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    Recognition and Disclosure of Medical Errors Among Residents in Surgical Specialties in a Tertiary Hospital in Ibadan
    (Springer Nature, 2019) Balogun J. A.; Adekanmbi A.; Balogun F. M.
    Background Medical error (ME) remains central to discussions regarding patient’s safety and its frequency appears high in surgical specialties because of some peculiarities. We set out to study the perception of surgical residents about medical errors, their ability to recognize them and predisposition to disclosing their errors. Methods This was a cross-sectional study among surgical residents at the University College Hospital, Nigeria. Data about their knowledge, perception and recognition of medical errors were obtained. Knowledge and practice of medical error disclosure was also examined. Each of these was scored on Likert scale and scores categorized. Chisquare test and logistic regression were used for analysis with p at\0.05. Results 92 residents participated and 11(12.0%) were females. 32.6% of the respondents had less knowledge about medical errors and these were significantly junior residents. Residents with poor perception about ME were 43.5% and recent involvement with ME was significantly associated with good perception about ME. Delay in obtaining consultation and delay in diagnosis were identified respectively as MEs by only 40(43.5%) and 31(33.7) of the Participants. While 82(89.1%) agreed that all errors should be reported to the consultant, only 20(21.7%) believed patients/relatives should be informed of all errors, while 49(53.3%) were well disposed to disclosing ME. Only 4(4.3%) residents had a formal training on ME. Conclusions Knowledge of ME was low among junior residents and residents are less likely to disclose error to patients/relatives. A formal training on ME will impact on their recognition, practice, and disclosure of ME.
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    Access to the Intensive Care Unit by Severe Head Injury Patients
    (Scientific Scholar, 2019) Balogun J. A.; Akwada O.; Awana E.; Balogun F. M.
    Background The management of severe traumatic brain injury is directed at avoidance of secondary brain injuries. The intensive care unit (ICU) provides the ideal environment to achieving improved survival and functional outcome. The study sets out to identify the factors that determine the access of patients with severe head injury presenting at our hospital, to the ICU and their impact on outcome. Materials and Methods This was a longitudinal study at the University College Hospital, Ibadan. Data of all consecutive severe head injury patients over a 9-month period, presenting to the accident and emergency department, was collected and analyzed using descriptive statistics and chi-squared test. The level of significance was p < 0.05. Result There were 36 males (80.0%) in our study, with road crashes (25; 79.5%) as the most common mechanism of injury. Most patients (33; 73.3%) were transferred to our center after initial care in another hospital. Though 31(68.9%) patients had access to the ICU, they were all delayed, with the most common reason for the delay being lack of ICU space. More patients who got admitted into ICU (14; 45.2%) were alive at 28 days into admission (p = 0.04). The females (6; 13.3%) significantly survived till 28 days on admission compared with males (p = 0.03), but there was no difference in the survival rates between children and adults. Conclusion Our study underscores the need for ICU admission in these patients to optimize outcome and identify the non-availability of beds, as the most important cause of delayed access, as well as the need for increased manpower capacity and organized resource utilization.