medication error
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Clinical trials in oncology are important tools to identify and establish new effective drugs for cancer treatment. Since the development of the concept of precision oncology, a huge number of multi-centric biomarker-driven clinical trials have been performed and promoted by either academic institutions or pharmaceutical companies. In this scenario, the role of pathologists is essential in multiple aspects, with new challenges that should be addressed. In this position paper of the European Society of Pathology, the role of pathologists as contributors to the design of the clinical trial, as local collaborators, or as members of central review laboratories is discussed. Moreover, the paper emphasizes the important role of pathologists in guiding methods and criteria of tissue biomarker testing in the biomarker-driven clinical trials. The paper also addresses issues regarding quality control, training, and the possible role of digital pathology.
- MeSH
- klinické zkoušky jako téma * MeSH
- laboratorní medicína normy metody MeSH
- lidé MeSH
- nádorové biomarkery * analýza MeSH
- nádory * patologie farmakoterapie MeSH
- patologové * MeSH
- společnosti lékařské MeSH
- výzkumný projekt normy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Evropa MeSH
PURPOSE: The aim of this study was to develop a simple, robust, and easy-to-use calibration procedure for correcting misalignments in rosette MRI k-space sampling, with the objective of producing images with minimal artifacts. METHODS: Quick automatic calibration scans were proposed for the beginning of the measurement to collect information on the time course of the rosette acquisition trajectory. A two-parameter model was devised to match the measured time-varying readout gradient delays and approximate the actual rosette sampling trajectory. The proposed calibration approach was implemented, and performance assessment was conducted on both phantoms and human subjects. RESULTS: The fidelity of phantom and in vivo images exhibited significant improvement compared with uncorrected rosette data. The two-parameter calibration approach also demonstrated enhanced precision and reliability, as evidenced by quantitative T2*$$ {\mathrm{T}}_2^{\ast } $$ relaxometry analyses. CONCLUSION: Adequate correction of data sampling is a crucial step in rosette MRI. The presented experimental results underscore the robustness, ease of implementation, and suitability for routine experimental use of the proposed two-parameter rosette trajectory calibration approach.
- MeSH
- algoritmy * MeSH
- artefakty * MeSH
- fantomy radiodiagnostické * MeSH
- kalibrace MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- mozek diagnostické zobrazování MeSH
- počítačové zpracování obrazu * metody MeSH
- reprodukovatelnost výsledků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE: Dual velocity encoding PC-MRI can produce spurious artifacts when using high ratios of velocity encoding values (VENCs), limiting its ability to generate high-quality images across a wide range of encoding velocities. This study aims to propose and compare dual-VENC correction methods for such artifacts. THEORY AND METHODS: Two denoising approaches based on spatiotemporal regularization are proposed and compared with a state-of-the-art method based on sign correction. Accuracy is assessed using simulated data from an aorta and brain aneurysm, as well as 8 two-dimensional (2D) PC-MRI ascending aorta datasets. Two temporal resolutions (30,60) ms and noise levels (9,12) dB are considered, with noise added to the complex magnetization. The error is evaluated with respect to the noise-free measurement in the synthetic case and to the unwrapped image without additional noise in the volunteer datasets. RESULTS: In all studied cases, the proposed methods are more accurate than the Sign Correction technique. Using simulated 2D+T data from the aorta (60 ms, 9 dB), the Dual-VENC (DV) error 0.82±0.07$$ 0.82\pm 0.07 $$ is reduced to: 0.66±0.04$$ 0.66\pm 0.04 $$ (Sign Correction); 0.34±0.04$$ 0.34\pm 0.04 $$ and 0.32±0.04$$ 0.32\pm 0.04 $$ (proposed techniques). The methods are found to be significantly different (p-value <0.05$$ <0.05 $$ ). Importantly, brain aneurysm data revealed that the Sign Correction method is not suitable, as it increases error when the flow is not unidirectional. All three methods improve the accuracy of in vivo data. CONCLUSION: The newly proposed methods outperform the Sign Correction method in improving dual-VENC PC-MRI images. Among them, the approach based on temporal differences has shown the highest accuracy.
- MeSH
- algoritmy * MeSH
- aorta * diagnostické zobrazování MeSH
- artefakty * MeSH
- fantomy radiodiagnostické MeSH
- interpretace obrazu počítačem metody MeSH
- intrakraniální aneurysma diagnostické zobrazování MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- mozek diagnostické zobrazování MeSH
- počítačová simulace MeSH
- počítačové zpracování obrazu * metody MeSH
- poměr signál - šum * MeSH
- reprodukovatelnost výsledků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- chybná zdravotní péče * prevence a kontrola MeSH
- lidé MeSH
- poškození pacienta MeSH
- senioři MeSH
- terapie kořenového kanálku * metody škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
INTRODUCTION: The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) may be as high as 38% in the adult population with potential serious complications, multiple comorbidities and a high socioeconomic burden. However, there is a general lack of awareness and knowledge about MASLD and its progressive stages (metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis). Therefore, MASLD is still far underdiagnosed. The 'Global Research Initiative for Patient Screening on MASH' (GRIPonMASH) consortium focuses on this unmet public health need. GRIPonMASH will help (primary) healthcare providers to implement a patient care pathway, as recommended by multiple scientific societies, to identify patients at risk of severe MASLD and to raise awareness. Furthermore, GRIPonMASH will contribute to a better understanding of the pathophysiology of MASLD and improved identification of diagnostic and prognostic markers to detect individuals at risk. METHODS: This is a prospective multicentre observational study in which 10 000 high-risk patients (type 2 diabetes mellitus, obesity, metabolic syndrome or hypertension) will be screened in 10 European countries using at least two non-invasive tests (Fibrosis-4 index and FibroScan). Blood samples and liver biopsy material will be collected and biobanked, and multiomics analyses will be conducted. ETHICS AND DISSEMINATION: The study will be conducted in compliance with this protocol and applicable national and international regulatory requirements. The study initiation package is submitted at the local level. The study protocol has been approved by local medical ethical committees in all 10 participating countries. Results will be made public and published in scientific, peer-reviewed, international journals and at international conferences. REGISTRATION DETAILS: NCT05651724, registration date: 15 Dec 2022.
- MeSH
- diabetes mellitus 2. typu komplikace MeSH
- jaterní cirhóza diagnóza MeSH
- lidé MeSH
- metabolický syndrom komplikace MeSH
- multicentrické studie jako téma MeSH
- nealkoholová steatóza jater * diagnóza MeSH
- plošný screening * metody MeSH
- prospektivní studie MeSH
- výzkumný projekt MeSH
- ztučnělá játra * diagnóza epidemiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- protokol klinické studie MeSH
Nežiaduce udalosti predstavujú globálny problém s negatívnym dopadom na bezpečnosť pacientov. Jedným z kľúčových nástrojov na zvýšenie kvality starostlivosti a bezpečnosti pacientov je hlásenie týchto udalostí. Cieľom štúdie bolo zistiť, aká je frekvencia hlásenia nežiaducich udalostí, aké faktory ovplyvňujú frekvenciu hlásenia, a aké bariéry hlásenia nežiaducich udalostí vnímajú sestry pracujúce na jednotkách intenzívnej starostlivosti (JIS) vo vybraných nemocniciach Slovenskej republiky. Zber údajov prebiehal od júla do októbra 2023 prostredníctvom dotazníka pozostávajúceho z troch častí: frekvencia hlásenia, bariéry a demografické údaje. Výskumný súbor zahŕňal 153 sestier zo štyroch slovenských nemocníc. Údaje boli spracované pomocou deskriptívnej a inferenčnej štatistiky. Frekvencia hlásenia dosiahla skóre 3,39 (SD = 1,33), čo naznačuje priemerné hlásenie nežiaducich udalostí. Faktory ako spokojnosť na pracovisku, materiálne vybavenie, vnímaná bezpečnosť pacientov a vzdelanie sestier významne ovplyvňovali hlásenie. Medzi najvýznamnejšie bariéry patrili nedostatočné vedomosti o tom, ktoré udalosti hlásiť, slabé povedomie o vzniku udalostí a nejasnosti v procese hlásenia. Napriek relatívne vysokej frekvencii hlásenia nežiaducich udalostí na JIS pretrvávajú bariéry, ktoré obmedzujú jeho efektivitu. Kľúčovými výzvami je nedostatok vedomostí a jasných inštrukcií, ktoré je potrebné riešiť prostredníctvom vzdelávania a organizačných opatrení. Podpora faktorov ako spokojnosť na pracovisku a dostupnosť zdrojov môže prispieť k zvýšeniu bezpečnosti pacientov a kvality starostlivosti.
Adverse events represent a global issue with a significant negative impact on patient safety. Reporting these events is one of the key tools for improving the quality of care and patient safety. The aim of this study was to determine the frequency of adverse event reporting, identify factors influencing reporting frequency, and explore barriers to adverse event reporting as perceived by nurses working in intensive care units (ICUs) in selected hospitals in Slovakia. Data collection took place from July to October 2023 through a questionnaire consisting of three sections: reporting frequency, barriers, and demographic information. The sample included 153 nurses from four Slovak hospitals. Data were analyzed using descriptive and inferential statistics. The reporting frequency score was 3.39 (SD = 1.33), indicating relatively average reporting of adverse events. Factors such as workplace satisfaction, material resources, perceived patient safety, and nurse education significantly influenced reporting. The most critical barriers identified were insufficient knowledge about which events to report, limited awareness of adverse event occurrence, and unclear reporting processes. Despite the relatively high frequency of adverse event reporting in ICUs, barriers limiting its effectiveness persist. Key challenges include a lack of knowledge and clear guidelines, which should be addressed through education and organizational measures. Supporting factors such as workplace satisfaction and resource availability could further enhance patient safety and care quality
Intravenózní podávání medikací a infuzních roztoků patří mezi častou modalitu léčby nejen v nemocničních zařízeních, ale i v následné péči, ambulantních provozech či domácím prostředí. Cílem textu je poskytnout zdravotnickým pracovníkům informace o doporučeních přispívajících k bezpečné aplikaci a prevenci chybovosti při podávání léčiv intravenózní cestou ve zdravotnických zařízeních.
Intravenous administration of medications and infusion solutions is a frequent treatment modality not only in hospital settings, but also in aftercare, outpatient settings and home environments. The aim of this text is to provide healthcare professionals with information on recommendations contributing to the safe administration and prevention of errors in the administration of drugs by the intravenous route in healthcare settings.
- MeSH
- bezpečnost pacientů * MeSH
- chybná zdravotní péče prevence a kontrola MeSH
- intravenózní podání * MeSH
- lidé MeSH
- riziko MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
U seniorů se poměrně často v důsledku dysfagie vyskytují obtíže s užíváním léčiv, zejména pevných lékových forem podávaných perorálně. V takových případech lékaři často rozhodují o drcení těchto léčiv. Takový zásah však může být rizikový – může vést ke změně účinnosti i bezpečnosti léčivého přípravku, k výkyvům plazmatických hladin účinné látky nebo k toxickému působení léčiva na personál při jeho úpravě. Alternativní způsoby podání perorálních léčiv navíc zvyšují riziko pochybení při jejich aplikaci. Podávání léčiv pacientům s poruchou perorálního příjmu představuje oblast, kde je nezbytná spolupráce mezi ošetřujícím lékařem a klinickým farmaceutem. Tento příspěvek ilustruje význam takové spolupráce na konkrétní kazuistice reálného pacienta.
In the elderly, it is quite common to encounter problems taking medicines orally due to dysphagia, especially solid dosage forms. In such cases, it is often decided by doctors to crush these drugs. However, such interventions can be risky, there may be a change in the efficacy and safety of the drugs, fluctuating plasma levels may occur. There is a potential for toxic effects of certain medicines on the staff during preparation. Alternative methods of administering oral medications is riskier due to occurrence of medication administration errors. The administration of medicines to patients with an intake disorder is one area where collaboration between the physician and pharmacist should be established. In this paper, this collaboration is illustrated on the example of a case report.
- Klíčová slova
- drcení léčiv,
- MeSH
- aplikace orální MeSH
- komorbidita MeSH
- léčivé přípravky aplikace a dávkování MeSH
- lékové formy MeSH
- lidé MeSH
- poruchy polykání * komplikace MeSH
- riziko MeSH
- senioři nad 80 let MeSH
- týmová péče o pacienty MeSH
- způsoby aplikace léků * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- Publikační typ
- kazuistiky MeSH
AIMS: To explore all medication administration errors (MAEs) throughout the entire process of medication administration by nurses in the inpatient setting, to describe their prevalence, and to analyse associated factors, including deviation from the good practice standards. BACKGROUND: Worldwide, MAEs are very common and regarded as a serious risk factor to inpatient safety. Nurses assume an essential role in the hospital setting during the administration of medications. DESIGN: The prospective observational study was carried out in accordance with the STROBE guidance. METHODS: This study was conducted in four regional hospitals from June to August 2021. MAEs were collected when nurses administered medications to the adult inpatients during the morning, noon, and evening medication rounds at the internal, surgical, and follow-up care departments in each hospital over three consecutive days. Direct observation by the multidisciplinary team was employed. MAEs were classified as major MAEs (from the potentially most serious and common to all drug forms), specific MAEs (specific to a drug form), and procedural MAEs (e.g., patient identification, hygiene standards, or generic drug substitution). Predictors of either major MAE or specific MAE frequency were analysed using the generalised linear model and the decision tree model. RESULTS: Overall, 58 nurses administering medication to 331 inpatients at 12 departments were observed. In total, 6356 medication administrations were observed, of which 461 comprised major MAEs, 1497 specific MAEs, and 12,045 procedural MAEs. The predictors of the occurrence of major MAEs and specific MAEs were the specific hospital, the nurse's length of practice (less than 2 years), and two procedural MAEs (the unclear prescription and the wrong strength). CONCLUSIONS: Non-adherence to the standard processes in healthcare facilities for prescribing and administering drugs increased the prevalence of severe MAEs. Determinants of MAE occurrence such as incorrect prescriptions or limited experience of nurses should be considered. IMPLICATION FOR THE PROFESSION AND PATIENT CARE: The identified determinants of MAE should be considered by hospital stakeholders in their support programs to reduce the level of burden for nurses during medication administration. PATIENT OR PUBLIC CONTRIBUTION: Neither patients nor public was not involved in the design, data collection, or dissemination plans of this study. The researchers observed nurse care delivery at medical departments acting as passive participants.
- MeSH
- dospělí MeSH
- hospitalizace * statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- medikační omyly * ošetřování statistika a číselné údaje prevence a kontrola MeSH
- personál sesterský nemocniční statistika a číselné údaje MeSH
- prospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
