Patients injury data

Operational risk Psychosocial risk Data theft/loss patient injury Productivity loss increased health benefits Loss of customers/ trading partners Data theft ... 

Indicators can also be classified as sentinel-event indicators and aggregate data indicators. A performance measurement of an individual event that triggers further analysis is called a sentinel-event indicator. These are often undesirable events that do not occur often. These are often related to safety issues and do not lend themselves easily to quality-improvement opportunities. An example may include equipment failures that result in a patient injury. 

The best conclusion that can be drawn from these data is perhaps that treatment with naltrexone may offer promise for some, but certainly not all, patients with self-injury. Treatment effects may depend on background opioid levels, dosage, and treatment regimen. Noninvasive measures that predict individual treatment response have not been established. Self-injury is a heterogeneous phenomenon from a clinical and biological perspective (Buitelaar, 1993 Willemsen-Swinkels et ah, 1998). Further studies are required in this area, and and should include carefully clinically documented cases, large samples, and controlled designs. At this time, the use of naltrexone for the treatment of self-injury is to be considered experimental. 

Hughes reviewed mainly British and European reports and cited official British data estimating that 75-90% of mustard gas casualties had some degree of ocular Injury. A rough estimate, based on information reported by Case and Lea,13 indicates a little over 100,000 cases of eye Injury. Hughes stated that about 10% of these injuries resulted In corneal erosion, which he considered predictive of visual degeneration. Corneal transplants or contact lenses could be expected to help many patients. 

The clinical implications of such data point to a relationship between abnormalities in the central serotonin system and self-injurious behavior. These findings have led to an interest in developing specific drugs that alter 5-HT activity to treat suicidality, impulsivity, and aggressivity independent of any specific psychiatric disorder. Central serotonin function can be enhanced by agents such as lithium and various serotonin reuptake inhibitors. Recent studies have found that the use of such agents is associated with reductions in the likelihood of suicide attempts and completions in both patients with major depression and those with cluster... 

ECT should be considered for more severe forms of depression (e.g., those associated with melancholic and psychotic features, particularly when the patient exhibits an increased risk for self-injurious behavior) or when there is a past, well-documented history of nonresponse or intolerance to pharmacological intervention. Limited data indicate that bipolar depressed patients may be at risk for a switch to mania when given a standard TCA. A mood stabilizer alone (i.e., lithium, valproate, carbamazepine, lamotrigine), or in combination with an antidepressant, may be the strategy of choice in these patients. Some elderly patients and those with acquired immunodeficiency syndrome may also benefit from low doses of a psychostimulant only (e.g., methylphenidate) (see also Chapter 14, The HIV-Infected Patient ). Fig. 7-1 summarizes the strategy for a patient whose depressive episode is insufficiently responsive to standard therapies. 

To make his case, Kessler cited the example of a drug called Dilevalol, which he said was approved in Japan, Portugal, and England on the basis of data summaries. Americans, he said, were spared morbidity and mortality because the FDA medical reviewer noted in the raw data evidence that some patients had severe liver injury. Another untruth. The record shows it was... 

---