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Aurelian Udristioiu. Medical Safety and Risk Management in patients care. International Association of Risk Management in Medicine (IARMM). , 4, p. 150, 2015.

Abstract: Medical Safety and Risk Management in patients care


In this year, 4th World Congress of Clinical Safety was held in Vienna, Austria, http://www.iarmm.org/4WCCS/ with the theme “ Clinical Management and Governance for Healthcare Risk and Crisis”, 28 (Mon) - 30 (Wed) September 2015, at
Schlos Schonbrunn Palace, Apothekertrakt Hole, hosted by International Association of Risk Management in Medicine (IARMM).
Major Organizers, was Presidential Board, Ryoji Sakai (Congress Co-President. IARMM President, Dr. Med. Hon. Prof. SU,former Profs. TWU, EPFL, USM, etc., Japan) and Job Harenberg ,Congress Co-President. Prof. Dr. Med. Ruprecht-Karls-University Heidelberg, Germany,
In an International Organizing Committee, between the members like as Donald Berwick (Emeritus Prof. MD. Harvard University, Founder, Institute for Healthcare Improvement, Boston, USA), Allen J Vaida (Dr. Executive Vice President, The Institute for Safe Medication Practice , USA), Aidan Halligan (Prof. MD University College London, Brighton and Sussex University Hospitals, UK, has been and Aurelian UDRISTOIU (Dr. Spitalul Judetean de Urgenta Targu Jiu, Romania).
This Vienna Congress was organized by IARMM to improve and promote high advanced safe and clean science and technology in both risk and crisis management and governance. The congress covered a wide range of topics such as patient safety, medication safety, infectious disease outbreak, and other related subjects.
As in every rear, the congress registered a numerous participants from 51 countries from all five continents. From Romania at this Congress attended Dr. Aurelian Udristioiu, with a specific work of researches, Molecular mechanisms of bone reconstruction in new dental implant technology”, authors Aurelian Udristioiu¹, Staniloiu Mihail¹, Manole Cojocaru², ¹Emergency County Hospital Targu Jiu & UCB University, Romania,, ²Titu Maiorescu University, Faculty of Medicine, Physiology, Department, Bucharest, Romania
In this work was investigated the potential role of bone remodeling cells (osteoblasts and osteoclasts), in a new technique of dental implant. Peripheral blood (PB) in steady state was collected at apparent health patients which followed the technique of dental implant, after the medical recommendations of Cell Biology Departmens and Neuroscience from different countries.
A total of 10 patients (8 males and 2 females), between 50 and 65 years (mean age 57.5 years) were appropriately informed and after that them were collected a small volume of blood. The plasma delivered in biochemistry dry vacuetts, were keeped for time a 30 minutes, in a thermostat at 37 C*, for to obtain auto-homolougous fibrin for to be used in the seal at post-extraction site. The patients, after 24 weeks from extraction with the alveolus sealing, have made the CT scan for the evaluation of regenerated new bone density and in all caseses gingival retraction together with resorbtion maxilar bone was prevented.
Conclusion. These results provide strong evidence for a sequential physiologic mechanism through which the molecular mechanisms gain access to active Transfroming Growth Factor β (TGF-β), from plasma blood to renew dental bone.
Another researches from different countries showed the importance of patient safety and health informatics which are considered newly and merged sciences in health care in all development countries. This is evident through their extensive contribution in patient care delivery through effectiveness and efficiency.
Risk is not a straightforward concept. In Quality management systems—Fundamentals and vocabulary,” risk is defined as the “effect of uncertainty.” The term “uncertainty” is clarified as a lack of information or knowledge about an event that can be expressed in terms of consequences the likelihood of occurrence, further describe risk as a “deviation from the expected,” either positive or negative.
Risk can be described by the product of the probability of damage {Pd}, and the amount of damage. (Ad). When combining these dimensions in 2 x2 risk table of a high risc situation will result when both Pd (happens often) and Ad are high (loss of life). A low risk situation will result when Pd is high but Ad is low. First, clinical safety reflects the perception of risk. Second, the consequences of risk management will depend of the individual perception but no calculation of risks expressed as Perceived Sfety(PaSa), [Prof. Porzsold F, Germany).
In every hospital from development western countries it is implemented a compartment of medical vigilance and monitoring of clinical alerts at ills admitted in clinical wars and ICU. In this department works permanently, non-stop, a team composed of medical nurses, informatics, economists, which receive signals of alerts from medical personal which care ills and they have drop clinical parameters alert as, sudnley very high or low hypotension, hemoglobin, glucose, loss of blood, etc..
Every medical department of hospital establishes self parameters of alert, for every specific disease. These aspects are transmitted to safety team which rapid call or announce online doctors in specific specialty of diseases, to run at signaled case and to solve medical problem, very quickly, in your specialty, beside of doctor in duty in that medical section. Participation of nurses on ward rounds is crucial for patient safety, communication between patients and members of healthcare team and economic efficiency in health care.
Nosocomial or healthcare associate infections (NIs) are a frequent risk and often a severe complication affecting hospitalized patients speciallyon ICU. The growing availability patient record in hospitals allows an extend monitoring of early signs Nis with the aim of reduce NIs rates by early starting appropriate therapies or preventive measures. The monitoring of the nosocomial infections software with its automated identifications, monitoring and reporting of healthcare associated infections in ICU by Screening Intensive care information. Clinical alert criteria are established together with the physicians to detect early signs or symptoms of Nis.[Prof. Blacky A &Co, Austria].
Activity in improve medication safety and reduce medication errors are being conducted in various countries, driven by regulation, as well as innovative organizations looking to provide best practice solution for their patients. Drugs round tabards have been shown to decrease medication administration errors, and improve the quality of nursing care, [Prof. Nahser O, & Co, UK]. Minimizing medication administration errors ensuring accurate medication, dispensing recording accurate medication data, needed in the case of product recall or to enable traceability are all fundamental process that can be enhanced by use a global standards, [Prof. Snioch T, Kreysa U, Belgium].
Clinician experiences internal and external turmoil and may be in a state of shock in the midst of trying to both determine what happened and manage a patient who may be unstable or in crisis. Clinician is distracted and self-reflected, needs others to take over.
Tumor markers ™, is currently essentially available in clinical practice. The medical studies showed a high percentage of inappropriate of TM. Its improper use can cause unnecessary and harmful additional tests for the patients and anguish for suspected cancer, (42% TM positive from patients without tumor pathology. Appropriate use is recommended and safe for reducing risks in practice patients care, (Prof. Campoy EEV, Spain).
Before use, stem cells must be manipulated so that they possess the necessary characteristics for successful differentiation, transplantation, and engraftment. This “minimal manipulation” has become the central point of stem cell regulation in the U.S. Stem cell therapies are regulated as biologics and are subject to premarket approval under the risk-based approach to approving cellular and tissue-based products.
The global differences in regulation of research involving stem cells and novel therapies are required. Overall, stem cell therapy remains hope for the future rather than immediate reality, with very few exceptions. Caution is highly advisable for anyone who is seeking novel and emerging treatments for currently incurable diseases, [Dr. Valdova V, USA].
In conclusion of Congress in the Plenary Sessions, conferences, oral presentations, work shop and Educational trials was emphasis general idea that medical errors in healthcare cause high morbidity and mortality with a impact of patient and a high economic and social impact. It is particularly important to quantify this cost on take decision, development of prevention strategies, in the field of patient safety, [Prof. Angel M & Co, Spain].

Dr. Aurelian Udristioiu, MD,
Emergency County Hospital TARGU-JIU &USB University,
Primary Physician of Laboratory Medicine,
General Chemical Pathology, EuSpLM,
City Targu Jiu, Romania
National Academy of Biochemical Chemistry (NACB) Member,
Washington D.C, USA.

Keywords: Medical Safety , Risk Management , Nosocomial infection, osteoblasts, osteoclasts

URL: http://www.iarmm.org/4WCCS/

Posted by Aurelian Udristioiu

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