BACKGROUND AND OBJECTIVE

data-mce-style="text-align: justify;">Medication errors pose substantial risks in hospitals, particularly concerning patient safety. These errors, occurring throughout the medication use process, are one of the most common causes of morbidity and mortality in clinical practice. In the Philippines, there is a lack of evidence on the prevalence and effects of medication errors, emphasizing the need for further investigation. This study evaluated the prescribing, transcribing, and monitoring errors among inpatients under the Pulmonary Medicine Service of the Department of Medicine in the Philippine General Hospital.

data-mce-style="text-align: justify;">This cross-sectional retrospective records review used the total population purposive sampling technique to examine eligible charts of inpatients with asthma and/or COPD from August 1 to December 31, 2022. The frequency, type, and severity of medication errors were determined. Linear regression and Cox proportional hazards models were used to examine the relationship between patient-related factors and medication errors, and length of hospital stay and mortality.

data-mce-style="text-align: justify;">Fifty (50) out of 226 medical records were processed and analyzed. Included patients were predominantly older male adults. More than two-thirds of the patients were diagnosed with COPD while approximately one-fourth suffered from asthma. All patients were practicing polypharmacy and the vast majority presented with comorbidities. A total of 6,517 medication errors, predominantly prescribing errors (99.1%), were identified. Despite the high prevalence of medication errors, the majority were classified as “error, no harm” (98.8%), while only 1.17% were deemed as “error, harm.” As the frequency of prescribing errors increases in the power of three (rough approximation of e), from 1 to 3 to 9 to 27, etc., the expected hospital stay increases by 2.078 days (pCONCLUSION

data-mce-style="text-align: justify;">All eligible patient charts had at least one medication error, with the majority being prescribing errors. Among the variables, prescribing errors significantly affected the length of stay, while severity of transcribing errors had a marginally significant effect. It is essential to develop comprehensive education and training initiatives and adopt a systematic approach to mitigate medication errors and promote patient safety.

BACKGROUND AND OBJECTIVE

data-mce-style="text-align: justify;">There is a call for changes in health professions education to help address current and future challenges. For the effective management of change in institutions involved with health professions education, it is important to consider organizational readiness for change and psychological safety. In organizations, the presence of psychological safety facilitates learning that is integral in organizational development, especially those undergoing changes. There are tools available to measure organizational readiness to change and psychological safety but they are separate and tend to be lengthy. The study developed and validated a brief, straightforward tool that integrates psychological safety in the measurement of organizational readiness for change. It can be useful in the assessment of academic organizations undergoing change in order to facilitate implementation and promote effective change.

data-mce-style="text-align: justify;">The study used a sequential exploratory mixed methods design. A conceptual framework on organizational readiness to change which included psychological safety was developed from a review of literature. Relevant constructs were defined and corresponding questions were constructed and scaled. Five content experts qualitatively assessed the scale and removed items which were redundant, lacked clarity, or were irrelevant. The items were then reviewed by selected participants to ensure face validity. Finally, the questionnaire was administered to members of a unit (N=89) which was undergoing organizational change to ensure construct validity. Construct validity, internal consistency, convergent validity, and discriminant validity were determined using PLS-SEM and yielded acceptable results.

data-mce-style="text-align: justify;">The scale developed addressed components of organizational readiness to change and psychological safety. The scale was deemed to have good content validity by five experts, good face validity as tested by a small pilot group, and acceptable construct validity, internal consistency, convergent validity, and discriminant validity.

data-mce-style="text-align: justify;">The quantitative scale developed for measuring readiness to change was assessed qualitatively and quantitatively, and deemed to have relevance and validity. It can be used by academic units embarking on change initiatives to assess organizational readiness with due consideration for psychological safety. Quantitative results from the tool can be supplemented with qualitative measures such as observations, interviews or focused group discussions to better identify and address areas needing attention. The study has the potential to make a significant contribution to both the theory and practice of change management.

BACKGROUND AND OBJECTIVE

data-mce-style="text-align: justify;">Proper documentation of patient safety events is important to be able to provide changes that can prevent events from occurring again. The Philippine General Hospital launched an online platform for reporting patient safety events in 2017. This paper aimed to describe the patient safety events, initial response to the event, and preventive actions done in the institution.

data-mce-style="text-align: justify;">This is a retrospective descriptive study of patient safety event records from August 2017 to April 2022. General data of the patients, details surrounding the events, response to the event, and preventive measures done after the event were documented. Descriptive analysis was performed.

data-mce-style="text-align: justify;">There was a total of 625 events reported with 525 total unique reports. There was an increased rate of patient safety event reports from 2021 to 2022. The average rate was 23.8 and 25.7 reports per month, respectively. Most reports were for in-patient cases and were type 3 preventable adverse events. The general initial response of healthcare personnel to the adverse events is to provide the appropriate clinical care. Preventive measures include re-orientation and event specific actions.

data-mce-style="text-align: justify;">Documentation is crucial for patient safety events to provide solutions and prevent reoccurrence of these events that can cause harm to patients.

BACKGROUND

data-mce-style="text-align: justify;">State universities in the Philippines should comply with the 2020 Occupational Safety and Health (OSH) standards for government workers and must be guided by the 2017 ASEAN University Network’s Healthy University Framework (HUF) for them to become healthy universities. Both policy documents identify OSH policy and programs as key components.

data-mce-style="text-align: justify;">This study aimed to explore the challenges and opportunities in the implementation of health and safety policies and programs in a state university in the Philippines.

data-mce-style="text-align: justify;">A case study design was used with a state university as its study site. Investigators conducted 14 key informant interviews and nine focus group discussions which were participated by system officials, campus officials, academic teaching staff, academic non-teaching Staff, support staff, and students. Thematic analysis was used to identify and understand emerging patterns and themes.

data-mce-style="text-align: justify;">The results generated seven themes consisting of Policy and Committee, Dedicated Personnel and Unit,Budget and Technology, Collaboration, Programs and Services, Working and Learning Environment, and Role Models. The identified challenges in the implementation of health and safety programs in the university were: (1) limited budget to implement initiatives, (2) lack of collaboration among its offices, and (3) absence of a dedicated unit and staff. There were also opportunities to improve implementation: (1) strong implementation of certain policies and programs, (2) presence of a good working and learning environment, and (3) existence of role models.

data-mce-style="text-align: justify;">The identified challenges and opportunities correspond to the elements of the system and infrastructure considered as principal determinants of a healthy university. There is a need to recognize the interrelatedness of such elements to ensure effective implementation of health and safety programs in the university. It also underscores the relevance of the HUF in promoting OSH within a university context.

BACKGROUND AND OBJECTIVES

data-mce-style="text-align: justify;">This study at a national tertiary hospital in Manila, Philippines investigated the use of the "Copy and Paste" Function (CPF) within their Electronic Medical Record (EMR). While CPF has benefits and risks, little is known about its usage patterns and impact on patient safety at the institution. This study explores nurses' perceptions and recommendations on CPF use in this hospital’s EMR, assessing its prevalence, impact on patient safety, associations between prevalence and impact, and providing usage recommendations.

data-mce-style="text-align: justify;">A sequential explanatory research design was employed using surveys and semi-structured interviews. Ethical clearance was obtained before data collection. Instruments were adapted from similar studies and have undergone expert validation. Content validity was confirmed, and internal consistency was acceptable (Cronbach’s Alpha = 0.77). Stratified random sampling determined the respondents per area. Data analysis included descriptive statistics, Spearman’s rho, and thematic analysis.

data-mce-style="text-align: justify;">The survey (n = 256) showed CPF use by nurses and doctors, and was confirmed by semi-structured interviews (n = 9). Nurses generally perceived CPF's impact on documentation as neutral (40.17%), leaning towards positive impact. Interviews supported this, revealing both “challenges” and “benefits” of CPF use as themes after thematic analysis. There was no statistically significant association between perceived CPF prevalence and its perceived impact on patient safety (p = 0.164). The theme “considerations for safe CPF use” also emerged from the analysis.

data-mce-style="text-align: justify;">This study found mixed perceptions on CPF’s impact in healthcare. There is a call to continue its use, but safety measures must be implemented first. Recommendations include order verification, caution, practice standardization, selective CPF usage, additional technological features, and alternative documentation methods. A governance structure to manage EMR-related issues, such as unsafe CPF practices, is also recommended to ensure proper monitoring and response.

Philippines ; Health ; Safety

INTRODUCTION: Medical errors commonly occur in medical imaging departments. These errors are frequently influenced by patient safety culture. This study aimed to develop a suitable patient safety culture assessment tool for medical imaging departments. METHODS: Staff members of a teaching hospital medical imaging department were invited to complete the generic short version of the Safety Attitude Questionnaire (SAQ). Internal consistency and reliability were evaluated using Cronbach's α. Confirmatory factor analysis (CFA) was conducted to examine model fit. A cut-off of 60% was used to define the percentage positive responses (PPR). PPR values were compared between occupational groups. RESULTS: A total of 300 complete responses were received and the response rate was 75.4%. In reliability analysis, the Cronbach's α for the original 32-item SAQ was 0.941. Six subscales did not demonstrate good fit with CFA. A modified five-subscale, 22-item model (SAQ-MI) showed better fit (goodness-to-fit index ≥0.9, comparative fit index ≥ 0.9, Tucker-Lewis index ≥0.9 and root mean square error of approximation ≤0.08). The Cronbach's α for the 22 items was 0.921. The final five subscales were safety and teamwork climate, job satisfaction, stress recognition, perception of management and working condition, with PPR of 62%, 68%, 57%, 61% and 60%, respectively. Statistically significant differences in PPR were observed between radiographers, doctors and others occupational groups. CONCLUSION The modified five-factor, 22-item SAQ-MI is a suitable tool for the evaluation of patient safety culture in a medical imaging department. Differences in patient safety culture exist between occupation groups, which will inform future intervention studies.
Humans ; Surveys and Questionnaires ; Patient Safety ; Attitude of Health Personnel ; Diagnostic Imaging ; Reproducibility of Results ; Male ; Female ; Adult ; Job Satisfaction ; Factor Analysis, Statistical ; Middle Aged ; Hospitals, Teaching ; Safety Management ; Organizational Culture ; Medical Errors/prevention & control*

INTRODUCTION: In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) virus emerged and caused a worldwide pandemic, leading to measures being imposed by many countries to reduce its transmission. Singapore implemented the 'circuit breaker', which restricted all movements except for access to necessities and healthcare services. We aimed to investigate the impact of lockdown measures on the pattern of trauma and its effects. METHODS: An observational, retrospective, single-centre descriptive study was conducted using the trauma registry in Singapore General Hospital. It included patients above 18 years old who presented to the emergency department with trauma and were subsequently admitted. Patients admitted from 1 February 2020 to 31 July 2020 and those admitted during the same timeframe in 2019 were studied. Subgroup analyses were performed for patients aged ≥65 years and those <65 years. RESULTS: A total of 1,037 patients were included for analysis. A 17.6% increase in trauma presentations was seen from 2019 to 2020. Patients aged ≥65 years accounted for the rise in admissions. The predominant mechanism of injury was falls at home for older patients and vehicular accidents in patients <65 years. There were no significant differences in injury severity score, intensive care/high-dependency unit admission rates, length of stay, mortality rate, and subsequent need for inpatient rehabilitation. CONCLUSION Our study provided information on differences in trauma presentations before and during the COVID-19 pandemic. Further studies are required to better inform on additional precautionary measures needed to reduce trauma and improve safety during future lockdowns and pandemics.
Humans ; COVID-19/prevention & control* ; Aged ; Retrospective Studies ; Singapore/epidemiology* ; Male ; Female ; Wounds and Injuries/epidemiology* ; Aged, 80 and over ; Middle Aged ; SARS-CoV-2 ; Hospitalization/statistics & numerical data* ; Adult ; Emergency Service, Hospital/statistics & numerical data* ; Registries ; Accidental Falls/statistics & numerical data* ; Pandemics ; Patient Admission/statistics & numerical data* ; Length of Stay ; Accidents, Traffic/statistics & numerical data*

Aviation medicine safeguards flight safety by addressing three critical areas: managing physiological challenges of the aviation environment, preventing in-flight medical incapacitation and ensuring psychological fitness for flight. The field adopts occupational medicine's hierarchy of risk control to mitigate physiological risks in the operating environment, while employing systematic medical screening with tailored standards based on operational requirements to reduce the likelihood of in-flight incapacitation. A comprehensive approach incorporating mental health education, support systems and regular monitoring helps prevent psychological incapacitation. Recent data from the Singapore Changi Aeromedical Centre reveal that ophthalmological, otolaryngological and respiratory conditions are the primary causes of medical disqualification during air force pilot screening, reflecting the unique physiological demands of military aviation. This review emphasises the ongoing challenge of balancing rigorous medical standards with maintaining an adequate pilot recruitment pool, while highlighting the need for evidence-based approaches to aeromedical assessment and certification.
Humans ; Aerospace Medicine/methods* ; Singapore ; Aviation ; Pilots ; Accidents, Aviation/prevention & control* ; Occupational Health ; Safety ; Occupational Medicine ; Military Personnel

Fatigue driving is one of the leading causes of traffic accidents, posing a significant threat to drivers and road safety. Most existing methods focus on studying whole-brain multi-channel electroencephalogram (EEG) signals, which involve a large number of channels, complex data processing, and cumbersome wearable devices. To address this issue, this paper proposes a fatigue detection method based on frontal EEG signals and constructs a fatigue driving detection model using an asymptotic hierarchical fusion network. The model employed a hierarchical fusion strategy, integrating an attention mechanism module into the multi-level convolutional module. By utilizing both cross-attention and self-attention mechanisms, it effectively fused the hierarchical semantic features of power spectral density (PSD) and differential entropy (DE), enhancing the learning of feature dependencies and interactions. Experimental validation was conducted on the public SEED-VIG dataset. The proposed model achieved an accuracy of 89.80% using only four frontal EEG channels. Comparative experiments with existing methods demonstrate that the proposed model achieves high accuracy and superior practicality, providing valuable technical support for fatigue driving monitoring and prevention.
Humans ; Electroencephalography/methods* ; Automobile Driving ; Fatigue/diagnosis* ; Accidents, Traffic/prevention & control* ; Signal Processing, Computer-Assisted ; Neural Networks, Computer ; Algorithms ; Prefrontal Cortex/physiology*