Mandatory patient safety training, from the board room to linen room

Here is a list of counter-intuitive statements about patient safety, a list of required reading on the subject, and an excerpt of a tool that can help you analyze your organizations patient safety strengths and weaknesses.     

From antiseptics to antibiotics – and back?

There is no straight line to trace the trajectory of antiseptics; rather, this has been manifested more as a fluctuating line, a backwards and forwards movement, seen in the wake of major discoveries but of colossal mistakes too. While today no one would allow their prophylactic policies to be guided by miasma or contagia, there continues to be some uncertainly about how to manage anti-infectives effectively even today.When in 1941 the first human being was successfully treated with penicillin, interest in antiseptics gradually waned. From that time onwards, everything was treated with antibiotics, unleashing a race for the discovery of novel antibiotics, as witnessed decades earlier in the case of antiseptics. The significance of antiseptics declined to such an extent that among physicians they were associated merely with cleaning agents or sanitary disinfection. Today, at the beginning of the 21^st century we know that the euphoria generated by antibiotics was just another station along the pathway of discoveries. Bacterial infections and new, hitherto unknown infectious diseases continue to play a major role. Several viral infections continue to be refractory to successful treatment and bacterial antibiotic resistance has become a problem worldwide. The most effective countermeasures no longer entail only the development of new antibiotics but above all responsible management of antibiotics and strict observance of infection control measures in the hospital setting. Set against that background, interest in antiseptics has been rekindled. In that spirit we can look eagerly forward over the coming years to further developments in antisepsis.     

装饰板加工工人腰背痛病因初探

目的探讨装饰板加工工人腰背痛发病情况与工人劳动操作中不良生产条件的关系。方法采用作业场所工效学分析和问卷调查方法对某装饰板加工企业进行了不良工效学因素和工人腰背痛症状的调查。结果装饰板加工工人存在的不良工效学因素主要有操作台面较低、工作姿势和动作不良、劳动时间过长等。选板、贴面和修补工种工人腰背痛主诉分别为72．2％、56．8％和100．0％，且与工人操作台面高低和弯腰持续的时间长短、弯腰的频率和幅度大小有关。结论操作台面过低，工人弯腰时间较长与腰背痛高发有一定关系。     

From the operating room to the office: paradigm shift in the economics of surgical practice

In the past decade, there has been a trend from doing procedures in the hospital operating room and the ambulatory treatment center to performing procedures in the doctor's office. This trend is becoming more prevalent as doctors have recognized that they have more control over their practices by working in the office rather than at a hospital or ambulatory treatment center. This article will focus on the trend and provide financial examples of this movement and why doctors need to be cognizant of their increased productivity in the office.     

Back to the drawing board

An integrated delivery system in Mississippi prepares for managed care with a massive information systems overhaul that scraps old systems in favor of new.     

Inequality and ethics in paediatric HIV remission research: From Mississippi to South Africa and back

In 2013, physician-researchers announced that a baby in Mississippi had been ‘functionally cured’ of HIV [Persaud, D., Gay, H., Ziemniak, C. F., Chen, Y. H., Piatak, M., Chun, T.-W.,?…?Luzuriaga, K. (2013b, March). Functional HIV cure after very early ART of an infected infant. Paper presented at the 20th conference on retroviruses and opportunistic infections, Atlanta, GA]. Though the child later developed a detectable viral load, the case remains unprecedented, and trials to build on the findings are planned [National Institute of Allergy and Infectious Diseases. (2014). ‘Mississippi baby’ now has detectable HIV, researchers find. Retrieved from http://www.niaid.nih.gov/news/newsreleases/2014/pages/mississippibabyhiv.aspx]. Whether addressing HIV ‘cure’ or ‘remission’, scrutiny of this case has focused largely on scientific questions, with only introductory attention to ethics. The social inequalities and gaps in care that made the discovery possible – and their ethical implications for paediatric HIV remission – have gone largely unexamined. This paper describes structural inequalities surrounding the ‘Mississippi baby’ case and a parallel case in South Africa, where proof-of-concept studies are in the early stages. We argue that an ethical programme of research into infant HIV remission ought to be ‘structurally competent’, and recommend that paediatric remission studies consider including a research component focused on social protection and barriers to care.