2%) and systematic process-related (22.2%). The contributing factors were situational inexperience (77.8%) and inappropriate patient evaluation (44.4%). An awareness of anesthetic performer (100%) and experience (88.9%) were defined as incident-mitigating factors. The suggested corrective strategies were quality assurance activity (88.9%), improved supervision (44.4%) and equipment utilization (33.3%), respectively. Conclusion Nine intraoperative awareness incidents were observed, however the causes were preventable. The anesthetic component seems to be the most influential to prevent these events.Background Pharmaceutical compounding allows individuals with special requirements access to medicines. Compounding can also be used to provide cheaper alternatives to commercially produced medicines which may be less strictly regulated than those commercially produced as they do not require marketing authorisation. Objective This review describes the issues and potential risks associated with compounded medicines and equally importantly identifies best practices. Methods To establish reports about lack of effectiveness, adverse events and medication errors occurring with compounded pharmaceuticals, a literature search was conducted of PubMed, Embase and MEDLINE databases for relevant cases in European countries which were published between 2003 and 2018. Case reports/series that described instances of successful use of compounded medicines over the same period were also identified. Results Overall, 12 case reports/case series describing problems associated with compounded medicines in Europe have been identi Stricter regulation is necessary to prevent similar cases from occurring in the future as the European market for compounded medications grows. 2. A comprehensive pan-European survey to gain a greater understanding of compounding procedures and techniques. This would provide valuable information to the benefit of hospital systems and their patients. 3. The results of the survey can then be used to improve the knowledge and quality control of compounded medicines for the good of patient safety.Background In the case of depression (and other psychiatric disorders), a huge number of scientists have been trying for decades to establish and postulate the disease-based drug concept for antidepressants and these efforts have not born fruits. Objective To show that the discussions about statistical significance of the efficiency of the antidepressants over placebo are non-productive and irrelevant. Method Researching the history of the onset of a chemical imbalance theory in the brain and the launch of antidepressants according to the drug-based disease model was the basis for doubting the appropriateness of using antidepressants in the treatment of depression. Results Antidepressants (AD), as their name suggests, are supposed to address a disease-specific model to reverse the neuropathological basis of depression. However, science has not constituted the theory, using various brain imagining techniques or measuring the concentration of serotonin in various body liquids, that depression is characterized by the lack of serotonin in synapses and then created a substance that would block the reuptake of this neurotransmitter or in some other ways elevate its content. Conclusion Even the reductionistic phase of the AD story, the mechanism of action, failed to be consistent so it is unclear how the largest meta-analysis of about 21 antidepressants by Andrea Cipriani et al. appeared in The Lancet.Background Physicians and nurses are responsible for reporting medical adverse events. Each views these events through a different lens subject to their role-based perceptions and barriers. Physicians typically engage with diagnosis and treatment while nurses primarily care for patients' daily lives and mental well-being. This results in reporting and describing medical adverse events. Objective We aimed to compare adverse medical event reports generated by physicians and nurses to better understand the differences and similarities in perspective as well as the nature of adverse medical events using social network analysis (SNA) and latent Dirichlet allocation (LDA). Methods The current study examined data from the Maccabi Healthcare Community. TMP269 Approximately 17,868 records were collected between 2000-2017 regarding medical adverse events. Data analysis used SNA and LDA to perform descriptive text analytics and understand underlying phenomenon. Results A significant difference in harm levels reported by physicians and nurses was discovered. Shared topic keyword lists broken down by physicians and nurses were derived. Overall, communication, lack of attention, and information transfer issues were reported in medical adverse events data. Specialized keywords, more likely to be used by a physician were determined as repeated prescriptions, diabetes complications, and x-ray examinations. For nurses, the most common special adverse event behavior keywords were vaccine problem, certificates of fitness, death and incapacity, and abnormal dosage. Conclusions Communication and inattentiveness appeared most frequently in medical adverse events reports regardless of whether doctors or nurses did the reporting. Findings suggest feedback and information sharing processes could be implemented as a step toward alleviating many issues. Institutional management, healthcare managers and government officials should take actions to decrease medical adverse events, many of which may be preventable.Background Nosocomial infection is a significant burden on healthcare facilities. Its multifactorial nature renders it challenging to control. However, quality healthcare necessitates a safer service that poses no harm to the patient. Objective The aim of this project was to reduce the infection rates in the adult ICU to the benchmark levels. Method An internal audit was conducted as a result of the high infection rates in the adult ICU. The audit started with root cause analysis using the fishbone quality tool. FOCUS-PDCA quality tool was used to design the framework. We opted to introduce a change in the staff uniform laundry in addition to a campaign to improve hand hygiene compliance using a multimodality approach. Moreover, we conducted training on aseptic techniques in ventilation, urinary catheter, and central lines insertion. Finally, we changed the ventilator filter to a higher quality brand that meets the standard specifications. Infection rates were monitored before and after the proposed changes. Results There was a marked reduction in ventilator-associated pneumonia; however, it did not lower the benchmark rates.