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Medical Cognitive Error

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1. Higher Fit-fOR-The-Aged (FORTA) Scores Comprising Medication Errors are Associated with Impaired Cognitive and Physical Function Tests in the VALFORTA Trial. (PubMed)

Higher Fit-fOR-The-Aged (FORTA) Scores Comprising Medication Errors are Associated with Impaired Cognitive and Physical Function Tests in the VALFORTA Trial. The Fit fOR The Aged (FORTA) list, a drug classification combining positive and negative labelling of drugs, has been clinically (VALFORTA-trial) validated to improve medication quality and clinical endpoints.The objective of this study was to determine the association of medication quality with functional abilities tested in cognitive (...) and physical function tests.Data from the prospective, randomized controlled VALFORTA trial on 409 geriatric (mean age 81.53 years) in-hospital patients were tested for associations between the FORTA score (sum of over- and under-treatment errors) on admission and cognitive and physical function tests. Univariate and multivariate linear correlations corrected for age, sex, number of medications, number of chronic conditions, and body mass index as well as comparisons between high and low FORTA-score (cut

2018 Drugs & Aging

2. Impact of Interruptions, Distractions, and Cognitive Load on Procedure Failures and Medication Administration Errors. (PubMed)

Impact of Interruptions, Distractions, and Cognitive Load on Procedure Failures and Medication Administration Errors. Medication administration errors are difficult to intercept since they occur at the end of the process. The study describes interruptions, distractions, and cognitive load experienced by registered nurses during medication administration and explores their impact on procedure failures and medication administration errors. The focus of this study was unique as it investigated how (...) known individual and environmental factors interacted and culminated in errors.

2017 Journal of Nursing Care Quality

3. Cognitive Errors in Reconciling Complex Medication Lists (PubMed)

Cognitive Errors in Reconciling Complex Medication Lists Discrepancies between multiple electronic versions of patient medication records contribute to adverse drug events. Regular reconciliation increases their accuracy but is often inadequately supported by EHRs. We evaluated two systems with conceptually different interface designs for their effectiveness in resolving discrepancies. Eleven clinicians reconciled a complex list of 16 medications using both EHRs in the same standardized (...) scenario. Errors such as omissions to add or discontinue a drug or to update a dose were analyzed. Clinicians made three times as many errors working with an EHR with lists arranged in a single column than when using a system with side-by-side lists. Excessive cognitive effort and reliance on memory was likely a strong contributing factor for lower accuracy of reconciliation. As errors increase with task difficulty, evaluations of reconciliation tools need to focus on complex prescribing scenarios

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2017 AMIA Annual Symposium Proceedings

4. Virtual patients designed for training against medical error: Exploring the impact of decision-making on learner motivation. (PubMed)

in the activities has the potential to drive additional generative cognitive processing and improved learning outcomes, but the increased cognitive load on learning risks negatively affecting learner motivation. The aim of this study is to better understand the impact that the inclusion of decision-making and inducing errors within the VP activities has on learner motivation.Using a repeated study design, over a period of six weeks we provided undergraduate medical students at six institutions in three (...) Virtual patients designed for training against medical error: Exploring the impact of decision-making on learner motivation. Medical error is a significant cause of patient harms in clinical practice, but education and training are recognised as having a key role in minimising their incidence. The use of virtual patient (VP) activities targeting training in medical error allows learners to practice patient management in a safe environment. The inclusion of branched decision-making elements

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2019 PLoS ONE

5. Medical Cognitive Error

Medical Cognitive Error Medical Cognitive Error Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Medical Cognitive Error Medical (...) Cognitive Error Aka: Medical Cognitive Error , Decision Making Strategy , Cognitive Mistakes in Medicine , Anchoring Bias , Confirmation Bias , Diagnosis Momentum , Availability Bias , Representative Restraint , Visceral Bias , Blois' Funnel , Diagnostic Inference , Value-Induced Bias , Loss Aversion , Non-linear Probability Weighting , Base Rate Fallacy , Base Rate Neglect , Base Rate Bias , Diagnostic Time-Out , Diagnosis Premature Closure , Cognitive Dispositions to Respond in Medicine , SPIT

2018 FP Notebook

6. Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains (PubMed)

Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo (...) a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates.We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates.Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception

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2016 BMJ quality & safety

7. Comparison of Standardized Plant Analysis Risk Human Reliability Analysis (SPAR-H) and Cognitive Reliability Error Analysis Methods (CREAM) in Quantifying Human Error in Nursing Practice (PubMed)

Comparison of Standardized Plant Analysis Risk Human Reliability Analysis (SPAR-H) and Cognitive Reliability Error Analysis Methods (CREAM) in Quantifying Human Error in Nursing Practice 27141509 2016 05 04 2018 11 13 2251-6085 45 3 2016 Mar Iranian journal of public health Iran. J. Public Health Comparison of Standardized Plant Analysis Risk Human Reliability Analysis (SPAR-H) and Cognitive Reliability Error Analysis Methods (CREAM) in Quantifying Human Error in Nursing Practice. 401-2 (...) Mohammadfam Iraj I Dept. of Occupational Hygiene, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran. Movafagh Maryam M Dept. of Occupational Hygiene, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran. Bashirian Saeid S Dept. of Health Education, Hamadan University of Medical Sciences, Hamadan, Iran. eng Journal Article Iran Iran J Public Health 7505531 2251-6085 2016 5

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2016 Iranian journal of public health

8. A mixed-methods exploration of cognitive dispositions to respond and clinical reasoning errors with multiple choice questions (PubMed)

A mixed-methods exploration of cognitive dispositions to respond and clinical reasoning errors with multiple choice questions Cognitive dispositions to respond (i.e., cognitive biases and heuristics) are well-established clinical reasoning phenomena. While thought by many to be error-prone, some scholars contest that these cognitive dispositions to respond are pragmatic solutions for reasoning through clinical complexity that are associated with errors largely due to hindsight bias and flawed (...) experimental design. The purpose of this study was to prospectively identify cognitive dispositions to respond occurring during clinical reasoning to determine whether they are actually associated with increased odds of an incorrect answer (i.e., error).Using the cognitive disposition to respond framework, this mixed-methods study applied a constant comparative qualitative thematic analysis to transcripts of think alouds performed during completion of clinical-vignette multiple-choice questions. The number

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2018 BMC medical education

9. Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load. (PubMed)

Impact of drug and equipment preparation on pre-hospital emergency Anaesthesia (PHEA) procedural time, error rate and cognitive load. We examined the effect of advanced preparation and organisation of equipment and drugs for Pre-hospital Emergency Anaesthesia (PHEA) and tracheal intubation on procedural time, error rates, and cognitive load.This study was a randomised, controlled experiment with a crossover design. Clinical teams (physician and paramedic) from the Emergency Medical Retrieval (...) Service and the Scottish Air Ambulance Division were randomised to perform a standardised pre-hospital clinical simulation using either unprepared (standard practice) or pre-prepared (experimental method) PHEA equipment and drugs. Following a two-week washout period, each team performed the corresponding simulation. The primary outcome was intervention time. Secondary outcomes were safety-related incidents and errors, and degree of cognitive load.In total 23 experiments were completed, 12 using

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2018 Scandinavian journal of trauma, resuscitation and emergency medicine

10. Impulsivity across reactive, proactive and cognitive domains in Parkinson's disease on dopaminergic medication: Evidence for multiple domain impairment. (PubMed)

, we aimed to investigate if reactive, proactive and cognitive impulsivity involving risk taking are concomitantly affected in medicated PD patients, and whether deficits were dependent on response strategies, such as speed accuracy tradeoffs, or the proportion of omission vs. commission errors. We assessed three different impulsivity domains in a sample of 21 PD patients and 13 matched controls. We found impaired impulsivity in both reactive (p = 0.042) and cognitive domains (p = 0.015) for the PD (...) Impulsivity across reactive, proactive and cognitive domains in Parkinson's disease on dopaminergic medication: Evidence for multiple domain impairment. Impulse control disorders (ICD) may occur in Parkinson's disease (PD) although it remains to be understood if such deficits may occur even in the absence of a formal ICD diagnosis. Moreover, studies addressing simultaneously distinct neurobehavioral domains, such as cognitive, proactive and reactive motor impulsivity, are still lacking. Here

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2019 PLoS ONE

11. Caregivers have the power to prevent medical error

challenge Chronic illnesses, such as cancer, pose a cognitive challenge to medical diagnostics and decision-making. These illnesses are and multi-faceted problems, requiring complex solutions. Ill-defined problems in medical settings are prone to . The longer the continuum of care, the higher the risk of errors. Incorrect diagnoses can lead to devastating results, especially in the ICU because it is so fast-paced with a lot of time pressure. Time pressure requires quick diagnostics or decision-making (...) Caregivers have the power to prevent medical error Caregivers have the power to prevent medical error Caregivers have the power to prevent medical error | | July 10, 2018 110 Shares What if it is your parent? Your spouse? Your child? Imagine supporting a loved one through a journey of serious illness. You go to all the appointments, know all the medications, almost feel the aches and pains as if they were our own. You repeat the same thing over and over again to one doctor after another making

2018 KevinMD blog

12. An acetaminophen icon helps reduce medication decision errors in an experimental setting. (PubMed)

taken. Outcome measures were errors in medication decisions and response time.The icon reduced the odds of participants making medication-decision errors by 53% (CI 31%-68%), with effects evident across medication categories. The icon eliminated a trend for those with lower health literacy or less education to have a greater likelihood of making errors. The icon also reduced response times, indicating reduced cognitive load for decisions.An icon can improve decision making regarding acetaminophen (...) An acetaminophen icon helps reduce medication decision errors in an experimental setting. To assess the effect of adding an acetaminophen ingredient icon to acetaminophen medication labels on consumer decision making about concomitant use of acetaminophen medications to avoid overdose, which is associated with liver injury.Parallel-group randomized study.Consumer research facilities in Indianapolis, Baltimore, and Los Angeles.A total of 517 adults (30% with limited health literacy) recruited

2017 Journal of the American Pharmacists Association : JAPhA

13. Reducing Medication Errors and Time to Drugs Delivery During Pediatric Cardiopulmonary Resuscitation: a Multicenter RCT

Reducing Medication Errors and Time to Drugs Delivery During Pediatric Cardiopulmonary Resuscitation: a Multicenter RCT Reducing Medication Errors and Time to Drugs Delivery During Pediatric Cardiopulmonary Resuscitation: a Multicenter RCT - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum (...) number of saved studies (100). Please remove one or more studies before adding more. Reducing Medication Errors and Time to Drugs Delivery During Pediatric Cardiopulmonary Resuscitation: a Multicenter RCT The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03021122 Recruitment Status : Completed First

2017 Clinical Trials

14. Reliability of mobility measures in older medical patients with cognitive impairment. (PubMed)

Reliability of mobility measures in older medical patients with cognitive impairment. Mobility is a key indicator of physical functioning in older people, but there is limited evidence of the reliability of mobility measures in older people with cognitive impairment. This study aimed to examine the test-retest reliability and measurement error of common measurement instruments of mobility and physical functioning in older patients with dementia, delirium or other cognitive impairment.A cross (...) and go test, Barthel Index mobility subscale and Functional Ambulation Categories. As appropriate, the intraclass correlation coefficient (ICC), Cohen's kappa, standard error of measurement, limits of agreement and minimal detectable change (MDC) values were estimated.Sixty-five older acute medical patients with cognitive impairment participated in the study (mean age: 82 ± 7 years; mean MMSE: 20 ± 4, range: 10 to 24 points). Some participants were physically or cognitively unable to perform the gait

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2019 BMC Geriatrics

15. Beneficial and adverse effects of antipsychotic medication on cognitive flexibility are related to COMT genotype in first episode psychosis. (PubMed)

Beneficial and adverse effects of antipsychotic medication on cognitive flexibility are related to COMT genotype in first episode psychosis. This study evaluated the ability to flexibly shift cognitive set and to consistently maintain a new response preference using the Penn Conditional Exclusion Test (PCET). The relationship of performance errors with catechol-O-methyltransferase (COMT) rs4680 (Val158Met) genotype (Met carriers vs. Val homozygotes) on test performance before and after (...) antipsychotic treatment in 32 first episode psychosis (FEP) patients was examined. After treatment, patients demonstrated a mixture of beneficial and adverse cognitive outcomes that varied in relation to COMT genotype. Met carriers showed decreased perseverative and regressive errors, reflecting improved cognitive flexibility and enhanced stability of behavioral preferences, respectively. In contrast, Val homozygotes exhibited an increase in regressive errors after treatment. These findings suggest that Val

2018 Schizophrenia Research

16. Cognitive bias in clinical practice – nurturing healthy skepticism among medical students (PubMed)

Cognitive bias in clinical practice – nurturing healthy skepticism among medical students Errors in clinical reasoning, known as cognitive biases, are implicated in a significant proportion of diagnostic errors. Despite this knowledge, little emphasis is currently placed on teaching cognitive psychology in the undergraduate medical curriculum. Understanding the origin of these biases and their impact on clinical decision making helps stimulate reflective practice. This article outlines some (...) of the common types of cognitive biases encountered in the clinical setting as well as cognitive debiasing strategies. Medical educators should nurture healthy skepticism among medical students by raising awareness of cognitive biases and equipping them with robust tools to circumvent such biases. This will enable tomorrow's doctors to improve the quality of care delivered, thus optimizing patient outcomes.

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2018 Advances in medical education and practice

17. Similar profiles of cognitive domain deficits between medication-naïve patients with bipolar II depression and those with major depressive disorder. (PubMed)

Similar profiles of cognitive domain deficits between medication-naïve patients with bipolar II depression and those with major depressive disorder. Bipolar disorder (BD) II is more likely to be misdiagnosed as major depressive disorder (MDD) than other types of BD, leading to incorrect treatment and poor outcomes. Previous studies have shown inconsistent results regarding the differences in cognitive deficits between the two disorders. To eliminate the compounding effects of medication (...) and aging, we sought to investigate changes in cognitive function in medication-naïve, non-late-life patients with BDII and MDD.Three subject groups were enrolled: 30 depressed BDII patients, 30 depressed MDD patients and 30 healthy controls. All subjects underwent a battery of cognitive tests to assess 8 cognitive domains. The cognitive domains were compared between the three subject groups. In BDII and MDD, the effect sizes were computed as evaluation parameters, weighing the degree of the cognitive

2018 Journal of Affective Disorders

18. Medical errors: Disclosure styles, interpersonal forgiveness, and outcomes. (PubMed)

Medical errors: Disclosure styles, interpersonal forgiveness, and outcomes. This study investigates the intrapersonal and interpersonal factors and processes that are associated with patient forgiveness of a provider in the aftermath of a harmful medical error.This study aims to examine what antecedents are most predictive of patient forgiveness and non-forgiveness, and the extent to which social-cognitive factors (i.e., fault attributions, empathy, rumination) influence the forgiveness process (...) . Furthermore, the study evaluates the role of different disclosure styles in two different forgiveness models, and measures their respective causal outcomes.In January 2011, 318 outpatients at Wake Forest Baptist Medical Center in the United States were randomly assigned to three hypothetical error disclosure vignettes that operationalized verbally effective disclosures with different nonverbal disclosure styles (i.e., high nonverbal involvement, low nonverbal involvement, written disclosure vignette

2016 Social Science & Medicine

19. Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study (PubMed)

Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study Cognitive impairment is highly prevalent among older adults (aged ≥65 years) hospitalized for heart failure and has been associated with poor outcomes. Poor medication self-management skills have been associated with poor outcomes in this population as well. The presence and extent of an association between cognitive impairment and poor medication self-management (...) skills in this population has not been clearly defined.We assessed the cognition of consecutive older adults hospitalized for heart failure, in relation to their medication self-management skills.We conducted a cross-sectional study of older adults (aged ≥65 years) who were hospitalized for heart failure and were being discharged home. Prior to discharge, we assessed cognition using the Mini-Cog. We also tested patients' ability to read a pill bottle label, open a pill bottle safety cap, and allocate

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2017 SAGE open medicine

20. Cognitive errors in medicine: The common errors

different biases will represent opposite ends of a cognitive spectrum, both ends of which can result in errors. This list represents the cognitive biases that are most often described in the context of medical errors, but there are that affect our daily lives. For example, I particularly like the IKEA effect: our tendency to disproportionately value objects we had a hand in putting together, regardless of end result. Affective error (aka outcome bias, value bias, the chagrin factor) This is the tendency (...) Cognitive errors in medicine: The common errors Cognitive errors in medicine: The common errors - First10EM Search Cognitive errors in medicine: The common errors by | Published - Updated | This is Part 2 of a 4 part series. This post will review the common cognitive errors described in medicine. You will notice that this list is not clean. Human cognition is a complex process. Many of the biases overlap. Some are more general descriptions that encompass other more specific examples. Often, two

2015 First10EM

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