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- Okkenhaug, Arne, et al.
(författare)
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Mitigating risk in Norwegian psychiatric care : Identifying indicators of adverse events through Global Trigger Tool for psychiatric care
- 2019
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Ingår i: International Journal of Risk and Safety in Medicine. - : IOS Press. - 0924-6479 .- 1878-6847. ; 30:4, s. 203-216
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Patients treated in psychiatric care are exposed to the risk of adverse events, similar to patients treated in somatic health care. OBJECTIVES:In this article we report the findings of triggers associated with adverse events (AEs) identified by a version of the Global Trigger Tool – Psychiatry (GTT-P) adapted for Norwegian hospital-based psychiatric treatment. METHODS:The design was a retrospective analysis of a random sample of 240 patient records from a psychiatric clinic in one Norwegian hospital. Patient records were sampled from both inpatient and outpatient psychiatric clinics in hospitals serving the northern part of the county of Trøndelag, Norway. RESULTS:Our analysis was based on the identification of 32 potential triggers of adverse events. Eighteen of the triggers were significantly related to adverse events. No adverse events were identified in patient records that did not also contain triggers included in the Global Trigger Tool. CONCLUSIONS:There is a clear relationship between the presence of triggers in a patient record and the likelihood of adverse events. Particularly relevant for psychiatric patients is ‘suffering’ as a trigger and this may also be relevant to somatic care and has implications for inclusion in the GTT-P.
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| 3. |
- Savage, R. L., et al.
(författare)
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Severe muscle symptoms with lipid-lowering agents may be confused with neurogenic claudication associated with spinal canal stenosis
- 2012
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Ingår i: International Journal of Risk and Safety in Medicine. - 0924-6479 .- 1878-6847. ; 24:4, s. 215-219
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Tidskriftsartikel (refereegranskat)abstract
- Background: Screening of the WHO global individual case safety report database (VigiBase) has recently identified case reports with HMG CoA reductase inhibitors and muscle symptoms co-reported with spinal stenosis. In some reports spinal stenosis appears to have been listed as a coincidental finding. Objective: To assess reports with sufficient information to ascertain if they suggested that there may have been diagnostic confusion between muscle symptoms attributable to HMG CoA reductase inhibitors with or without ezetimibe and symptoms of spinal stenosis. Method: Reports were examined for patient demographics, past history, clinical and investigational findings, co-prescribed medicines and outcomes. Results: Three case histories recorded details suggestive of diagnostic confusion between severe and disabling muscle symptoms affecting the lower limbs attributable to an HMG CoA reductase inhibitor with and without ezetimbe and symptoms of neurogenic claudication due to spinal stenosis. The statins were not discontinued promptly leading to prolonged morbidity. Serum creatine kinase levels (CK) were normal in two patients and not recorded for the third. Conclusion: The reports include two safety issues, firstly the need to consider HMG CoA reductase inhibitors as a cause of severe lower limb muscle symptoms even in the presence of spinal stenosis and normal CK levels and the second, the need to measure serum creatine kinase when these symptoms occur to detect progression of myopathy and potentially serious outcomes.
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