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Patient Safety: Efforts to reduce risk, to address and reduce incidents and accidents that may negatively impact healthcare consumers.

Safety Checks and Five Rights of Medication Administration

JoVE 10235

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT

According to the 1999 Institution of Medicine (IOM) report titled To Err is Human: Building a Safer Health System, medication errors are significant contributors to avoidable patient deaths in the hospital environment. Therefore, to maintain patient safety and to avoid medication errors, it is important that every nurse adheres to at least five "rights" of safe medication administration. These five "rights" refer to the right patient, right medication, right medication dose, right time of administration, and right route of administration. The nurse should check for these five "rights" at three different checkpoints points in the mediation administration process: 1) while comparing the Medication Administration Record (MAR) when withdrawing medications, 2) while comparing the MAR to acquired medications, and 3) while comparing the MAR to both the medication and patient identifiers at the bedside. This video will demonstrate the acquisition component of medication administration, which consists of performing the five "rights" during the first, second, and third checkpoints. Prior to acquiring medications from a medication dispensing system (M


 Nursing Skills

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

1Center for Advanced Design, Research, and Exploration, University of Illinois at Chicago, 2Attune Medical, 3University of Maryland School of Nursing, 4University of Western Ontario, 5University Medical Centre Maribor, 6University of Maryland, 7Department of Emergency Medicine, University of Texas, Southwestern Medical Center

JoVE 56579


 Medicine

Performing Behavioral Tasks in Subjects with Intracranial Electrodes

1Department of Neurosciences, Cleveland Clinic Foundation, 2Epilepsy Center, Cleveland Clinic Foundation, 3Department of Neurosciences and Center for Neurological Restoration, Cleveland Clinic Foundation, 4Department of Biomedical Engineering, Johns Hopkins University

JoVE 51947


 Behavior

Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators

1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, 2Department of Obstetrics and Gynaecology, National University Health Systems, 3Experimental Fetal Medicine Group, Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore

Video Coming Soon

JoVE 57328


 JoVE In-Press

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

1Department of Radiation Oncology, Taipei Medical University Hospital, 2Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, 3Taipei Medical University, 4Graduate Institute of Biomedical Materials & Tissue Engineering, College of Biomedical Engineering, Taipei Medical University

Video Coming Soon

JoVE 57050


 JoVE In-Press

General Approach to the Physical Exam

JoVE 10043

Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

The examination of the body is fundamental to the practice of medicine. Since the Roman Empire, physicians have described the connection between alterations in function of specific parts of the body and specific disease states and have sought to further scientific understanding to improve bedside diagnosis. However, in this modern age of increasing technology within medical diagnostics, it is important to consider the role that physical examination plays today. It is misguided to believe that physical examination holds all the answers, and much has been written about the questionable utility of certain maneuvers previously held in high regard. It is equally misguided to suggest that physical examination plays little role in the modern patient encounter. Physical examination remains a valuable diagnostic tool; there are many diagnoses that can only be made by physical examination. A diagnosis made by labs or imaging is rarely done in the absence of findings detectable at the bedside. As the provider conducts a history and physical, they are actively generating and testing hypotheses to explain the patient's condition. The information one gathers may not replace the need


 Physical Examinations I

Adapted Resistance Training Improves Strength in Eight Weeks in Individuals with Multiple Sclerosis

1Motion Analysis Laboratory, Kennedy Krieger Institute, 2Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, 3Johns Hopkins University School of Medicine, 4Department of Neurology, Johns Hopkins University School of Medicine

JoVE 53449


 Medicine

Palpation

JoVE 10143

Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

The physical examination requires the use of all of the provider's senses to gain information about the patient. The sense of touch is utilized to obtain diagnostic information through palpation.

The specific parts of the examiner's hand used for palpation differ based on the body part being examined. Because of their dense sensory innervation, the finger pads are useful for fine discrimination (e.g., defining the borders of masses, lymph nodes) (Figure 1). The dorsal surface of the hand provides a rough sense of relative temperature (Figure 2). The palmar surfaces of the fingers and hands are most useful for surveying large areas of the body (e.g., abdomen) (Figure 3). Vibration is best appreciated with the ulnar surface of the hands and 5th fingers (e.g., tactile fremitus) (Figure 4). While palpation is fundamental to the diagnostic aspect of the physical exam, it is also important to acknowledge the role that touch plays in communicating caring and comfort during the patient encounter. Patients generally perceive to


 Physical Examinations I

Bioelectric Analyses of an Osseointegrated Intelligent Implant Design System for Amputees

1Department of Veteran Affairs, 2Department of Bioengineering, University of Utah, 3Scientific Computing and Imaging Institute , University of Utah, 4Department of Physical Medicine and Rehabilitation, University of Utah, 5Department of Orthopaedics, University of Utah

JoVE 1237


 Biology

Absorption of Nasal and Bronchial Fluids: Precision Sampling of the Human Respiratory Mucosa and Laboratory Processing of Samples

1National Heart and Lung Institute, Faculty of Medicine, Imperial College London, St Mary's Hospital, 2St Mary's Hospital, Imperial College Healthcare Trust

JoVE 56413


 Medicine

Techniques for Processing Eyes Implanted With a Retinal Prosthesis for Localized Histopathological Analysis

1Bionics Institute, 2Department of Anatomical Pathology, St Vincent's Hospital Melbourne, 3Department of Pathology, University of Melbourne, 4Medical Bionics Department, University of Melbourne

JoVE 50411


 Medicine

Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging

1Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, 2Department of Pathology, Icahn School of Medicine at Mount Sinai, 3Department of Bioengineering, Rice University

JoVE 50992


 Bioengineering

Techniques for Processing Eyes Implanted with a Retinal Prosthesis for Localized Histopathological Analysis: Part 2 Epiretinal Implants with Retinal Tacks

1Bionics Institute, 2Department of Pathology, The University of Melbourne, 3Cochlear Limited, 4Department of Anatomical Pathology, St Vincent's Hospital Melbourne, 5Medical Bionics Department, The University of Melbourne

JoVE 52348


 Medicine

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