Search results for: patient safety incidents
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6186

Search results for: patient safety incidents

6096 ‘Honour’ Crime and the Need for Differentiation from Domestic Violence in UK Law

Authors: Mariam Shah

Abstract:

‘Honour’ crime has commonly been perceived in the UK as being a ‘domestic violence’ related issue due to incidents perceived to take place within a domestic context, and commonly by familial perpetrators. The lack of differentiation between domestic violence and ‘honour’ related incidents has several negative implications. Firstly, the prevalence and extent of ‘honour’ related crime within the UK cannot be accurately quantified due to ‘honour’ incidents being classed statistically as domestic violence incidents. Secondly, lack of differentiation means that the negative stereotypical attitudes ascribed to domestic violence which has resulted in lower criminal conviction rates that are also impacting the conviction of perpetrators of ‘honour’ crime. Thirdly, ‘honour’ related crime is innately distinct from domestic violence due to the perpetrator’s resolute intent of cleansing perceived ‘shame’ in any way possible, often with the involvement and collusion of multiple perpetrators from within the family and/or community. Domestic violence is typically restricted to the ‘home’, but ‘honour’ crime can operate between national and international boundaries. This paper critically examines the current academic literature and concludes that the few similarities between domestic violence and ‘honour’ related crime are not sufficient to warrant identical treatment under UK criminal law. ‘Honour’ related crime is a distinct and stand-alone offence which should be recognised as such. The appropriate identification and treatment of ‘honour’ crime are crucial, particularly in light of the UK’s first ‘white’ honour killing which saw a young English woman murdered after being deemed to have brought ‘shame’ on her ex-boyfriend’s family. This incident highlights the possibility of ‘honour’ crime extending beyond its perceived ‘ethnic minority’ roots and becoming more of a ‘mainstream’ issue for the multi-cultural and multi-racial UK.

Keywords: differentiation, domestic violence, honour crime, United Kingdom

Procedia PDF Downloads 204
6095 [Keynote Talk]: The Emotional Life of Patients with Chronic Diseases: A Framework for Health Promotion Strategies

Authors: Leslie Beale

Abstract:

Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.

Keywords: health promotion, emotional health, patients with chronic disease, patient-centered care

Procedia PDF Downloads 207
6094 Transforming Personal Healthcare through Patient Engagement: An In-Depth Analysis of Tools and Methods for the Digital Age

Authors: Emily Hickmann, Peggy Richter, Maren Kaehlig, Hannes Schlieter

Abstract:

Patient engagement is a cornerstone of high-quality care and essential for patients with chronic diseases to achieve improved health outcomes. Through digital transformation, possibilities to engage patients in their personal healthcare have multiplied. However, the exploitation of this potential is still lagging. To support the transmission of patient engagement theory into practice, this paper’s objective is to give a state-of-the-art overview of patient engagement tools and methods. A systematic literature review was conducted. Overall, 56 tools and methods were extracted and synthesized according to the four attributes of patient engagement, i.e., personalization, access, commitment, and therapeutic alliance. The results are discussed in terms of their potential to be implemented in digital health solutions under consideration of the “computers are social actors” (CASA) paradigm. It is concluded that digital health can catalyze patient engagement in practice, and a broad future research agenda is formulated.

Keywords: chronic diseases, digitalization, patient-centeredness, patient empowerment, patient engagement

Procedia PDF Downloads 60
6093 Applications of Social Marketing in Road Safety of Georgia

Authors: Charita Jashi

Abstract:

The aim of the paper is to explore the role of social marketing in changing the behavior of consumers on road safety, identify critical aspects and priority needs which impede the implementation of road safety program in Georgia. Given the goals of the study, a quantitative method was used to carry out interviews for primary data collection. This research identified the awareness level of road safety, legislation base, and marketing interventions to change behavior of drivers and pedestrians. During several years the non-governmental sector together with the local authorities and media have been very intensively working on the road safety issue in Georgia, but only seat-belts campaign should be considered rather successful. Despite achievements in this field, efficiency of road safety programs far from fulfillment and needs strong empowering.

Keywords: road safety, social marketing interventions, behavior change, well-being

Procedia PDF Downloads 164
6092 Improving the Safety Performance of Workers by Assessing the Impact of Safety Culture on Workers’ Safety Behaviour in Nigeria Oil and Gas Industry: A Pilot Study in the Niger Delta Region

Authors: Efua Ehiaguina, Haruna Moda

Abstract:

Interest in the development of appropriate safety culture in the oil and gas industry has taken centre stage among stakeholders in the industry. Human behaviour has been identified as a major contributor to occupational accidents, where abnormal activities associated with safety management are taken as normal behaviour. Poor safety culture is one of the major factors that influence employee’s safety behaviour at work, which may consequently result in injuries and accidents and strengthening such a culture can improve workers safety performance. Nigeria oil and gas industry has contributed to the growth and development of the country in diverse ways. However, in terms of safety and health of workers, this industry is a dangerous place to work as workers are often exposed to occupational safety and health hazard. To ascertain the impact of employees’ safety and how it impacts health and safety compliance within the local industry, online safety culture survey targeting frontline workers within the industry was administered covering major subjects that include; perception of management commitment and style of leadership; safety communication method and its resultant impact on employees’ behaviour; employee safety commitment and training needs. The preliminary result revealed that 54% of the participants feel that there is a lack of motivation from the management to work safely. In addition, 55% of participants revealed that employers place more emphasis on work delivery over employee’s safety on the installation. It is expected that the study outcome will provide measures aimed at strengthening and sustaining safety culture in the Nigerian oil and gas industry.

Keywords: oil and gas safety, safety behaviour, safety culture, safety compliance

Procedia PDF Downloads 106
6091 The Nursing Rounds System: Effect of Patient's Call Light Use, Bed Sores, Fall and Satisfaction Level

Authors: Bassem Saleh, Hussam Nusair, Nariman Al Zubadi, Shams Al Shloul, Usama Saleh

Abstract:

The nursing round system (NRS) means checking patients on an hourly basis during the A (0700–2200 h) shift and once every 2 h during the B (2200–0700 h) by the assigned nursing staff. The overall goal of this prospective study is to implement an NRS in a major rehabilitation centre—Sultan Bin Abdulaziz Humanitarian City—in the Riyadh area of the Kingdom of Saudi Arabia. The purposes of this study are to measure the effect of the NRS on: (i) the use of patient call light; (ii) the number of incidences of patients’ fall; (iii) the number of incidences of hospital-acquired bed sores; and (iv) the level of patients’ satisfaction. All patients hospitalized in the male stroke unit will be involved in this study. For the period of 8 weeks (17 December 2009–17 February 2010) All Nursing staff on the unit will record each call light and the patient’s need. Implementation of the NRS would start on 18 February 2010 and last for 8 weeks, until 18 April 2010. Data collected throughout this period will be compared with data collected during the 8 weeks period immediately preceding the implementation of the NRS (17 December 2009–17 February 2010) in order to measure the impact of the call light use. The following information were collected on all subjects involved in the study: (i) the Demographic Information Form; (ii) authors’ developed NRS Audit Form; (iii) Patient Call Light Audit Form; (iv) Patient Fall Audit Record; (v) Hospital-Acquired Bed Sores Audit Form; and (vi) hospital developed Patient Satisfaction Records. The findings suggested that a significant reduction on the use of call bell (P < 0.001), a significant reduction of fall incidence (P < 0.01) while pressure ulcer reduced by 50% before and after the implementation of NRS. In addition, the implementation of NRS increased patient satisfaction by 7/5 (P < 0.05).

Keywords: call light, patient-care management, patient safety, patient satisfaction, rounds

Procedia PDF Downloads 332
6090 Ethical Leadership and Individual Creativity: The Mediating Role of Psychological Safety

Authors: Hyeondal Jeong, Yoonjung Baek

Abstract:

This study examines the relationship between ethical leadership and individual creativity and focused on mediating effects of psychological safety. In order to clarify the mechanism of ethical leadership, psychological safety of the members was set as a mediator. Using data gathered from a sample of 150 employees. For data analysis, exploratory factor analysis, correlation analysis, hierarchical regression analysis and Sobel-Test were performed. The results showed that ethical leadership had a positive effect on psychological safety and individual creativity, and psychological safety had a positive mediating effect. Since the mediating effect of psychological safety has been confirmed, we need to find ways to improve the psychological safety of the members in terms of organizational management. Psychological safety has a positive effect on individual creativity, which can have a positive impact on innovation throughout the organization.

Keywords: ethical leadership, creativity, psychological safety, ethics management, innovative behaviors

Procedia PDF Downloads 215
6089 Emergency Management and Patient Transportation of Road Traffic Accident Victims Admitted to the District General Hospital, Matale, Sri Lanka

Authors: Asanka U. K. Godamunne

Abstract:

Road traffic accidents (RTA) are a leading cause of death globally as well as in Sri Lanka and results in a large proportion of disability especially among young people. Ninety-percent of world’s road traffic deaths occur in low- and middle-income countries. The gross disparities in injury outcomes relate to immediate post-crash and hospital management. Emergency management, methods of patient transportation following road traffic accidents and safety measures are important factors to reduce mortality and morbidity. Studies in this area are limited in Sri Lanka. The main objective of this research was to assess the emergency management and proper method of transportation of road traffic accident victims. This offers the best way to explore the ways to reduce the mortality and morbidity and raise the public awareness. This study was conducted as a descriptive cross-sectional study. All the consecutive road traffic accident victims admitted to surgical wards at District General Hospital, Matale, Sri Lanka, over a period of three months were included in the study. Data from 387 victims were analyzed. The majority were in the 20-30 year age group. Seventy six percent of the patients were males. Motorcycles and trishaws were most affected. First-aid was given to only 2% of patients and it was given by non-medical persons. A significant proportion of patients (75%) were transported to the hospital by trishaws and only 1% transported by ambulance. About 86% of the patients were seated while transport and 14% were flat. Limbs and head were the most affected areas of the body. As per this study, immediate post-crash management and patient transportation were not satisfactory. There is a need to strengthen certain road safety laws and make sure people follow them.

Keywords: emergency management, patient transportation, road traffic accident victims, Sri Lanka

Procedia PDF Downloads 199
6088 Occupational Health and Safety Servicing in Turkey: A New Approach

Authors: Duygu Çelgin

Abstract:

Until the new Occupational Health and Safety Law of Turkey, most of the workers were excluded from the mandatory occupational health and safety services. This new law, made the OHS services mandatory for all workers from all sectors including both public and private. However, in the application some problems and disadvantageous cases are occurred and the government also considered these cases. In this study, the new OHS law of Turkey and the regulations prepared according to the law are studied with the literature search.

Keywords: occupational health and safety in Turkey, OHS servicing in Turkey, safety experts, OHS support

Procedia PDF Downloads 429
6087 Examining Occupational Health and Safety Supervision in Turkey by Comparison to EU Countries

Authors: Nuray Gökçek Karaca

Abstract:

This study aims to examine the application of occupational health and safety supervision in Turkey and EU countries in terms of legal regulations. The results of research reveal that occupational health and safety supervision in EU countries, whatever the understanding of welfare state, is effectively carried out and almost all legal regulations on this subject are consistent with the EU directives. On the other hand, there are serious problems in applications, not legal regulations, of occupational health and safety supervision in Turkey by the side of EU countries. Indeed, Turkey has modern regulations on occupational health and safety supervision whereas there are several problems such as ignoring prevention policy on occupational health and safety supervision, understanding of monotype inspector, problems resulting from this understanding and dispersed structure of occupational health and safety organizations in workplaces. As a result, Turkey needs to carry out effective supervision mechanisms.

Keywords: legal rules, occupational health and safety, inspection, supervision, legislation

Procedia PDF Downloads 738
6086 A Brain Controlled Robotic Gait Trainer for Neurorehabilitation

Authors: Qazi Umer Jamil, Abubakr Siddique, Mubeen Ur Rehman, Nida Aziz, Mohsin I. Tiwana

Abstract:

This paper discusses a brain controlled robotic gait trainer for neurorehabilitation of Spinal Cord Injury (SCI) patients. Patients suffering from Spinal Cord Injuries (SCI) become unable to execute motion control of their lower proximities due to degeneration of spinal cord neurons. The presented approach can help SCI patients in neuro-rehabilitation training by directly translating patient motor imagery into walkers motion commands and thus bypassing spinal cord neurons completely. A non-invasive EEG based brain-computer interface is used for capturing patient neural activity. For signal processing and classification, an open source software (OpenVibe) is used. Classifiers categorize the patient motor imagery (MI) into a specific set of commands that are further translated into walker motion commands. The robotic walker also employs fall detection for ensuring safety of patient during gait training and can act as a support for SCI patients. The gait trainer is tested with subjects, and satisfactory results were achieved.

Keywords: brain computer interface (BCI), gait trainer, spinal cord injury (SCI), neurorehabilitation

Procedia PDF Downloads 128
6085 The Use and Safety of Leave from an Acute Inpatient Psychiatry Unit: A Retrospective Review of Pass Outcomes Over Four Years Abstract

Authors: Vasilis C. Hristidis, Ricardo Caceda, Ji Soo Kim, Brian Bronson, Emily A. Hill

Abstract:

Objective: Leave passes to provide authorized leave for hospitalized patients from a psychiatric inpatient unit. Though providing day passes was once a relatively common practice, there is relatively little data describing their safety and efficacy. Methods: This descriptive study examines the use of leave passes in an adult inpatient unit at a university hospital between 2017 and 2021, with attention to reasons for granting the day pass, duration, and outcome of the pass. Results: During the study period, ten patients with primary psychotic or mood disorders received 12 passes for either housing coordination, COVID-19 vaccination, or major family events. There were no fatalities or elopements. One patient experienced severe agitation and engaged in non-suicidal self-injurious behavior. A second patient showed mild, redirectable psychomotor agitation upon return to the unit. The remaining 10 passes were uneventful. Conclusions: Our findings support the view that patients with diverse diagnoses can safely be provided leave from an inpatient setting with adequate planning and support, yielding a low incidence of adverse events.

Keywords: passes, inpatient, psychiatry, inpatient leave, outcome

Procedia PDF Downloads 164
6084 Discourse Analysis of the Perception of ‘Safety’ in EU and Refugee Law

Authors: Klaudia Krogulec

Abstract:

The concept and the meaning of safety is largely undermined in International and EU refugee law. While the Geneva Convention 1951 concentrates mainly on the principle of non-refoulment (no-return) and the idea of physical safety of refugees, countries continue to implement harmful readmission agreements that presume ‘safe countries’ for the hosting and return of the refugees. This research intends to use discourse analysis of the legal provisions and interviews with Syrian refugees, NGO workers, and refugee lawyers in Tukey to understand what ‘safety’ actually means and how law shapes the experiences of Syrians in Turkey (the country that hosts the largest population of Syrians and is a key partner of the EU-Turkey Agreement 2016). The preliminary findings reveal the competing meanings of safety (rights-based vs state interests approach). As the refugee policies continue to prioritize state interests/safety over human safety and human rights, it is extremely important to provide recommendations on how ‘safety’ should be defined in the refugee law in the future.

Keywords: human rights law, refugee law, human safety, EU-turkey agreement

Procedia PDF Downloads 106
6083 Comparing the SALT and START Triage System in Disaster and Mass Casualty Incidents: A Systematic Review

Authors: Hendri Purwadi, Christine McCloud

Abstract:

Triage is a complex decision-making process that aims to categorize a victim’s level of acuity and the need for medical assistance. Two common triage systems have been widely used in Mass Casualty Incidents (MCIs) and disaster situation are START (Simple triage algorithm and rapid treatment) and SALT (sort, asses, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over START triage system. This systematic review aims to investigate and compare the effectiveness between SALT and START triage system in disaster and MCIs setting. Literatures were searched via systematic search strategy from 2009 until 2019 in PubMed, Cochrane Library, CINAHL, Scopus, Science direct, Medlib, ProQuest. This review included simulated-based and medical record -based studies investigating the accuracy and applicability of SALT and START triage systems of adult and children population during MCIs and disaster. All type of studies were included. Joana Briggs institute critical appraisal tools were used to assess the quality of reviewed studies. As a result, 1450 articles identified in the search, 10 articles were included. Four themes were identified by review, they were accuracy, under-triage, over-triage and time to triage per individual victim. The START triage system has a wide range and inconsistent level of accuracy compared to SALT triage system (44% to 94. 2% of START compared to 70% to 83% of SALT). The under-triage error of START triage system ranged from 2.73% to 20%, slightly lower than SALT triage system (7.6 to 23.3%). The over-triage error of START triage system was slightly greater than SALT triage system (START ranged from 2% to 53% compared to 2% to 22% of SALT). The time for applying START triage system was faster than SALT triage system (START was 70-72.18 seconds compared to 78 second of SALT). Consequently; The START triage system has lower level of under-triage error and faster than SALT triage system in classifying victims of MCIs and disaster whereas SALT triage system is known slightly more accurate and lower level of over-triage. However, the magnitude of these differences is relatively small, and therefore the effect on the patient outcomes is not significance. Hence, regardless of the triage error, either START or SALT triage system is equally effective to triage victims of disaster and MCIs.

Keywords: disaster, effectiveness, mass casualty incidents, START triage system, SALT triage system

Procedia PDF Downloads 104
6082 Communicating Safety: A Digital Ethnography Investigating Social Media Use for Workplace Safety

Authors: Kelly Jaunzems

Abstract:

Social media is a powerful instrument of communication, enabling the presentation of information in multiple forms and modes, amplifying the interactions between people, organisations, and stakeholders, and increasing the range of communication channels available. Younger generations are highly engaged with social media and more likely to use this channel than any other to seek information. Given this, it may appear extraordinary that occupational safety and health professionals have yet to seriously engage with social media for communicating safety messages to younger audiences who, in many industries, might be statistically more likely to encounter more workplace harm or injury. Millennials, defined as those born between 1981-2000, have distinctive characteristics that also impact their interaction patterns rendering many traditional occupational safety and health communication channels sub-optimal or near obsolete. Used to immediate responses, 280-character communication, shares, likes, and visual imagery, millennials struggle to take seriously the low-tech, top-down communication channels such as safety noticeboards, toolbox meetings, and passive tick-box online inductions favoured by traditional OSH professionals. This paper draws upon well-established communication findings, which argue that it is important to know a target audience and reach them using their preferred communication pathways, particularly if the aim is to impact attitudes and behaviours. Health practitioners have adopted social media as a communication channel with great success, yet safety practitioners have failed to follow this lead. Using a digital ethnography approach, this paper examines seven organisations’ Facebook posts from two one-month periods one year apart, one in 2018 and one in 2019. Each of the years informs organisation-based case studies. Comparing, contrasting, and drawing upon these case studies, the paper discusses and evaluates the (non) use of social media communication of safety information in terms of user engagement, shareability, and overall appeal. The success of health practitioners’ use of social media provides a compelling template for the implementation of social media into organisations’ safety communication strategies. Highly visible content such as that found on social media allows an organization to become more responsive and engage in two-way conversations with their audience, creating more engaged and participatory conversations around safety. Further, using social media to address younger audiences with a range of tonal qualities (for example, the use of humour) can achieve cut through in a way that grim statistics fail to do. On the basis of 18 months of interviews, filed work, and data analysis, the paper concludes with recommendations for communicating safety information via social media. It proposes exploration of the social media communication formula that, when utilised by safety practitioners, may create an effective social media presence. It is anticipated that such social media use will increase engagement, expand the number of followers and reduce the likelihood and severity of safety-related incidents. The tools offered may provide a path for safety practitioners to reach a disengaged generation of workers to build a cohesive and inclusive conversation around ways to keep people safe at work.

Keywords: social media, workplace safety, communication strategies, young workers

Procedia PDF Downloads 91
6081 Inconsistent Safety Leadership as a Predictor of Employee Safety Behavior

Authors: Jane Mullen, Ann Rheaume, Kevin Kelloway

Abstract:

Research on the effects of inconsistent safety leadership is limited, particularly regarding employee safety behavior in organizations. Inconsistent safety leadership occurs when organizational leaders display both effective and ineffective styles of safety leadership (i.e., transformational vs laissez-faire). In this study, we examine the effect of inconsistent safety leadership style on employee safety participation. Defined as the interaction of S.A.F.E.R (Speak, Act, Focus, Engage and Recognize) leadership style and passive leadership style, inconsistent safety leadership was found to be a significant predictor of safety participation in a sample of 307 nurses in Eastern Canada. Results of the moderated regression analysis also showed a significant main effect for S.A.F.E.R leadership, but not for passive leadership. To further explore the significant interaction, the simple slopes for S.A.F.E.R leadership at high and low levels (1 SD above and below the mean) of passive leadership were plotted. As predicted, the positive effects of S.A.F.E.R leadership behavior were attenuated when leaders were perceived by employees as also displaying high levels of passive leadership (i.e., inconsistent leadership styles). The research makes important theoretical and practical contributions to the occupational health and safety literature. The results demonstrate that leadership behavior, which is characteristic of the S.A.F.E.R model, is positively associated with employee safety participation. This finding is particularly important as researchers continue to explore what leaders can do to engage employees in work-related safety activities. The results also demonstrate how passive leadership may undermine the positive outcomes associated with safety leadership behavior in organizations. The data suggest that employee safety behavior is highest when leaders engage in safety effective leadership behavior on a consistent basis, rather than periodically.

Keywords: employee safety behavior, leadership, participation, safety training

Procedia PDF Downloads 329
6080 An Evaluation of the Effectiveness of Health and Safety Induction Practices in the Zambian Construction Industry

Authors: Josephine Mutwale-Ziko, Nonde Lushinga, Inonge Akakandelwa

Abstract:

The study discusses the effectiveness of health and safety induction practices on construction sites against the background of the Zambian construction industry experience. The research design included the literature review of relevant literature. Questionnaires and interviews were administered to regulatory bodies, health, and safety personnel. Observation was also employed on construction sites to assess the health and safety practices being used. Health and safety in the construction industry are not something to be ignored or overlooked. The construction industry needs to take heed of the serious consequences of inadequate health and safety induction practices. The implications of inadequate health and safety induction procedures included among others threats to profitability, corporate social responsibility and increased turnover of the workforce leading to poor productivity. Adequate health and safety practices can improve the health and wellbeing of employees, reduce financial implications on firms and encourage productivity on construction sites. Despite this, accidents are still prevalent on construction sites in Zambia. The overall result of this research denotes that the implementation of health and safety induction practices is inadequate, as indicated by the negligent and non-adherent attitude to health and safety induction aspects on the sites by most stakeholders on construction sites. Therefore, health and safety induction practices are ineffective as preventive measures for reduction of accidents on construction sites in Zambia.

Keywords: accidents, health and safety, inadequate, induction

Procedia PDF Downloads 396
6079 Industrial and Environmental Safety in the Integrated Security Policy of the Industry: A Corporation and an Enterprise

Authors: Vladimir A. Grachev

Abstract:

Today, in the context of rapidly developing technosphere and hourly emerging new technologies, the industrial and environmental safety issue is ever more pressing. The article is devoted to the relationship of social, environmental, and industrial policies with industrial safety, occupational health and safety, environmental safety, and environmental protection. The author assesses the up-to-day situation through system analysis and on the basis of the existing practices. A complex system of the policies implementation without "gaps" and missing links ensures preservation of human lives, health and a favorable living environment. The author demonstrates that absence of an "environmental safety" high-priority link can lead to a significant loss of human lives and health and the global changes in the environment. The role of implementing the environmental policy of enterprises and organizations, and of economic sectors in the implementation of national environmental policy is shown. It was established that the system for implementing environmental policy should be based on a system analysis.

Keywords: environmental protection, environmental safety, industrial safety, occupational health and safety

Procedia PDF Downloads 179
6078 Role of Imaging in Alzheimer's Disease Trials: Impact on Trial Planning, Patient Recruitment and Retention

Authors: Kohkan Shamsi

Abstract:

Background: MRI and PET are now extensively utilized in Alzheimer's disease (AD) trials for patient eligibility, efficacy assessment, and safety evaluations but including imaging in AD trials impacts site selection process, patient recruitment, and patient retention. Methods: PET/MRI are performed at baseline and at multiple follow-up timepoints. This requires prospective site imaging qualification, evaluation of phantom data, training and continuous monitoring of machines for acquisition of standardized and consistent data. This also requires prospective patient/caregiver training as patients must go to multiple facilities for imaging examinations. We will share our experience form one of the largest AD programs. Lesson learned: Many neurological diseases have a similar presentation as AD or could confound the assessment of drug therapy. The inclusion of wrong patients has ethical and legal issues, and data could be excluded from the analysis. Centralized eligibility evaluation read process will be discussed. Amyloid related imaging abnormalities (ARIA) were observed in amyloid-β trials. FDA recommended regular monitoring of ARIA. Our experience in ARIA evaluations in large phase III study at > 350 sites will be presented. Efficacy evaluation: MRI is utilized to evaluate various volumes of the brain. FDG PET or amyloid PET agents has been used in AD trials. We will share our experience about site and central independent reads. Imaging logistic issues that need to be handled in the planning phase will also be discussed as it can impact patient compliance thereby increasing missing data and affecting study results. Conclusion: imaging must be prospectively planned to include standardizing imaging methodologies, site selection process and selecting assessment criteria. Training should be transparently conducted and documented. Prospective patient/caregiver awareness of imaging requirement is essential for patient compliance and reduction in missing imaging data.

Keywords: Alzheimer's disease, ARIA, MRI, PET, patient recruitment, retention

Procedia PDF Downloads 91
6077 A Fundamental Study for Real-Time Safety Evaluation System of Landing Pier Using FBG Sensor

Authors: Heungsu Lee, Youngseok Kim, Jonghwa Yi, Chul Park

Abstract:

A landing pier is subjected to safety assessment by visual inspection and design data, but it is difficult to check the damage in real-time. In this study, real - time damage detection and safety evaluation methods were studied. As a result of structural analysis of the arbitrary landing pier structure, the inflection point of deformation and moment occurred at 10%, 50%, and 90% of pile length. The critical value of Fiber Bragg Grating (FBG) sensor was set according to the safety factor, and the FBG sensor application method for real - time safety evaluation was derived.

Keywords: FBG sensor, harbor structure, maintenance, safety evaluation system

Procedia PDF Downloads 182
6076 Employers' Occupational Health and Safety Training Obligations in Framework Directive and Training Procedure and Rules in Turkey

Authors: Nuray Gökçek Karaca, Berrin Gökçek

Abstract:

Employers occupational safety and health training obligations are regulated in 89/391/EEC Framework Directive and also in 6331 numbered Occupational Health and Safety Law in Turkey. The main objective of this research is to determine and evaluate the employers’ occupational health and safety training obligations in Framework Directive in comparison with the 6331 numbered Occupational Health and Safety Law and to examine training principles in Turkey. For this purpose, employers’ occupational health and safety training obligations examined in Framework Directive and Occupational Health and Safety Law. This study carried out through comparative scanning model and literature model. The research data were collected through European Agency and ministry legislations. As a result, employers’ occupational health and safety training obligations in the 6331 numbered Occupational Health and Safety Law are compatible with the 89/391/EEC numbered Framework Directive and training principles are determined by in different ways like the trained workers, training issues, training period, training time, and trainers. In this study, employers’ training obligations are evaluated in detail.

Keywords: directive, occupational health and safety, training, work accidences

Procedia PDF Downloads 308
6075 A Fuzzy Structural Equation Model for Development of a Safety Performance Index Assessment Tool in Construction Sites

Authors: Murat Gunduz, Mustafa Ozdemir

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In this research, a framework is to be proposed to model the safety performance in construction sites. Determinants of safety performance are to be defined through extensive literature review and a multidimensional safety performance model is to be developed. In this context, a questionnaire is to be administered to construction companies with sites. The collected data through questionnaires including linguistic terms are then to be defuzzified to get concrete numbers by using fuzzy set theory which provides strong and significant instruments for the measurement of ambiguities and provides the opportunity to meaningfully represent concepts expressed in the natural language. The validity of the proposed safety performance model, relationships between determinants of safety performance are to be analyzed using the structural equation modeling (SEM) which is a highly strong multi variable analysis technique that makes possible the evaluation of latent structures. After validation of the model, a safety performance index assessment tool is to be proposed by the help of software. The proposed safety performance assessment tool will be based on the empirically validated theoretical model.

Keywords: Fuzzy set theory, safety performance assessment, safety index, structural equation modeling (SEM), construction sites

Procedia PDF Downloads 482
6074 Design and Manufacture Detection System for Patient's Unwanted Movements during Radiology and CT Scan

Authors: Anita Yaghobi, Homayoun Ebrahimian

Abstract:

One of the important tools that can help orthopedic doctors for diagnose diseases is imaging scan. Imaging techniques can help physicians in see different parts of the body, including the bones, muscles, tendons, nerves, and cartilage. During CT scan, a patient must be in the same position from the start to the end of radiation treatment. Patient movements are usually monitored by the technologists through the closed circuit television (CCTV) during scan. If the patient makes a small movement, it is difficult to be noticed by them. In the present work, a simple patient movement monitoring device is fabricated to monitor the patient movement. It uses an electronic sensing device. It continuously monitors the patient’s position while the CT scan is in process. The device has been retrospectively tested on 51 patients whose movement and distance were measured. The results show that 25 patients moved 1 cm to 2.5 cm from their initial position during the CT scan. Hence, the device can potentially be used to control and monitor patient movement during CT scan and Radiography. In addition, an audible alarm situated at the control panel of the control room is provided with this device to alert the technologists. It is an inexpensive, compact device which can be used in any CT scan machine.

Keywords: CT scan, radiology, X Ray, unwanted movement

Procedia PDF Downloads 434
6073 Interdisciplinary Teaching for Nursing Students: A Key to Understanding Teamwork

Authors: Ilana Margalith, Yaron Niv

Abstract:

One of the most important factors of professional health treatment is teamwork, in which each discipline contributes its expert knowledge, thus ensuring quality and a high standard of care as well as efficient communication (one of the International Patient Safety Goals). However, in most countries, students are educated separately by each health discipline. They are exposed to teamwork only during their clinical experience, which in some cases is short and skill-oriented. In addition, health organizations in most countries are hierarchical and although changes have occurred in the hierarchy of the medical system, there are still disciplines that underrate the unique contributions of other health professionals, thus, young graduates of health professions develop and base their perception of their peers from other disciplines on insufficient knowledge. In order to establish a wide-ranging perception among nursing students as to the contribution of different health professionals to the health of their patients, students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel, participated in an interdisciplinary clinical discussion with students from several different professions, other than nursing, who were completing their clinical experience at Rabin Medical Center in medicine, health psychology, social work, audiology, physiotherapy and occupational therapy. The discussion was led by a medical-surgical nursing instructor. Their tutors received in advance, a case report enabling them to prepare the students as to how to present their professional theories and interventions regarding the case. Mutual stimulation and acknowledgment of the unique contribution of each part of the team enriched the nursing students' understanding as to how their own nursing interventions could be integrated into the entire process towards a safe and speedy recovery of the patient.

Keywords: health professions' students, interdisciplinary clinical discussion, nursing education, patient safety

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6072 On-Site Coaching on Freshly-Graduated Nurses to Improves Quality of Clinical Handover and to Avoid Clinical Error

Authors: Sau Kam Adeline Chan

Abstract:

World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.

Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error

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6071 A Statistical Study on Young UAE Driver’s Behavior towards Road Safety

Authors: Sadia Afroza, Rakiba Rouf

Abstract:

Road safety and associated behaviors have received significant attention in recent years, reflecting general public concern. This paper portrays a statistical scenario of the young drivers in UAE with emphasis on various concern points of young driver’s behavior and license issuance. Although there are many factors contributing to road accidents, statistically it is evident that age plays a major role in road accidents. Despite ensuring strict road safety laws enforced by the UAE government, there is a staggering correlation among road accidents and young driver’s at UAE. However, private organizations like BMW and RoadSafetyUAE have extended its support on conducting surveys on driver’s behavior with an aim to ensure road safety. Various strategies such as road safety law enforcement, license issuance, adapting new technologies like safety cameras and raising awareness can be implemented to improve the road safety concerns among young drivers.

Keywords: driving behavior, Graduated Driver Licensing System (GLDS), road safety, UAE drivers, young drivers

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6070 Evaluating the Radiation Dose Involved in Interventional Radiology Procedures

Authors: Kholood Baron

Abstract:

Radiologic interventional studies use fluoroscopy imaging guidance to perform both diagnostic and therapeutic procedures. These could result in high radiation doses being delivered to the patients and also to the radiology team. This is due to the prolonged fluoroscopy time and the large number of images taken, even when dose-minimizing techniques and modern fluoroscopic tools are applied. Hence, these procedures are part of the everyday routine of interventional radiology doctors, assistant nurses, and radiographers. Thus, it is important to estimate the radiation exposure dose they received in order to give objective advice and reduce both patient and radiology team radiation exposure dose. The aim of this study was to find out the total radiation dose reaching the radiologist and the patient during an interventional procedure and to determine the impact of certain parameters on the patient dose. Method: The radiation dose was measured by TLD devices (thermoluminescent dosimeter; radiation dosimeter device). Physicians, patients, nurses, and radiographers wore TLDs during 12 interventional radiology procedures performed in two hospitals, Mubarak and Chest Hospital. This study highlights the need for interventional radiologists to be mindful of the radiation doses received by both patients and medical staff during interventional radiology procedures. The findings emphasize the impact of factors such as fluoroscopy duration and the number of images taken on the patient dose. By raising awareness and providing insights into optimizing techniques and protective measures, this research contributes to the overall goal of reducing radiation doses and ensuring the safety of patients and medical staff.

Keywords: dosimetry, radiation dose, interventional radiology procedures, patient radiation dose

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6069 Implementation of a Multidisciplinary Weekly Safety Briefing in a Tertiary Paediatric Cardiothoracic Transplant Unit

Authors: Lauren Dhugga, Meena Parameswaran, David Blundell, Abbas Khushnood

Abstract:

Context: A multidisciplinary weekly safety briefing was implemented at the Paediatric Cardiothoracic Unit at the Freeman Hospital in Newcastle-upon-Tyne. It is a tertiary referral centre with a quarternary cardiac paediatric intensive care unit and provides complexed care including heart and lung transplants, mechanical support and advanced heart failure assessment. Aim: The aim of this briefing is to provide a structured platform of communication, in an effort to improve efficiency, safety, and patient care. Problem: The paediatric cardiothoracic unit is made up of a vast multidisciplinary team including doctors, intensivists, anaesthetists, surgeons, specialist nurses, echocardiogram technicians, physiotherapists, psychologists, dentists, and dietitians. It provides care for children with congenital and acquired cardiac disease and is one of only two units in the UK to offer paediatric heart transplant. The complexity of cases means that there can be many teams involved in providing care to each patient, and frequent movement of children between ward, high dependency, and intensive care areas. Currently, there is no structured forum for communicating important information across the department, for example, staffing shortages, prescribing errors and significant events. Strategy: An initial survey questioning the need for better communication found 90% of respondents agreed that they could think of an incident that had occurred due to ineffective communication, and 85% felt that incident could have been avoided had there been a better form of communication. Lastly, 80% of respondents felt that a weekly 60 second safety briefing would be beneficial to improve communication within our multidisciplinary team. Based on those promising results, a weekly 60 second safety briefing was implemented to be conducted on a Monday morning. The safety briefing covered four key areas (SAFE): staffing, awareness, fix and events. This was to highlight any staffing gaps, any incident reports to be learned from, any issues that required fixing and any events including teachings for the week ahead. The teams were encouraged to email suggestions or issues to be raised for the week or to approach in person with information to add. The safety briefing was implemented using change theory. Effect: The safety briefing has been trialled over 6 weeks and has received a good buy in from staff across specialties. The aim is to embed this safety briefing into a weekly meeting using the PDSA cycle. There will be a second survey in one month to assess the efficacy of the safety briefing and to continue to improve the delivery of information. The project will be presented at the next clinical governance briefing to attract wider feedback and input from across the trust. Lessons: The briefing displays promise as a tool to improve vigilance and communication in a busy multi-disciplinary unit. We have learned about how to implement quality improvement and about the culture of our hospital - how hierarchy influences change. We demonstrate how to implement change through a grassroots process, using a junior led briefing to improve the efficiency, safety, and communication in the workplace.

Keywords: briefing, communication, safety, team

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6068 Contributing Factors Affecting the Safety in Construction Sites of Bangladesh

Authors: Farzana Rahman, Mohammed Hossain Ezaz, Dipak Halder, Proshanta Mondal

Abstract:

Site safety is an important function regardless of project size. A key goal, which must be met for a successful project, is to finish the project with a good safety record. Construction safety is an important issue in all over the world. Today, developed countries strictly follow the safety procedure to avoid any hazard, accident or fatality. However, for a least developed country like Bangladesh, still accidents and fatalities are quite high due to lack of safety management. With the increased volume of construction work in Bangladesh, the need for proper attention in safety issues has become essential for human, economic and other consideration. Recently lots of accidents are taking place in construction sites of Bangladesh causing severe injury to death to the workers and pedestrians. There are a number of reasons/factors that these high numbers are widespread to the construction industry that are not found in most other businesses. The objective of this research work is to identify and explore the various factor that affect the construction site safety in Bangladesh. A questionnaire surveys was conducted to the reputed construction companies of Bangladesh to examine the present safety situation in construction sites. Nine factors were selected for the survey. The finding shows that 78% of organizations’ from the respondents are conscious about the safety procedure and they usually provide safety measures for the workers. Promotion of safety measures at the working site results in a better working environment, higher productivity and greater contentment among the workers.

Keywords: construction sites, fatalities, safety issues, safety situation

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6067 Storage Tank Overfill Protection in Compliance with Functional Safety Standard: IEC 61511

Authors: Hassan Alsada

Abstract:

Tank overfill accidents are major concerns for industries handling large volumes of hydrocarbons. Buncefield, Jaipur, Puerto Rico, and West Virginia are just a few accidents with catastrophic consequences. Thus, it is very important for any industry to take the right safety measures for overfill prevention. Moreover, one of the main causative factors in the overfill accidents was inadequate risk analysis and, subsequently, inadequate design. This study aims to provide a full assessment in accordance with the Functional safety standard: “IEC 615 11 – Safety instrumented systems for the process industry” to the tank overfill scenario according to the standard’s Safety Life Cycle (SLC), which includes: the analysis phase, the implementation phase, and the operation phase. The paper discusses in depth the tank overfills Independent Protection Layers (IPLs) with systematic analysis to avoid the safety risks of under-design and the financial risk of facility overdesign. The result shows a clear and systematic assessment in compliance with the standards that can help to assist existing tank overfilling setup or a guide to support designing new storage facilities overfill protection.

Keywords: IEC 61511, PHA, LOPA, process safety, safety, health, environment, safety instrumented systems, safety instrumented function, functional safety, safety life cycle

Procedia PDF Downloads 55