This document provides guidelines for medication administration and preventing errors. It outlines the 5 rights of medication administration as well as dos and don'ts such as checking the patient's identification and allergy bands, documenting administration immediately, and avoiding distractions. It distinguishes time-critical from non-time-critical scheduled medications and establishes time windows for administering each. The document also addresses look-alike medication names, requirements for verbal and telephone orders, and restrictions on those order types.
At the end of the session patient/ family/ advisors/ champions as well as health providers/ leaders/ authorities will leave with at least one practical idea to advance patient engagement in medication safety as a result of their increased understanding of:
. the role and responsibilities of patients/ families in medication safety
. different approaches to patient engagement in medication safety
. influencing factors (e.g. health literacy, culture, organizational and public policy)
. supporting resources and leading practices
The document provides guidance on improving medication safety. It outlines that medication use has become complex, errors are common, and future healthcare workers have an important role in prevention. It describes learning objectives around medication safety and defines key terms. It details the steps in medication use, common errors at each step, high risk patients and situations, and emphasizes clear communication, checklists, and reporting errors to enhance safety.
The document discusses medication errors, including common types, causes, and strategies for prevention. It notes that medication errors are a serious issue, causing up to 98,000 deaths per year. Errors can occur at any step in the medication process and are often due to human factors like poor communication or illegible handwriting, as well as system factors like confusing drug names. Strategies to reduce errors include using clear verbal order protocols, limiting dangerous abbreviations, implementing computerized physician order entry and barcoding, and having a just culture approach that supports healthcare workers involved in errors.
Medication errors can occur at any stage of the medication use process and can be caused by various factors. Common types of errors include communication failures, look-alike and sound-alike drug names, dosing errors, and environmental distractions. Root cause analysis seeks to identify underlying factors that lead to errors through retrospective review. Frameworks like the Ishikawa diagram can help categorize root causes as related to people, processes, technology, environment, or other factors to prevent future errors.
Adverse drug reaction monitoring and reportingTHUSHARA MOHAN
This document discusses types of adverse drug reactions and factors influencing them. It describes types A-E reactions, which include augmented, bizarre, chemical, delayed and end of treatment reactions. Polypharmacy, age, drug characteristics, gender, race and genetic factors can influence susceptibility. Detection methods include pre-marketing studies, post-marketing surveillance, underreporting and communicating reactions. Healthcare professionals should monitor high-risk patients and gather information to assess causality between drugs and adverse events. Underreporting is common due to various barriers but can be addressed through improved reporting systems and education.
This document provides guidelines for medication administration and preventing errors. It outlines the 5 rights of medication administration as well as dos and don'ts such as checking the patient's identification and allergy bands, documenting administration immediately, and avoiding distractions. It distinguishes time-critical from non-time-critical scheduled medications and establishes time windows for administering each. The document also addresses look-alike medication names, requirements for verbal and telephone orders, and restrictions on those order types.
At the end of the session patient/ family/ advisors/ champions as well as health providers/ leaders/ authorities will leave with at least one practical idea to advance patient engagement in medication safety as a result of their increased understanding of:
. the role and responsibilities of patients/ families in medication safety
. different approaches to patient engagement in medication safety
. influencing factors (e.g. health literacy, culture, organizational and public policy)
. supporting resources and leading practices
The document provides guidance on improving medication safety. It outlines that medication use has become complex, errors are common, and future healthcare workers have an important role in prevention. It describes learning objectives around medication safety and defines key terms. It details the steps in medication use, common errors at each step, high risk patients and situations, and emphasizes clear communication, checklists, and reporting errors to enhance safety.
The document discusses medication errors, including common types, causes, and strategies for prevention. It notes that medication errors are a serious issue, causing up to 98,000 deaths per year. Errors can occur at any step in the medication process and are often due to human factors like poor communication or illegible handwriting, as well as system factors like confusing drug names. Strategies to reduce errors include using clear verbal order protocols, limiting dangerous abbreviations, implementing computerized physician order entry and barcoding, and having a just culture approach that supports healthcare workers involved in errors.
Medication errors can occur at any stage of the medication use process and can be caused by various factors. Common types of errors include communication failures, look-alike and sound-alike drug names, dosing errors, and environmental distractions. Root cause analysis seeks to identify underlying factors that lead to errors through retrospective review. Frameworks like the Ishikawa diagram can help categorize root causes as related to people, processes, technology, environment, or other factors to prevent future errors.
Adverse drug reaction monitoring and reportingTHUSHARA MOHAN
This document discusses types of adverse drug reactions and factors influencing them. It describes types A-E reactions, which include augmented, bizarre, chemical, delayed and end of treatment reactions. Polypharmacy, age, drug characteristics, gender, race and genetic factors can influence susceptibility. Detection methods include pre-marketing studies, post-marketing surveillance, underreporting and communicating reactions. Healthcare professionals should monitor high-risk patients and gather information to assess causality between drugs and adverse events. Underreporting is common due to various barriers but can be addressed through improved reporting systems and education.
Medication errors are a significant problem in healthcare that can harm patients. They occur commonly at various stages of the medication process including prescribing, transcribing, preparing, dispensing, and administering medications. Several studies over decades have found high rates of medication errors and preventable adverse drug events in hospitals. James Reason developed a widely used model for classifying errors as either active failures by frontline staff or latent failures due to upstream organizational or management issues. Understanding the causes of errors through models like Reason's can help pharmacists and other healthcare providers develop effective strategies to improve medication safety.
Medication errors are preventable events that can lead to inappropriate medication use or patient harm. While most errors do not cause harm, some can result in catastrophic outcomes or death. Common causes of errors include poor communication, look-alike and sound-alike drug names, dose miscalculations, and human factors like distractions. Nurses can help prevent errors by clarifying any unclear orders, confirming unusual doses, double checking high alert medications, and thoroughly educating patients about their medications. Reporting all errors can help identify system weaknesses and improve safety.
This document provides information on various aspects of medication administration in a nursing context. It discusses definitions of key terms, indications for drug use, routes of administration including oral, topical, intravenous, intramuscular and more. It also covers assessing patients, drug orders, rights of medication administration, policies, guidelines and procedures for safely preparing and giving different types of medications to patients.
Here are the key steps I would take:
1. Return to Mrs. Veena immediately to inform her of the error and assess for any allergic reaction symptoms. Her safety is the top priority.
2. Notify the physician right away about the error so they can determine the appropriate treatment and monitoring plan for Mrs. Veena.
3. Fill out an incident report per hospital policy documenting exactly what occurred, the medications involved, actions taken, patient assessment and outcome.
4. Review the situation to understand what factors may have contributed to the error so I can learn and help prevent similar mistakes going forward. Proper documentation and reporting of all errors is important for quality improvement.
5. Apologize to
This document provides information about medication administration by nurses. It discusses key responsibilities of nurses including having thorough knowledge of the medications being administered, ensuring the right patient, drug, dose, route, time and frequency. It covers drug classifications, effects, interactions and incompatibilities. The document also reviews the nursing process for safe administration including assessment, diagnosis, planning intervention and evaluation. Different routes of medication administration such as oral, parenteral, topical and inhalation are explained.
In the presentation, a summary of initiatives to be taken by hospitals in different areas for patient safety have been described for the knowledge, practices and implementation of patient safety initiative by hospital managers/Administrators.
This document discusses quality issues related to patient safety, specifically medication errors. It defines key terms like medical error, adverse event, and near miss. It then identifies systems and personnel issues that can contribute to medication errors, such as staffing levels, the physical environment, and a lack of adherence to policies and procedures. The document also outlines the nurse's role in preventing errors and systems that have been implemented, such as computerized order entry and barcoding. It provides an overview of a trigger tool for measuring adverse drug events and discusses the results of a previous study on using clinical decision support systems to change physician ordering behavior and reduce errors.
Universities aim to equip students with leadership skills and personal tools to succeed after graduation. Developing leadership requires confidence, skills, and the ability to work with others. It is recommended that universities incorporate leadership development into their curriculums through inclusion in coursework, extracurricular activities, and contextual learning opportunities to prepare students for future careers and hiring.
This document outlines the structure for a presentation focusing on a patient safety project, including sections for background on the current situation, goals, analysis, recommendations and plans, and follow up. It discusses creating a culture change, setting outcome measures and goals, importance of recommendations, reaching goals, costs, and planning follow up through repeat cycles. The presentation was developed collaboratively using a template adapted for the topic context and with peer review.
This document discusses using statistical process control (SPC) tools to measure and improve processes. SPC uses charts to analyze variation in measured data over time to determine if changes resulted in improvement. It can be used for any measurable output, such as compliance to personal protective equipment guidelines, to identify patterns/trends in non-compliance events.
The document discusses using Six Sigma and the DMAIC model to improve PPE compliance on a surgical ward. It describes conducting an audit that found the ward's hand hygiene was not compliant with WHO guidelines. To address this, the DMAIC process would be used to define the problem, measure compliance rates and causes of non-compliance, analyze the root causes, improve practices through an action plan addressing challenges and costs/benefits, and control the process through monitoring.
The document discusses using Six Sigma and the DMAIC model to improve PPE compliance on a surgical ward. It describes conducting an audit that found the ward's hand hygiene practices were not compliant with WHO guidelines. The DMAIC phases would then be used to define the problem, measure compliance rates, analyze the causes of non-compliance, improve practices through an action plan, and control to maintain the improvements through monitoring. The goal is to reduce health risks and better meet patient needs through a Six Sigma approach to process improvement.
Leadership and Power discusses the relationship between leadership and power. It identifies three ways individuals can exercise power to ascend to leadership positions: persuasive power, erudite power, and positional power. The document also outlines seven bases of power leaders can utilize, including power of position, charisma, relationships, information, expertise, punishment, and reward. Finally, it provides tips for how leaders can effectively leverage power, such as making relationships a priority, maximizing communication networks, and tailoring power to reward others.
The document discusses the nursing hierarchy and leadership roles within a hospital ward. It outlines the different nursing roles from Nurse Manager down to Assistant in Nursing. The Nurse Manager is responsible for maintaining standards, controlling risk, motivating staff, and using leadership to ensure goals are efficiently met. The Clinical Development Nurse provides leadership, education, and facilitates quality improvement. Informal leaders gain influence through characteristics like education, experience, and decisiveness that establish their credibility among staff.
This document discusses several theories of how people learn. It mentions that experiential learning cannot be taught, and discusses Fleming's VAK model of visual, auditory and kinaesthetic learning styles. It also discusses cognitive theories of multimedia learning from Mayer, discovery learning from Bruner, problem-based learning, situated learning theory from Lave, and how learning is best embedded within contexts and culture.
Quality care outcomes can be measured in several ways including patient readmission rates, length of stay, and morbidity and mortality. These outcome measures place pressure on healthcare systems and can impact patient satisfaction, costs, and the risk of hospital-acquired infections if not addressed properly. Evaluating sustainability of quality improvement initiatives is important for ongoing management of these outcomes over time.
A strategic plan supports an organization's mission, vision and values. It should be the result of a careful evaluation of the organization's position based on parameters like service, quality, access, scope, innovation and demographics. An organization cannot serve everyone and must identify goals and objectives that best position it in the marketplace for success. The strategic plan identifies the organization's chosen approach to achieving these goals and objectives.
This document discusses systems and microsystems in healthcare. It defines a microsystem as a small group that provides care to a specific patient population. Microsystems aim to provide care, meet patient needs, and maintain operations. The quality of macro health systems depends on the quality of its microsystems. Microsystems can vary in how clinical staff work together, how information flows, and the quality of care provided. When microsystems function well, patients experience high-quality, efficient care.
\n\nQuality improvement aims to identify areas causing deficits in outcomes and implement positive changes. The document discusses analyzing problems, gathering data on structures like resources, processes like work procedures, and outcomes to measure the effects. It also covers defining desired outcomes and goals, testing improvement ideas, and monitoring progress to reduce gaps between current and ideal results. The overall purpose is to learn and enhance healthcare systems and processes through participation, support, and continuous development.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Medication errors are a significant problem in healthcare that can harm patients. They occur commonly at various stages of the medication process including prescribing, transcribing, preparing, dispensing, and administering medications. Several studies over decades have found high rates of medication errors and preventable adverse drug events in hospitals. James Reason developed a widely used model for classifying errors as either active failures by frontline staff or latent failures due to upstream organizational or management issues. Understanding the causes of errors through models like Reason's can help pharmacists and other healthcare providers develop effective strategies to improve medication safety.
Medication errors are preventable events that can lead to inappropriate medication use or patient harm. While most errors do not cause harm, some can result in catastrophic outcomes or death. Common causes of errors include poor communication, look-alike and sound-alike drug names, dose miscalculations, and human factors like distractions. Nurses can help prevent errors by clarifying any unclear orders, confirming unusual doses, double checking high alert medications, and thoroughly educating patients about their medications. Reporting all errors can help identify system weaknesses and improve safety.
This document provides information on various aspects of medication administration in a nursing context. It discusses definitions of key terms, indications for drug use, routes of administration including oral, topical, intravenous, intramuscular and more. It also covers assessing patients, drug orders, rights of medication administration, policies, guidelines and procedures for safely preparing and giving different types of medications to patients.
Here are the key steps I would take:
1. Return to Mrs. Veena immediately to inform her of the error and assess for any allergic reaction symptoms. Her safety is the top priority.
2. Notify the physician right away about the error so they can determine the appropriate treatment and monitoring plan for Mrs. Veena.
3. Fill out an incident report per hospital policy documenting exactly what occurred, the medications involved, actions taken, patient assessment and outcome.
4. Review the situation to understand what factors may have contributed to the error so I can learn and help prevent similar mistakes going forward. Proper documentation and reporting of all errors is important for quality improvement.
5. Apologize to
This document provides information about medication administration by nurses. It discusses key responsibilities of nurses including having thorough knowledge of the medications being administered, ensuring the right patient, drug, dose, route, time and frequency. It covers drug classifications, effects, interactions and incompatibilities. The document also reviews the nursing process for safe administration including assessment, diagnosis, planning intervention and evaluation. Different routes of medication administration such as oral, parenteral, topical and inhalation are explained.
In the presentation, a summary of initiatives to be taken by hospitals in different areas for patient safety have been described for the knowledge, practices and implementation of patient safety initiative by hospital managers/Administrators.
This document discusses quality issues related to patient safety, specifically medication errors. It defines key terms like medical error, adverse event, and near miss. It then identifies systems and personnel issues that can contribute to medication errors, such as staffing levels, the physical environment, and a lack of adherence to policies and procedures. The document also outlines the nurse's role in preventing errors and systems that have been implemented, such as computerized order entry and barcoding. It provides an overview of a trigger tool for measuring adverse drug events and discusses the results of a previous study on using clinical decision support systems to change physician ordering behavior and reduce errors.
Universities aim to equip students with leadership skills and personal tools to succeed after graduation. Developing leadership requires confidence, skills, and the ability to work with others. It is recommended that universities incorporate leadership development into their curriculums through inclusion in coursework, extracurricular activities, and contextual learning opportunities to prepare students for future careers and hiring.
This document outlines the structure for a presentation focusing on a patient safety project, including sections for background on the current situation, goals, analysis, recommendations and plans, and follow up. It discusses creating a culture change, setting outcome measures and goals, importance of recommendations, reaching goals, costs, and planning follow up through repeat cycles. The presentation was developed collaboratively using a template adapted for the topic context and with peer review.
This document discusses using statistical process control (SPC) tools to measure and improve processes. SPC uses charts to analyze variation in measured data over time to determine if changes resulted in improvement. It can be used for any measurable output, such as compliance to personal protective equipment guidelines, to identify patterns/trends in non-compliance events.
The document discusses using Six Sigma and the DMAIC model to improve PPE compliance on a surgical ward. It describes conducting an audit that found the ward's hand hygiene was not compliant with WHO guidelines. To address this, the DMAIC process would be used to define the problem, measure compliance rates and causes of non-compliance, analyze the root causes, improve practices through an action plan addressing challenges and costs/benefits, and control the process through monitoring.
The document discusses using Six Sigma and the DMAIC model to improve PPE compliance on a surgical ward. It describes conducting an audit that found the ward's hand hygiene practices were not compliant with WHO guidelines. The DMAIC phases would then be used to define the problem, measure compliance rates, analyze the causes of non-compliance, improve practices through an action plan, and control to maintain the improvements through monitoring. The goal is to reduce health risks and better meet patient needs through a Six Sigma approach to process improvement.
Leadership and Power discusses the relationship between leadership and power. It identifies three ways individuals can exercise power to ascend to leadership positions: persuasive power, erudite power, and positional power. The document also outlines seven bases of power leaders can utilize, including power of position, charisma, relationships, information, expertise, punishment, and reward. Finally, it provides tips for how leaders can effectively leverage power, such as making relationships a priority, maximizing communication networks, and tailoring power to reward others.
The document discusses the nursing hierarchy and leadership roles within a hospital ward. It outlines the different nursing roles from Nurse Manager down to Assistant in Nursing. The Nurse Manager is responsible for maintaining standards, controlling risk, motivating staff, and using leadership to ensure goals are efficiently met. The Clinical Development Nurse provides leadership, education, and facilitates quality improvement. Informal leaders gain influence through characteristics like education, experience, and decisiveness that establish their credibility among staff.
This document discusses several theories of how people learn. It mentions that experiential learning cannot be taught, and discusses Fleming's VAK model of visual, auditory and kinaesthetic learning styles. It also discusses cognitive theories of multimedia learning from Mayer, discovery learning from Bruner, problem-based learning, situated learning theory from Lave, and how learning is best embedded within contexts and culture.
Quality care outcomes can be measured in several ways including patient readmission rates, length of stay, and morbidity and mortality. These outcome measures place pressure on healthcare systems and can impact patient satisfaction, costs, and the risk of hospital-acquired infections if not addressed properly. Evaluating sustainability of quality improvement initiatives is important for ongoing management of these outcomes over time.
A strategic plan supports an organization's mission, vision and values. It should be the result of a careful evaluation of the organization's position based on parameters like service, quality, access, scope, innovation and demographics. An organization cannot serve everyone and must identify goals and objectives that best position it in the marketplace for success. The strategic plan identifies the organization's chosen approach to achieving these goals and objectives.
This document discusses systems and microsystems in healthcare. It defines a microsystem as a small group that provides care to a specific patient population. Microsystems aim to provide care, meet patient needs, and maintain operations. The quality of macro health systems depends on the quality of its microsystems. Microsystems can vary in how clinical staff work together, how information flows, and the quality of care provided. When microsystems function well, patients experience high-quality, efficient care.
\n\nQuality improvement aims to identify areas causing deficits in outcomes and implement positive changes. The document discusses analyzing problems, gathering data on structures like resources, processes like work procedures, and outcomes to measure the effects. It also covers defining desired outcomes and goals, testing improvement ideas, and monitoring progress to reduce gaps between current and ideal results. The overall purpose is to learn and enhance healthcare systems and processes through participation, support, and continuous development.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
3. Patient safety?
“Patient safety is the absence of preventable
harm to a patient during the process of health
care.”
WHO 2012
Health Prevent
Patients
care harm
4. Why?
Evidence of unsafe care!
WHO summarized the current research into patient
safety and published the findings in a report
which identified some key findings.
Developed
Harm Gaps
Countries
Patient safety research: an overview of the global evidence
Jha A K, Prasopa-Plaizier N, Larizgoitia I, Bates D W
5. Primary areas of focus;
patient safety
After orientating
ourselves to the
literature, we started to
note and identify
relevant topics that
recurred in our
searches...
6.
7.
8.
9. The National Quality Forum in 2006 published a list
of ‘errors’ pertaining to patient safety and called
them "never events”.
Among the errors cited, were;
Hospital &
community Drug errors Surgical errors
acquired infections
Other sources of patient safety problems resulted in
compromised patient protection, adverse events
involving devices/equipment and criminal events.
10. “The Mission of the High 5s Project is to
facilitate implementation and
evaluation of standardised patient
safety solutions within a global
learning community to achieve
measurable, significant, and sustained
reductions in highly important patient
safety problems.”
-WHO (2012)
WHO (2012) is implementing the high 5’s
project multi-nationally, focusing on
similar areas to those we found to be
of most importance through their
predominance in the literature
surrounding Patient Safety..
Editor's Notes
This is how our presentations will be structured today Patient safety, a general overview of patient safety, quality issues &introduce main issues Infection control Medication errorsDocumentation, pertaining to surgical error How we worked towards and decided on the selection on areas of focus for the presentations, will be discussed towards the end of this presentation.
Patient safety is a term we hear often, in relation to health care provision and delivery. It’s quite plausible to say that people involved in the health care system and areas that constitute the system (ie. wards) will have an idea of what patient safety is.. In this case, if we were to ask the question “What does the term ‘patient safety’ mean?” There would be a variance in answers..So in describing what patient safety is, we can look to a quote from the World Health Organization.. “Patient safety is the absence of preventable harm to a patient during the process of health care.”WHO (2012) also states that..“The discipline of patient safety is the coordinated efforts to prevent harm, caused by the process of health care itself, from occurring to patients...patient safety has been increasingly recognized as an issue of global importance...”----------------------------------------------Information adapted from:World Health Organization [WHO]. (2012). Patient safety. Retrieved January 1, 2012, from World Health Organization: http://www.who.int/patientsafety/en/
Why do we need to focus on, research into & monitor the quality of patient safety?..Because there is evidence of unsafe care.. Which is based upon the findings of research & subsequently data collection in the area.The World Health Organization summarized the current research of patient safety and published the findings in a report which identified some key findings.The available data suggest that harmas a direct outcome of health care provided to patients, poses a significant burden to people and their families, globally.Much of the evidence base has been created in the developed countries. There is some epidemiological evidence of poor clinical outcomes due to unsafe health care in developing countries, but the information on contributing factors to unsafecare is derived almost entirely from a number of developed countries. Although some of the means for reducing harm are known, large gaps in knowledge need to be filled before comprehensive solutions can be found.--------------------------------------------------------Information adapted from:World Health Organization [WHO]. (2012). Evidence of unsafe care. Retrieved January 1, 2012, from World Health Organistaion: http://www.who.int/patientsafety/research/country_studies/en/index.htmlArticle:Patient safety research: an overview of the global evidenceJha A K, Prasopa-Plaizier N, Larizgoitia I, Bates D W. Patient safety research: an overview of the global evidence. Qual Saf Health Care 2010;19:42-47 doi:10.1136/qshc.2008.029165
The primary areas for concern/research/quality improvement in regards to patient safety were identified through an orientation to the literature available, (primarily articles and web pages from the WHO).. Then a brief literature review, to identify which areas were occurring most frequently when the term ‘patient safety’ was entered into the database engines...-------------------------------------Image sourced from:http://www.med.uottawa.ca/sim/data/Patient_Safety_Measures_e.htm&docid=saz1LRPSQOAWsM&imgurl=http://www.med.uottawa.ca/sim/data/Images/Infection_hospital_cartoon.jpg&w=299&h=296&ei=LI4BT4a0O4WLswbZttgS&zoom=1&iact=rc&dur=2&sig=108125072540068073160&page=1&tbnh=111&tbnw=112&start=0&ndsp=22&ved=1t:429,r:19,s:0&tx=65&ty=-9***Screen print & highlight results that coincide with the topics chosen
Google scholar article search --------------------------------------Screen print:http://scholar.google.com/scholar?hl=en&q=patient+safety+issues&as_sdt=0%2C5&as_ylo=&as_vis=1
WHO patient safety webpage----------------------------------****** Jess, I was thinking it would be best just to read what is highlighted in this screen & if it’s not COMPLETELY obvious how it fits in with our topics, just say “So-and-so, is relative to medication errors” etc etc (:Screen print:http://www.who.int/topics/patient_safety/en/
Who High 5’s project..Point 1 & 2 – Ties into the topic of Medication errorsPoint 3 – Ties into the field of documentation to prevent surgical error????Point 4 – Although we’re not addressing it directly, handover & communication is relevant to all 3 topics, as there needs to be information passed for all aspects to be sustained & subsequent patient safety quality to be improvedPoint 5 – Part of infection control is to identify and minimise risks for hospital and health-care acquired infections..Screen print:http://www.who.int/patientsafety/implementation/solutions/high5s/ps_high5s_project_overview_fs_2010_en.pdf
Hospital and community acquired infections: Hospital patients may develop infections making their illnesses and treatment more difficult. Including those with compromised immune systems, such as those with an open wound from injury or surgery, those who require catheters for drainage or drug delivery, or the elderly.Drug errors: Including badhandwriting on a prescription, mistakes at the pharmacy, dosage errors, time frames and route of administrationSurgical errors: Wrong site surgeries and procedures, or patient misidentification comprise the bulk of surgical errors.----------------------------------------------Information adapted from:National Quality Forum (2008). Serious Reportable Events (SREs): Transparency & Accountability are Critical to Reducing Medical Errors. Retrieved January 2, 2012: http://www.qualityforum.org/Publications/2008/10/Serious_Reportable_Events.aspx.Torrey, T. (2008). Issues in patient safety. Retrieved January 2, 2012, from Patient empowerment: http://patients.about.com/od/empowermentbasics/a/patientsafety.htm
Information adapted from:World Health Organization. (2009). Welcome to the high 5's project website. Retrieved January 2, 2012, from High 5's: https://www.high5s.org/bin/view/Main/WebHomeImage sourced form:http://www.who.int/patientsafety/events/media/h5-p1.jpg
