharing and reuse are social in nature, arising from researchers’ concerns about and attitudes toward sharing their data. In addition, clinical and basic science researchers face their own unique sets of challenges to sharing data within their communities. This study investigates these differences in experiences with and perceptions about sharing data, as well as barriers to sharing among clinical and basic science researchers. Methods Clinical and basic science researchers in the Intramural Research Program at the National Institutes of Health were surveyed about their attitudes toward and experiences with sharing and reusing research data. Of 190 respondents to the survey, the 135 respondents who identified themselves as clinical or basic science researchers were included in this analysis. Odds ratio and Fisher’s exact tests were the primary methods to examine potential relationships between variables. Worst-case scenario sensitivity tests were conducted when necessary. Results and Discussion While most respondents considered data sharing and reuse important to their work, they generally rated their expertise as low. Sharing data directly with other researchers was common, but most respondents did not have experience with uploading data to a repository. A number of significant differences exist between the attitudes and practices of clinical and basic science researchers, including their motivations for sharing, their reasons for not sharing, and the amount of work required to prepare their data. Conclusions Even within the scope of biomedical research, addressing the unique concerns of diverse research communities is important to encouraging researchers to share and reuse data

  9. [Dealing with errors in medicine].

    PubMed

    Schoenenberger, R A; Perruchoud, A P

    1998-12-24

    Iatrogenic disease is probably more commonly than assumed the consequence of errors and mistakes committed by physicians and other medical personnel. Traditionally, strategies to prevent errors in medicine focus on inspection and rely on the professional ethos of health care personnel. The increasingly complex nature of medical practise and the multitude of interventions that each patient receives increases the likelihood of error. More efficient approaches to deal with errors have been developed. The methods include routine identification of errors (critical incidence report), systematic monitoring of multiple-step processes in medical practice, system analysis, and system redesign. A search for underlying causes of errors (rather than distal causes) will enable organizations to collectively learn without denying the inevitable occurrence of human error. Errors and mistakes may become precious chances to increase the quality of medical care.

  10. Data sharing reveals complexity in the westward spread of domestic animals across Neolithic Turkey.

    PubMed

    Arbuckle, Benjamin S; Kansa, Sarah Whitcher; Kansa, Eric; Orton, David; Çakırlar, Canan; Gourichon, Lionel; Atici, Levent; Galik, Alfred; Marciniak, Arkadiusz; Mulville, Jacqui; Buitenhuis, Hijlke; Carruthers, Denise; De Cupere, Bea; Demirergi, Arzu; Frame, Sheelagh; Helmer, Daniel; Martin, Louise; Peters, Joris; Pöllath, Nadja; Pawłowska, Kamilla; Russell, Nerissa; Twiss, Katheryn; Würtenberger, Doris

    2014-01-01

    This study presents the results of a major data integration project bringing together primary archaeozoological data for over 200,000 faunal specimens excavated from seventeen sites in Turkey spanning the Epipaleolithic through Chalcolithic periods, c. 18,000-4,000 cal BC, in order to document the initial westward spread of domestic livestock across Neolithic central and western Turkey. From these shared datasets we demonstrate that the westward expansion of Neolithic subsistence technologies combined multiple routes and pulses but did not involve a set 'package' comprising all four livestock species including sheep, goat, cattle and pig. Instead, Neolithic animal economies in the study regions are shown to be more diverse than deduced previously using quantitatively more limited datasets. Moreover, during the transition to agro-pastoral economies interactions between domestic stock and local wild fauna continued. Through publication of datasets with Open Context (opencontext.org), this project emphasizes the benefits of data sharing and web-based dissemination of large primary data sets for exploring major questions in archaeology (Alternative Language Abstract S1).

  11. ShareSync: A Solution for Deterministic Data Sharing over Ethernet

    NASA Technical Reports Server (NTRS)

    Dunn, Daniel J., II; Koons, William A.; Kennedy, Richard D.; Davis, Philip A.

    2007-01-01

    As part of upgrading the Contact Dynamics Simulation Laboratory (CDSL) at the NASA Marshall Space Flight Center (MSFC), a simple, cost effective method was needed to communicate data among the networked simulation machines and I/O controllers used to run the facility. To fill this need and similar applicable situations, a generic protocol was developed, called ShareSync. ShareSync is a lightweight, real-time, publish-subscribe Ethernet protocol for simple and deterministic data sharing across diverse machines and operating systems. ShareSync provides a simple Application Programming Interface (API) for simulation programmers to incorporate into their code. The protocol is compatible with virtually all Ethernet-capable machines, is flexible enough to support a variety of applications, is fast enough to provide soft real-time determinism, and is a low-cost resource for distributed simulation development, deployment, and maintenance. The first design cycle iteration of ShareSync has been completed, and the protocol has undergone several testing procedures including endurance and benchmarking tests and approaches the 2001ts data synchronization design goal for the CDSL.

  12. Data Sharing Reveals Complexity in the Westward Spread of Domestic Animals across Neolithic Turkey

    PubMed Central

    Arbuckle, Benjamin S.; Kansa, Sarah Whitcher; Kansa, Eric; Orton, David; Çakırlar, Canan; Gourichon, Lionel; Atici, Levent; Galik, Alfred; Marciniak, Arkadiusz; Mulville, Jacqui; Buitenhuis, Hijlke; Carruthers, Denise; De Cupere, Bea; Demirergi, Arzu; Frame, Sheelagh; Helmer, Daniel; Martin, Louise; Peters, Joris; Pöllath, Nadja; Pawłowska, Kamilla; Russell, Nerissa; Twiss, Katheryn; Würtenberger, Doris

    2014-01-01

    This study presents the results of a major data integration project bringing together primary archaeozoological data for over 200,000 faunal specimens excavated from seventeen sites in Turkey spanning the Epipaleolithic through Chalcolithic periods, c. 18,000-4,000 cal BC, in order to document the initial westward spread of domestic livestock across Neolithic central and western Turkey. From these shared datasets we demonstrate that the westward expansion of Neolithic subsistence technologies combined multiple routes and pulses but did not involve a set ‘package’ comprising all four livestock species including sheep, goat, cattle and pig. Instead, Neolithic animal economies in the study regions are shown to be more diverse than deduced previously using quantitatively more limited datasets. Moreover, during the transition to agro-pastoral economies interactions between domestic stock and local wild fauna continued. Through publication of datasets with Open Context (opencontext.org), this project emphasizes the benefits of data sharing and web-based dissemination of large primary data sets for exploring major questions in archaeology (Alternative Language Abstract S1). PMID:24927173

  13. 42 CFR 431.960 - Types of payment errors.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... payment errors. (c) Medical review errors. (1) A medical review error is an error resulting in an...) Medical review errors include, but are not limited to the following: (i) Lack of documentation. (ii... 42 Public Health 4 2014-10-01 2014-10-01 false Types of payment errors. 431.960 Section...

  14. 42 CFR 431.960 - Types of payment errors.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... payment errors. (c) Medical review errors. (1) A medical review error is an error resulting in an...) Medical review errors include, but are not limited to the following: (i) Lack of documentation. (ii... 42 Public Health 4 2013-10-01 2013-10-01 false Types of payment errors. 431.960 Section...

  15. 42 CFR 431.960 - Types of payment errors.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... payment errors. (c) Medical review errors. (1) A medical review error is an error resulting in an...) Medical review errors include, but are not limited to the following: (i) Lack of documentation. (ii... 42 Public Health 4 2012-10-01 2012-10-01 false Types of payment errors. 431.960 Section...

  16. 42 CFR 431.960 - Types of payment errors.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... payment errors. (c) Medical review errors. (1) A medical review error is an error resulting in an...) Medical review errors include, but are not limited to the following: (i) Lack of documentation. (ii... 42 Public Health 4 2011-10-01 2011-10-01 false Types of payment errors. 431.960 Section...

  17. Normal vitamin D levels and bone mineral density among children with inborn errors of metabolism consuming medical food-based diets.

    PubMed

    Geiger, Katie E; Koeller, David M; Harding, Cary O; Huntington, Kathleen L; Gillingham, Melanie B

    2016-01-01

    A higher incidence of osteopenia is observed among children with inherited metabolic disorders (inborn errors of metabolism, or IEMs) who consume medical food-based diets that restrict natural vitamin D-containing food sources. We evaluated the vitamin D status of children with IEMs who live in the Pacific Northwest with limited sun exposure and determined whether bone mineral density (BMD) in children with phenylketonuria (PKU), the most common IEM, correlated with diet or biochemical markers of bone metabolism. We hypothesized that children with IEMs would have lower serum vitamin D concentrations than controls and that some children with PKU would have reduced bone mineralization. A retrospective record review of 88 patients with IEMs, and 445 children on unrestricted diets (controls) found the 25-hydroxyvitamin D concentrations were normal and not significantly different between groups (IEM patients, 27.1 ± 10.9; controls, 27.6 ± 11.2). Normal BMD at the hip or spine (-2 medical food-based diets supports normal 25-hydroxyvitamin D levels and BMD in children with IEMs, including PKU. The risk of vitamin D deficiency among patients consuming a medical food-based diet is similar to the general population.

  18. DeID – a data sharing tool for neuroimaging studies

    PubMed Central

    Song, Xuebo; Wang, James; Wang, Anlin; Meng, Qingping; Prescott, Christian; Tsu, Loretta; Eckert, Mark A.

    2015-01-01

    Funding institutions and researchers increasingly expect that data will be shared to increase scientific integrity and provide other scientists with the opportunity to use the data with novel methods that may advance understanding in a particular field of study. In practice, sharing human subject data can be complicated because data must be de-identified prior to sharing. Moreover, integrating varied data types collected in a study can be challenging and time consuming. For example, sharing data from structural imaging studies of a complex disorder requires the integration of imaging, demographic and/or behavioral data in a way that no subject identifiers are included in the de-identified dataset and with new subject labels or identification values that cannot be tracked back to the original ones. We have developed a Java program that users can use to remove identifying information in neuroimaging datasets, while still maintaining the association among different data types from the same subject for further studies. This software provides a series of user interaction wizards to allow users to select data variables to be de-identified, implements functions for auditing and validation of de-identified data, and enables the user to share the de-identified data in a single compressed package through various communication protocols, such as FTPS and SFTP. DeID runs with Windows, Linux, and Mac operating systems and its open architecture allows it to be easily adapted to support a broader array of data types, with the goal of facilitating data sharing. DeID can be obtained at http://www.nitrc.org/projects/deid. PMID:26441500

  19. Lessons learned while building the Deepwater Horizon Database: Toward improved data sharing in coastal science

    NASA Astrophysics Data System (ADS)

    Thessen, Anne E.; McGinnis, Sean; North, Elizabeth W.

    2016-02-01

    Process studies and coupled-model validation efforts in geosciences often require integration of multiple data types across time and space. For example, improved prediction of hydrocarbon fate and transport is an important societal need which fundamentally relies upon synthesis of oceanography and hydrocarbon chemistry. Yet, there are no publically accessible databases which integrate these diverse data types in a georeferenced format, nor are there guidelines for developing such a database. The objective of this research was to analyze the process of building one such database to provide baseline information on data sources and data sharing and to document the challenges and solutions that arose during this major undertaking. The resulting Deepwater Horizon Database was approximately 2.4 GB in size and contained over 8 million georeferenced data points collected from industry, government databases, volunteer networks, and individual researchers. The major technical challenges that were overcome were reconciliation of terms, units, and quality flags which were necessary to effectively integrate the disparate data sets. Assembling this database required the development of relationships with individual researchers and data managers which often involved extensive e-mail contacts. The average number of emails exchanged per data set was 7.8. Of the 95 relevant data sets that were discovered, 38 (40%) were obtained, either in whole or in part. Over one third (36%) of the requests for data went unanswered. The majority of responses were received after the first request (64%) and within the first week of the first request (67%). Although fewer than half of the potentially relevant datasets were incorporated into the database, the level of sharing (40%) was high compared to some other disciplines where sharing can be as low as 10%. Our suggestions for building integrated databases include budgeting significant time for e-mail exchanges, being cognizant of the cost versus

  20. Panel A report: Standards needed to interconnect ADS pilots for data sharing for catalogues, directories, and dictionaries

    NASA Technical Reports Server (NTRS)

    1981-01-01

    User requirements, guidelines, and standards for interconnecting an Applications Data Service (ADS) program for data sharing are discussed. Methods for effective sharing of information (catalogues, directories, and dictionaries) among member installations are addressed. An ADS Directory/Catalog architectural model is also given.

  1. a Public Platform for Geospatial Data Sharing for Disaster Risk Management

    NASA Astrophysics Data System (ADS)

    Balbo, S.; Boccardo, P.; Dalmasso, S.; Pasquali, P.

    2013-01-01

    Several studies have been conducted in Africa to assist local governments in addressing the risk situation related to natural hazards. Geospatial data containing information on vulnerability, impacts, climate change, disaster risk reduction is usually part of the output of such studies and is valuable to national and international organizations to reduce the risks and mitigate the impacts of disasters. Nevertheless this data isn't efficiently widely distributed and often resides in remote storage solutions hardly reachable. Spatial Data Infrastructures are technical solutions capable to solve this issue, by storing geospatial data and making them widely available through the internet. Among these solutions, GeoNode, an open source online platform for geospatial data sharing, has been developed in recent years. GeoNode is a platform for the management and publication of geospatial data. It brings together mature and stable open-source software projects under a consistent and easy-to-use interface allowing users, with little training, to quickly and easily share data and create interactive maps. GeoNode data management tools allow for integrated creation of data, metadata, and map visualizations. Each dataset in the system can be shared publicly or restricted to allow access to only specific users. Social features like user profiles and commenting and rating systems allow for the development of communities around each platform to facilitate the use, management, and quality control of the data the GeoNode instance contains (http://geonode.org/). This paper presents a case study scenario of setting up a Web platform based on GeoNode. It is a public platform called MASDAP and promoted by the Government of Malawi in order to support development of the country and build resilience against natural disasters. A substantial amount of geospatial data has already been collected about hydrogeological risk, as well as several

  2. Facilitating Oil Industry Access to Federal Lands through Interagency Data Sharing

    SciTech Connect

    Paul Jehn; Ben Grunewald

    2007-05-31

    -commerce. The next step beyond mere data sharing for facilitating the permitting process is to make it possible for industry to file those permit applications electronically. This process will involve the use of common XML schemas.

  3. Refractive Errors

    MedlinePlus

    ... and lens of your eye helps you focus. Refractive errors are vision problems that happen when the shape ... cornea, or aging of the lens. Four common refractive errors are Myopia, or nearsightedness - clear vision close up ...

  4. Why is data sharing in collaborative natural resource efforts so hard and what can we do to improve it?

    PubMed

    Volk, Carol J; Lucero, Yasmin; Barnas, Katie

    2014-05-01

    Increasingly, research and management in natural resource science rely on very large datasets compiled from multiple sources. While it is generally good to have more data, utilizing large, complex datasets has introduced challenges in data sharing, especially for collaborating researchers in disparate locations ("distributed research teams"). We surveyed natural resource scientists about common data-sharing problems. The major issues identified by our survey respondents (n = 118) when providing data were lack of clarity in the data request (including format of data requested). When receiving data, survey respondents reported various insufficiencies in documentation describing the data (e.g., no data collection description/no protocol, data aggregated, or summarized without explanation). Since metadata, or "information about the data," is a central obstacle in efficient data handling, we suggest documenting metadata through data dictionaries, protocols, read-me files, explicit null value documentation, and process metadata as essential to any large-scale research program. We advocate for all researchers, but especially those involved in distributed teams to alleviate these problems with the use of several readily available communication strategies including the use of organizational charts to define roles, data flow diagrams to outline procedures and timelines, and data update cycles to guide data-handling expectations. In particular, we argue that distributed research teams magnify data-sharing challenges making data management training even more crucial for natural resource scientists. If natural resource scientists fail to overcome communication and metadata documentation issues, then negative data-sharing experiences will likely continue to undermine the success of many large-scale collaborative projects.

  5. An intelligent monitoring and management system for cross-enterprise biomedical data sharing platform

    NASA Astrophysics Data System (ADS)

    Wang, Tusheng; Yang, Yuanyuan; Zhang, Jianguo

    2013-03-01

    In order to enable multiple disciplines of medical researchers, clinical physicians and biomedical engineers working together in a secured, efficient, and transparent cooperative environment, we had designed an e-Science platform for biomedical imaging research and application cross multiple academic institutions and hospitals in Shanghai by using grid-based or cloud-based distributed architecture and presented this work in SPIE Medical Imaging conference held in San Diego in 2012. However, when the platform integrates more and more nodes over different networks, the first challenge is that how to monitor and maintain all the hosts and services operating cross multiple academic institutions and hospitals in the e-Science platform, such as DICOM and Web based image communication services, messaging services and XDS ITI transaction services. In this presentation, we presented a system design and implementation of intelligent monitoring and management which can collect system resource status of every node in real time, alert when node or service failure occurs, and can finally improve the robustness, reliability and service continuity of this e-Science platform.

  6. Sharing My Health Data: A Survey of Data Sharing Preferences of Healthy Individuals

    PubMed Central

    Bell, Elizabeth A.; Ohno-Machado, Lucila; Grando, M. Adela

    2014-01-01

    We interviewed 70 healthy volunteers to understand their choices about how the information in their health record should be shared for research. Twenty-eight survey questions captured individual preferences of healthy volunteers. The results showed that respondents felt comfortable participating in research if they were given choices about which portions of their medical data would be shared, and with whom those data would be shared. Respondents indicated a strong preference towards controlling access to specific data (83%), and a large proportion (68%) indicated concern about the possibility of their data being used by for-profit entities. The results suggest that transparency in the process of sharing is an important factor in the decision to share clinical data for research. PMID:25954442

  7. Preventing errors in laterality.

    PubMed

    Landau, Elliot; Hirschorn, David; Koutras, Iakovos; Malek, Alexander; Demissie, Seleshie

    2015-04-01

    An error in laterality is the reporting of a finding that is present on the right side as on the left or vice versa. While different medical and surgical specialties have implemented protocols to help prevent such errors, very few studies have been published that describe these errors in radiology reports and ways to prevent them. We devised a system that allows the radiologist to view reports in a separate window, displayed in a simple font and with all terms of laterality highlighted in separate colors. This allows the radiologist to correlate all detected laterality terms of the report with the images open in PACS and correct them before the report is finalized. The system is monitored every time an error in laterality was detected. The system detected 32 errors in laterality over a 7-month period (rate of 0.0007 %), with CT containing the highest error detection rate of all modalities. Significantly, more errors were detected in male patients compared with female patients. In conclusion, our study demonstrated that with our system, laterality errors can be detected and corrected prior to finalizing reports.

  8. Precompetitive Data Sharing as a Catalyst to Address Unmet Needs in Parkinson's Disease.

    PubMed

    Stephenson, Diane; Hu, Michele T; Romero, Klaus; Breen, Kieran; Burn, David; Ben-Shlomo, Yoav; Bhattaram, Atul; Isaac, Maria; Venuto, Charles; Kubota, Ken; Little, Max A; Friend, Stephen; Lovestone, Simon; Morris, Huw R; Grosset, Donald; Sutherland, Margaret; Gallacher, John; Williams-Gray, Caroline; Bain, Lisa J; Avilés, Enrique; Marek, Ken; Toga, Arthur W; Stark, Yafit; Forrest Gordon, Mark; Ford, Steve

    2015-01-01

    Parkinson's disease is a complex heterogeneous disorder with urgent need for disease-modifying therapies. Progress in successful therapeutic approaches for PD will require an unprecedented level of collaboration. At a workshop hosted by Parkinson's UK and co-organized by Critical Path Institute's (C-Path) Coalition Against Major Diseases (CAMD) Consortiums, investigators from industry, academia, government and regulatory agencies agreed on the need for sharing of data to enable future success. Government agencies included EMA, FDA, NINDS/NIH and IMI (Innovative Medicines Initiative). Emerging discoveries in new biomarkers and genetic endophenotypes are contributing to our understanding of the underlying pathophysiology of PD. In parallel there is growing recognition that early intervention will be key for successful treatments aimed at disease modification. At present, there is a lack of a comprehensive understanding of disease progression and the many factors that contribute to disease progression heterogeneity. Novel therapeutic targets and trial designs that incorporate existing and new biomarkers to evaluate drug effects independently and in combination are required. The integration of robust clinical data sets is viewed as a powerful approach to hasten medical discovery and therapies, as is being realized across diverse disease conditions employing big data analytics for healthcare. The application of lessons learned from parallel efforts is critical to identify barriers and enable a viable path forward. A roadmap is presented for a regulatory, academic, industry and advocacy driven integrated initiative that aims to facilitate and streamline new drug trials and registrations in Parkinson's disease. PMID:26406139

  9. Metadata Repository for Improved Data Sharing and Reuse Based on HL7 FHIR.

    PubMed

    Ulrich, Hannes; Kock, Ann-Kristin; Duhm-Harbeck, Petra; Habermann, Jens K; Ingenerf, Josef

    2016-01-01

    Unreconciled data structures and formats are a common obstacle to the urgently required sharing and reuse of data within healthcare and medical research. Within the North German Tumor Bank of Colorectal Cancer, clinical and sample data, based on a harmonized data set, is collected and can be pooled by using a hospital-integrated Research Data Management System supporting biobank and study management. Adding further partners who are not using the core data set requires manual adaptations and mapping of data elements. Facing this manual intervention and focusing the reuse of heterogeneous healthcare instance data (value level) and data elements (metadata level), a metadata repository has been developed. The metadata repository is an ISO 11179-3 conformant server application built for annotating and mediating data elements. The implemented architecture includes the translation of metadata information about data elements into the FHIR standard using the FHIR Data Element resource with the ISO 11179 Data Element Extensions. The FHIR-based processing allows exchange of data elements with clinical and research IT systems as well as with other metadata systems. With increasingly annotated and harmonized data elements, data quality and integration can be improved for successfully enabling data analytics and decision support. PMID:27577363

  10. Precompetitive Data Sharing as a Catalyst to Address Unmet Needs in Parkinson's Disease.

    PubMed

    Stephenson, Diane; Hu, Michele T; Romero, Klaus; Breen, Kieran; Burn, David; Ben-Shlomo, Yoav; Bhattaram, Atul; Isaac, Maria; Venuto, Charles; Kubota, Ken; Little, Max A; Friend, Stephen; Lovestone, Simon; Morris, Huw R; Grosset, Donald; Sutherland, Margaret; Gallacher, John; Williams-Gray, Caroline; Bain, Lisa J; Avilés, Enrique; Marek, Ken; Toga, Arthur W; Stark, Yafit; Forrest Gordon, Mark; Ford, Steve

    2015-01-01

    Parkinson's disease is a complex heterogeneous disorder with urgent need for disease-modifying therapies. Progress in successful therapeutic approaches for PD will require an unprecedented level of collaboration. At a workshop hosted by Parkinson's UK and co-organized by Critical Path Institute's (C-Path) Coalition Against Major Diseases (CAMD) Consortiums, investigators from industry, academia, government and regulatory agencies agreed on the need for sharing of data to enable future success. Government agencies included EMA, FDA, NINDS/NIH and IMI (Innovative Medicines Initiative). Emerging discoveries in new biomarkers and genetic endophenotypes are contributing to our understanding of the underlying pathophysiology of PD. In parallel there is growing recognition that early intervention will be key for successful treatments aimed at disease modification. At present, there is a lack of a comprehensive understanding of disease progression and the many factors that contribute to disease progression heterogeneity. Novel therapeutic targets and trial designs that incorporate existing and new biomarkers to evaluate drug effects independently and in combination are required. The integration of robust clinical data sets is viewed as a powerful approach to hasten medical discovery and therapies, as is being realized across diverse disease conditions employing big data analytics for healthcare. The application of lessons learned from parallel efforts is critical to identify barriers and enable a viable path forward. A roadmap is presented for a regulatory, academic, industry and advocacy driven integrated initiative that aims to facilitate and streamline new drug trials and registrations in Parkinson's disease.

  11. Metadata Repository for Improved Data Sharing and Reuse Based on HL7 FHIR.

    PubMed

    Ulrich, Hannes; Kock, Ann-Kristin; Duhm-Harbeck, Petra; Habermann, Jens K; Ingenerf, Josef

    2016-01-01

    Unreconciled data structures and formats are a common obstacle to the urgently required sharing and reuse of data within healthcare and medical research. Within the North German Tumor Bank of Colorectal Cancer, clinical and sample data, based on a harmonized data set, is collected and can be pooled by using a hospital-integrated Research Data Management System supporting biobank and study management. Adding further partners who are not using the core data set requires manual adaptations and mapping of data elements. Facing this manual intervention and focusing the reuse of heterogeneous healthcare instance data (value level) and data elements (metadata level), a metadata repository has been developed. The metadata repository is an ISO 11179-3 conformant server application built for annotating and mediating data elements. The implemented architecture includes the translation of metadata information about data elements into the FHIR standard using the FHIR Data Element resource with the ISO 11179 Data Element Extensions. The FHIR-based processing allows exchange of data elements with clinical and research IT systems as well as with other metadata systems. With increasingly annotated and harmonized data elements, data quality and integration can be improved for successfully enabling data analytics and decision support.

  12. Help prevent hospital errors

    MedlinePlus

    ... A.D.A.M. Editorial team. Related MedlinePlus Health Topics Medication Errors Patient Safety Browse the Encyclopedia A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission ... for online health information and services. Learn more about A.D. ...

  13. Error Analysis

    NASA Astrophysics Data System (ADS)

    Scherer, Philipp O. J.

    Input data as well as the results of elementary operations have to be represented by machine numbers, the subset of real numbers which is used by the arithmetic unit of today's computers. Generally this generates rounding errors. This kind of numerical error can be avoided in principle by using arbitrary precision arithmetics or symbolic algebra programs. But this is unpractical in many cases due to the increase in computing time and memory requirements. Results from more complex operations like square roots or trigonometric functions can have even larger errors since series expansions have to be truncated and iterations accumulate the errors of the individual steps. In addition, the precision of input data from an experiment is limited. In this chapter we study the influence of numerical errors on the uncertainties of the calculated results and the stability of simple algorithms.

  14. A systematic literature review of individuals' perspectives on broad consent and data sharing in the United States

    PubMed Central

    Garrison, Nanibaa' A.; Sathe, Nila A.; Antommaria, Armand H. Matheny; Holm, Ingrid A.; Sanderson, Saskia C.; Smith, Maureen E.; McPheeters, Melissa L.; Clayton, Ellen W.

    2016-01-01

    Purpose: In 2011, an Advanced Notice of Proposed Rulemaking proposed that de-identified human data and specimens be included in biobanks only if patients provide consent. The National Institutes of Health Genomic Data Sharing policy went into effect in 2015, requiring broad consent from almost all research participants. Genet Med 18 7, 663–671. Methods: We conducted a systematic literature review of attitudes toward biobanking, broad consent, and data sharing. Bibliographic databases included MEDLINE, Web of Science, EthxWeb, and GenETHX. Study screening was conducted using DistillerSR. Genet Med 18 7, 663–671. Results: The final 48 studies included surveys (n = 23), focus groups (n = 8), mixed methods (n = 14), interviews (n = 1), and consent form analyses (n = 2). Study quality was characterized as good (n = 19), fair (n = 27), and poor (n = 2). Although many participants objected, broad consent was often preferred over tiered or study-specific consent, particularly when broad consent was the only option, samples were de-identified, logistics of biobanks were communicated, and privacy was addressed. Willingness for data to be shared was high, but it was lower among individuals from under-represented minorities, individuals with privacy and confidentiality concerns, and when pharmaceutical companies had access to data. Genet Med 18 7, 663–671. Conclusions: Additional research is needed to understand factors affecting willingness to give broad consent for biobank research and data sharing in order to address concerns to enhance acceptability. Genet Med 18 7, 663–671. PMID:26583683

  15. Northwestern University schizophrenia data sharing for SchizConnect: A longitudinal dataset for large-scale integration.

    PubMed

    Kogan, Alex; Alpert, Kathryn; Ambite, Jose Luis; Marcus, Daniel S; Wang, Lei

    2016-01-01

    In this paper, we describe an instance of the Northwestern University Schizophrenia Data and Software Tool (NUSDAST), a schizophrenia-related dataset hosted at XNAT Central, and the SchizConnect data portal used for accessing and sharing the dataset. NUSDAST was built and extended upon existing, standard schemas available for data sharing on XNAT Central (http://central.xnat.org/). With the creation of SchizConnect, we were able to link NUSDAST to other neuroimaging data sources and create a powerful, federated neuroimaging resource.

  16. Errors in neuroradiology.

    PubMed

    Caranci, Ferdinando; Tedeschi, Enrico; Leone, Giuseppe; Reginelli, Alfonso; Gatta, Gianluca; Pinto, Antonio; Squillaci, Ettore; Briganti, Francesco; Brunese, Luca

    2015-09-01

    Approximately 4 % of radiologic interpretation in daily practice contains errors and discrepancies that should occur in 2-20 % of reports. Fortunately, most of them are minor degree errors, or if serious, are found and corrected with sufficient promptness; obviously, diagnostic errors become critical when misinterpretation or misidentification should significantly delay medical or surgical treatments. Errors can be summarized into four main categories: observer errors, errors in interpretation, failure to suggest the next appropriate procedure, failure to communicate in a timely and a clinically appropriate manner. Misdiagnosis/misinterpretation percentage should rise up in emergency setting and in the first moments of the learning curve, as in residency. Para-physiological and pathological pitfalls in neuroradiology include calcification and brain stones, pseudofractures, and enlargement of subarachnoid or epidural spaces, ventricular system abnormalities, vascular system abnormalities, intracranial lesions or pseudolesions, and finally neuroradiological emergencies. In order to minimize the possibility of error, it is important to be aware of various presentations of pathology, obtain clinical information, know current practice guidelines, review after interpreting a diagnostic study, suggest follow-up studies when appropriate, communicate significant abnormal findings appropriately and in a timely fashion directly with the treatment team.

  17. The primary reasons behind data sharing, its wider benefits and how to cope with the realities of commercial data.

    PubMed

    Tellam, Ross L; Rushton, Paul; Schuerman, Peter; Pala, Irene; Anane, Derek

    2015-01-01

    Data availability expectations have changed over the years in scientific publishing, nowhere more so than in the field of genomics. This field has spearheaded openness and transparency via public and structured deposition of data. BMC Genomics strongly encourages deposition and unrestricted availability of all primary data underlying research studies both as a way of ensuring reproducibility and standardisation, but also as part of overall community-driven expectation on data deposition and sharing. With funders and publishers moving towards more explicit mandates (regarding data availability), we examined the current barriers to unrestricted availability of data and explored different scenarios in which commercial agreements might run contrary to scientific convention and data sharing policies. In this editorial, Ross Tellam (CSIRO, Australia), Paul Rushton (Texas A&M AgriLife Research) and Peter Schuerman (University of California, Merced), give their views on the importance of data sharing and examine the current challenges in research fields like crop and livestock genomics, where often it is necessary to integrate the interests of academic and commercial stakeholders. We discuss the current approaches, highlight the importance of community-driven standards, and propose ways forward. PMID:26343138

  18. The primary reasons behind data sharing, its wider benefits and how to cope with the realities of commercial data.

    PubMed

    Tellam, Ross L; Rushton, Paul; Schuerman, Peter; Pala, Irene; Anane, Derek

    2015-09-07

    Data availability expectations have changed over the years in scientific publishing, nowhere more so than in the field of genomics. This field has spearheaded openness and transparency via public and structured deposition of data. BMC Genomics strongly encourages deposition and unrestricted availability of all primary data underlying research studies both as a way of ensuring reproducibility and standardisation, but also as part of overall community-driven expectation on data deposition and sharing. With funders and publishers moving towards more explicit mandates (regarding data availability), we examined the current barriers to unrestricted availability of data and explored different scenarios in which commercial agreements might run contrary to scientific convention and data sharing policies. In this editorial, Ross Tellam (CSIRO, Australia), Paul Rushton (Texas A&M AgriLife Research) and Peter Schuerman (University of California, Merced), give their views on the importance of data sharing and examine the current challenges in research fields like crop and livestock genomics, where often it is necessary to integrate the interests of academic and commercial stakeholders. We discuss the current approaches, highlight the importance of community-driven standards, and propose ways forward.

  19. The surveillance error grid.

    PubMed

    Klonoff, David C; Lias, Courtney; Vigersky, Robert; Clarke, William; Parkes, Joan Lee; Sacks, David B; Kirkman, M Sue; Kovatchev, Boris

    2014-07-01

    Currently used error grids for assessing clinical accuracy of blood glucose monitors are based on out-of-date medical practices. Error grids have not been widely embraced by regulatory agencies for clearance of monitors, but this type of tool could be useful for surveillance of the performance of cleared products. Diabetes Technology Society together with representatives from the Food and Drug Administration, the American Diabetes Association, the Endocrine Society, and the Association for the Advancement of Medical Instrumentation, and representatives of academia, industry, and government, have developed a new error grid, called the surveillance error grid (SEG) as a tool to assess the degree of clinical risk from inaccurate blood glucose (BG) monitors. A total of 206 diabetes clinicians were surveyed about the clinical risk of errors of measured BG levels by a monitor. The impact of such errors on 4 patient scenarios was surveyed. Each monitor/reference data pair was scored and color-coded on a graph per its average risk rating. Using modeled data representative of the accuracy of contemporary meters, the relationships between clinical risk and monitor error were calculated for the Clarke error grid (CEG), Parkes error grid (PEG), and SEG. SEG action boundaries were consistent across scenarios, regardless of whether the patient was type 1 or type 2 or using insulin or not. No significant differences were noted between responses of adult/pediatric or 4 types of clinicians. Although small specific differences in risk boundaries between US and non-US clinicians were noted, the panel felt they did not justify separate grids for these 2 types of clinicians. The data points of the SEG were classified in 15 zones according to their assigned level of risk, which allowed for comparisons with the classic CEG and PEG. Modeled glucose monitor data with realistic self-monitoring of blood glucose errors derived from meter testing experiments plotted on the SEG when compared to

  20. Data Governance and Data Sharing Agreements for Community-Wide Health Information Exchange: Lessons from the Beacon Communities

    PubMed Central

    Allen, Claudia; Des Jardins, Terrisca R.; Heider, Arvela; Lyman, Kristin A.; McWilliams, Lee; Rein, Alison L.; Schachter, Abigail A.; Singh, Ranjit; Sorondo, Barbara; Topper, Joan; Turske, Scott A.

    2014-01-01

    Purpose: Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are “nontraditional” health care entities and/or new partners. This paper shares lessons learned based on the experiences of six federally funded communities participating in the Beacon Community Cooperative Agreement Program, and offers guidance for navigating data governance issues and developing DSAs to facilitate community-wide health information exchange. Innovation: While all entities involved in electronic data sharing must address governance issues and create DSAs accordingly, until recently little formal guidance existed for doing so – particularly for community-based initiatives. Despite this lack of guidance, together the Beacon Communities’ experiences highlight promising strategies for navigating complex governance issues, which may be useful to other entities or communities initiating information exchange efforts to support delivery system transformation. Credibility: For the past three years, AcademyHealth has provided technical assistance to most of the 17 Beacon Communities, 6 of whom contributed to this collaborative writing effort. Though these communities varied widely in terms of their demographics, resources, and Beacon-driven priorities, common themes emerged as they described their approaches to data governance and DSA development. Conclusions: The 6 Beacon Communities confirmed that DSAs are necessary to satisfy legal and market-based concerns, and they identified several specific issues, many of which have been noted by others involved in

  1. Improving HIV Surveillance Data for Public Health Action in Washington, DC: A Novel Multiorganizational Data-Sharing Method

    PubMed Central

    Smart, JC

    2016-01-01

    Background The National HIV/AIDS Strategy calls for active surveillance programs for human immunodeficiency virus (HIV) to more accurately measure access to and retention in care across the HIV care continuum for persons living with HIV within their jurisdictions and to identify persons who may need public health services. However, traditional public health surveillance methods face substantial technological and privacy-related barriers to data sharing. Objective This study developed a novel data-sharing approach to improve the timeliness and quality of HIV surveillance data in three jurisdictions where persons may often travel across the borders of the District of Columbia, Maryland, and Virginia. Methods A deterministic algorithm of approximately 1000 lines was developed, including a person-matching system with Enhanced HIV/AIDS Reporting System (eHARS) variables. Person matching was defined in categories (from strongest to weakest): exact, very high, high, medium high, medium, medium low, low, and very low. The algorithm was verified using conventional component testing methods, manual code inspection, and comprehensive output file examination. Results were validated by jurisdictions using internal review processes. Results Of 161,343 uploaded eHARS records from District of Columbia (N=49,326), Maryland (N=66,200), and Virginia (N=45,817), a total of 21,472 persons were matched across jurisdictions over various strengths in a matching process totaling 21 minutes and 58 seconds in the privacy device, leaving 139,871 uniquely identified with only one jurisdiction. No records matched as medium low or low. Over 80% of the matches were identified as either exact or very high matches. Three separate validation methods were conducted for this study, and they all found ≥90% accuracy between records matched by this novel method and traditional matching methods. Conclusions This study illustrated a novel data-sharing approach that may facilitate timelier and better

  2. Developing Ethical Practices for Public Health Research Data Sharing in South Africa: The Views and Experiences From a Diverse Sample of Research Stakeholders.

    PubMed

    Denny, Spencer G; Silaigwana, Blessing; Wassenaar, Douglas; Bull, Susan; Parker, Michael

    2015-07-01

    The abundance of South African clinical and public health research data has the potential to unlock important and valuable future advances in biomedical science. Amid increasing calls for more effective sharing of individual-level data, commitment to promote access to research data is evident within South Africa's public research sector, but national guidance and regulation are absent. This qualitative study examined the perceptions, experiences and concerns of 32 research stakeholders about data-sharing practices. There was consensus about the utility of data sharing in publicly funded health research. However, disparate views emerged about the possible harms and benefits of sharing data and how these should be weighed. The relative dearth of policies governing data-sharing practices needs to be addressed and a framework of support developed that incentivizes data-sharing practices for researchers that are both ethical and effective.

  3. Sharing Public Health Research Data: Toward the Development of Ethical Data-Sharing Practice in Low- and Middle-Income Settings.

    PubMed

    Parker, Michael; Bull, Susan

    2015-07-01

    It is increasingly recognized that effective and appropriate data sharing requires the development of models of good data-sharing practice capable of taking seriously both the potential benefits to be gained and the importance of ensuring that the rights and interests of participants are respected and that risk of harms is minimized. Calls for the greater sharing of individual-level data from biomedical and public health research are receiving support among researchers and research funders. Despite its potential importance, data sharing presents important ethical, social, and institutional challenges in low-income settings. In this article, we report on qualitative research conducted in five low- and middle-income countries exploring the experiences of key research stakeholders and their views about what constitutes good data-sharing practice. PMID:26297744

  4. Data sharing in stem cell translational science: policy statement by the International Stem Cell Forum Ethics Working Party.

    PubMed

    Bredenoord, Annelien L; Mostert, Menno; Isasi, Rosario; Knoppers, Bartha M

    2015-01-01

    Data and sample sharing constitute a scientific and ethical imperative but need to be conducted in a responsible manner in order to protect individual interests as well as maintain public trust. In 2014, the Global Alliance for Genomics and Health (GA4GH) adopted a common Framework for Responsible Sharing of Genomic and Health-Related Data. The GA4GH Framework is applicable to data sharing in the stem cell field, however, interpretation is required so as to provide guidance for this specific context. In this paper, the International Stem Cell Forum Ethics Working Party discusses those principles that are specific to translational stem cell science, including engagement, data quality and safety, privacy, security and confidentiality, risk-benefit analysis and sustainability.

  5. Data sharing and intellectual property in a genomic epidemiology network: policies for large-scale research collaboration.

    PubMed Central

    Chokshi, Dave A.; Parker, Michael; Kwiatkowski, Dominic P.

    2006-01-01

    Genomic epidemiology is a field of research that seeks to improve the prevention and management of common diseases through an understanding of their molecular origins. It involves studying thousands of individuals, often from different populations, with exacting techniques. The scale and complexity of such research has required the formation of research consortia. Members of these consortia need to agree on policies for managing shared resources and handling genetic data. Here we consider data-sharing and intellectual property policies for an international research consortium working on the genomic epidemiology of malaria. We outline specific guidelines governing how samples and data are transferred among its members; how results are released into the public domain; when to seek protection for intellectual property; and how intellectual property should be managed. We outline some pragmatic solutions founded on the basic principles of promoting innovation and access. PMID:16710548

  6. Identifying organizational capacities and incentives for clinical data-sharing: the case of a regional perinatal information system.

    PubMed

    Korst, Lisa M; Signer, Jordana M K; Aydin, Carolyn E; Fink, Arlene

    2008-01-01

    The development of regional data-sharing among healthcare organizations is viewed as an important step in the development of health information technology (HIT), but little is known about this complex task. This is a case study of a regional perinatal data system that involved four hospitals, together responsible for over 10,000 births annually. Using standard qualitative methods, we chronicled project milestones, and identified 31 "critical incidents" that delayed or prevented their achievement. We then used these critical incidents to articulate six organizational capacity domains associated with the achievement of project milestones, and a seventh domain consisting of organizational incentives. Finally, we analyzed the relationship of milestone achievement to the presence of these capacities and incentives. This data center case suggests four requirements for sharing data across organizations: 1) a readiness assessment; 2) a perceived mandate; 3) a formal governance structure; and 4) a third party IT component.

  7. National Geothermal Data System: Case Studies on Exploration and Development of Potential Geothermal Sites Through Distributed Data Sharing

    SciTech Connect

    Anderson, Arlene; Allison, Lee; Richard, Steve; Caudill-Daugherty, Christy; Patten, Kim

    2014-09-29

    The NGDS released version 1 of the system on April 30, 2014 using the US Geoscience Information Network (USGIN) as its data integration platform. NGDS supports the 2013 Open Data Policy, and as such, the launch was featured at the 2014 Energy Datapalooza. Currently, the NGDS features a comprehensive user interface for searching and accessing nearly 41,000 documents and more than 9 million data points shared by scores of data providers across the U.S. The NGDS supports distributed data sharing, permitting the data owners to maintain the raw data that is made available to the consumer. Researchers and industry have been utilizing the NGDS as a mechanism for promoting geothermal development across the country, from hydrothermal to ground source heat pump applications. Case studies in geothermal research and exploration from across the country are highlighted.

  8. 141 Gene Discovery and Data Sharing in Genome Wide Association Analyses: lessons form AIDS genetic restriction genes

    PubMed Central

    O'Brien, Stephen J; Svitin, Anton; Malov, Sergey; Cherkazov, Nikolay; Dobrynin, Pavel; Geerts, Paul; Troyer, Jennifer; Hendrickson-Lambert, Sher; Sezgin, Efe; Hutcheson, Holli

    2014-01-01

    As genome wide association studies plus whole genome sequence analyses for complex human disease determinants are expanding, it seems useful to develop strategies to facilitate large data sharing, rapid replication and validation of provocative statistical associations that straddle the threshold for genome wide significance. At this conference, we shall announce GWATCH, (Genome Wide Association Tracks Chromosome Highway) a web based data release platform that can freely display and inspect unabridged genome tracked association data without compromising privacy or Informed Consent constrictions, allowing for rapid discovery and replication opportunities. We illustrate the utility with HIV-AIDS resistance genes screened in combined large multicenter cohort studies GWAS (MACS, HGDS, MHGS, ALLIVE, LSOCA HOMER) developed and studied over the last decades.

  9. Sweat, Skepticism, and Uncharted Territory: A Qualitative Study of Opinions on Data Sharing Among Public Health Researchers and Research Participants in Mumbai, India.

    PubMed

    Hate, Ketaki; Meherally, Sanna; Shah More, Neena; Jayaraman, Anuja; Bull, Susan; Parker, Michael; Osrin, David

    2015-07-01

    Efforts to internalize data sharing in research practice have been driven largely by developing international norms that have not incorporated opinions from researchers in low- and middle-income countries. We sought to identify the issues around ethical data sharing in the context of research involving women and children in urban India. We interviewed researchers, managers, and research participants associated with a Mumbai non-governmental organization, as well as researchers from other organizations and members of ethics committees. We conducted 22 individual semi-structured interviews and involved 44 research participants in focus group discussions. We used framework analysis to examine ideas about data and data sharing in general; its potential benefits or harms, barriers, obligations, and governance; and the requirements for consent. Both researchers and participants were generally in favor of data sharing, although limited experience amplified their reservations. We identified three themes: concerns that the work of data producers may not receive appropriate acknowledgment, skepticism about the process of sharing, and the fact that the terrain of data sharing was essentially uncharted and confusing. To increase data sharing in India, we need to provide guidelines, protocols, and examples of good practice in terms of consent, data preparation, screening of applications, and what individuals and organizations can expect in terms of validation, acknowledgment, and authorship.

  10. Sweat, Skepticism, and Uncharted Territory: A Qualitative Study of Opinions on Data Sharing Among Public Health Researchers and Research Participants in Mumbai, India.

    PubMed

    Hate, Ketaki; Meherally, Sanna; Shah More, Neena; Jayaraman, Anuja; Bull, Susan; Parker, Michael; Osrin, David

    2015-07-01

    Efforts to internalize data sharing in research practice have been driven largely by developing international norms that have not incorporated opinions from researchers in low- and middle-income countries. We sought to identify the issues around ethical data sharing in the context of research involving women and children in urban India. We interviewed researchers, managers, and research participants associated with a Mumbai non-governmental organization, as well as researchers from other organizations and members of ethics committees. We conducted 22 individual semi-structured interviews and involved 44 research participants in focus group discussions. We used framework analysis to examine ideas about data and data sharing in general; its potential benefits or harms, barriers, obligations, and governance; and the requirements for consent. Both researchers and participants were generally in favor of data sharing, although limited experience amplified their reservations. We identified three themes: concerns that the work of data producers may not receive appropriate acknowledgment, skepticism about the process of sharing, and the fact that the terrain of data sharing was essentially uncharted and confusing. To increase data sharing in India, we need to provide guidelines, protocols, and examples of good practice in terms of consent, data preparation, screening of applications, and what individuals and organizations can expect in terms of validation, acknowledgment, and authorship. PMID:26297746

  11. Medication safety during your hospital stay

    MedlinePlus

    Five-rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety ... Medication safety means you get the right medicine, the right dose, at ... stay, your health care team needs to follow many steps to ...

  12. If we share data, will anyone use them? Data sharing and reuse in the long tail of science and technology.

    PubMed

    Wallis, Jillian C; Rolando, Elizabeth; Borgman, Christine L

    2013-01-01

    Research on practices to share and reuse data will inform the design of infrastructure to support data collection, management, and discovery in the long tail of science and technology. These are research domains in which data tend to be local in character, minimally structured, and minimally documented. We report on a ten-year study of the Center for Embedded Network Sensing (CENS), a National Science Foundation Science and Technology Center. We found that CENS researchers are willing to share their data, but few are asked to do so, and in only a few domain areas do their funders or journals require them to deposit data. Few repositories exist to accept data in CENS research areas.. Data sharing tends to occur only through interpersonal exchanges. CENS researchers obtain data from repositories, and occasionally from registries and individuals, to provide context, calibration, or other forms of background for their studies. Neither CENS researchers nor those who request access to CENS data appear to use external data for primary research questions or for replication of studies. CENS researchers are willing to share data if they receive credit and retain first rights to publish their results. Practices of releasing, sharing, and reusing of data in CENS reaffirm the gift culture of scholarship, in which goods are bartered between trusted colleagues rather than treated as commodities.

  13. A Dynamic Bridge for Data Sharing on e-Science Grid Implementing Web 2.0 Service

    NASA Astrophysics Data System (ADS)

    Jung, Im Y.; Yeom, Heon Y.

    This paper proposes a dynamic bridge for e-Science Grid, implementing Web 2.0 service in order to share experimental data effectively.An e-Science Grid has been established as a cyber laboratory for the users with a special research purpose on science. As an open space, e-Science Grid is expected to stimulate the collaborative researches and the cross domain ones. These research trends need a more efficient and convenient data service satisfying the science researchers. A dynamic bridge designed based on HVEM DataGrid, satisfies the users' requirements for the data sharing on e-Science Grid effectively. It supports a data tagging service in order for HVEM DataGrid to be utilized more extensively without any modification of the existing Grid architecture or services. Moreover, it can be adopted and deleted easily without any effect to the legacy Grid. With the legacyinterface to access data in e-Science Grid, the data tags endow the Grid with the flexibility for data access. This paper evaluates the usefulness of the dynamic bridge by analyzing its overhead and performance.

  14. If We Share Data, Will Anyone Use Them? Data Sharing and Reuse in the Long Tail of Science and Technology

    PubMed Central

    Wallis, Jillian C.; Rolando, Elizabeth; Borgman, Christine L.

    2013-01-01

    Research on practices to share and reuse data will inform the design of infrastructure to support data collection, management, and discovery in the long tail of science and technology. These are research domains in which data tend to be local in character, minimally structured, and minimally documented. We report on a ten-year study of the Center for Embedded Network Sensing (CENS), a National Science Foundation Science and Technology Center. We found that CENS researchers are willing to share their data, but few are asked to do so, and in only a few domain areas do their funders or journals require them to deposit data. Few repositories exist to accept data in CENS research areas.. Data sharing tends to occur only through interpersonal exchanges. CENS researchers obtain data from repositories, and occasionally from registries and individuals, to provide context, calibration, or other forms of background for their studies. Neither CENS researchers nor those who request access to CENS data appear to use external data for primary research questions or for replication of studies. CENS researchers are willing to share data if they receive credit and retain first rights to publish their results. Practices of releasing, sharing, and reusing of data in CENS reaffirm the gift culture of scholarship, in which goods are bartered between trusted colleagues rather than treated as commodities. PMID:23935830

  15. The Benefits and Challenges of Having AN Open and Free Basis Satellite Data Sharing Platform in Turkey: GEZGİN

    NASA Astrophysics Data System (ADS)

    Seda Deveci, Hüsne; Koru, Aziz; Sakarya, Ufuk; Tevrizoğlu, İsmail; Teke, Mustafa; Küpçü, Ramazan; Avenoğlu, Bülent; Demirkesen, Can; Zübeyde Gürbüz, Sevgi; Feray Öztoprak, A.; Açıkgöz, İbrahim Serdar; Hakkı Demirhan, İsmail; Ömer Kozal, Ali; Efendioğlu, Mehmet; Berke, Erdinç; Fehmi Şimşek, F.; Atıl, İlkay; Kaya, Derya; Uçmak, Pınar; Ersöz, Eda; Özen, Hilal

    2016-06-01

    Turkey is a county that experiences rapid socioeconomic development, which, in turn, leads to high urbanization rates due to migration of people from rural to urban areas, many large-scale development projects (e.g. highways, dams, housing and infrastructure), and environmental problems that adversely affect agriculture, such as soil erosion and deforestation. Furthermore, Turkey lies in a region prone to natural disasters, especially earthquakes, landslides, flooding and forest fires. Successfully overcoming these challenges requires continuous monitoring to enable rapid response as well as the development of effective socioeconomic policies. In this regard, space-based earth observation (EO) systems play a critical role in the rapid acquisiton and extraction of crucial information. The first launch of the first Turkish-designed satellite, RASAT, in 2011 led to the wide-spread exploitation of space-based resources by Turkish institutions through the dissemination of EO data on an open and free basis via the GEZGIN internet portal (http://www.gezgin.gov.tr). The push for data sharing was further instigated by the nationally funded project GEOPORTAL ("Satellite Image Processing and Geoportal Development Project") and European Union FP7 project EOPOWER ("Earth Observation for Economic Empowerment"), which strove to create conditions for sustainable economic development through the increased use of Earth observation products and services for environmental applications. In this work, the technical challenges involving processing and preparing raw satellite data for dissemination as well as software design of the GEZGIN Portal will be presented.

  16. A 3D multi-modal and multi-dimensional digital brain model as a framework for data sharing.

    PubMed

    Mailly, Philippe; Haber, Suzanne N; Groenewegen, Henk J; Deniau, Jean-Michel

    2010-12-15

    Computer based three-dimensional reconstruction and co-registration of experimental data provide powerful tools for integration of observation derived from various technical approaches leading to better understanding of brain functions. Here we describe a method to build a 3D multi-modal and multi-dimensional model of brain structures providing framework for data sharing. All image processing, registration and 3D reconstruction were performed using open source software IMOD package software and ImageJ. The reconstruction procedure is based on series of AChE and Nissl stained sections aligned to blockface pictures. Integration of experimental data into the reference model is achieved by co-registration of Nissl sections of experimental brain cases by positioning landmarks on corresponding anatomical structures. To overcome the challenge of comparing for experimental sections with those of the reference model, adjustment of experimental model to the brain model was done section by section and limited to the structures of interest. For this adjustment we stress the use of cytoarchitectural criteria for accurate registration of anatomical structures and co-registration procedures.

  17. The concordance between nonclinical and phase I clinical cardiovascular assessment from a cross-company data sharing initiative.

    PubMed

    Ewart, Lorna; Aylott, Mike; Deurinck, Mark; Engwall, Mike; Gallacher, David J; Geys, Helena; Jarvis, Philip; Ju, Haisong; Leishman, Derek; Leong, Louise; McMahon, Nick; Mead, Andy; Milliken, Phil; Suter, Willi; Teisman, Ard; Van Ammel, Karel; Vargas, Hugo M; Wallis, Rob; Valentin, Jean-Pierre

    2014-12-01

    It is widely accepted that more needs to be done to bring new, safe, and efficacious drugs to the market. Cardiovascular toxicity detected both in early drug discovery as well as in the clinic, is a major contributor to the high failure rate of new molecules. The growth of translational safety offers a promising approach to improve the probability of success for new molecules. Here we describe a cross-company initiative to determine the concordance between the conscious telemetered dog and phase I outcome for 3 cardiovascular parameters. The data indicate that, in the context of the methods applied in this analysis, the ability to detect compounds that affect the corrected QT interval (QTc) was good within the 10-30x exposure range but the predictive or detective value for heart rate and diastolic blood pressure was poor. These findings may highlight opportunities to refine both the animal and the clinical study designs, as well as refocusing the assessment of value of dog cardiovascular assessments beyond phase 1. This investigation has also highlighted key considerations for cross-company data sharing and presents a unique learning opportunity to improve future translational projects.

  18. Medication safety.

    PubMed

    Keohane, Carol A; Bates, David W

    2008-03-01

    Patient safety is a state of mind, not a technology. The technologies used in the medical setting represent tools that must be properly designed, used well, and assessed on an on-going basis. Moreover, in all settings, building a culture of safety is pivotal for improving safety, and many nontechnologic approaches, such as medication reconciliation and teaching patients about their medications, are also essential. This article addresses the topic of medication safety and examines specific strategies being used to decrease the incidence of medication errors across various clinical settings.

  19. Data sharing through an NIH central database repository: a cross-sectional survey of BioLINCC users

    PubMed Central

    Ross, Joseph S; Ritchie, Jessica D; Finn, Emily; Desai, Nihar R; Lehman, Richard L; Krumholz, Harlan M; Gross, Cary P

    2016-01-01

    Objective To characterise experiences using clinical research data shared through the National Institutes of Health (NIH)'s Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) clinical research data repository, along with data recipients’ perceptions of the value, importance and challenges with using BioLINCC data. Design and setting Cross-sectional web-based survey. Participants All investigators who requested and received access to clinical research data from BioLINCC between 2007 and 2014. Main outcome measures Reasons for BioLINCC data request, research project plans, interactions with original study investigators, BioLINCC experience and other project details. Results There were 536 investigators who requested and received access to clinical research data from BioLINCC between 2007 and 2014. Of 441 potential respondents, 195 completed the survey (response rate=44%); 89% (n=174) requested data for an independent study, 17% (n=33) for pilot/preliminary analysis. Commonly cited reasons for requesting data through BioLINCC were feasibility of collecting data of similar size and scope (n=122) and insufficient financial resources for primary data collection (n=76). For 95% of respondents (n=186), a primary research objective was to complete new research, as opposed to replicate prior analyses. Prior to requesting data from BioLINCC, 18% (n=36) of respondents had contacted the original study investigators to obtain data, whereas 24% (n=47) had done so to request collaboration. Nearly all (n=176; 90%) respondents found the data to be suitable for their proposed project; among those who found the data unsuitable (n=19; 10%), cited reasons were data too complicated to use (n=5) and data poorly organised (n=5). Half (n=98) of respondents had completed their proposed projects, of which 67% (n=66) have been published. Conclusions Investigators were primarily using clinical research data from BioLINCC for independent research, making use of

  20. The eTOX data-sharing project to advance in silico drug-induced toxicity prediction.

    PubMed

    Cases, Montserrat; Briggs, Katharine; Steger-Hartmann, Thomas; Pognan, François; Marc, Philippe; Kleinöder, Thomas; Schwab, Christof H; Pastor, Manuel; Wichard, Jörg; Sanz, Ferran

    2014-01-01

    The high-quality in vivo preclinical safety data produced by the pharmaceutical industry during drug development, which follows numerous strict guidelines, are mostly not available in the public domain. These safety data are sometimes published as a condensed summary for the few compounds that reach the market, but the majority of studies are never made public and are often difficult to access in an automated way, even sometimes within the owning company itself. It is evident from many academic and industrial examples, that useful data mining and model development requires large and representative data sets and careful curation of the collected data. In 2010, under the auspices of the Innovative Medicines Initiative, the eTOX project started with the objective of extracting and sharing preclinical study data from paper or pdf archives of toxicology departments of the 13 participating pharmaceutical companies and using such data for establishing a detailed, well-curated database, which could then serve as source for read-across approaches (early assessment of the potential toxicity of a drug candidate by comparison of similar structure and/or effects) and training of predictive models. The paper describes the efforts undertaken to allow effective data sharing intellectual property (IP) protection and set up of adequate controlled vocabularies) and to establish the database (currently with over 4000 studies contributed by the pharma companies corresponding to more than 1400 compounds). In addition, the status of predictive models building and some specific features of the eTOX predictive system (eTOXsys) are presented as decision support knowledge-based tools for drug development process at an early stage. PMID:25405742

  1. Using GIS servers and interactive maps in spectral data sharing and administration: Case study of Ahvaz Spectral Geodatabase Platform (ASGP)

    NASA Astrophysics Data System (ADS)

    Karami, Mojtaba; Rangzan, Kazem; Saberi, Azim

    2013-10-01

    With emergence of air-borne and space-borne hyperspectral sensors, spectroscopic measurements are gaining more importance in remote sensing. Therefore, the number of available spectral reference data is constantly increasing. This rapid increase often exhibits a poor data management, which leads to ultimate isolation of data on disk storages. Spectral data without precise description of the target, methods, environment, and sampling geometry cannot be used by other researchers. Moreover, existing spectral data (in case it accompanied with good documentation) become virtually invisible or unreachable for researchers. Providing documentation and a data-sharing framework for spectral data, in which researchers are able to search for or share spectral data and documentation, would definitely improve the data lifetime. Relational Database Management Systems (RDBMS) are main candidates for spectral data management and their efficiency is proven by many studies and applications to date. In this study, a new approach to spectral data administration is presented based on spatial identity of spectral samples. This method benefits from scalability and performance of RDBMS for storage of spectral data, but uses GIS servers to provide users with interactive maps as an interface to the system. The spectral files, photographs and descriptive data are considered as belongings of a geospatial object. A spectral processing unit is responsible for evaluation of metadata quality and performing routine spectral processing tasks for newly-added data. As a result, by using internet browser software the users would be able to visually examine availability of data and/or search for data based on descriptive attributes associated to it. The proposed system is scalable and besides giving the users good sense of what data are available in the database, it facilitates participation of spectral reference data in producing geoinformation.

  2. The eTOX Data-Sharing Project to Advance in Silico Drug-Induced Toxicity Prediction

    PubMed Central

    Cases, Montserrat; Briggs, Katharine; Steger-Hartmann, Thomas; Pognan, François; Marc, Philippe; Kleinöder, Thomas; Schwab, Christof H.; Pastor, Manuel; Wichard, Jörg; Sanz, Ferran

    2014-01-01

    The high-quality in vivo preclinical safety data produced by the pharmaceutical industry during drug development, which follows numerous strict guidelines, are mostly not available in the public domain. These safety data are sometimes published as a condensed summary for the few compounds that reach the market, but the majority of studies are never made public and are often difficult to access in an automated way, even sometimes within the owning company itself. It is evident from many academic and industrial examples, that useful data mining and model development requires large and representative data sets and careful curation of the collected data. In 2010, under the auspices of the Innovative Medicines Initiative, the eTOX project started with the objective of extracting and sharing preclinical study data from paper or pdf archives of toxicology departments of the 13 participating pharmaceutical companies and using such data for establishing a detailed, well-curated database, which could then serve as source for read-across approaches (early assessment of the potential toxicity of a drug candidate by comparison of similar structure and/or effects) and training of predictive models. The paper describes the efforts undertaken to allow effective data sharing intellectual property (IP) protection and set up of adequate controlled vocabularies) and to establish the database (currently with over 4000 studies contributed by the pharma companies corresponding to more than 1400 compounds). In addition, the status of predictive models building and some specific features of the eTOX predictive system (eTOXsys) are presented as decision support knowledge-based tools for drug development process at an early stage. PMID:25405742

  3. Nanoinformatics workshop report: current resources, community needs and the proposal of a collaborative framework for data sharing and information integration

    NASA Astrophysics Data System (ADS)

    Harper, Stacey L.; Hutchison, James E.; Baker, Nathan; Ostraat, Michele; Tinkle, Sally; Steevens, Jeffrey; Hoover, Mark D.; Adamick, Jessica; Rajan, Krishna; Gaheen, Sharon; Cohen, Yoram; Nel, Andre; Cachau, Raul E.; Tuominen, Mark

    2013-01-01

    The quantity of information on nanomaterial properties and behavior continues to grow rapidly. Without a concerted effort to collect, organize and mine disparate information coming out of current research efforts, the value and effective use of this information will be limited at best. Data will not be translated to knowledge. At worst, erroneous conclusions will be drawn and future research may be misdirected. Nanoinformatics can be a powerful approach to enhance the value of global information in nanoscience and nanotechnology. Much progress has been made through grassroots efforts in nanoinformatics resulting in a multitude of resources and tools for nanoscience researchers. In 2012, the nanoinformatics community believed it was important to critically evaluate and refine currently available nanoinformatics approaches in order to best inform the science and support the future of predictive nanotechnology. The Greener Nano 2012: Nanoinformatics Tools and Resources Workshop brought together informatics groups with materials scientists active in nanoscience research to evaluate and reflect on the tools and resources that have recently emerged in support of predictive nanotechnology. The workshop goals were to establish a better understanding of current nanoinformatics approaches and to clearly define immediate and projected informatics infrastructure needs of the nanotechnology community. The theme of nanotechnology environmental health and safety (nanoEHS) was used to provide real-world, concrete examples on how informatics can be utilized to advance our knowledge and guide nanoscience. The benefit here is that the same properties that impact the performance of products could also be the properties that inform EHS. From a decision management standpoint, the dual use of such data should be considered a priority. Key outcomes include a proposed collaborative framework for data collection, data sharing and information integration.

  4. Errors as allies: error management training in health professions education.

    PubMed

    King, Aimee; Holder, Michael G; Ahmed, Rami A

    2013-06-01

    This paper adopts methods from the organisational team training literature to outline how health professions education can improve patient safety. We argue that health educators can improve training quality by intentionally encouraging errors during simulation-based team training. Preventable medical errors are inevitable, but encouraging errors in low-risk settings like simulation can allow teams to have better emotional control and foresight to manage the situation if it occurs again with live patients. Our paper outlines an innovative approach for delivering team training.

  5. Is Medical Student Writing Wrong?

    ERIC Educational Resources Information Center

    Frisof, Kenneth B.; Moseley, James L.

    The prevalence of writing errors made by third-year medical students from the class of 1981 at a large midwestern medical school was studied. The papers of 253 students taking family medicine were evaluated for spelling, grammar, and punctuation errors. Four types of grammar errors and seven punctuation errors were analyzed, and each word…

  6. Negligence, genuine error, and litigation.

    PubMed

    Sohn, David H

    2013-01-01

    Not all medical injuries are the result of negligence. In fact, most medical injuries are the result either of the inherent risk in the practice of medicine, or due to system errors, which cannot be prevented simply through fear of disciplinary action. This paper will discuss the differences between adverse events, negligence, and system errors; the current medical malpractice tort system in the United States; and review current and future solutions, including medical malpractice reform, alternative dispute resolution, health courts, and no-fault compensation systems. The current political environment favors investigation of non-cap tort reform remedies; investment into more rational oversight systems, such as health courts or no-fault systems may reap both quantitative and qualitative benefits for a less costly and safer health system. PMID:23426783

  7. Errors associated with outpatient computerized prescribing systems

    PubMed Central

    Rothschild, Jeffrey M; Salzberg, Claudia; Keohane, Carol A; Zigmont, Katherine; Devita, Jim; Gandhi, Tejal K; Dalal, Anuj K; Bates, David W; Poon, Eric G

    2011-01-01

    Objective To report the frequency, types, and causes of errors associated with outpatient computer-generated prescriptions, and to develop a framework to classify these errors to determine which strategies have greatest potential for preventing them. Materials and methods This is a retrospective cohort study of 3850 computer-generated prescriptions received by a commercial outpatient pharmacy chain across three states over 4 weeks in 2008. A clinician panel reviewed the prescriptions using a previously described method to identify and classify medication errors. Primary outcomes were the incidence of medication errors; potential adverse drug events, defined as errors with potential for harm; and rate of prescribing errors by error type and by prescribing system. Results Of 3850 prescriptions, 452 (11.7%) contained 466 total errors, of which 163 (35.0%) were considered potential adverse drug events. Error rates varied by computerized prescribing system, from 5.1% to 37.5%. The most common error was omitted information (60.7% of all errors). Discussion About one in 10 computer-generated prescriptions included at least one error, of which a third had potential for harm. This is consistent with the literature on manual handwritten prescription error rates. The number, type, and severity of errors varied by computerized prescribing system, suggesting that some systems may be better at preventing errors than others. Conclusions Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors. The authors offer targeted recommendations on improving computerized prescribing systems to prevent errors. PMID:21715428

  8. The International Data Sharing Challenge: Realities and Lessons Learned from International Field Projects and Data Analysis Efforts

    NASA Astrophysics Data System (ADS)

    Williams, S. F.; Moore, J. A.

    2014-12-01

    data sharing and open data. This will be done through the framework of the projects noted above in an environment of proprietary data claims, multiple formats and data collection procedures, stockpiling of data, international data restrictions and mistrust of other scientists.

  9. Review article: Emergency department data sharing to reduce alcohol-related violence: a systematic review of the feasibility and effectiveness of community-level interventions.

    PubMed

    Droste, Nicolas; Miller, Peter; Baker, Tim

    2014-08-01

    The present paper aims to review current evidence for the effectiveness and/or feasibility of using inter-agency data sharing of ED recorded assault information to direct interventions reducing alcohol-related or nightlife assaults, injury or violence. Potential data-sharing partners involve police, local council, liquor licensing regulators and venue management. A systematic review of the peer-reviewed literature was conducted. The initial search discovered 19,506 articles. After removal of duplicates and articles not meeting review criteria, n = 8 articles were included in quantitative and narrative synthesis. Seven of eight studies were conducted in UK EDs, with the remaining study presenting Australian data. All studies included in the review deemed data sharing a worthwhile pursuit. All studies attempting to measure intervention effectiveness reported substantial reductions of assaults and ED attendances post-intervention, with one reporting no change. Negative logistic feasibility concerns were minimal, with general consensus among authors being that data-sharing protocols and partnerships could be easily implemented into modern ED triage systems, with minimal cost, staff workload burden, impact to patient safety, service and anonymity, or risk of harm displacement to other licensed venues, or increase to length of patient stay. However, one study reported a potential harm displacement effect to streets surrounding intervention venues. In future, data-sharing systems should triangulate ED, police and ambulance data sources, and assess intervention effectiveness using randomised controlled trials that account for variations in venue capacity, fluctuations in ED attendance and population levels, seasonal variations in assault and injury, and control for concurrent interventions. PMID:24931278

  10. Using Medications Safely

    MedlinePlus

    ... health systems play an important role in preventing medication errors. To make sure you use medicines safely and effectively, ASHP recommends that you: Keep a list of all medications that you take (prescribed drugs, nonprescription medicines, herbal ...

  11. Enhancing interdisciplinary collaboration and decisionmaking with J-Earth: an open source data sharing, visualization and GIS analysis platform

    NASA Astrophysics Data System (ADS)

    Prashad, L. C.; Christensen, P. R.; Fink, J. H.; Anwar, S.; Dickenshied, S.; Engle, E.; Noss, D.

    2010-12-01

    Our society currently is facing a number of major environmental challenges, most notably the threat of climate change. A multifaceted, interdisciplinary approach involving physical and social scientists, engineers and decisionmakers is critical to adequately address these complex issues. To best facilitate this interdisciplinary approach, data and models at various scales - from local to global - must be quickly and easily shared between disciplines to effectively understand environmental phenomena and human-environmental interactions. When data are acquired and studied on different scales and within different disciplines, researchers and practitioners may not be able to easily learn from each others results. For example, climate change models are often developed at a global scale, while strategies that address human vulnerability to climate change and mitigation/adaptation strategies are often assessed on a local level. Linkages between urban heat island phenomena and global climate change may be better understood with increased data flow amongst researchers and those making policy decisions. In these cases it would be useful have a single platform to share, visualize, and analyze numerical model and satellite/airborne remote sensing data with social, environmental, and economic data between researchers and practitioners. The Arizona State University 100 Cities Project and Mars Space Flight Facility are developing the open source application J-Earth, with the goal of providing this single platform, that facilitates data sharing, visualization, and analysis between researchers and applied practitioners around environmental and other sustainability challenges. This application is being designed for user communities including physical and social scientists, NASA researchers, non-governmental organizations, and decisionmakers to share and analyze data at multiple scales. We are initially focusing on urban heat island and urban ecology studies, with data and users from

  12. [Diagnostic Errors in Medicine].

    PubMed

    Buser, Claudia; Bankova, Andriyana

    2015-12-01

    The recognition of diagnostic errors in everyday practice can help improve patient safety. The most common diagnostic errors are the cognitive errors, followed by system-related errors and no fault errors. The cognitive errors often result from mental shortcuts, known as heuristics. The rate of cognitive errors can be reduced by a better understanding of heuristics and the use of checklists. The autopsy as a retrospective quality assessment of clinical diagnosis has a crucial role in learning from diagnostic errors. Diagnostic errors occur more often in primary care in comparison to hospital settings. On the other hand, the inpatient errors are more severe than the outpatient errors.

  13. [Diagnostic Errors in Medicine].

    PubMed

    Buser, Claudia; Bankova, Andriyana

    2015-12-01

    The recognition of diagnostic errors in everyday practice can help improve patient safety. The most common diagnostic errors are the cognitive errors, followed by system-related errors and no fault errors. The cognitive errors often result from mental shortcuts, known as heuristics. The rate of cognitive errors can be reduced by a better understanding of heuristics and the use of checklists. The autopsy as a retrospective quality assessment of clinical diagnosis has a crucial role in learning from diagnostic errors. Diagnostic errors occur more often in primary care in comparison to hospital settings. On the other hand, the inpatient errors are more severe than the outpatient errors. PMID:26649954

  14. Research Stakeholders’ Views on Benefits and Challenges for Public Health Research Data Sharing in Kenya: The Importance of Trust and Social Relations

    PubMed Central

    Jao, Irene; Kombe, Francis; Mwalukore, Salim; Bull, Susan; Parker, Michael; Kamuya, Dorcas; Molyneux, Sassy; Marsh, Vicki

    2015-01-01

    Background There is increasing recognition of the importance of sharing research data within the international scientific community, but also of the ethical and social challenges this presents, particularly in the context of structural inequities and varied capacity in international research. Public involvement is essential to building locally responsive research policies, including on data sharing, but little research has involved stakeholders from low-to-middle income countries. Methods Between January and June 2014, a qualitative study was conducted in Kenya involving sixty stakeholders with varying experiences of research in a deliberative process to explore views on benefits and challenges in research data sharing. In-depth interviews and extended small group discussions based on information sharing and facilitated debate were used to collect data. Data were analysed using Framework Analysis, and charting flow and dynamics in debates. Findings The findings highlight both the opportunities and challenges of communicating about this complex and relatively novel topic for many stakeholders. For more and less research-experienced stakeholders, ethical research data sharing is likely to rest on the development and implementation of appropriate trust-building processes, linked to local perceptions of benefits and challenges. The central nature of trust is underpinned by uncertainties around who might request what data, for what purpose and when. Key benefits perceived in this consultation were concerned with the promotion of public health through science, with legitimate beneficiaries defined differently by different groups. Important challenges were risks to the interests of study participants, communities and originating researchers through stigmatisation, loss of privacy, impacting autonomy and unfair competition, including through forms of intentional and unintentional 'misuse' of data. Risks were also seen for science. Discussion Given background structural

  15. Diagnostic Errors in Ambulatory Care: Dimensions and Preventive Strategies

    ERIC Educational Resources Information Center

    Singh, Hardeep; Weingart, Saul N.

    2009-01-01

    Despite an increasing focus on patient safety in ambulatory care, progress in understanding and reducing diagnostic errors in this setting lag behind many other safety concerns such as medication errors. To explore the extent and nature of diagnostic errors in ambulatory care, we identified five dimensions of ambulatory care from which errors may…

  16. Sun compass error model

    NASA Technical Reports Server (NTRS)

    Blucker, T. J.; Ferry, W. W.

    1971-01-01

    An error model is described for the Apollo 15 sun compass, a contingency navigational device. Field test data are presented along with significant results of the test. The errors reported include a random error resulting from tilt in leveling the sun compass, a random error because of observer sighting inaccuracies, a bias error because of mean tilt in compass leveling, a bias error in the sun compass itself, and a bias error because the device is leveled to the local terrain slope.

  17. A New Cure for Medical Errors

    NASA Technical Reports Server (NTRS)

    2002-01-01

    In May 2000, senior officials of the U.S. Department of Veterans Affairs (VA) and NASA signed an agreement that would commit the two agencies to create the Patient Safety Reporting System (PSRS) to report: events or situations that could have resulted in accident, injury, or illness, but did not, either by chance or through timely intervention (close-calls); unexpected serious occurrences that involved a patient or employee's death, physical injury, or psychological injury; lessens learned; and safety ideas. The VA provided NASA with funding for the initial development of the new system, which automatically removes all personal names, facility names and locations, and other potentially identifying information before entering reports into its database. Designed to complement the VA's current internal reporting systems, the PSRS is modeled after NASA's Aviation Safety Reporting System, which was established in 1975 under a Memorandum of Agreement between the Federal Aviation Administration and NASA and began operation in 1976.

  18. Unforced errors and error reduction in tennis

    PubMed Central

    Brody, H

    2006-01-01

    Only at the highest level of tennis is the number of winners comparable to the number of unforced errors. As the average player loses many more points due to unforced errors than due to winners by an opponent, if the rate of unforced errors can be reduced, it should lead to an increase in points won. This article shows how players can improve their game by understanding and applying the laws of physics to reduce the number of unforced errors. PMID:16632568

  19. Errors inducing radiation overdoses.

    PubMed

    Grammaticos, Philip C

    2013-01-01

    There is no doubt that equipments exposing radiation and used for therapeutic purposes should be often checked for possibly administering radiation overdoses to the patients. Technologists, radiation safety officers, radiologists, medical physicists, healthcare providers and administration should take proper care on this issue. "We must be beneficial and not harmful to the patients", according to the Hippocratic doctrine. Cases of radiation overdose are often reported. A series of cases of radiation overdoses have recently been reported. Doctors who were responsible, received heavy punishments. It is much better to prevent than to treat an error or a disease. A Personal Smart Card or Score Card has been suggested for every patient undergoing therapeutic and/or diagnostic procedures by the use of radiation. Taxonomy may also help. PMID:24251304

  20. Error in radiology.

    PubMed

    Goddard, P; Leslie, A; Jones, A; Wakeley, C; Kabala, J

    2001-10-01

    The level of error in radiology has been tabulated from articles on error and on "double reporting" or "double reading". The level of error varies depending on the radiological investigation, but the range is 2-20% for clinically significant or major error. The greatest reduction in error rates will come from changes in systems.

  1. Never too old for anonymity: a statistical standard for demographic data sharing via the HIPAA Privacy Rule

    PubMed Central

    Benitez, Kathleen; Masys, Daniel

    2010-01-01

    Objective Healthcare organizations must de-identify patient records before sharing data. Many organizations rely on the Safe Harbor Standard of the HIPAA Privacy Rule, which enumerates 18 identifiers that must be suppressed (eg, ages over 89). An alternative model in the Privacy Rule, known as the Statistical Standard, can facilitate the sharing of more detailed data, but is rarely applied because of a lack of published methodologies. The authors propose an intuitive approach to de-identifying patient demographics in accordance with the Statistical Standard. Design The authors conduct an analysis of the demographics of patient cohorts in five medical centers developed for the NIH-sponsored Electronic Medical Records and Genomics network, with respect to the US census. They report the re-identification risk of patient demographics disclosed according to the Safe Harbor policy and the relative risk rate for sharing such information via alternative policies. Measurements The re-identification risk of Safe Harbor demographics ranged from 0.01% to 0.19%. The findings show alternative de-identification models can be created with risks no greater than Safe Harbor. The authors illustrate that the disclosure of patient ages over the age of 89 is possible when other features are reduced in granularity. Limitations The de-identification approach described in this paper was evaluated with demographic data only and should be evaluated with other potential identifiers. Conclusion Alternative de-identification policies to the Safe Harbor model can be derived for patient demographics to enable the disclosure of values that were previously suppressed. The method is generalizable to any environment in which population statistics are available. PMID:21169618

  2. Precompetitive Data Sharing as a Catalyst to Address Unmet Needs in Parkinson’s Disease 1

    PubMed Central

    Stephenson, Diane; Hu, Michele T.; Romero, Klaus; Breen, Kieran; Burn, David; Ben-Shlomo, Yoav; Bhattaram, Atul; Isaac, Maria; Venuto, Charles; Kubota, Ken; Little, Max A.; Friend, Stephen; Lovestone, Simon; Morris, Huw R.; Grosset, Donald; Sutherland, Margaret; Gallacher, John; Williams-Gray, Caroline; Bain, Lisa J.; Avilés, Enrique; Marek, Ken; Toga, Arthur W.; Stark, Yafit; Forrest Gordon, Mark; Ford, Steve

    2015-01-01

    Abstract Parkinson’s disease is a complex heterogeneous disorder with urgent need for disease-modifying therapies. Progress in successful therapeutic approaches for PD will require an unprecedented level of collaboration. At a workshop hosted by Parkinson’s UK and co-organized by Critical Path Institute’s (C-Path) Coalition Against Major Diseases (CAMD) Consortiums, investigators from industry, academia, government and regulatory agencies agreed on the need for sharing of data to enable future success. Government agencies included EMA, FDA, NINDS/NIH and IMI (Innovative Medicines Initiative). Emerging discoveries in new biomarkers and genetic endophenotypes are contributing to our understanding of the underlying pathophysiology of PD. In parallel there is growing recognition that early intervention will be key for successful treatments aimed at disease modification. At present, there is a lack of a comprehensive understanding of disease progression and the many factors that contribute to disease progression heterogeneity. Novel therapeutic targets and trial designs that incorporate existing and new biomarkers to evaluate drug effects independently and in combination are required. The integration of robust clinical data sets is viewed as a powerful approach to hasten medical discovery and therapies, as is being realized across diverse disease conditions employing big data analytics for healthcare. The application of lessons learned from parallel efforts is critical to identify barriers and enable a viable path forward. A roadmap is presented for a regulatory, academic, industry and advocacy driven integrated initiative that aims to facilitate and streamline new drug trials and registrations in Parkinson’s disease. PMID:26406139

  3. Reducing prescribing error: competence, control, and culture.

    PubMed

    Barber, N; Rawlins, M; Dean Franklin, B

    2003-12-01

    Medication errors are probably the most prevalent form of medical error, and prescribing errors are the most important source of medication errors. In this article we suggest interventions are needed at three levels to improve prescribing: (1) improve the training, and test the competence, of prescribers; (2) control the environment in which prescribers perform in order to standardise it, have greater controls on riskier drugs, and use technology to provide decision support; and (3) change organisational cultures, which do not support the belief that prescribing is a complex, technical, act, and that it is important to get it right. Solutions involve overt acknowledgement of this by senior clinicians and managers, and an open process of sharing and reviewing prescribing decisions. PMID:14645746

  4. A systems approach to error prevention in medicine.

    PubMed

    Wieman, Thomas Jeffery; Wieman, Eric Andrew

    2004-12-01

    Minimization of medical errors is at the core of all clinical medical practices. The first tenet of care is to do no harm. The enormous complexity of modern medical care has made error detection and management extremely difficult. Traditional deterministic methods of solving the "error issue" cannot cope with the huge number of potential errors that are possible. Systems thinking and approach to error reduction provides a different avenue for tackling this challenging dilemma. The intent of this article is to introduce a systems view of medical errors and to explain how it can provide new insights about dealing with massively complex organizations such as the healthcare system. Important features include an understanding of system relationships, sources of error, human components, optimization versus perfection in systems and the interrelationships between human and system processes.

  5. Understanding and Confronting Our Mistakes: The Epidemiology of Error in Radiology and Strategies for Error Reduction.

    PubMed

    Bruno, Michael A; Walker, Eric A; Abujudeh, Hani H

    2015-10-01

    Arriving at a medical diagnosis is a highly complex process that is extremely error prone. Missed or delayed diagnoses often lead to patient harm and missed opportunities for treatment. Since medical imaging is a major contributor to the overall diagnostic process, it is also a major potential source of diagnostic error. Although some diagnoses may be missed because of the technical or physical limitations of the imaging modality, including image resolution, intrinsic or extrinsic contrast, and signal-to-noise ratio, most missed radiologic diagnoses are attributable to image interpretation errors by radiologists. Radiologic interpretation cannot be mechanized or automated; it is a human enterprise based on complex psychophysiologic and cognitive processes and is itself subject to a wide variety of error types, including perceptual errors (those in which an important abnormality is simply not seen on the images) and cognitive errors (those in which the abnormality is visually detected but the meaning or importance of the finding is not correctly understood or appreciated). The overall prevalence of radiologists' errors in practice does not appear to have changed since it was first estimated in the 1960s. The authors review the epidemiology of errors in diagnostic radiology, including a recently proposed taxonomy of radiologists' errors, as well as research findings, in an attempt to elucidate possible underlying causes of these errors. The authors also propose strategies for error reduction in radiology. On the basis of current understanding, specific suggestions are offered as to how radiologists can improve their performance in practice. PMID:26466178

  6. Information-Gathering Patterns Associated with Higher Rates of Diagnostic Error

    ERIC Educational Resources Information Center

    Delzell, John E., Jr.; Chumley, Heidi; Webb, Russell; Chakrabarti, Swapan; Relan, Anju

    2009-01-01

    Diagnostic errors are an important source of medical errors. Problematic information-gathering is a common cause of diagnostic errors among physicians and medical students. The objectives of this study were to (1) determine if medical students' information-gathering patterns formed clusters of similar strategies, and if so (2) to calculate the…

  7. [The digital information platform after-sale service of medical equipment].

    PubMed

    Cao, Shaoping; Li, Bin

    2015-01-01

    This paper describes the after-sale service of medical equipment information management platform, with large data sharing resources to further enhance customer service in the whole management process of medical service, to strengthen quality management, to control medical risk. PMID:26027303

  8. Are patients morally responsible for their errors?

    PubMed

    Buetow, S; Elwyn, G

    2006-05-01

    Amid neglect of patients' contribution to error has been a failure to ask whether patients are morally responsible for their errors. This paper aims to help answer this question and so define a worthy response to the errors. Recent work on medical errors has emphasised system deficiencies and discouraged finding people to blame. We scrutinize this approach from an incompatibilist, agent causation position and draw on Hart's taxonomy of four senses of moral responsibility: role responsibility; capacity responsibility; causal responsibility; and liability responsibility. Each sense is shown to contribute to an overall theoretical judgment as to whether patients are morally responsible for their errors (and success in avoiding them). Though how to weight the senses is unclear, patients appear to be morally responsible for the avoidable errors they make, contribute to or can influence. PMID:16648274

  9. User-Friendly Data-Sharing Practices for Fostering Collaboration within a Research Network: Roles of a Vanguard Center for a Community-Based Study

    PubMed Central

    Lee, Jae Eun; Sung, Jung Hye; Barnett, M. Edwina; Norris, Keith

    2015-01-01

    Although various attempts have been made to build collaborative cultures for data sharing, their effectiveness is still questionable. The Jackson Heart Study (JHS) Vanguard Center (JHSVC) at the NIH-funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) may be a new concept in that the data are being shared with a research network where a plethora of scientists/researchers are working together to achieve their common goal. This study describes the current practices to share the JHS data through the mechanism of JHSVC. The JHS is the largest single-site cohort study to prospectively investigate the determinants of cardiovascular disease among African-Americans. It has adopted a formal screened access method through a formalized JHSVC mechanism, in which only a qualified scientist(s) can access the data. The role of the DCC was to help RTRN researchers explore hypothesis-driven ideas to enhance the output and impact of JHS data through customized services, such as feasibility tests, data querying, manuscript proposal development and data analyses for publication. DCC has implemented these various programs to facilitate data utility. A total of 300 investigators attended workshops and/or received training booklets. DCC provided two online and five onsite workshops and developed/distributed more than 250 copies of the booklet to help potential data users understand the structure of and access to the data. Information on data use was also provided through the RTRN website. The DCC efforts led to the production of five active manuscript proposals, seven completed publications, 11 presentations and four NIH grant proposals. These outcomes resulted from activities during the first four years; over the last couple of years, there were few new requests. Our study suggested that DCC-customized services enhanced the accessibility of JHS data and their utility by RTRN researchers and helped to achieve the

  10. User-Friendly Data-Sharing Practices for Fostering Collaboration within a Research Network: Roles of a Vanguard Center for a Community-Based Study.

    PubMed

    Lee, Jae Eun; Sung, Jung Hye; Barnett, M Edwina; Norris, Keith

    2015-12-22

    Although various attempts have been made to build collaborative cultures for data sharing, their effectiveness is still questionable. The Jackson Heart Study (JHS) Vanguard Center (JHSVC) at the NIH-funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) may be a new concept in that the data are being shared with a research network where a plethora of scientists/researchers are working together to achieve their common goal. This study describes the current practices to share the JHS data through the mechanism of JHSVC. The JHS is the largest single-site cohort study to prospectively investigate the determinants of cardiovascular disease among African-Americans. It has adopted a formal screened access method through a formalized JHSVC mechanism, in which only a qualified scientist(s) can access the data. The role of the DCC was to help RTRN researchers explore hypothesis-driven ideas to enhance the output and impact of JHS data through customized services, such as feasibility tests, data querying, manuscript proposal development and data analyses for publication. DCC has implemented these various programs to facilitate data utility. A total of 300 investigators attended workshops and/or received training booklets. DCC provided two online and five onsite workshops and developed/distributed more than 250 copies of the booklet to help potential data users understand the structure of and access to the data. Information on data use was also provided through the RTRN website. The DCC efforts led to the production of five active manuscript proposals, seven completed publications, 11 presentations and four NIH grant proposals. These outcomes resulted from activities during the first four years; over the last couple of years, there were few new requests. Our study suggested that DCC-customized services enhanced the accessibility of JHS data and their utility by RTRN researchers and helped to achieve the

  11. Field error lottery

    NASA Astrophysics Data System (ADS)

    James Elliott, C.; McVey, Brian D.; Quimby, David C.

    1991-07-01

    The level of field errors in a free electron laser (FEL) is an important determinant of its performance. We have computed 3D performance of a large laser subsystem subjected to field errors of various types. These calculations have been guided by simple models such as SWOOP. The technique of choice is use of the FELEX free electron laser code that now possesses extensive engineering capabilities. Modeling includes the ability to establish tolerances of various types: fast and slow scale field bowing, field error level, beam position monitor error level, gap errors, defocusing errors, energy slew, displacement and pointing errors. Many effects of these errors on relative gain and relative power extraction are displayed and are the essential elements of determining an error budget. The random errors also depend on the particular random number seed used in the calculation. The simultaneous display of the performance versus error level of cases with multiple seeds illustrates the variations attributable to stochasticity of this model. All these errors are evaluated numerically for comprehensive engineering of the system. In particular, gap errors are found to place requirements beyond convenient mechanical tolerances of ± 25 μm, and amelioration of these may occur by a procedure using direct measurement of the magnetic fields at assembly time.

  12. Field error lottery

    NASA Astrophysics Data System (ADS)

    Elliott, C. James; McVey, Brian D.; Quimby, David C.

    1990-11-01

    The level of field errors in an FEL is an important determinant of its performance. We have computed 3D performance of a large laser subsystem subjected to field errors of various types. These calculations have been guided by simple models such as SWOOP. The technique of choice is utilization of the FELEX free electron laser code that now possesses extensive engineering capabilities. Modeling includes the ability to establish tolerances of various types: fast and slow scale field bowing, field error level, beam position monitor error level, gap errors, defocusing errors, energy slew, displacement, and pointing errors. Many effects of these errors on relative gain and relative power extraction are displayed and are the essential elements of determining an error budget. The random errors also depend on the particular random number seed used in the calculation. The simultaneous display of the performance versus error level of cases with multiple seeds illustrates the variations attributable to stochasticity of this model. All these errors are evaluated numerically for comprehensive engineering of the system. In particular, gap errors are found to place requirements beyond mechanical tolerances of (plus minus)25(mu)m, and amelioration of these may occur by a procedure utilizing direct measurement of the magnetic fields at assembly time.

  13. Field error lottery

    SciTech Connect

    Elliott, C.J.; McVey, B. ); Quimby, D.C. )

    1990-01-01

    The level of field errors in an FEL is an important determinant of its performance. We have computed 3D performance of a large laser subsystem subjected to field errors of various types. These calculations have been guided by simple models such as SWOOP. The technique of choice is utilization of the FELEX free electron laser code that now possesses extensive engineering capabilities. Modeling includes the ability to establish tolerances of various types: fast and slow scale field bowing, field error level, beam position monitor error level, gap errors, defocusing errors, energy slew, displacement and pointing errors. Many effects of these errors on relative gain and relative power extraction are displayed and are the essential elements of determining an error budget. The random errors also depend on the particular random number seed used in the calculation. The simultaneous display of the performance versus error level of cases with multiple seeds illustrates the variations attributable to stochasticity of this model. All these errors are evaluated numerically for comprehensive engineering of the system. In particular, gap errors are found to place requirements beyond mechanical tolerances of {plus minus}25{mu}m, and amelioration of these may occur by a procedure utilizing direct measurement of the magnetic fields at assembly time. 4 refs., 12 figs.

  14. Accepting error to make less error.

    PubMed

    Einhorn, H J

    1986-01-01

    In this article I argue that the clinical and statistical approaches rest on different assumptions about the nature of random error and the appropriate level of accuracy to be expected in prediction. To examine this, a case is made for each approach. The clinical approach is characterized as being deterministic, causal, and less concerned with prediction than with diagnosis and treatment. The statistical approach accepts error as inevitable and in so doing makes less error in prediction. This is illustrated using examples from probability learning and equal weighting in linear models. Thereafter, a decision analysis of the two approaches is proposed. Of particular importance are the errors that characterize each approach: myths, magic, and illusions of control in the clinical; lost opportunities and illusions of the lack of control in the statistical. Each approach represents a gamble with corresponding risks and benefits.

  15. Inborn errors of metabolism

    MedlinePlus

    Metabolism - inborn errors of ... Bodamer OA. Approach to inborn errors of metabolism. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 205. Rezvani I, Rezvani G. An ...

  16. Full and Open Access to Data in the Global Earth Observing System of Systems (GEOSS): Implementing the GEOSS Data Sharing Principles

    NASA Astrophysics Data System (ADS)

    Chen, R. S.; Uhlir, P. F.; Gabrinowicz, J. I.

    2008-12-01

    Full and open access to data from remote sensing platforms and other sources can facilitate not only scientific research but also the more widespread and effective use of scientific data for the benefit of society. The Global Earth Observing System of Systems (GEOSS) is a major international initiative of the Group on Earth Observations (GEO) to develop "coordinated, comprehensive and sustained Earth observations and information." In 2005, GEO adopted the GEOSS Data Sharing Principles, which call for the "full and open exchange of data, metadata, and products shared within GEOSS, recognizing relevant international instruments and national policies and legislation." These Principles also note that "All shared data, metadata, and products will be made available with minimum time delay and at minimum cost" and that "All shared data, metadata, and products being free of charge or no more than cost of reproduction will be encouraged for research and education." GEOSS Task DA-06-01, aimed at developing a set of recommended implementation guidelines for the Principles, was established in 2006 under the leadership of CODATA, the Committee on Data for Science and Technology of the International Council for Science (ICSU). An international team of authors has developed a draft White Paper on the GEOSS Data Sharing Principles and a proposed set of implementation guidelines. These have been carefully reviewed by independent reviewers, various GEO Committees, and GEO National Members and Participating Organizations. It is expected that the proposed implementation guidelines will be discussed at the GEO-V Plenary in Budapest in November 2008. The current version of the proposed implementation guidelines recognizes the importance of good faith, voluntary adherence to the Principles by GEO National Members and Participating Organizations. It underscores the value of reuse and re-dissemination of GEOSS data with minimum restrictions, not only within GEOSS itself but on the part of

  17. The Development of the Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS): A Large-Scale Data Sharing Initiative

    PubMed Central

    Lutomski, Jennifer E.; Baars, Maria A. E.; Schalk, Bianca W. M.; Boter, Han; Buurman, Bianca M.; den Elzen, Wendy P. J.; Jansen, Aaltje P. D.; Kempen, Gertrudis I. J. M.; Steunenberg, Bas; Steyerberg, Ewout W.; Olde Rikkert, Marcel G. M.; Melis, René J. F.

    2013-01-01

    Introduction In 2008, the Ministry of Health, Welfare and Sport commissioned the National Care for the Elderly Programme. While numerous research projects in older persons’ health care were to be conducted under this national agenda, the Programme further advocated the development of The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS) which would be integrated into all funded research protocols. In this context, we describe TOPICS data sharing initiative (www.topics-mds.eu). Materials and Methods A working group drafted TOPICS-MDS prototype, which was subsequently approved by a multidisciplinary panel. Using instruments validated for older populations, information was collected on demographics, morbidity, quality of life, functional limitations, mental health, social functioning and health service utilisation. For informal caregivers, information was collected on demographics, hours of informal care and quality of life (including subjective care-related burden). Results Between 2010 and 2013, a total of 41 research projects contributed data to TOPICS-MDS, resulting in preliminary data available for 32,310 older persons and 3,940 informal caregivers. The majority of studies sampled were from primary care settings and inclusion criteria differed across studies. Discussion TOPICS-MDS is a public data repository which contains essential data to better understand health challenges experienced by older persons and informal caregivers. Such findings are relevant for countries where increasing health-related expenditure has necessitated the evaluation of contemporary health care delivery. Although open sharing of data can be difficult to achieve in practice, proactively addressing issues of data protection, conflicting data analysis requests and funding limitations during TOPICS-MDS developmental phase has fostered a data sharing culture. To date, TOPICS-MDS has been successfully incorporated into 41 research projects, thus supporting the

  18. Addressing Global Data Sharing Challenges

    PubMed Central

    Alter, George C.

    2015-01-01

    This issue of the Journal of Empirical Research on Human Research Ethics highlights the ethical issues that arise when researchers conducting projects in low- and middle-income countries seek to share the data they produce. Although sharing data is considered a best practice, the barriers to doing so are considerable and there is a need for guidance and examples. To that end, the authors of this article reviewed the articles in this special issue to identify challenges common to the five countries and to offer some practical advice to assist researchers in navigating this “uncharted territory,” as some termed it. Concerns around informed consent, data management, data dissemination, and validation of research contributions were cited frequently as particularly challenging areas, so the authors focused on these four topics with the goal of providing specific resources to consult as well as examples of successful projects attempting to solve many of the problems raised. PMID:26297753

  19. Data sharing in Surface Science

    NASA Astrophysics Data System (ADS)

    Kitchin, John R.

    2016-05-01

    Surface Science has an editorial policy that atomic positions that are determined in a publication (experimental and computational) be made accessible to its readers. In this Prospective, we suggest an even broader need in data and methodology sharing. We illustrate an approach we have used to embed experimental and computational data as well as code in manuscripts and supporting information files, and we show how it results in reusable data and code.

  20. Addressing Global Data Sharing Challenges.

    PubMed

    Alter, George C; Vardigan, Mary

    2015-07-01

    This issue of the Journal of Empirical Research on Human Research Ethics highlights the ethical issues that arise when researchers conducting projects in low- and middle-income countries seek to share the data they produce. Although sharing data is considered a best practice, the barriers to doing so are considerable and there is a need for guidance and examples. To that end, the authors of this article reviewed the articles in this special issue to identify challenges common to the five countries and to offer some practical advice to assist researchers in navigating this "uncharted territory," as some termed it. Concerns around informed consent, data management, data dissemination, and validation of research contributions were cited frequently as particularly challenging areas, so the authors focused on these four topics with the goal of providing specific resources to consult as well as examples of successful projects attempting to solve many of the problems raised. PMID:26297753

  1. Addressing Global Data Sharing Challenges.

    PubMed

    Alter, George C; Vardigan, Mary

    2015-07-01

    This issue of the Journal of Empirical Research on Human Research Ethics highlights the ethical issues that arise when researchers conducting projects in low- and middle-income countries seek to share the data they produce. Although sharing data is considered a best practice, the barriers to doing so are considerable and there is a need for guidance and examples. To that end, the authors of this article reviewed the articles in this special issue to identify challenges common to the five countries and to offer some practical advice to assist researchers in navigating this "uncharted territory," as some termed it. Concerns around informed consent, data management, data dissemination, and validation of research contributions were cited frequently as particularly challenging areas, so the authors focused on these four topics with the goal of providing specific resources to consult as well as examples of successful projects attempting to solve many of the problems raised.

  2. The Nurse's Medication Day

    PubMed Central

    Jennings, Bonnie Mowinski; Sandelowski, Margarete; Mark, Barbara

    2014-01-01

    The medication administration stage of the medication-use process is especially vulnerable to error because errors are least likely to be caught before reaching the patient. Medication administration, however, remains poorly understood. In this article we describe medication administration as observed in an ethnographic study conducted on one medical and one surgical unit. A central finding was that medication administration entailed a complex mixture of varied and often competing demands that temporally structured the nurses' entire workday. Articulation work was evident in time management strategies nurses used to handle demands from institutional policies, technical devices, patients, the physical environment, and the medications themselves. The average number of doses of medication per patient was more than double the number policy groups have indicated. Medication administration is neither simply the giving of drugs nor does it have clearly defined temporal boundaries. Because of its inseparability from other nurses' work, medication administration inherently entails interruption, thereby calling into question the current emphasis on reducing interruptions as a tactic to decrease medication errors. PMID:21693688

  3. Aircraft system modeling error and control error

    NASA Technical Reports Server (NTRS)

    Kulkarni, Nilesh V. (Inventor); Kaneshige, John T. (Inventor); Krishnakumar, Kalmanje S. (Inventor); Burken, John J. (Inventor)

    2012-01-01

    A method for modeling error-driven adaptive control of an aircraft. Normal aircraft plant dynamics is modeled, using an original plant description in which a controller responds to a tracking error e(k) to drive the component to a normal reference value according to an asymptote curve. Where the system senses that (1) at least one aircraft plant component is experiencing an excursion and (2) the return of this component value toward its reference value is not proceeding according to the expected controller characteristics, neural network (NN) modeling of aircraft plant operation may be changed. However, if (1) is satisfied but the error component is returning toward its reference value according to expected controller characteristics, the NN will continue to model operation of the aircraft plant according to an original description.

  4. Software error detection

    NASA Technical Reports Server (NTRS)

    Buechler, W.; Tucker, A. G.

    1981-01-01

    Several methods were employed to detect both the occurrence and source of errors in the operational software of the AN/SLQ-32. A large embedded real time electronic warfare command and control system for the ROLM 1606 computer are presented. The ROLM computer provides information about invalid addressing, improper use of privileged instructions, stack overflows, and unimplemented instructions. Additionally, software techniques were developed to detect invalid jumps, indices out of range, infinte loops, stack underflows, and field size errors. Finally, data are saved to provide information about the status of the system when an error is detected. This information includes I/O buffers, interrupt counts, stack contents, and recently passed locations. The various errors detected, techniques to assist in debugging problems, and segment simulation on a nontarget computer are discussed. These error detection techniques were a major factor in the success of finding the primary cause of error in 98% of over 500 system dumps.

  5. Error detection method

    DOEpatents

    Olson, Eric J.

    2013-06-11

    An apparatus, program product, and method that run an algorithm on a hardware based processor, generate a hardware error as a result of running the algorithm, generate an algorithm output for the algorithm, compare the algorithm output to another output for the algorithm, and detect the hardware error from the comparison. The algorithm is designed to cause the hardware based processor to heat to a degree that increases the likelihood of hardware errors to manifest, and the hardware error is observable in the algorithm output. As such, electronic components may be sufficiently heated and/or sufficiently stressed to create better conditions for generating hardware errors, and the output of the algorithm may be compared at the end of the run to detect a hardware error that occurred anywhere during the run that may otherwise not be detected by traditional methodologies (e.g., due to cooling, insufficient heat and/or stress, etc.).

  6. The Error in Total Error Reduction

    PubMed Central

    Witnauer, James E.; Urcelay, Gonzalo P.; Miller, Ralph R.

    2013-01-01

    Most models of human and animal learning assume that learning is proportional to the discrepancy between a delivered outcome and the outcome predicted by all cues present during that trial (i.e., total error across a stimulus compound). This total error reduction (TER) view has been implemented in connectionist and artificial neural network models to describe the conditions under which weights between units change. Electrophysiological work has revealed that the activity of dopamine neurons is correlated with the total error signal in models of reward learning. Similar neural mechanisms presumably support fear conditioning, human contingency learning, and other types of learning. Using a computational modelling approach, we compared several TER models of associative learning to an alternative model that rejects the TER assumption in favor of local error reduction (LER), which assumes that learning about each cue is proportional to the discrepancy between the delivered outcome and the outcome predicted by that specific cue on that trial. The LER model provided a better fit to the reviewed data than the TER models. Given the superiority of the LER model with the present data sets, acceptance of TER should be tempered. PMID:23891930

  7. Enhanced notification of infusion pump programming errors.

    PubMed

    Evans, R Scott; Carlson, Rick; Johnson, Kyle V; Palmer, Brent K; Lloyd, James F

    2010-01-01

    Hospitalized patients receive countless doses of medications through manually programmed infusion pumps. Many medication errors are the result of programming incorrect pump settings. When used appropriately, smart pumps have the potential to detect some programming errors. However, based on the current use of smart pumps, there are conflicting reports on their ability to prevent patient harm without additional capabilities and interfaces to electronic medical records (EMR). We developed a smart system that is connected to the EMR including medication charting that can detect and alert on potential pump programming errors. Acceptable programming limits of dose rate increases in addition to initial drug doses for 23 high-risk medications are monitored. During 22.5 months in a 24 bed ICU, 970 alerts (4% of 25,040 doses, 1.4 alerts per day) were generated for pump settings programmed outside acceptable limits of which 137 (14%) were found to have prevented potential harm. Monitoring pump programming at the system level rather than the pump provides access to additional patient data in the EMR including previous dosage levels, other concurrent medications and caloric intake, age, gender, vitals and laboratory results.

  8. Model Error Budgets

    NASA Technical Reports Server (NTRS)

    Briggs, Hugh C.

    2008-01-01

    An error budget is a commonly used tool in design of complex aerospace systems. It represents system performance requirements in terms of allowable errors and flows these down through a hierarchical structure to lower assemblies and components. The requirements may simply be 'allocated' based upon heuristics or experience, or they may be designed through use of physics-based models. This paper presents a basis for developing an error budget for models of the system, as opposed to the system itself. The need for model error budgets arises when system models are a principle design agent as is increasingly more common for poorly testable high performance space systems.

  9. Sharing electronic medical records across multiple heterogeneous and competing institutions.

    PubMed Central

    Kohane, I. S.; van Wingerde, F. J.; Fackler, J. C.; Cimino, C.; Kilbridge, P.; Murphy, S.; Chueh, H.; Rind, D.; Safran, C.; Barnett, O.; Szolovits, P.

    1996-01-01

    Most early reports of implemented World-Wide Web (W3) medical record systems describe single institution architectures. We describe W3-EMRS, a multi-institutional architecture, and its implementation. Thorny problems in data sharing underlined by the W3-EMRS project are reviewed. PMID:8947738

  10. Laboratory-based surveillance in the molecular era: the TYPENED model, a joint data-sharing platform for clinical and public health laboratories.

    PubMed

    Niesters, H G; Rossen, J W; van der Avoort, H; Baas, D; Benschop, K; Claas, E C; Kroneman, A; van Maarseveen, N; Pas, S; van Pelt, W; Rahamat-Langendoen, J C; Schuurman, R; Vennema, H; Verhoef, L; Wolthers, K; Koopmans, M

    2013-01-24

    Laboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories for characterisation and typing. However, with the introduction of molecular diagnostic methods and sequencing in most of the larger diagnostic and university hospital centres in high-income countries, the distinction between diagnostic and reference/public health laboratory functions has become less clear-cut. Given these developments, new ways of networking and data sharing are needed. Assuming that clinical and public health laboratories may be able to use the same data for their own purposes when sequence-based testing and typing are used, we explored ways to develop a collaborative approach and a jointly owned database (TYPENED) in the Netherlands. The rationale was that sequence data - whether produced to support clinical care or for surveillance -can be aggregated to meet both needs. Here we describe the development of the TYPENED approach and supporting infrastructure, and the implementation of a pilot laboratory network sharing enterovirus sequences and metadata.

  11. Medical confidentiality and patient safety: reporting procedures.

    PubMed

    Abbing, Henriette Roscam

    2014-06-01

    Medical confidentiality is of individual and of general interest. Medical confidentiality is not absolute. European countries differ in their legislative approaches of consent for data-sharing and lawful breaches of medical confidentiality. An increase of interference by the legislator with medical confidentiality is noticeable. In The Netherlands for instance this takes the form of new mandatory duties to report resp. of legislation providing for a release of medical confidentiality in specific situations, often under the condition that reporting takes place on the basis of a professional code that includes elements imposed by the legislator (e.g. (suspicion of) child abuse, domestic violence). Legislative interference must not result in the patient loosing trust in healthcare. To avoid erosion of medical confidentiality, (comparative) effectiveness studies and privacy impact assessments are necessary (European and national level). Medical confidentiality should be a subject of permanent education of health personnel.

  12. We need to talk about error: causes and types of error in veterinary practice.

    PubMed

    Oxtoby, C; Ferguson, E; White, K; Mossop, L

    2015-10-31

    Patient safety research in human medicine has identified the causes and common types of medical error and subsequently informed the development of interventions which mitigate harm, such as the WHO's safe surgery checklist. There is no such evidence available to the veterinary profession. This study therefore aims to identify the causes and types of errors in veterinary practice, and presents an evidence based system for their classification. Causes of error were identified from retrospective record review of 678 claims to the profession's leading indemnity insurer and nine focus groups (average N per group=8) with vets, nurses and support staff were performed using critical incident technique. Reason's (2000) Swiss cheese model of error was used to inform the interpretation of the data. Types of error were extracted from 2978 claims records reported between the years 2009 and 2013. The major classes of error causation were identified with mistakes involving surgery the most common type of error. The results were triangulated with findings from the medical literature and highlight the importance of cognitive limitations, deficiencies in non-technical skills and a systems approach to veterinary error. PMID:26489997

  13. We need to talk about error: causes and types of error in veterinary practice.

    PubMed

    Oxtoby, C; Ferguson, E; White, K; Mossop, L

    2015-10-31

    Patient safety research in human medicine has identified the causes and common types of medical error and subsequently informed the development of interventions which mitigate harm, such as the WHO's safe surgery checklist. There is no such evidence available to the veterinary profession. This study therefore aims to identify the causes and types of errors in veterinary practice, and presents an evidence based system for their classification. Causes of error were identified from retrospective record review of 678 claims to the profession's leading indemnity insurer and nine focus groups (average N per group=8) with vets, nurses and support staff were performed using critical incident technique. Reason's (2000) Swiss cheese model of error was used to inform the interpretation of the data. Types of error were extracted from 2978 claims records reported between the years 2009 and 2013. The major classes of error causation were identified with mistakes involving surgery the most common type of error. The results were triangulated with findings from the medical literature and highlight the importance of cognitive limitations, deficiencies in non-technical skills and a systems approach to veterinary error.

  14. Refractive error blindness.

    PubMed Central

    Dandona, R.; Dandona, L.

    2001-01-01

    Recent data suggest that a large number of people are blind in different parts of the world due to high refractive error because they are not using appropriate refractive correction. Refractive error as a cause of blindness has been recognized only recently with the increasing use of presenting visual acuity for defining blindness. In addition to blindness due to naturally occurring high refractive error, inadequate refractive correction of aphakia after cataract surgery is also a significant cause of blindness in developing countries. Blindness due to refractive error in any population suggests that eye care services in general in that population are inadequate since treatment of refractive error is perhaps the simplest and most effective form of eye care. Strategies such as vision screening programmes need to be implemented on a large scale to detect individuals suffering from refractive error blindness. Sufficient numbers of personnel to perform reasonable quality refraction need to be trained in developing countries. Also adequate infrastructure has to be developed in underserved areas of the world to facilitate the logistics of providing affordable reasonable-quality spectacles to individuals suffering from refractive error blindness. Long-term success in reducing refractive error blindness worldwide will require attention to these issues within the context of comprehensive approaches to reduce all causes of avoidable blindness. PMID:11285669

  15. Everyday Scale Errors

    ERIC Educational Resources Information Center

    Ware, Elizabeth A.; Uttal, David H.; DeLoache, Judy S.

    2010-01-01

    Young children occasionally make "scale errors"--they attempt to fit their bodies into extremely small objects or attempt to fit a larger object into another, tiny, object. For example, a child might try to sit in a dollhouse-sized chair or try to stuff a large doll into it. Scale error research was originally motivated by parents' and…

  16. [The notion and classification of expert errors].

    PubMed

    Klevno, V A

    2012-01-01

    The author presents the analysis of the legal and forensic medical literature concerning currently accepted concepts and classification of expert malpractice. He proposes a new easy-to-remember definition of the expert error and considers the classification of such mistakes. The analysis of the cases of erroneous application of the medical criteria for estimation of the harm to health made it possible to reveal and systematize the causes accounting for the cases of expert malpractice committed by forensic medical experts and health providers when determining the degree of harm to human health. PMID:22686055

  17. Action errors, error management, and learning in organizations.

    PubMed

    Frese, Michael; Keith, Nina

    2015-01-01

    Every organization is confronted with errors. Most errors are corrected easily, but some may lead to negative consequences. Organizations often focus on error prevention as a single strategy for dealing with errors. Our review suggests that error prevention needs to be supplemented by error management--an approach directed at effectively dealing with errors after they have occurred, with the goal of minimizing negative and maximizing positive error consequences (examples of the latter are learning and innovations). After defining errors and related concepts, we review research on error-related processes affected by error management (error detection, damage control). Empirical evidence on positive effects of error management in individuals and organizations is then discussed, along with emotional, motivational, cognitive, and behavioral pathways of these effects. Learning from errors is central, but like other positive consequences, learning occurs under certain circumstances--one being the development of a mind-set of acceptance of human error.

  18. Proofreading for word errors.

    PubMed

    Pilotti, Maura; Chodorow, Martin; Agpawa, Ian; Krajniak, Marta; Mahamane, Salif

    2012-04-01

    Proofreading (i.e., reading text for the purpose of detecting and correcting typographical errors) is viewed as a component of the activity of revising text and thus is a necessary (albeit not sufficient) procedural step for enhancing the quality of a written product. The purpose of the present research was to test competing accounts of word-error detection which predict factors that may influence reading and proofreading differently. Word errors, which change a word into another word (e.g., from --> form), were selected for examination because they are unlikely to be detected by automatic spell-checking functions. Consequently, their detection still rests mostly in the hands of the human proofreader. Findings highlighted the weaknesses of existing accounts of proofreading and identified factors, such as length and frequency of the error in the English language relative to frequency of the correct word, which might play a key role in detection of word errors.

  19. Concomitant prescribing and dispensing errors at a Brazilian hospital: a descriptive study

    PubMed Central

    Silva, Maria das Dores Graciano; Rosa, Mário Borges; Franklin, Bryony Dean; Reis, Adriano Max Moreira; Anchieta, Lêni Márcia; Mota, Joaquim Antônio César

    2011-01-01

    OBJECTIVE: To analyze the prevalence and types of prescribing and dispensing errors occurring with high-alert medications and to propose preventive measures to avoid errors with these medications. INTRODUCTION: The prevalence of adverse events in health care has increased, and medication errors are probably the most common cause of these events. Pediatric patients are known to be a high-risk group and are an important target in medication error prevention. METHODS: Observers collected data on prescribing and dispensing errors occurring with high-alert medications for pediatric inpatients in a university hospital. In addition to classifying the types of error that occurred, we identified cases of concomitant prescribing and dispensing errors. RESULTS: One or more prescribing errors, totaling 1,632 errors, were found in 632 (89.6%) of the 705 high-alert medications that were prescribed and dispensed. We also identified at least one dispensing error in each high-alert medication dispensed, totaling 1,707 errors. Among these dispensing errors, 723 (42.4%) content errors occurred concomitantly with the prescribing errors. A subset of dispensing errors may have occurred because of poor prescription quality. The observed concomitancy should be examined carefully because improvements in the prescribing process could potentially prevent these problems. CONCLUSION: The system of drug prescribing and dispensing at the hospital investigated in this study should be improved by incorporating the best practices of medication safety and preventing medication errors. High-alert medications may be used as triggers for improving the safety of the drug-utilization system. PMID:22012039

  20. Medication Administration Practices of School Nurses.

    ERIC Educational Resources Information Center

    McCarthy, Ann Marie; Kelly, Michael W.; Reed, David

    2000-01-01

    Assessed medication administration practices among school nurses, surveying members of the National Association of School Nurses. Respondents were extremely concerned about medication administration. Errors in administering medications were reported by 48.5 percent of respondents, with missed doses the most common error. Most nurses followed…

  1. Uncorrected refractive errors.

    PubMed

    Naidoo, Kovin S; Jaggernath, Jyoti

    2012-01-01

    Global estimates indicate that more than 2.3 billion people in the world suffer from poor vision due to refractive error; of which 670 million people are considered visually impaired because they do not have access to corrective treatment. Refractive errors, if uncorrected, results in an impaired quality of life for millions of people worldwide, irrespective of their age, sex and ethnicity. Over the past decade, a series of studies using a survey methodology, referred to as Refractive Error Study in Children (RESC), were performed in populations with different ethnic origins and cultural settings. These studies confirmed that the prevalence of uncorrected refractive errors is considerably high for children in low-and-middle-income countries. Furthermore, uncorrected refractive error has been noted to have extensive social and economic impacts, such as limiting educational and employment opportunities of economically active persons, healthy individuals and communities. The key public health challenges presented by uncorrected refractive errors, the leading cause of vision impairment across the world, require urgent attention. To address these issues, it is critical to focus on the development of human resources and sustainable methods of service delivery. This paper discusses three core pillars to addressing the challenges posed by uncorrected refractive errors: Human Resource (HR) Development, Service Development and Social Entrepreneurship. PMID:22944755

  2. Exploring discharge prescribing errors and their propagation post-discharge: an observational study.

    PubMed

    Riordan, Ciara O'; Delaney, Tim; Grimes, Tamasine

    2016-10-01

    Background Discharge prescribing error is common. Little is known about whether it persists post-discharge. Objective To explore the relationship between discharge prescribing error and post-discharge medication error. Setting This was a prospective observational study (March-May 2013) at an adult academic hospital in Ireland. Method Patients using three or more chronic medications pre-admission, with a clinical pharmacist documented gold-standard pre-admission medication list, having a chronic medication stopped or started in hospital and discharged to home were included. Within 10-14 days after discharge a gold standard discharge medication was prepared and compared to the discharge prescription to identify differences. Patients were telephoned to identify actual medication use. Community pharmacists, general practitioners and hospital prescribers were contacted to corroborate actual and intended medication use. Post-discharge medication errors were identified and the relationship to discharge prescribing error was explored. Main outcome measured Incidence, type, and potential severity of post-discharge medication error, and the relationship to discharge prescribing. Results Some 36 (43 %) of 83 patients experienced post-discharge medication error(s), for whom the majority (n = 31, 86 %) were at risk of moderate harm. Most (58 of 66) errors were discharge prescribing errors that persisted post-discharge. Unintentional prescription of an intentionally stopped medication; error in the dose, frequency or formulation and unintentional omission of active medication are the error types most likely to persist after discharge. Conclusion There is a need to implement discharge medication reconciliation to support medication optimisation post-hospitalisation.

  3. DATA SHARING REPORT CHARACTERIZATION OF POPULATION 7: PERSONAL PROTECTIVE EQUIPMENT, DRY ACTIVE WASTE, AND MISCELLANEOUS DEBRIS, SURVEILLANCE AND MAINTENANCE PROJECT OAK RIDGE NATIONAL LABORATORY OAK RIDGE, TENNESSEE

    SciTech Connect

    Harpenau, Evan M

    2013-10-10

    The U.S. Department of Energy (DOE) Oak Ridge Office of Environmental Management (EM-OR) requested that Oak Ridge Associated Universities (ORAU), working under the Oak Ridge Institute for Science and Education (ORISE) contract, provide technical and independent waste management planning support under the American Recovery and Reinvestment Act (ARRA). Specifically, DOE EM-OR requested that ORAU plan and implement a sampling and analysis campaign targeting certain URS|CH2M Oak Ridge, LLC (UCOR) surveillance and maintenance (S&M) process inventory waste. Eight populations of historical and reoccurring S&M waste at the Oak Ridge National Laboratory (ORNL) have been identified in the Waste Handling Plan for Surveillance and Maintenance Activities at the Oak Ridge National Laboratory, DOE/OR/01-2565&D2 (WHP) (DOE 2012) for evaluation and processing to determine a final pathway for disposal. Population 7 (POP 7) consists of 56 containers of aged, low-level and potentially mixed S&M waste that has been staged in various locations around ORNL. Several of these POP 7 containers primarily contain personal protective equipment (PPE) and dry active waste (DAW), but may contain other miscellaneous debris. This data sharing report addresses the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) specified waste in a 13-container subpopulation (including eight steel boxes, three 55-gal drums, one sealand, and one intermodal) that lacked sufficient characterization data for possible disposal at the Environmental Management Waste Management Facility (EMWMF) using the approved Waste Lot (WL) 108.1 profile.

  4. Error Prevention Aid

    NASA Technical Reports Server (NTRS)

    1987-01-01

    In a complex computer environment there is ample opportunity for error, a mistake by a programmer, or a software-induced undesirable side effect. In insurance, errors can cost a company heavily, so protection against inadvertent change is a must for the efficient firm. The data processing center at Transport Life Insurance Company has taken a step to guard against accidental changes by adopting a software package called EQNINT (Equations Interpreter Program). EQNINT cross checks the basic formulas in a program against the formulas that make up the major production system. EQNINT assures that formulas are coded correctly and helps catch errors before they affect the customer service or its profitability.

  5. Estimating Bias Error Distributions

    NASA Technical Reports Server (NTRS)

    Liu, Tian-Shu; Finley, Tom D.

    2001-01-01

    This paper formulates the general methodology for estimating the bias error distribution of a device in a measuring domain from less accurate measurements when a minimal number of standard values (typically two values) are available. A new perspective is that the bias error distribution can be found as a solution of an intrinsic functional equation in a domain. Based on this theory, the scaling- and translation-based methods for determining the bias error distribution arc developed. These methods are virtually applicable to any device as long as the bias error distribution of the device can be sufficiently described by a power series (a polynomial) or a Fourier series in a domain. These methods have been validated through computational simulations and laboratory calibration experiments for a number of different devices.

  6. Alcohol and error processing.

    PubMed

    Holroyd, Clay B; Yeung, Nick

    2003-08-01

    A recent study indicates that alcohol consumption reduces the amplitude of the error-related negativity (ERN), a negative deflection in the electroencephalogram associated with error commission. Here, we explore possible mechanisms underlying this result in the context of two recent theories about the neural system that produces the ERN - one based on principles of reinforcement learning and the other based on response conflict monitoring.

  7. Quantum Error Correction

    NASA Astrophysics Data System (ADS)

    Lidar, Daniel A.; Brun, Todd A.

    2013-09-01

    Prologue; Preface; Part I. Background: 1. Introduction to decoherence and noise in open quantum systems Daniel Lidar and Todd Brun; 2. Introduction to quantum error correction Dave Bacon; 3. Introduction to decoherence-free subspaces and noiseless subsystems Daniel Lidar; 4. Introduction to quantum dynamical decoupling Lorenza Viola; 5. Introduction to quantum fault tolerance Panos Aliferis; Part II. Generalized Approaches to Quantum Error Correction: 6. Operator quantum error correction David Kribs and David Poulin; 7. Entanglement-assisted quantum error-correcting codes Todd Brun and Min-Hsiu Hsieh; 8. Continuous-time quantum error correction Ognyan Oreshkov; Part III. Advanced Quantum Codes: 9. Quantum convolutional codes Mark Wilde; 10. Non-additive quantum codes Markus Grassl and Martin Rötteler; 11. Iterative quantum coding systems David Poulin; 12. Algebraic quantum coding theory Andreas Klappenecker; 13. Optimization-based quantum error correction Andrew Fletcher; Part IV. Advanced Dynamical Decoupling: 14. High order dynamical decoupling Zhen-Yu Wang and Ren-Bao Liu; 15. Combinatorial approaches to dynamical decoupling Martin Rötteler and Pawel Wocjan; Part V. Alternative Quantum Computation Approaches: 16. Holonomic quantum computation Paolo Zanardi; 17. Fault tolerance for holonomic quantum computation Ognyan Oreshkov, Todd Brun and Daniel Lidar; 18. Fault tolerant measurement-based quantum computing Debbie Leung; Part VI. Topological Methods: 19. Topological codes Héctor Bombín; 20. Fault tolerant topological cluster state quantum computing Austin Fowler and Kovid Goyal; Part VII. Applications and Implementations: 21. Experimental quantum error correction Dave Bacon; 22. Experimental dynamical decoupling Lorenza Viola; 23. Architectures Jacob Taylor; 24. Error correction in quantum communication Mark Wilde; Part VIII. Critical Evaluation of Fault Tolerance: 25. Hamiltonian methods in QEC and fault tolerance Eduardo Novais, Eduardo Mucciolo and

  8. Thermodynamics of Error Correction

    NASA Astrophysics Data System (ADS)

    Sartori, Pablo; Pigolotti, Simone

    2015-10-01

    Information processing at the molecular scale is limited by thermal fluctuations. This can cause undesired consequences in copying information since thermal noise can lead to errors that can compromise the functionality of the copy. For example, a high error rate during DNA duplication can lead to cell death. Given the importance of accurate copying at the molecular scale, it is fundamental to understand its thermodynamic features. In this paper, we derive a universal expression for the copy error as a function of entropy production and work dissipated by the system during wrong incorporations. Its derivation is based on the second law of thermodynamics; hence, its validity is independent of the details of the molecular machinery, be it any polymerase or artificial copying device. Using this expression, we find that information can be copied in three different regimes. In two of them, work is dissipated to either increase or decrease the error. In the third regime, the protocol extracts work while correcting errors, reminiscent of a Maxwell demon. As a case study, we apply our framework to study a copy protocol assisted by kinetic proofreading, and show that it can operate in any of these three regimes. We finally show that, for any effective proofreading scheme, error reduction is limited by the chemical driving of the proofreading reaction.

  9. Enhance the Accuracy of Medication Histories for the Elderly by Using an Electronic Medication Checklist

    PubMed Central

    Wang, Tiankai; Biederman, Sue

    2012-01-01

    Medication errors may result in serious safety issues for patients. Medication error issues are more prevalent among elderly patients, who take more medications and have prescriptions that change frequently. The challenge of obtaining accurate medication histories for the elderly at the time of hospital admission creates the potential for medication errors starting at admission. A study at a central Texas hospital was conducted to assess whether an electronic medication checklist can enhance the accuracy of medication histories for the elderly. The empirical outcome demonstrated that medication errors were significantly reduced by using an electronic medication checklist at the time of admission. The findings of this study suggest that implementing electronic health record systems with decision support for identifying inaccurate doses and frequencies of prescribed medicines will increase the accuracy of patients’ medication histories. PMID:23209450

  10. Human error in aviation operations

    NASA Technical Reports Server (NTRS)

    Nagel, David C.

    1988-01-01

    The role of human error in commercial and general aviation accidents and the techniques used to evaluate it are reviewed from a human-factors perspective. Topics addressed include the general decline in accidents per million departures since the 1960s, the increase in the proportion of accidents due to human error, methods for studying error, theoretical error models, and the design of error-resistant systems. Consideration is given to information acquisition and processing errors, visually guided flight, disorientation, instrument-assisted guidance, communication errors, decision errors, debiasing, and action errors.

  11. Error monitoring in musicians.

    PubMed

    Maidhof, Clemens

    2013-01-01

    To err is human, and hence even professional musicians make errors occasionally during their performances. This paper summarizes recent work investigating error monitoring in musicians, i.e., the processes and their neural correlates associated with the monitoring of ongoing actions and the detection of deviations from intended sounds. Electroencephalography (EEG) studies reported an early component of the event-related potential (ERP) occurring before the onsets of pitch errors. This component, which can be altered in musicians with focal dystonia, likely reflects processes of error detection and/or error compensation, i.e., attempts to cancel the undesired sensory consequence (a wrong tone) a musician is about to perceive. Thus, auditory feedback seems not to be a prerequisite for error detection, consistent with previous behavioral results. In contrast, when auditory feedback is externally manipulated and thus unexpected, motor performance can be severely distorted, although not all feedback alterations result in performance impairments. Recent studies investigating the neural correlates of feedback processing showed that unexpected feedback elicits an ERP component after note onsets, which shows larger amplitudes during music performance than during mere perception of the same musical sequences. Hence, these results stress the role of motor actions for the processing of auditory information. Furthermore, recent methodological advances like the combination of 3D motion capture techniques with EEG will be discussed. Such combinations of different measures can potentially help to disentangle the roles of different feedback types such as proprioceptive and auditory feedback, and in general to derive at a better understanding of the complex interactions between the motor and auditory domain during error monitoring. Finally, outstanding questions and future directions in this context will be discussed. PMID:23898255

  12. Errata: Papers in Error Analysis.

    ERIC Educational Resources Information Center

    Svartvik, Jan, Ed.

    Papers presented at the symposium of error analysis in Lund, Sweden, in September 1972, approach error analysis specifically in its relation to foreign language teaching and second language learning. Error analysis is defined as having three major aspects: (1) the description of the errors, (2) the explanation of errors by means of contrastive…

  13. Abortion - medical

    MedlinePlus

    ... womb (uterus). There are different types of medical abortions: Therapeutic medical abortion is done because the woman has ... Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion

  14. Computation of Standard Errors

    PubMed Central

    Dowd, Bryan E; Greene, William H; Norton, Edward C

    2014-01-01

    Objectives We discuss the problem of computing the standard errors of functions involving estimated parameters and provide the relevant computer code for three different computational approaches using two popular computer packages. Study Design We show how to compute the standard errors of several functions of interest: the predicted value of the dependent variable for a particular subject, and the effect of a change in an explanatory variable on the predicted value of the dependent variable for an individual subject and average effect for a sample of subjects. Empirical Application Using a publicly available dataset, we explain three different methods of computing standard errors: the delta method, Krinsky–Robb, and bootstrapping. We provide computer code for Stata 12 and LIMDEP 10/NLOGIT 5. Conclusions In most applications, choice of the computational method for standard errors of functions of estimated parameters is a matter of convenience. However, when computing standard errors of the sample average of functions that involve both estimated parameters and nonstochastic explanatory variables, it is important to consider the sources of variation in the function's values. PMID:24800304

  15. Compact disk error measurements

    NASA Technical Reports Server (NTRS)

    Howe, D.; Harriman, K.; Tehranchi, B.

    1993-01-01

    The objectives of this project are as follows: provide hardware and software that will perform simple, real-time, high resolution (single-byte) measurement of the error burst and good data gap statistics seen by a photoCD player read channel when recorded CD write-once discs of variable quality (i.e., condition) are being read; extend the above system to enable measurement of the hard decision (i.e., 1-bit error flags) and soft decision (i.e., 2-bit error flags) decoding information that is produced/used by the Cross Interleaved - Reed - Solomon - Code (CIRC) block decoder employed in the photoCD player read channel; construct a model that uses data obtained via the systems described above to produce meaningful estimates of output error rates (due to both uncorrected ECC words and misdecoded ECC words) when a CD disc having specific (measured) error statistics is read (completion date to be determined); and check the hypothesis that current adaptive CIRC block decoders are optimized for pressed (DAD/ROM) CD discs. If warranted, do a conceptual design of an adaptive CIRC decoder that is optimized for write-once CD discs.

  16. Dialogues on prediction errors.

    PubMed

    Niv, Yael; Schoenbaum, Geoffrey

    2008-07-01

    The recognition that computational ideas from reinforcement learning are relevant to the study of neural circuits has taken the cognitive neuroscience community by storm. A central tenet of these models is that discrepancies between actual and expected outcomes can be used for learning. Neural correlates of such prediction-error signals have been observed now in midbrain dopaminergic neurons, striatum, amygdala and even prefrontal cortex, and models incorporating prediction errors have been invoked to explain complex phenomena such as the transition from goal-directed to habitual behavior. Yet, like any revolution, the fast-paced progress has left an uneven understanding in its wake. Here, we provide answers to ten simple questions about prediction errors, with the aim of exposing both the strengths and the limitations of this active area of neuroscience research.

  17. Experimental Quantum Error Detection

    PubMed Central

    Jin, Xian-Min; Yi, Zhen-Huan; Yang, Bin; Zhou, Fei; Yang, Tao; Peng, Cheng-Zhi

    2012-01-01

    Faithful transmission of quantum information is a crucial ingredient in quantum communication networks. To overcome the unavoidable decoherence in a noisy channel, to date, many efforts have been made to transmit one state by consuming large numbers of time-synchronized ancilla states. However, such huge demands of quantum resources are hard to meet with current technology and this restricts practical applications. Here we experimentally demonstrate quantum error detection, an economical approach to reliably protecting a qubit against bit-flip errors. Arbitrary unknown polarization states of single photons and entangled photons are converted into time bins deterministically via a modified Franson interferometer. Noise arising in both 10 m and 0.8 km fiber, which induces associated errors on the reference frame of time bins, is filtered when photons are detected. The demonstrated resource efficiency and state independence make this protocol a promising candidate for implementing a real-world quantum communication network. PMID:22953047

  18. Error Free Software

    NASA Technical Reports Server (NTRS)

    1985-01-01

    A mathematical theory for development of "higher order" software to catch computer mistakes resulted from a Johnson Space Center contract for Apollo spacecraft navigation. Two women who were involved in the project formed Higher Order Software, Inc. to develop and market the system of error analysis and correction. They designed software which is logically error-free, which, in one instance, was found to increase productivity by 600%. USE.IT defines its objectives using AXES -- a user can write in English and the system converts to computer languages. It is employed by several large corporations.

  19. Real-time medical collaboration services over the web.

    PubMed

    Andrikos, Christos; Rassias, Georgios; Tsanakas, Panayiotis; Maglogiannis, Ilias

    2015-08-01

    The gradual shift in modern medical practice, from working alone clinical doctors to MDTs (Multi-Disciplinary Teams), raises the need of online real-time collaboration among geographically distributed medical personnel. The paper presents a Web-based platform, featuring an efficient medical data management and exchange, for hosting real-time collaborative services. The presented work leverages state-of-the-art features of the web (technologies and APIs) to support client-side medical data processing. Moreover, to address the typical bandwidth bottleneck and known scalability issues of centralized data sharing, an indirect RPC (Remote Process Call) scheme is introduced through object synchronization over the WebRTC paradigm.

  20. Institute for Safe Medication Practices

    MedlinePlus

    ... for healthcare connectors - the "Stay Connected" program" The Root Cause Analysis Workbook for Community/ Ambulatory Pharmacy National Patient Safety Foundation Guidelines on Root Cause Analysis Special Error Alerts Targeted Medication Safety ...

  1. Orwell's Instructive Errors

    ERIC Educational Resources Information Center

    Julian, Liam

    2009-01-01

    In this article, the author talks about George Orwell, his instructive errors, and the manner in which Orwell pierced worthless theory, faced facts and defended decency (with fluctuating success), and largely ignored the tradition of accumulated wisdom that has rendered him a timeless teacher--one whose inadvertent lessons, while infrequently…

  2. Evaluation of the Medication Sketch Artist, a New Method of Determining Unknown Patient Medications

    PubMed Central

    Lowrey, Geoffrey; Lee, Esther; Gerber, Ben

    2003-01-01

    Medication errors are responsible for a significant number of hospital admissions, and significant morbidity and mortality. Many of these errors result from differences in physicians’ and patients’ understanding of medications. Health care providers think in terms of medication name and dose, however patients remember size, shape, and markings of their medications more frequently than the names. The Medication Sketch Artist was developed to be a graphically interfaced medication identification system to aid in physician-patient communication. This pilot study evaluated the software’s ability to identify medications described from memory by volunteers. Out of 25 pills, each described 5 separate times, there were 80 correct identifications, and 9 identifications of the correct medication, but at a different dose. The Medication Sketch Artist shows promise as a tool to determine unknown medications. It could play an important role in reducing medication errors. PMID:14728203

  3. Evaluation of the medication sketch artist, a new method of determining unknown patient medications.

    PubMed

    Lowrey, Geoffrey; Lee, Esther; Gerber, Ben

    2003-01-01

    Medication errors are responsible for a significant number of hospital admissions, and significant morbidity and mortality. Many of these errors result from differences in physicians' and patients' understanding of medications. Health care providers think in terms of medication name and dose, however patients remember size, shape, and markings of their medications more frequently than the names. The Medication Sketch Artist was developed to be a graphically interfaced medication identification system to aid in physician-patient communication. This pilot study evaluated the software's ability to identify medications described from memory by volunteers. Out of 25 pills, each described 5 separate times, there were 80 correct identifications, and 9 identifications of the correct medication, but at a different dose. The Medication Sketch Artist shows promise as a tool to determine unknown medications. It could play an important role in reducing medication errors.

  4. Preventing Communication Errors in Telephone Medicine

    PubMed Central

    Reisman, Anna B; Brown, Karen E

    2005-01-01

    Errors in telephone communication can result in outcomes ranging from inconvenience and anxiety to serious compromises in patient safety. Although 25% of interactions between physicians and patients take place on the telephone, little has been written about telephone communication and medical mishaps. Similarly, training in telephone medicine skills is limited; only 6% of residency programs teach any aspect of telephone medicine. Increasing familiarity with common telephone challenges with patients may help physicians decrease the likelihood of negative outcomes. We use case vignettes to highlight communication errors in common telephone scenarios. These scenarios include giving sensitive test results, requests for narcotics, managing ill patients who are not sick enough for the emergency room, dealing with late-night calls, communicating with unintelligible patients, and handling calls from family members. We provide management strategies to minimize the occurrence of these errors. P