A hospital incident reporting system (2016-2019) : Learning from notifier's perception on incidents'risk, severity and frecuency of adverse events

Incident reporting systems (IRSs) are considered safety culture promoters. Nevertheless, they have not been contemplated to monitor professionals' perception about patient safety related risks. This study aims to describe the characteristics and evolution of incident notifications reported between 2016 and 2019 in a high complexity reference hospital in Barcelona and explores the association between notifications' characteristics and notifier's perception about incidents severity, probability of occurrence and risk. The main analysis unit was notifications reported. A descriptive analysis was performed and taxes by hospital activity were calculated. Odds ratios were obtained to study the association between the type of incident, the moment of incident, notifiers' professional category, reported incident's severity, probability and incidents' calculated risk. Through the study period, a total of 6379 notifications were reported, observing an annual increase of notifications until 2018. Falls (21.22%), Medical and procedures management (18.91%) and Medication incidents (15.49%) were the most frequently notified. Departments reporting the highest number of notifications were Emergency room and Obstetrics & Gynaecology. Incident type and notifiers' characteristics were consistently included in the models constructed to assess risk perception. Pharmaceutics were the most frequent notifiers when considering the proportion of staff members. Notification patterns can inform professionals' patient risk perception and increase awareness of professionals' misconceptions regarding patient safety

Patient safety culture in orthopaedics surgery. Influence of a training activities plan

Objetivo: Conocer las características de la cultura de seguridad clínica en cirugía ortopédica y traumatología, valorando la influencia de una intervención formativa en su tendencia evolutiva. Población y metodología: Estudio observacional ecológico con intervención formativa. La población objeto de estudio fueron los profesionales del Servicio de Cirugía Ortopédica y Traumatología del Hospital Clínic Universitario de Barcelona. Se utilizó la versión española del cuestionario HSOPS para valorar la cultura de seguridad clínica. Resultados: El porcentaje de respuestas válidas obtenidas fue superior al 60% en las dos mediciones de la cultura realizadas. Las 12 dimensiones consideradas mejoraron su tendencia. El trabajo en equipo dentro del servicio se identificó como una dimensión de fortaleza del modelo. Conclusiones: La intervención formativa ha consolidado una tendencia favorable. La mejora de la cultura de seguridad clínica requiere tiempo y actuaciones periódicas

The role of patient safety incident reporting systems in Home Hospitalization

Introduction: The present study aimed to assess the effectiveness of the current hospitalbased electronic patient safety incident reporting system (IRS) in the improvement of patient safety in home hospitalization (HH). Materials and Methods: Out of 6381 patient safety reports voluntarily presented by healthcare professionals in a tertiary hospital in Barcelona between 2016 and 2019, all those related to HH were analyzed. They were characterized by incident type,description, risk and year, the ways to get notified, patient's age, and the results of the analysis. Moreover, falls were classified depending on circumstances. Results: Based on the results, 68 HH incident reports were related to the following factors: use of medication (n=2), procedures (1), patient's behavior (n=1), and falls (n=64). Regarding the damage degree, the incidents were reported as extreme risk (n=1), high (n=8), moderate (n=27), low (29), and very low risk (n=3). The majority of patients involved in the incidents were more than 60 years old. Out of the reported falls, 8 cases were categorized as high risk, and 32 cases reported health consequences. Moreover, 19 falls from height, 31 cases of falling while sitting or lying, and 30 incidents classified as unknown were identified. Conclusion: Patient safety is a matter of great concern, especially in HH but with some differential features. The IRS can play a peculiar role in minimizing patient safety risks and promoting a safety culture. The results of the present study pointed to some frequent risks and suggested improving opportunities in HH. Nonetheless, further studies are needed to design tailored patient safety interventions in HH, as well as a tailored IRS adapted to this growing settin

Prescription refill, patient self-report and physician report in assessing adherence to oral endocrine therapy in early breast cancer patients: a restrospective cohort study in Catalonia, Spain.

AIMS: To compare different methods in order to assess adherence and persistence with oral endocrine therapy in women diagnosed with breast cancer (BC) in Catalonia. MATERIALS AND METHODS: This study covered all women newly diagnosed with stage I, II or IIIa BC and positive hormone receptors at six hospitals in Catalonia (Spain) in 2004. Adherence was assessed on the basis of physician report and patient self-report using a telephone questionnaire. Persistence was measured by refill prescriptions. We used the Kappa index to compare adherence measures and logistic regression to evaluate adherence-related risk factors. RESULTS: The study covered a total of 692 women. Adherence ranged from 92% (self-report) to 94.7% (physician report), depending on the measure used; persistence was 74.7% at 5 years of follow-up. Low concordance between measures was observed (Kappa range: 0.018-0.267). Patients aged 50-74 years showed higher adherence than those aged <50 years. Adherence was also associated with: adjuvant chemotherapy and sequential hormonal therapy. CONCLUSIONS: Concordance between the different measures was remarkably low, indicating the need for further research. Adherence is an issue in the management of BC patients taking oral drugs, and should be assessed in clinical practice

Book review

Teresa MORENO and Wes GIBBONS (eds.), The Geology of Chile. London: Geological Society, 2007

Safety, activity, and molecular heterogeneity following neoadjuvant non-pegylated liposomal doxorubicin, paclitaxel, trastuzumab, and pertuzumab in HER2-positive breast cancer (Opti-HER HEART): an open-label, single-group, multicenter, phase 2 trial

Antecedents: L'assaig Opti-HER HEART tenia com a objectiu optimitzar l'activitat i minimitzar el risc cardíac combinant trastuzumab, pertuzumab i paclitaxel amb doxorubicina liposomal no pegilada en el tractament del càncer de mama precoç HER2-positiu. Mètodes: Els pacients amb càncer de mama HER2 positiu en fase II-IIIB van rebre trastuzumab neoadjuvant, pertuzumab, paclitaxel i una doxorubicina liposomal no pegilada cada tres setmanes durant sis cicles. El principal criteri final va ser la seguretat cardíaca durant la teràpia neoadjuvant. Es van avaluar els esdeveniments cardíacs tipus A (insuficiència cardíaca congestiva simptomàtica) i B (reducció asimptomàtica de la fracció d'ejecció del ventricle esquerre). Els criteris finals secundaris van incloure l'avaluació de la taxa de resposta patològica completa (pCR) i la taxa de resposta global, entre d'altres. Com a anàlisi exploratòria ad-hoc , es va mesurar l'expressió de 55 gens relacionats amb el càncer de mama, inclosos els gens PAM50 , en 58 mostres de tumors basals i 60 mostres quirúrgiques. Resultats: Es van reclutar vuitanta-tres pacients. La incidència d'esdeveniments cardíacs durant el tractament neoadjuvant va ser del 2,4%. No es va observar cap esdeveniment cardíac de tipus A. La taxa global de pCR va ser del 56,6% (interval de confiança (IC) del 95%: 45,3-67,5%). El subtipus enriquit amb HER2, que representava el 52,0% de totes les mostres basals, es va associar amb una taxa de pCR més alta en comparació amb els tumors no enriquits amb HER2 (83,3% vs. 46,3%; odds ratio 5,76; 95% CI 1,71-19,42). L'associació de subtipus amb pCR va ser independent de les variables clínicopatològiques conegudes, inclòs l'estat del receptor hormonal. En comparació amb les mostres basals, els exemplars quirúrgics van mostrar una significativa regulació descendent dels nivells relacionats amb la proliferació ( MKI67 i CCNB1 ) i ERBB2 , i una regulació ascendent significativa dels relacionats amb la llum (ESR1 i PGR ) i gens immunes ( CD8A ). Conclusions: La combinació de doble bloqueig HER2 amb trastuzumab i pertuzumab amb paclitaxel i doxorubicina liposomal no pegilada s'associa amb una baixa taxa d'esdeveniments cardíacs. El subtipus enriquit amb HER2 s'associa a una alta taxa de pCR

La devoción como factor de jerarquización urbana en el arzobispado de Toledo (ss. XIV-XV). Apuntes para su estudio

This paper focuses on the devotional features of the six leading cities in the Archbishopric of Toledo (Toledo, Talavera, Madrid, Guadalajara, Ciudad Real and Alcaraz) in the Late Middle Ages. Aspects such as religious place-names, the festive calendar, and the patronage of Virgins and saints are analysed in an attempt to identify the hierarchical relationships between these urban settlements and compare their respective realities.El presente trabajo se centra en la faceta devocional de las seis principales ciudades del arzobispado de Toledo (Toledo, Talavera, Madrid, Guadalajara, Ciudad Real y Alcaraz) a finales de la Edad Media. Aspectos como la toponimia religiosa, el calendario festivo o el patronazgo de vírgenes y santos son analizados en un intento de señalar las relaciones jerárquicas entre esos núcleos de población y comparar sus respectivas realidade

Post-Franco Theatre

In the multiple realms and layers that comprise the contemporary Spanish theatrical landscape, “crisis” would seem to be the word that most often lingers in the air, as though it were a common mantra, ready to roll off the tongue of so many theatre professionals with such enormous ease, and even enthusiasm, that one is prompted to wonder whether it might indeed be a miracle that the contemporary technological revolution – coupled with perpetual quandaries concerning public and private funding for the arts – had not by now brought an end to the evolution of the oldest of live arts, or, at the very least, an end to drama as we know it

Aspectos toxicológicos da exposição ao óxido de etileno

Some important aspects of the use of ethylene oxide as a sterilizing agent for medical instruments are reviewed in this paper. Toxic, mutagenic, teratogenic and carcinogenic effects are the main risks described and emphasis it given to preventive mesures.En este trabajo se revisan los principales riesgos de la utilización del óxido de etileno como agente esterilizante del material médico-quirúrgico. Resaltando los efectos tóxicos, mutagénicos, teratogénicos y cancerígenos como los más importantes, enfatizando en la necesidad de adoptar medidas de prevención para controlar dichos riesgos.Neste trabalho são revisados os principais riscos de utilização do óxido de etileno como agente esterilizante do material médico-cirúrgico. Ressaltam-se efeitos tóxicos, mutagênicos, teratogênicos e cancerígenos como sendo os mais importantes, enfatizando a necessidade de adotar medidas de prevenção para controlar os referidos riscos

Capacitación de estudiantes de Farmacia como agentes educadores de la salud

Podeu consultar la Setena trobada de professorat de Ciències de la Salut completa a: http://hdl.handle.net/2445/43352El objetivo general de la iniciativa presentada es contribuir a la capacitación de los estudiantes del último curso de Farmacia como agentes activos de educación sanitaria. Las áreas temáticas principales a desarrollar son las relacionadas con la medicación, los hábitos de salud y la prevención de la enfermedades o problemas de salud más habituales entre la población. La línea formativa se sustenta en el diseño y elaboración de los recursos didácticos más adecuados que permitan desarrollar la acción educativa a nivel de la comunidad, así como la identificación de aquellas técnicas de comunicación más favorables según las características de los contenidos a impartir