Physical Medicine and Rehabilitation Clinics of North America RSS feed: Current Issue. Physical Medicine and Rehabilitation Clinics of North America updates you on the latest trends in patient management; keeps you up to date on the newest advances; and provides a sound basis for choosing treatment options. Each issue focuses on a single topic in physical and rehabilitation medicine and is presented under the direction of an experienced guest editor. http://www.pmr.theclinics.com/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Physical Medicine and Rehabilitation Clinics of North America1047-9651232May 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.pmr.theclinics.com/article/PIIS1047965112000319/abstract?rss=yesContributors10.1016/S1047-9651(12)00031-9Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-05-01Physical Medicine and Rehabilitation Clinics of North America2012-05-01232S1047-9651(11)X0007-4iiiviihttp://www.pmr.theclinics.com/article/PIIS1047965112000320/abstract?rss=yesContents10.1016/S1047-9651(12)00032-0Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-05-01Physical Medicine and Rehabilitation Clinics of North America2012-05-01232S1047-9651(11)X0007-4ixxiiihttp://www.pmr.theclinics.com/article/PIIS1047965112000332/abstract?rss=yesForthcoming Issues10.1016/S1047-9651(12)00033-2Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-05-01Physical Medicine and Rehabilitation Clinics of North America2012-05-01232S1047-9651(11)X0007-4xivxivhttp://www.pmr.theclinics.com/article/PIIS1047965112000241/abstract?rss=yes“First Do No Harm.” These words were immortalized by Hippocrates and are part of the Hippocratic Oath taken by newly minted physicians graduating from medical school. Its profound meaning is that no harm should come to an individual receiving medical care. Regrettably, 98,000 people die each year in US hospitals due to injuries. The total cost of preventable adverse events has been estimated to range between $17 billion and $29 billion.PrefaceAdrian Cristian10.1016/j.pmr.2012.02.016Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-03-19Physical Medicine and Rehabilitation Clinics of North America2012-03-19232S1047-9651(11)X0007-4xvxvihttp://www.pmr.theclinics.com/article/PIIS1047965112000095/abstract?rss=yesPatient safety in medical settings has become a major concern. As more and more individuals seek rehabilitative care for their medical conditions or are referred to rehabilitation specialists with increasingly complex medical conditions, the issue of patient safety in the rehabilitation setting takes on added importance. This article introduces the concepts of patient safety, cognitive biases, systems thinking, and quality improvement as they apply to the rehabilitation medicine.Patient Safety and Quality Improvement in Rehabilitation MedicineAdrian Cristian, Jonah Green10.1016/j.pmr.2012.02.001Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-03-19Physical Medicine and Rehabilitation Clinics of North America2012-03-19232S1047-9651(11)X0007-4221230http://www.pmr.theclinics.com/article/PIIS1047965112000101/abstract?rss=yesThe rehabilitation medicine prescription is a communication tool between the referring physician and the rehabilitation team in both the inpatient and outpatient settings. This instrument is critical in both directing a course of treatment as well as minimizing risk to the patient during the treatment sessions. The goal of this article is to provide an overview of the rehabilitation prescription with an emphasis on safety.Safety Precautions in the Rehabilitation Medicine PrescriptionDeborah Brathwaite, Frederick Aziz, Chauncy Eakins, Andrea Jno Charles, Adrian Cristian10.1016/j.pmr.2012.02.002Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-03-26Physical Medicine and Rehabilitation Clinics of North America2012-03-26232S1047-9651(11)X0007-4231239http://www.pmr.theclinics.com/article/PIIS1047965112000113/abstract?rss=yesThe Joint Commission Center for Transforming Healthcare has cited communication as the most frequent root cause in sentinel events, with failed patient handoffs playing a “role in an estimated 80% of serious preventable adverse events.” Handoff, or transfer of patient care information, occurs formally and informally many times each day, within and between care teams, across all levels of care providers and between institutions. Handoff at rehabilitation admission is at a particularly high risk for communication failure, potentially affecting patient safety. This review of the patient handoff literature discusses the importance of safe handoff, the information to be included, barriers to handoff, and improvement methodologies.Patient Safety at Handoff in Rehabilitation MedicineJason W. Siefferman, Emerald Lin, Jeffrey S. Fine10.1016/j.pmr.2012.02.003Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-03-19Physical Medicine and Rehabilitation Clinics of North America2012-03-19232S1047-9651(11)X0007-4241257http://www.pmr.theclinics.com/article/PIIS1047965112000125/abstract?rss=yesPatient safety, including keeping patients safe from harm or unintentional injury, is key to shortening the length of hospital stays, encouraging positive patient outcomes, and contributing to the hospital's financial state. Freedom from pressure ulcers, falls, and medication errors is an important component of patient safety. The parallel concept of nurse safety cannot be ignored. Keeping nurses safe from injury helps decrease their feelings of stress and minimizes sick time. Maintaining a safe environment for patients and staff is a win–win situation for all involved.Safety in the Rehabilitation Setting: A Nursing PerspectiveAudrey J. Schmerzler, Lisa Martin, Beth Oliver, Lou Ann London10.1016/j.pmr.2012.02.004Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-03-29Physical Medicine and Rehabilitation Clinics of North America2012-03-29232S1047-9651(11)X0007-4259270http://www.pmr.theclinics.com/article/PIIS1047965112000137/abstract?rss=yesRehabilitation medicine is practiced in a variety of settings. Physiatrists are an integral part of the care provided in many of these settings and are often consulted to provide diagnostic and therapeutic services and expertise to individuals with a variety of diagnoses. In this role, it is imperative that physiatrists have a working knowledge of various medications as well as the principles of medication safety. This article provides a foundation in the general and specific aspects of medication safety as they apply to the practice of rehabilitation medicine.Medication Safety in Rehabilitation MedicineLaurentiu Iulius Dinescu, Darko Todorov, Michael Biglow, Yuliana Toderika, Henry Cohen, Karishma Patel10.1016/j.pmr.2012.02.005Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-05-01Physical Medicine and Rehabilitation Clinics of North America2012-05-01232S1047-9651(11)X0007-4271303http://www.pmr.theclinics.com/article/PIIS1047965112000149/abstract?rss=yesOlder adults are rehabilitated for a variety of conditions in an inpatient rehabilitation facility (IRF), and they are often at an increased risk for falling during their stay. This article (1) provides an overview of the incidence, prevalence, and impact of falls in facilities that provide inpatient rehabilitation; (2) provides some key factors to be considered in the assessment of the patient admitted to the IRF for risk factors associated with falling; and (3) identifies strategies that can help reduce the risk of falling in patients admitted to an IRF.Falls in the Inpatient Rehabilitation FacilityMarc K. Ross, Ethan Egan, Mohammed Zaman, Besem Aziz, Tad Dewald, Salem Mohammed10.1016/j.pmr.2012.02.006Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-04-09Physical Medicine and Rehabilitation Clinics of North America2012-04-09232S1047-9651(11)X0007-4305314http://www.pmr.theclinics.com/article/PIIS1047965112000150/abstract?rss=yesDeficits in cognitive functioning are associated with many safety concerns, including difficulties performing activities of daily living, medication errors, motor vehicle accidents, impaired awareness of deficits, decision-making capacity, falls, and travel away from home. Preventing adverse safety outcomes is particularly relevant in rehabilitation patients. Integration of information and recommendations stemming from allied disciplines, such as rehabilitation medicine, physical therapy, occupational therapy, speech therapy, and neuropsychology, is the most effective way to limit poor outcomes. Education and prevention counseling by health care professionals is an important approach in limiting adverse safety outcomes in patients with cognitive impairment.Patient Safety Considerations in the Rehabilitation of the Individual with Cognitive ImpairmentBrad T. Tyson, Martha T. Pham, Natashia T. Brown, Thomas R. Mayer10.1016/j.pmr.2012.02.007Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-03-19Physical Medicine and Rehabilitation Clinics of North America2012-03-19232S1047-9651(11)X0007-4315334http://www.pmr.theclinics.com/article/PIIS1047965112000162/abstract?rss=yesThe interdisciplinary health care team is responsible for providing medical care based on a patient-centered model while maintaining professional and ethical standards. However, an emerging body of research suggests that ineffective and inappropriate care, or fatal errors, arise from the lack of productive communication between patients, families, and medical caregivers. This has prompted the evolution of a new health care discipline, patient safety, which became increasingly prominent in the 1990s. The purpose of this article is to bridge the gap between the discipline of patient safety and its relationship to the diagnosis of dysphagia.Safety Concerns and Multidisciplinary Management of the Dysphagic PatientClaudia Giammarino, Elizabeth Adams, Christina Moriarty, Adrian Cristian10.1016/j.pmr.2012.02.008Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-03-30Physical Medicine and Rehabilitation Clinics of North America2012-03-30232S1047-9651(11)X0007-4335342http://www.pmr.theclinics.com/article/PIIS1047965112000253/abstract?rss=yesCommunication barriers can pose a significant safety risk for patients. Individuals in a communication-vulnerable state are commonly seen in rehabilitation settings. These patients cannot adequately communicate their symptoms, wants, and needs to providers. Causes of communication barriers include neurologic impairments, such as stroke, cerebral palsy, and Parkinson disease, and language barriers. The ability of clinicians to adequately diagnose, treat, and monitor these patients is also hindered. This article identifies key communication barriers and strategies that clinicians can use to effectively communicate with these patients.Safety Considerations for Patients with Communication Disorders in Rehabilitation Medicine SettingsAdrian Cristian, Claudia Giammarino, Michael Olds, Elizabeth Adams, Christina Moriarty, Sabina Ratner, Shruti Mural, Eric C. Stobart10.1016/j.pmr.2012.02.017Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-04-12Physical Medicine and Rehabilitation Clinics of North America2012-04-12232S1047-9651(11)X0007-4343347http://www.pmr.theclinics.com/article/PIIS1047965112000174/abstract?rss=yesThis article describes patient safety after traumatic brain injury (TBI). Patient safety in rehabilitation after TBI is important. Thorough assessment on initial evaluation, vigilance for medical and procedural errors, appropriate communication between medical professionals, and evaluation of systems-based practices increases patient safety. It is the responsibility of the rehabilitation treatment team to ensure that appropriate measures are taken to reduce risk of adverse events. This article is intended to promote discussion of patient safety after TBI within rehabilitation teams and to help improve outcomes throughout the spectrum of recovery.Patient Safety in Rehabilitation Medicine: Traumatic Brain InjuryAjit B. Pai, Yevgeny Zadov, Allison Hickman10.1016/j.pmr.2012.02.009Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-04-12Physical Medicine and Rehabilitation Clinics of North America2012-04-12232S1047-9651(11)X0007-4349370http://www.pmr.theclinics.com/article/PIIS1047965112000186/abstract?rss=yesThere are approximately 12,000 new cases of traumatic spinal cord injury (SCI) annually. In 2010, there were approximately 265,000 individuals living with SCI. Over time, the average age of people with SCI has steadily risen, and it is now 40.7 years. There are multiple medical complications that are commonly seen in individuals with SCI. These include, but are not exclusively limited to, pneumonia, decubiti ulcers, undiagnosed fractures, urinary tract infections, autonomic dysreflexia, deep venous thrombosis, and pulmonary embolism. This article addresses the issue of patient safety in the care of adults living with an SCI.Patient Safety in the Rehabilitation of the Adult with a Spinal Cord InjuryMatthew Shatzer10.1016/j.pmr.2012.02.010Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-04-09Physical Medicine and Rehabilitation Clinics of North America2012-04-09232S1047-9651(11)X0007-4371375http://www.pmr.theclinics.com/article/PIIS1047965112000198/abstract?rss=yesThis article reviews and summarizes the literature on patient safety issues in the rehabilitation of adults with an amputation. Safety issues in the following areas are discussed; the prosthesis, falls, wound care, pain, and treatment of complex patients. Specific recommendations for further research and implementation strategies to prevent injury and improve safety are also provided. Communication between interdisciplinary team members and patient and caregiver education are crucial to executing a safe treatment plan. The multidisciplinary rehabilitation team members should feel comfortable discussing safety issues with patients and be able to recommend preventive approaches to patients as appropriate.Patient Safety in the Rehabilitation of the Adult with an AmputationGail Latlief, Christine Elnitsky, Stephanie Hart-Hughes, Samuel L. Phillips, Laurel Adams-Koss, Robert Kent, M. Jason Highsmith10.1016/j.pmr.2012.02.011Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-05-01Physical Medicine and Rehabilitation Clinics of North America2012-05-01232S1047-9651(11)X0007-4377392http://www.pmr.theclinics.com/article/PIIS1047965112000204/abstract?rss=yesWith the advent of newer and better therapies available, patient safety is emerging as a new topic. Pediatric patient safety is relatively new, in that there are few guidelines available. Safety in children with traumatic brain injury (TBI) given the incidence of TBI is very vital. This is an attempt to identify the key points in TBI.Patient Safety in the Rehabilitation of Children with Traumatic Brain Injury and Cerebral PalsyRajashree Srinivasan10.1016/j.pmr.2012.02.012Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-03-30Physical Medicine and Rehabilitation Clinics of North America2012-03-30232S1047-9651(11)X0007-4393400http://www.pmr.theclinics.com/article/PIIS1047965112000265/abstract?rss=yesPediatric patient safety continues to challenge both pediatricians and pediatric physiatrists. While there is a trend toward developing general patient safety initiatives, there is little research on pediatric patient safety. This article identifies major areas of general safety risk, with a focus on timely diagnosis and care coordination to prevent secondary complications that compromise health, function, and quality of life in pediatric neuromuscular disease, spinal cord disorders, and amputation.Patient Safety in the Rehabilitation of Children with Spinal Cord Injuries, Spina Bifida, Neuromuscular Disorders, and AmputationsDavid Cancel, Jaishree Capoor10.1016/j.pmr.2012.03.001Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-05-01Physical Medicine and Rehabilitation Clinics of North America2012-05-01232S1047-9651(11)X0007-4401422http://www.pmr.theclinics.com/article/PIIS1047965112000228/abstract?rss=yesThe objective of this article was to present a systematic review of the safety issues encountered in interventional pain management. Patient safety is an important consideration in the practice of interventional pain management. Although there is a paucity of scientific articles addressing this topic, the authors have reviewed the literature and present a review of the topic, as well as strategies to minimize the risk to patients undergoing interventional spine procedures.Patient Safety in Interventional Pain ProceduresSamuel P. Thampi, Vishal Rekhala, Travis Vontobel, Vamsi Nukula10.1016/j.pmr.2012.02.014Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-04-12Physical Medicine and Rehabilitation Clinics of North America2012-04-12232S1047-9651(11)X0007-4423432http://www.pmr.theclinics.com/article/PIIS1047965112000216/abstract?rss=yesAs more and more patients with cardiac and pulmonary diseases are living longer lives, the need for cardio-pulmonary rehabilitation continues to grow. The goal of this article is to provide clinicians of rehabilitation medicine with an overview of the safety concerns and strategies to implement in the rehabilitation of patients with cardiac and/or pulmonary disorder.Safety Considerations During Cardiac and Pulmonary Rehabilitation ProgramYelena Suler, Laurentiu Iulius Dinescu10.1016/j.pmr.2012.02.013Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-04-09Physical Medicine and Rehabilitation Clinics of North America2012-04-09232S1047-9651(11)X0007-4433440http://www.pmr.theclinics.com/article/PIIS104796511200023X/abstract?rss=yesCancer patients receive rehabilitation services in acute hospitalizations, rehabilitation wards, outpatient rehabilitation facilities, and home settings. Given the complexity and acuity of their medical care coupled with the long-term effects of the cancer and its treatments, patient safety is a significant concern in the delivery of rehabilitation services for this population. Cancer survivorship is growing in importance as a significant number of adults and children diagnosed with cancer are surviving beyond the 5-year mark. The goal of this article is to provide an overview to rehabilitation clinicians on the topic of patient safety in the rehabilitation of cancer patients.Patient Safety in Cancer RehabilitationAdrian Cristian, Andy Tran, Karishma Patel10.1016/j.pmr.2012.02.015Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-04-12Physical Medicine and Rehabilitation Clinics of North America2012-04-12232S1047-9651(11)X0007-4441456http://www.pmr.theclinics.com/article/PIIS1047965112000344/abstract?rss=yesIndex10.1016/S1047-9651(12)00034-4Physical Medicine and Rehabilitation Clinics of North America 23, 2 (2012)2012-05-01Physical Medicine and Rehabilitation Clinics of North America2012-05-01232S1047-9651(11)X0007-4457474