Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
Learn about the principles behind the surgical checklist and the evidence for adopting the checklist and how one NHS Board has applied the checklist to their surgical theatres and how another has expanded the checklist principle to other areas.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
Learn about the principles behind the surgical checklist and the evidence for adopting the checklist and how one NHS Board has applied the checklist to their surgical theatres and how another has expanded the checklist principle to other areas.
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
Improving Surgical Safety and Patient OutcomesC Daniel Smith
Keynote talk delivered at New Jersey Hospital Association Seminary on Improving Surgical Safety & Patient Outcomes held on September 25, 2013 at their Conference Center in Princeton New Jersey. Over physicians, administrators, nurses and perioperative services providers in attendance.
In this presentation it has been tried to give a glimpse of different type of consent, how it should be taken, how the patient to be explained, when consent is must and conditions where consent is not required, so as to guide you in your every day practice.
Improving Surgical Safety and Patient OutcomesC Daniel Smith
Keynote talk delivered at New Jersey Hospital Association Seminary on Improving Surgical Safety & Patient Outcomes held on September 25, 2013 at their Conference Center in Princeton New Jersey. Over physicians, administrators, nurses and perioperative services providers in attendance.
ethical and cultural issues is a problem for child and nurse,ethical challenge is affect the nursing care of the child ,it impact the child health ,and development ,it may lead to the dangerous problems of the child .
The good doctors is who is good in relationship to his patients what ever the reason. but do not use your relationship to date a girl in as your her doctor unless you finish that relationship as a medical doctor.
There are a law and ethics that protects the patients and the doctor relationship to prevent the damage or suit for both of them.
As there is relation b/w the patient and doctor there is also a relation b/w doctor and another doctor and this is important both of them to take a care for patient.
Any misunderstanding of both doctors should try to solve it because we do not need to harm the patient.
5 The Physician–Patient Relationship Learning Objectives After.docxalinainglis
5 The Physician–Patient Relationship
Learning Objectives
After completing this chapter, you will be able to:
· 1. Define the key terms.
· 2. Describe the rights a physician has when practicing medicine and when accepting a patient.
· 3. Discuss the nine principles of medical ethics as designated by the American Medical Association (AMA).
· 4. Summarize “A Patient’s Bill of Rights.”
· 5. Understand standard of care and how it is applied to the practice of medicine.
· 6. Discuss three patient self-determination acts.
· 7. Describe the difference between implied consent and informed consent.
Key Terms
Abandonment
Acquired immune deficiency syndrome (AIDS)
Advance directive
Against medical advice (AMA)
Agent
Consent
Do not resuscitate (DNR)
Durable power of attorney
Human immunodeficiency
virus (HIV)
Implied consent
Informed (or expressed)
consent
Incompetent patient
In loco parentis
Living will
Minor
Noncompliant patient
Parens patriae authority
Privileged communication
Prognosis
Proxy
Uniform Anatomical Gift Act
THE CASE OF DAVID Z. AND AMYOTROPHIC LATERAL SCLEROSIS (ALS)
David, who has suffered with ALS for 20 years, is now hospitalized in a private religious hospital on a respirator. He spoke with his physician before he became incapacitated and asked that he be allowed to die if the suffering became too much for him. The physician agreed that, while he would not give David any drugs to assist a suicide, he would discontinue David’s respirator if asked to do so. David has now indicated through a prearranged code of blinking eye movements that he wants the respirator discontinued. David had signed his living will before he became ill, indicating that he did not want extraordinary means keeping him alive.
The nursing staff has alerted the hospital administrator about the impending discontinuation of the respirator. The administrator tells the physician that this is against the hospital’s policy. She states that once a patient is placed on a respirator, the family must seek a court order to have him or her removed from this type of life support. In addition, it is against hospital policy to have any staff members present during such a procedure. After consulting with the family, the physician orders an ambulance to transport the patient back to his home, where the physician discontinues the life support.
· 1. What were the primary concerns of the hospital?
· 2. What was the physician’s primary concern?
· 3. When should the discussion about the patient’s future plans have taken place with the hospital administrator?
Introduction
Few topics are as important as the physician–patient relationship. This relationship impacts the entire healthcare team. All healthcare professionals who interact with the patient must understand their responsibilities to both the patient and the physician. The patient’s right to confidentiality must always be paramount.
The first physicians were “medicine men,” witch doctors, or sorcerers. The physician–pa.
How to Bust Clinical Trial Myths and Increase Participation - mdgroupmdgroup
In order for the public to benefit from ground-breaking medical research, well-attended clinical trials are vital. What holds potential participants back from participating in trials?
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
1. Recommendoma
Syndrome
Or
VIP
(very important person )
Syndrome
Muhammad Muhammad Al Hennawy
Senior Consultant Obstetrician &
Gynacologist
Ras El Bar Central Hospital ,Egypt
mmhennawy.site44.com
www.drhennawy.8m.net
2. Definition
• The presence of numerous unexpected and
unusual complications in recommended
patients that the treating physician is trying to
give a better assistance
3. • VIPs are given
• the best care,
• faster and
• greater access,
• enhanced and more convenient facilities, and
• special attention from physicians,
• VIP care can be singularly harmful
4. • Unfortunately, trying to provide better care
sets up the VIP for a higher complication rate
and a greater chance of death.
5. Recommended Or VIP Patients?
• It is a person given special privileges in view of
his or her status or wealth.
• Examples of VIPs include
• Royalty,
• Politicians,
• Celebrities,
• Corporate leaders,
• Wealthy individuals , and
• Medical personnel or their relatives
6. Names
• Recommendoma Syndrome
• Recommendosarcoma syndrome
• Syndrome of recommended patient
• VIP (very important person) syndrome
7. History
• This situation was first documented in a paper
published in the 1960s which noted that VIP
patients have worse outcomes.
• Then described by Dr. Walter Weintraub of the
University of Maryland School of Medicine in a
1964 paper,
• VIP Syndrome is shorthand for how the influence
of wealth and the allure of fame can cause
doctors to veer into risky territory when they
cater to stars.
9. Patients' Attitude
• Stars may reject medical advice
• Stars may demand ineffective treatments.
• Star-struck doctors may order unnecessary
tests or not enough.
• Chairperson’s syndrome is pressure from the
patient, family member, hospital
representative, or even the VIP patient to be
cared for by the department chairperson.
10. • A VIP may insist on the senior-most specialist
at an academic institution or teaching
hospital—the chair of the department of
medicine, or of surgery, for instance. But the
senior-most, or most eminent, caregiver is not
necessarily the most skilled at performing a
given procedure. Such an individual may be
out of practice, or no longer up-to-date, and
the "no name" subordinate may actually be
much more skilled.
11. Inefficient Use Of Health Resources
• Medical professionals can be vulnerable to clouded
judgment, and thus cause harm to their patients
• When physicians suffer a loss of judgment in the face
of the glamour and prestige of a famous client
• (Doctors Didn’t Follow Standard Practices because the
Patient was a VIP”)
• Absence of an adequate register of clinical data and
• Change in usual clinical practice on interpretation of
diagnostic tests as well as
• In the indication of treatment of these patients
12. • Every test has its own set of possible
complications. Each consultant feels
compelled to add something to the
evaluation, which usually means even more
tests, and more possible complications. And
once too many consultants are involved, there
is no “captain of the ship” and care can
become fragmented and even more inefficient
and dangerous.
13. • VIPs may be prescribed narcotics or other
controlled substances when an ordinary
patient would be denied them, or they may be
over-medicated with larger amounts of such
drugs than appropriate.
• VIP medicine can be extravagant and wasteful.
Excessive drug prescriptions may be written
and imaging studies ordered
14. • Using his or her status to influence a given
professional or institution to make
unorthodox decisions under the pressure or
presence of said VIP—that relates to the
accessibility and quality of health care
15. • When treating a V.I.P., doctors may avoid
giving bad news. In hopes of sparing their
special patient from pain or time-consuming
care, a doctor may opt to skip basic tests or
procedures — even though these exams may
have provided important information. The flip
side is that V.I.P. treatment may result in extra
and unnecessary tests
16. • Prominent or famous people who fall ill have obvious
reasons for desiring instant and ample medical care.
Additionally, they have a desire to avoid public scrutiny
in matters of private medical care, as all patients do,
and may demand special accommodations on this
basis. They may want to avoid the prying eyes of
journalists as well as those of the curious onlookers
among the hospital staff who may not be directly
involved in their care. Their desire for privacy is an
understandable aspect of their need for extra security.
Often the pressure on medical staff for special
accommodations comes from a VIP's entourage rather
than from the patient.
18. • Some observers object that, although it is not
surprising that those with fame or wealth
receive more attention when sick, it seems
unfair that they should get "better" medical
care than others, especially in cases where
scarce resources, including time, are
reallocated to accommodate them.
20. • when former President Gerald Ford was
discharged from the hospital with the
diagnosis of an inner-ear infection when, in
fact, he had suffered a stroke
21. • Prince died of an opioid addiction that may
have been facilitated by physicians prescribing
too powerful a drug under circumstances in
which they were not licensed or registered to
prescribe them.
22. • Jackson's personal doctor, Conrad Murray,
spent two years in prison after his involuntary
manslaughter conviction in the King of Pop's
2009 death. Jackson had requested a surgical
anesthetic, propofol, to help him sleep, calling
it his "milk," according to trial testimony.
Prosecutors said Murray supplied the drug
and didn't notice when Jackson stopped
breathing.
23. • Another doctor took a cellphone photo of
Joan Rivers on the operating table, according
to a recently settled malpractice lawsuit.
That's a clear sign of clouded judgment,
Dinwiddie said.
25. • The best way to prevent this "syndrome of
recommended patient" is to
• maintain, even within these patients, an
attitude based on solid clinical knowledge and
• to follow up the same clinical rules accepted
for other patients.
26. Mariano and McLeod
• Based on their experience caring for three American
presidents, Mariano and McLeod7 offered three
directives for caring for VIPs:
• Vow to value your medical skills and judgment
• Intend to command the medical aspects of the
situation
• Practice medicine the same way for all your patients.7
• In this paper, we hope to extend the sparse literature
on the VIP syndrome by proposing nine principles of
caring for VIPs, with recommendations specific to the
type of VIP where applicable.
27. Guzman et al offer
9 principles in handling VIPs
28. • “that’s where you’ve got to
• take a deep breath
• and reassess.”
29. Principle 1
• Don’t bend the rules.
• Any deviation of clinical practice when caring
for a VIP can compromise delivery of the right
care.
30. Principle 2
• Work as a team, not in “silos.”
• Teamwork is crucial in ensuring good clinical
outcomes.
31. Principle 3
• Communicate, communicate, communicate.
• Heightened communication should include
the patient, family, and other health staff
members involved in providing care.
32. Principle 4
• Carefully manage communication with the
media.
• Confidentiality in the physician-patient
relationship must be guarded.
33. Principle 5
• Resist “chairperson’s syndrome.”
• Chairperson’s syndrome is pressure from the
patient, family member, hospital
representative, or even the VIP patient to be
cared for by the department chairperson.
34. Principle 6
• Care should occur where it is most
appropriate.
• Decisions on where to place the VIP patient
should be made on the basis of the venue
where the optimal care can be delivered.
35. Principle 7
• Protect the patient’s security.
• Ensuring security is of paramount importance
in managing VIP syndrome.
36. Principle 8
• Be careful about accepting or declining gifts.
• It is suggested that physicians decline gifts
graciously to minimize unmet expectations
and misunderstandings, and also affirm the
care that is free of gifts.
37. Principle 9
• Work with the patient’s personal physicians.
• Effective interactions with the VIP’s personal
caregivers can facilitate communication and
decision making for the patient.
38. Not To Treat Our Own Family Members
• To provide the best care, a physician needs to
be detached and objective. That’s why we are
advised not to treat our own family members.
I’ve spoken to several doctors who admitted
that they too often sought and received V.I.P.
care when they became ill, particularly from
their own hospitals.
39. • “When you’re contemplating superhuman or
very heroic, unorthodox behavior in your zeal
to help a famous patient,” Lerner said, “that’s
where you’ve got to take a deep breath and
reassess.”