Displaying publications 1 - 20 of 31 in total

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  1. Taha MA, Ravindran J
    Med J Malaysia, 2003 Mar;58 Suppl A:9-18.
    PMID: 14556346
    When a doctor is required to go to court, he does so with some amount of trepidation. The degree of trepidation increases in direct proportion as to whether he is required to be a witness or a defendant. The practice of medicine on the other hand requires the patient to have full confidence and open out his secrets to the doctor. If you hold back vital information, the diagnosis may be entirely different to the disease that you have. Lawyers who enter hospitals may also do so with some trepidation, maybe even more so than doctors who enter courts, as their lives are at stake. There is a perception that medico-legal matters are on the rise. We may put forward a few reasons for this: 1. A better educated and increasingly assertive public with greater awareness of the medical and legal systems; 2. Rising expectations of medical results; 3. Commercialization of medical care with erosion of the doctor-patient trust relationship. This paper will discuss the reasons for and the ways to address medical errors as well as explore the reasons for defensive medicine. The argument is put forward that public education programs on the risks inherent in some of the new advances in treatment modalities and surgery and professional education programs on the need for obtaining the patient's informed consent to such treatment is needed. Public advocacy programs to demonstrate the problems in medicine and the delivery of health care resulting from strict cost containment limitations should be carried out. There is also the need to enhance the level and quality of medical education for all physicians, including improved clinical training experiences. Doctors' must manage their clinical affairs in a professional manner without being dictated to by the legal system. However, it would be wise to take note of the views expressed by learned counsel and judges in their courts. The middle road is always the best and we must never be extreme in our viewpoints. We must always remember the patient is why we are here and the patient must never suffer in the process while we formulate our responses to the medico-legal challenges that lie ahead.
    Matched MeSH terms: Medical Errors/legislation & jurisprudence*
  2. Nagara CS
    Med J Malaysia, 2003 Mar;58 Suppl A:83-5.
    PMID: 14556355
    Matched MeSH terms: Medical Errors/prevention & control*
  3. Lee YF
    Med J Malaysia, 2017 04;72(2):89-90.
    PMID: 28473669
    No abstract available.
    Matched MeSH terms: Medical Errors/prevention & control
  4. Mohd Kamaruzaman AZ, Ibrahim MI, Mokhtar AM, Mohd Zain M, Satiman SN, Yaacob NM
    Int J Environ Res Public Health, 2022 May 26;19(11).
    PMID: 35682042 DOI: 10.3390/ijerph19116454
    After a patient safety incident, the involved healthcare providers may experience sustained second-victim distress and reduced professional efficacy, with subsequent negative work-related outcomes and the cultivation of resilience. This study aims to investigate the factors affecting negative work-related outcomes and resilience with a hypothetical triad of support as the mediators: colleague, supervisor, and institutional support. This cross-sectional study recruited 733 healthcare providers from three tertiary care hospitals in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for both outcomes (negative work-related outcomes and resilience). Four multiple mediator models of the support triad were analyzed. Second-victim distress, professional efficacy, and the support triad contributed significantly in all the regression models. Colleague support partially mediated the relationship defining the effects of professional efficacy on negative work-related outcomes and resilience, whereas colleague and supervisor support partially mediated the effects of second-victim distress on negative work-related outcomes. Similar results were found regarding resilience, with all support triads producing similar results. As mediators, the support triads ameliorated the effect of second-victim distress on negative work-related outcomes and resilience, suggesting an important role of having good support, especially after encountering patient safety incidents.
    Matched MeSH terms: Medical Errors*
  5. Usin MF, Ramesh P, Lopez CG
    Malays J Pathol, 2004 Jun;26(1):43-8.
    PMID: 16190106
    Event reporting can provide data to study the failure points of an organization's work process. As part of the ongoing efforts to improve transfusion safety, a Medical Event Reporting System Transfusion Medicine, (MERS - TM) as designed by Kaplan et al was implemented in the Transfusion Medicine Unit of the University Malaya Medical Centre to provide a standardized means of organized data collection and analysis of transfusion errors, adverse events and near misses. An event reporting form was designed to detect, identify, classify and study the frequency and pattern of events occurring in the unit. Events detected were classified according to Eihdhoven Classification model (ECM) adopted for MERS - TM. Since our system reported all events, we called it Event Reporting System - Transfusion Medicine (ERS-TM). Data was collected and analyzed from the reporting forms for a period of five months from January 15th to June 15th 2002. The initial half of the period was a process of evaluation during which 118 events were reported, coded, analyzed and corrective measures adopted to prevent the recurrence of the same event. The latter half saw the reporting of 122 events following the adoption of corrective measures. There was a reduction in the occurrence of some events and an increase in others, which were mainly beyond the organization's control. A longer period of evaluation is necessary to identify the underlying contributory causes that can be useful to develop plans for corrective and preventive action and thereby reduce the rate of recurrence of errors through proper training and adoption of just culture.
    Matched MeSH terms: Medical Errors/classification*; Medical Errors/prevention & control; Medical Errors/statistics & numerical data
  6. Olufisayo O, Mohd Yusof M, Ezat Wan Puteh S
    Stud Health Technol Inform, 2018;255:112-116.
    PMID: 30306918
    Despite the widespread use of clinical decision support systems with its alert function, there has been an increase in medical errors, adverse events as well as issues regarding patient safety, quality and efficiency. The appropriateness of CDSS must be properly evaluated by ensuring that CDSS provides clinicians with useful information at the point of care. Inefficient clinical workflow affects clinical processes; hence, it is necessary to identify processes in the healthcare system that affect provider's workflow. The Lean method was used to eliminate waste (non-value added) activities that affect the appropriate use of CDSS. Ohno's seven waste model was used to categorize waste in the context of healthcare and information technology.
    Matched MeSH terms: Medical Errors
  7. Shudipta Choudhury
    MyJurnal
    Background: Technological diversity management in the manufacturing of advanced medical devices is
    essential. The manufacturing industries of medical devices should act in accordance with the technical
    guidelines and regulations in order to ensure best practices with the use of devices in hospitals
    Aim: To explore safety hazards, cost implications, and social and ethical standards to be considered during
    the manufacturing of advanced medical devices
    Subject and Methods: Aqualitative descriptive study was used. There was no targeted sample in the current
    study whereby secondary data were used to explore the research topic. Secondary sources were obtained
    from databases including EBSCOHOST, PubMed, ProQuest, Science Direct, and Google Scholar. Peerreviewed
    articles, journals, books, conference proceedings, and other web publications were used to gather
    relevant data.
    Results: The current study indicated that the technological diversity management of advanced medical
    devices is associated with safety hazards like security threats, integrity problems, and medical errors. The
    study also showed that high cost of standardizations, supply, and purchase of advanced medical devices is a
    huge burden faced by the manufacturers andusers. The study showed that the regulation of the medical
    devices, certification, and post-market surveillanceare essential social and ethical considerations during the
    manufacturing process of the new medical devices.
    Conclusion: The current study explored the technological diversity of advanced medical devices. It is
    evident in the current study that technology diversity of medical devices is associated with safety hazards
    and cost implications. The study disclosed that taking into account social and ethical issues aid in
    manufacturing safe and high quality medical devices.
    Matched MeSH terms: Medical Errors
  8. Sreeramareddy CT, Rahman M, Harsha Kumar HN, Shah M, Hossain AM, Sayem MA, et al.
    PMID: 25104297 DOI: 10.1186/1472-6947-14-67
    BACKGROUND: To estimate the amount of regret and weights of harm by omission and commission during therapeutic decisions for smear-negative pulmonary Tuberculosis.
    METHODS: An interviewer-administered survey was done among young physicians in India, Pakistan and Bangladesh with a previously used questionnaire. The physicians were asked to estimate probabilities of morbidity and mortality related with disease and treatment and intuitive weights of omission and commission for treatment of suspected pulmonary Tuberculosis. A comparison with weights based on literature data was made.
    RESULTS: A total of 242 physicians completed the interview. Their mean age was 28 years, 158 (65.3%) were males. Median probability (%) of mortality and morbidity of disease was estimated at 65% (inter quartile range [IQR] 50-75) and 20% (IQR 8-30) respectively. Median probability of morbidity and mortality in case of occurrence of side effects was 15% (IQR 10-30) and 8% (IQR 5-20) respectively. Probability of absolute treatment mortality was 0.7% which was nearly eight times higher than 0.09% reported in the literature data. The omission vs. commission harm ratios based on intuitive weights, weights calculated with literature data, weights calculated with intuitive estimates of determinants adjusted without and with regret were 3.0 (1.4-5.0), 16 (11-26), 33 (11-98) and 48 (11-132) respectively. Thresholds based on pure regret and hybrid model (clinicians' intuitive estimates and regret) were 25 (16.7-41.7), and 2(0.75-7.5) respectively but utility-based thresholds for clinicians' estimates and literature data were 2.9 (1-8.3) and 5.9 (3.7-7.7) respectively.
    CONCLUSION: Intuitive weight of harm related to false-negatives was estimated higher than that to false-positives. The mortality related to treatment was eightfold overestimated. Adjusting expected utility thresholds for subjective regret had little effect.
    Matched MeSH terms: Medical Errors/mortality; Medical Errors/statistics & numerical data*
  9. Choy CY
    Curr Opin Anaesthesiol, 2008 Apr;21(2):183-6.
    PMID: 18443485 DOI: 10.1097/ACO.0b013e3282f33592
    PURPOSE OF REVIEW: Updates on developments in critical incident monitoring in anaesthesia, and assesses its role in improving patient safety.
    RECENT FINDINGS: Critical incident reporting has become more widely accepted as an effective way to improve anaesthetic safety, and has continued to highlight the importance of human errors and system failures. The establishment of an international database also improves critical incident reporting. Experiences from the national reporting and learning system in the UK have provided some solutions to the many problems and criticisms faced by the critical incident reporting technique. Direct observations to detect errors are more accurate than voluntary reporting of critical incidents, and may be a promising new approach.
    SUMMARY: Critical incident monitoring is a valuable tool in ensuring patient safety due to its low cost and the ability to provide a comprehensive body of detailed qualitative information. The qualitative information gathered can be used to develop strategies to prevent and manage existing problems, as well as to plan further initiatives for patient safety. Novel approaches should complement existing methods to achieve better results. The development of a culture which emphasises safety should go hand in hand with current audit activities.
    Matched MeSH terms: Medical Errors/prevention & control*; Medical Errors/statistics & numerical data
  10. Koh KC, Lau KM, Yusof SA, Mohamad AI, Shahabuddin FS, Ahmat NH, et al.
    Med J Malaysia, 2015 Dec;70(6):334-40.
    PMID: 26988205 MyJurnal
    INTRODUCTION: Misinterpretation of abbreviations by healthcare professionals has been reported to compromise patient safety. This study was done to determine the prevalence of abbreviations usage among medical doctors and nurses and their ability to interpret commonly used abbreviations in medical practice.

    METHODS: Seventy-seven medical doctors and eighty nurses answered a self-administered questionnaire designed to capture demographic data and information regarding abbreviation use in medical practice. Comparisons were made between doctors and nurses with regards to frequency and reasons for using abbreviations; from where abbreviations were learned; frequency of encountering abbreviations in medical practice; prevalence of medical errors due to misinterpretation of abbreviations; and their ability to correctly interpret commonly used abbreviations.

    RESULTS: The use of abbreviations was highly prevalent among doctors and nurses. Time saving, avoidance of writing sentences in full and convenience, were the main reasons for using abbreviations. Doctors learned abbreviations from fellow doctors while nurses learned from fellow nurses and doctors. More doctors than nurses reported encountering abbreviations. Both groups reported no difficulties in interpreting abbreviations although nurses reported often resorting to guesswork. Both groups felt abbreviations were necessary and an acceptable part of work. Doctors outperformed nurses in correctly interpreting commonly used standard and non-standard abbreviations.

    CONCLUSION: The use of standard and non-standard abbreviation in clinical practice by doctors and nurses was highly prevalent. Significant variability in interpretation of abbreviations exists between doctors and nurses.

    Matched MeSH terms: Medical Errors
  11. Yusof M, Sahroni MN
    Int J Health Care Qual Assur, 2018 Oct 08;31(8):1014-1029.
    PMID: 30415623 DOI: 10.1108/IJHCQA-07-2017-0125
    PURPOSE: The purpose of this paper is to present a review of health information system (HIS)-induced errors and its management. This paper concludes that the occurrence of errors is inevitable but it can be minimised with preventive measures. The review of classifications can be used to evaluate medical errors related to HISs using a socio-technical approach. The evaluation could provide an understanding of errors as a learning process in managing medical errors.

    DESIGN/METHODOLOGY/APPROACH: A literature review was performed on issues, sources, management and approaches to HISs-induced errors. A critical review of selected models was performed in order to identify medical error dimensions and elements based on human, process, technology and organisation factors.

    FINDINGS: Various error classifications have resulted in the difficulty to understand the overall error incidents. Most classifications are based on clinical processes and settings. Medical errors are attributed to human, process, technology and organisation factors that influenced and need to be aligned with each other. Although most medical errors are caused by humans, they also originate from other latent factors such as poor system design and training. Existing evaluation models emphasise different aspects of medical errors and could be combined into a comprehensive evaluation model.

    RESEARCH LIMITATIONS/IMPLICATIONS: Overview of the issues and discourses in HIS-induced errors could divulge its complexity and enable its causal analysis.

    PRACTICAL IMPLICATIONS: This paper helps in understanding various types of HIS-induced errors and promising prevention and management approaches that call for further studies and improvement leading to good practices that help prevent medical errors.

    ORIGINALITY/VALUE: Classification of HIS-induced errors and its management, which incorporates a socio-technical and multi-disciplinary approach, could guide researchers and practitioners to conduct a holistic and systematic evaluation.

    Matched MeSH terms: Medical Errors/classification*; Medical Errors/prevention & control; Medical Errors/statistics & numerical data*
  12. Lim AK, Ulagantheran V V, Siow YC, Lim KS
    Med J Malaysia, 2008 Aug;63(3):249-50.
    PMID: 19248701 MyJurnal
    To report a case of methylene blue related endophthalmitis. Observational case report. Review of clinical record, photographs. A 60 year old man developed endophthalmitis after methylene blue was accidentally used to stain the anterior capsule during phacoemulsification of cataract. His left visual acuity deteriorated from 6/12 to 6/36 two weeks after the operation. Despite intensive treatment with topical and intravitreal antibiotics, his condition deteriorated. A vitrectomy and silicone oil injection eventually managed to control the progression of the disease and salvage the eye. However the visual outcome remained poor due to corneal decompensation and retinal ischemia. Both vitreous tap and vitreous biopsy were negative for any organism. Methylene blue is extremely toxic to ocular structures and should not be used intraocularly.
    Matched MeSH terms: Medical Errors/adverse effects*
  13. Kennedy KM, Flaherty GT
    J Travel Med, 2016 May;23(5).
    PMID: 27432905 DOI: 10.1093/jtm/taw048
    Matched MeSH terms: Medical Errors/prevention & control*
  14. Hs AS, Rashid A
    BMC Med Ethics, 2017 01 23;18(1):3.
    PMID: 28114911 DOI: 10.1186/s12910-016-0161-x
    BACKGROUND: In this study, medical errors are defined as unintentional patient harm caused by a doctor's mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors.

    METHODS: This cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors. Data was collected using a standardized and validated self-administered questionnaire intending to measure disclosure and attitudes/perceptions. The scale had four vignettes in total two medical and two surgical. Each vignette consisted of five questions and each question measured the disclosure. Disclosure was categorised as "No Disclosure", "Partial Disclosure" or "Full Disclosure". Data was keyed in and analysed using STATA v 13.0.

    RESULTS: Only 10.1% (n = 28) intended to disclose medical errors. Most respondents felt that they possessed an attitude/perception of adequately disclosing errors to patients. There was a statistically significant difference (p 

    Matched MeSH terms: Medical Errors*
  15. Pau CP, Aini A
    Med J Malaysia, 2019 04;74(2):182-183.
    PMID: 31079133
    Central venous cannulation is a common procedure done for various medical indications. The use of the central venous cannula is associated with various immediate complications such as pneumothorax, vascular injury, and arrhythmia. The following is an unusual case of delayed presentation of a right vertebral artery injury due to central venous cannulation which resulted in a posterior circulation stroke. This is a condition that can be difficult to diagnose and has a significant impact on patient's quality of life. Clinicians and radiologists should be alert to this possibility to prevent further morbidity resulting from the iatrogenic injury.
    Matched MeSH terms: Medical Errors/adverse effects
  16. Choy YC
    Med J Malaysia, 2006 Dec;61(5):577-85.
    PMID: 17623959
    Critical incident monitoring in anaesthesia is an important tool for quality improvement and maintenance of high safety standards in anaesthetic services. It is now widely accepted as a useful quality improvement technique for reducing morbidity and mortality in anaesthesia and has become part of the many quality assurance programmes of many general hospitals under the Ministry of Health. Despite wide-spread reservations about its value, critical incident monitoring is a classical qualitative research technique which is particularly useful where problems are complex, contextual and influenced by the interaction of physical, psychological and social factors. Thus, it is well suited to be used in probing the complex factors behind human error and system failure. Human error has significant contributions to morbidities and mortalities in anaesthesia. Understanding the relationships between, errors, incidents and accidents is important for prevention and risk management to reduce harm to patients. Cardiac arrests in the operating theatre (OT) and prolonged stay in recovery, constituted the bulk of reported incidents. Cardiac arrests in OT resulted in significant mortality and involved mostly de-compensated patients and those with unstable cardiovascular functions, presenting for emergency operations. Prolonged-stay in the recovery extended period of observation for ill patients. Prolonged stay in recovery was justifiable in some cases, as these patients needed a longer period of post-operative observation until they were stable enough to return to the ward. The advantages of the relatively low cost, and the ability to provide a comprehensive body of detailed qualitative information, which can be used to develop strategies to prevent and manage existing problems and to plan further initiatives for patient safety makes critical incident monitoring a valuable tool in ensuring patient safety. The contribution of critical incident reporting to the issue of patient safety is far from clear and very difficult to study. Efforts to do so have tended to rely on incident reporting, the only practical approach when funding is limited. The heterogeneity of critically ill patients as a group means that huge study populations would be required if other research techniques were to be used. In the era of evidence-based medicine, anaesthetists are looking for alternative evidence-based solutions to problems that we have accepted traditionally when we cannot quantify for good practical reasons. In the quest for patient safety, investment should be made in reliable audit, detection and reporting systems. The growing recognition that human error usually result from a failure of a system rather than an individual should be fostered to allow more lessons to be learnt, an approach that has been successful in other, safety-critical industries. New technology has a great deal to offer and investment is warranted in novel fail-safe drug administration systems. Last but not the least the importance of simple and sensible changes and better education should be remembered.
    Matched MeSH terms: Medical Errors/prevention & control*
  17. Beng TS, Ghee WK, Hui NY, Yin OC, Kelvin KWS, Yiling ST, et al.
    Palliat Support Care, 2021 Mar 15.
    PMID: 33715663 DOI: 10.1017/S1478951521000262
    OBJECTIVE: Dying is mostly seen as a dreadful event, never a happy experience. Yet, as palliative care physicians, we have seen so many patients who remained happy despite facing death. Hence, we conducted this qualitative study to explore happiness in palliative care patients at the University of Malaya Medical Centre.

    METHOD: Twenty terminally ill patients were interviewed with semi-structured questions. The results were thematically analyzed.

    RESULTS: Eight themes were generated: the meaning of happiness, connections, mindset, pleasure, health, faith, wealth, and work. Our results showed that happiness is possible at the end of life. Happiness can coexist with pain and suffering. Social connections were the most important element of happiness at the end of life. Wealth and work were given the least emphasis. From the descriptions of our patients, we recognized a tendency for the degree of importance to shift from the hedonic happiness to eudaimonic happiness as patients experienced a terminal illness.

    SIGNIFICANCE OF RESULTS: To increase the happiness of palliative care patients, it is crucial to assess the meaning of happiness for each patient and the degree of importance for each happiness domain to allow targeted interventions.

    Matched MeSH terms: Medical Errors
  18. Shitu, Zayyanu, Isyaku Hassan, Aung, Myat Moe Thwe, Musa, Rabiu Muazu, Tuan Hairulnizam Tuan Kamaruzaman
    Movement Health & Exercise, 2018;7(1):115-128.
    MyJurnal
    One of the major problems causing medication errors is ineffective
    communication between patients and health personnel. This paper discusses
    the communication issues in the healthcare environment and how
    medication errors can be avoided through effective communication. An
    internet-based search was conducted to locate relevant articles published
    between 2004 and 2017. Only articles that touch upon communication and
    health-related issues were selected. Online sources such as PubMed,
    ScienceDirect, and Google Scholar were utilized. The importance of good
    communication practices for effective health and improved patient safety in
    hospital settings has been highlighted. It is evident from this review that
    poor communication most frequent causes adverse effects, delay in
    treatment, medication errors, and wrong-site surgery. The major
    communication issues in healthcare environment include language barriers,
    the medium of communication, physical setting, and social setting.
    Healthcare workers tend to use technical language in the workplace because
    they consider the tone of communication to be always professional. It has
    been established that knowledge on professional-patient communication is
    essential and valuable in improving therapeutic outcomes. Patients need
    knowledge and support in order to be able and motivated to undergo
    medicine therapy. Health practitioners need to take responsibility for
    demanding and creating an environment where high-quality healthcare
    counselling is routinely practiced. To promote safe and effective practice in hospitals and avoid medication errors, clinicians should adhere to teamwork
    and effective communication with the patients. There is a need for designing
    strategies such as effective communication and teamwork amongst
    healthcare professionals, which can consequently influence the quality of
    healthcare services and patient outcomes.
    Matched MeSH terms: Medical Errors
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