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The field of occupational health and safety constantly changes, especially as it pertains to biomedical research. New infectious hazards are of particular importance at nonhuman-primate facilities. For example, the discovery that B virus can be transmitted via a splash on a mucous membrane raises new concerns that must be addressed, as does the discovery of the Reston strain of Ebola virus in import quarantine facilities in the U.S. The risk of such infectious hazards is best managed through a flexible and comprehensive Occupational Health and Safety Program (OHSP) that can identify and mitigate potential hazards. Occupational Health and Safety in the Care and Use of Nonhuman Primates is intended as a reference for vivarium managers, veterinarians, researchers, safety professionals, and others who are involved in developing or implementing an OHSP that deals with nonhuman primates. The book lists the important features of an OHSP and provides the tools necessary for informed decision-making in developing an optimal program that meets all particular institutional needs.
Research Laboratory Safety explains the most important prerequisite when working in a laboratory: Knowing the potential hazards of equipment and the chemical materials to be employed. Students learn how to assess and control risks in a research laboratory and to identify a possible danger. An approach on the hazard classes such as physical, chemical, biological and radiation hazards is given and exercises to each class prepare for exams.
Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.
Americans should be able to count on receiving health care that is safe. To achieve this, a new health care delivery system is needed â€" a system that both prevents errors from occurring, and learns from them when they do occur. The development of such a system requires a commitment by all stakeholders to a culture of safety and to the development of improved information systems for the delivery of health care. This national health information infrastructure is needed to provide immediate access to complete patient information and decision-support tools for clinicians and their patients. In addition, this infrastructure must capture patient safety information as a by-product of care and use this information to design even safer delivery systems. Health data standards are both a critical and time-sensitive building block of the national health information infrastructure. Building on the Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Patient Safety puts forward a road map for the development and adoption of key health care data standards to support both information exchange and the reporting and analysis of patient safety data.
Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.
This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
This book provides, as simply as possible, sound foundations for an in-depth understanding of reliability engineering with regard to qualitative analysis, modelling, and probabilistic calculations of safety and production systems. Drawing on the authors’ extensive experience within the field of reliability engineering, it addresses and discusses a variety of topics, including: • Background and overview of safety and dependability studies; • Explanation and critical analysis of definitions related to core concepts; • Risk identification through qualitative approaches (preliminary hazard analysis, HAZOP, FMECA, etc.); • Modelling of industrial systems through static (fault tree, reliability block diagram), sequential (cause-consequence diagrams, event trees, LOPA, bowtie), and dynamic (Markov graphs, Petri nets) approaches; • Probabilistic calculations through state-of-the-art analytical or Monte Carlo simulation techniques; • Analysis, modelling, and calculations of common cause failure and uncertainties; • Linkages and combinations between the various modelling and calculation approaches; • Reliability data collection and standardization. The book features illustrations, explanations, examples, and exercises to help readers gain a detailed understanding of the topic and implement it into their own work. Further, it analyses the production availability of production systems and the functional safety of safety systems (SIL calculations), showcasing specific applications of the general theory discussed. Given its scope, this book is a valuable resource for engineers, software designers, standard developers, professors, and students.
AN AUTHORITATIVE GUIDE THAT EXPLAINS THE EFFECTIVENESS AND IMPLEMENTATION OF BOW TIE ANALYSIS, A QUALITATIVE RISK ASSESSMENT AND BARRIER MANAGEMENT METHODOLOGY From a collaborative effort of the Center for Chemical Process Safety (CCPS) and the Energy Institute (EI) comes an invaluable book that puts the focus on a specific qualitative risk management methodology – bow tie barrier analysis. The book contains practical advice for conducting an effective bow tie analysis and offers guidance for creating bow tie diagrams for process safety and risk management. Bow Ties in Risk Management clearly shows how bow tie analysis and diagrams fit into an overall process safety and risk management framework. Implementing the methods outlined in this book will improve the quality of bow tie analysis and bow tie diagrams across an organization and the industry. This important guide: Explains the proven concept of bow tie barrier analysis for the preventing and mitigation of incident pathways, especially related to major accidents Shows how to avoid common pitfalls and is filled with real-world examples Explains the practical application of the bow tie method throughout an organization Reveals how to treat human and organizational factors in a sound and practical manner Includes additional material available online Although this book is written primarily for anyone involved with or responsible for managing process safety risks, this book is applicable to anyone using bow tie risk management practices in other safety and environmental or Enterprise Risk Management applications. It is designed for a wide audience, from beginners with little to no background in barrier management, to experienced professionals who may already be familiar with bow ties, their elements, the methodology, and their relation to risk management. The missions of both the CCPS and EI include developing and disseminating knowledge, skills, and good practices to protect people, property and the environment by bringing the best knowledge and practices to industry, academia, governments and the public around the world through collective wisdom, tools, training and expertise. The CCPS has been at the forefront of documenting and sharing important process safety risk assessment methodologies for more than 30 years. The EI's Technical Work Program addresses the depth and breadth of the energy sector, from fuels and fuels distribution to health and safety, sustainability and the environment. The EI program provides cost-effective, value-adding knowledge on key current and future international issues affecting those in the energy sector.
Thermal Design of Nuclear Reactors