@article { author = {Mirsane, Sayed Alireza and Mirsane, Sayed Mojtaba}, title = {The Necessity of Attention to Vitamin B12 Level Examination in Diabetic Patients Treated with Metformin}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {5}, number = {3}, pages = {553-553}, year = {2017}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2017.9036}, abstract = {people need to have healthy methods of therapy because such methods can protect one’s health(1, 2).Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder and paying adequate attention to areas related to this condition is very necessary (3). Metformin is a medication generally used in diabetic patients (4). Therefore, attention must be paid to the side effects of these medications. On the other hand, importance of vitamin B12 in the field of biological sciences has been well established. Vitamin B12 deficiency causes a wide range of neuropsychiatric and hematologic disorders. Unfortunately, the growing prevalence of vitamin B12 deficiency has been identified in diabetics treated with metformin. Sato have explained that metformin treatment is a reducer of vitamin B12 level (5). Also, researchers have suggested that metformin can cause vitamin B-12 deficiency (6, 7). Similarly, in their study, scholars indicated that the treatment of metformin has an underlying role in concentrated reduction of vitamin B12 (4). Due to the above-mentioned problems, the focus of the health workers of diabetic centers on examination of vitamin B12 level in treated patients by metformin can identify vitamin B12 deficiency and prevent further complications by proper treatment. It is recommended that the examination of vitamin B12 in diabetic patients treated with metformin be considered as a plan and a procedure for the purpose of improving the patients’ health condition.}, keywords = {Diabetes Mellitus,Metformin,Vitamin B 12}, url = {https://psj.mums.ac.ir/article_9036.html}, eprint = {https://psj.mums.ac.ir/article_9036_d6c7cca3e21cf253ced84a54ab295a07.pdf} } @article { author = {Saberi, Maryam and Jamshidi, Ensiyeh and Rajabi, Fatemeh and Seydali, Elham and Bairami, Firoozeh}, title = {Attitude of Nurses toward the Patient Safety Culture: A Cross-Sectional Study of the Hospitals in Tehran, Iran}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {5}, number = {3}, pages = {554-560}, year = {2017}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2017.9037}, abstract = {Introduction: Patient safety is a major component of healthcare quality, which is defined as the avoidance of causing harm to patients in providing healthcare services. The present study aimed to investigate the attitude of nurses toward the patient safety culture in the teaching general hospitals affiliated to Tehran University of Medical Sciences, Iran. Materials and Methods: This cross-sectional study was conducted in 2014. Data were collected using the adapted version of the safety attitude questionnaire (SAQ). Sample size consisted of 385 nurses, who were selected randomly. In total, 325 participants completed the questionnaire. Data analysis was performed in SPSS Version 19 using descriptive statistics, t-test, and analysis of variance (ANOVA). Results:Mean age of the participants was 36.21±6.9 years, and 92% and 8% of the respondents were female and male, respectively. In terms of the occupational status, 92.1% of the participants had a contractual job or permanent official employment. Mean percentage of the positive attitude toward the patient safety culture was 59.2±18.1, 55.6±17.0, 53.8±24.2, 49.5±16.5, and 43.0±22.4 in the dimensions of management perception, teamwork, job satisfaction, safety climate, and work conditions, respectively. In addition, a significant difference was observed in the dimension of management perception and employment status of the nurses (F=4.4; P=0.01). Conclusion: According to the results, attitude of the nurses in the selected hospitals was poor toward the dimensions of the patient safety culture. Therefore, it is strongly recommended that specific training interventions be performed to enhance the work conditions and safety climate in these hospitals}, keywords = {Attitude,Nurses,Patient Safety Culture,Patient safety}, url = {https://psj.mums.ac.ir/article_9037.html}, eprint = {https://psj.mums.ac.ir/article_9037_3e8f5895f948a0b6b275d76ffcfa24d4.pdf} } @article { author = {Laal, Fereydoon and Pouyakian, Mostafa and Fallah Madvari, Roohollah and Mohammadi, Mahdi and Rezaee, Mohammad Ali and Noorizadeh, Najaf and Adineh, Hossein Ali}, title = {Survey of the Patient Safety Culture in the Clinics and Hospitals of Chabahar, Iran}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {5}, number = {3}, pages = {561-566}, year = {2017}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2017.9038}, abstract = {Introduction: Patient safety is a basic principle of health care, and the purpose of the patient safety culture is to provide safe conditions for the care of patients. The present study aimed to evaluate the patient safety culture in the clinics and hospitals of Chabahar, Iran. Materials and Methods: This cross-sectional study was conducted on three groups of physicians, nurses, and paraclinical staff in 2017. Data were collected by using the hospital survey on patient safety culture (HSOPS). Data analysis was performed in SPSS version 21 using descriptive statistics, ANOVA, and Tukey’s post-hoc test. Results:In total, 255.85 subjects were enrolled in the study and equally divided into three groups (33.3%). The minimum and maximum work experience was one and 27 years, respectively. Among the participants, 116 cases (45.49%) were female, and 139 cases (54.50%) were male. Mean total score of the patient safety culture was 149.87±25.20. The lowest and highest scores were observed in the dimensions of ‘non-punitive response to errors’ (3.23±9.11) and ‘teamwork within units’ (3.86±15.41), respectively. The results indicated a significant difference between the three study groups in terms of the patient safety culture (P<0.001). However, mean score of the general perception of the safety culture had no significant difference between the physicians and nurses (P=0.064). Conclusion: Findings of the present study could help justify the establishment of a positive patient safety culture in the healthcare systems. In addition, recruitment of capable managers, who are committed to eliminating medical errors, is required for implementing the patient safety culture. Therefore, it is recommended that interventions in the field of the patient safety culture be planned and the association of patient safety and clinical outcomes be assessed in further investigations.}, keywords = {Clinic,Culture,Hospital,Patient safety}, url = {https://psj.mums.ac.ir/article_9038.html}, eprint = {https://psj.mums.ac.ir/article_9038_f3ad2b5e3c38c6ba5c324160e259e254.pdf} } @article { author = {Kakemam, Edris and Dargahi, Hossein and Rahimi Forushani, Abbas}, title = {Association between managers’ Competency and Technical Efficiency in General Hospitals in Iran}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {5}, number = {3}, pages = {567-571}, year = {2017}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2017.9039}, abstract = {Introduction: Inefficient management of hospitals leads to the substantial waste of resources. Therefore, hospital efficiency has recently been a major concern among researchers. The present study aimed to evaluate the association of the management competency and technical efficiency in the general hospitals of Tehran, Iran. Materials and Methods: This descriptive-analytical, cross-sectional study was conducted in 28 general hospitals in Tehran, Iran in 2015. In the first step, a survey was performed among 224 managers at different levels in the hospitals using a researcher-made management competency self-assessment questionnaire. In the second step, technical efficiency in the selected hospitals was measured by the Data Envelopment Analysis (DEA). Data analysis was performed using SPSS, Enterprise Management Software (EMS), and Deap1, 2. Results:The average of competency was relatively high among the hospitals managers. However, more than half of the hospital performances were observed to be inefficient. Moreover, the results indicated that the competency of hospital managers was significantly correlated with their field of education, participation in training courses, and managerial experience. Also, a significant, direct association was observed between the competency of managers and technical efficiency in the studied hospitals. Conclusion: According to the results, although the level of technical efficiency was favorable in the studied hospitals, the hospital managers with high competency should further develop and improve their performance and efficiency in these hospitals.  }, keywords = {General hospitals,Managers’ Competencies,Technical efficiency,Tehran Iran}, url = {https://psj.mums.ac.ir/article_9039.html}, eprint = {https://psj.mums.ac.ir/article_9039_a70b53a82b01196183f829604a83e7a3.pdf} } @article { author = {Seyyednozadi, Mohsen and Jarahi, Lida and Erfanian, Majid Reza and Shakeri, Mohammad Taghi}, title = {Pre-Hospital Emergency Medical Services: An Epidemiological Survey in Mashhad, Iran}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {5}, number = {3}, pages = {572-576}, year = {2017}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2017.9040}, abstract = {Introduction: Providing appropriate care, in the right place and at the right time, is the main goal of emergency medical services (EMS) to save lives. The present study aimed to assess the pre-hospital EMS in Mashhad, the second largest metropolis in Iran. Materials and Methods: In this research, data were extracted from the pre-hospital emergency mission forms, which were collected from the EMS stations in Mashhad and suburbs through systematic random sampling. In addition, supplementary information was obtained from the ambulance dispatch cards and emergency communication center forms. Results:Automobile accidents (33.7%) and cardiovascular events (17.8%) were the most common causes of contacts to the EMS. In the city and road stations, the mean response time was 2.6 and 1.6 minutes, while the mean time of arrival at the scene was 13.2 and 11.4 minutes, and the mean evacuation time was 13.2 and 11.4 minutes, respectively. Individuals aged 20-29 (25.2%) and more than 60 years (23.9%) constituted the majority of the cases receiving EMS. Conclusion: According to the results, the ‘golden time’ for emergency care was of great importance in the patients injured in car accidents or affected by cardiovascular events. Furthermore, a significant difference was observed in the time indices of EMS in Mashhad city with the EMS standards due to the lack of human resources or EMS facilities. Some contacts to the EMS were unnecessary, and no expert team aid was needed in some cases. It is recommended that citizens be trained on solving the problems associated with road traffic by implementing mobile emergency, while transfer units must be established for the better provision of emergency care by the EMS in Mashhad.}, keywords = {Emergency system,Epidemiological survey,Pre-hospital,Service providing}, url = {https://psj.mums.ac.ir/article_9040.html}, eprint = {https://psj.mums.ac.ir/article_9040_79545b729e9e976ee718c30713c9c150.pdf} } @article { author = {Tsang, Lap Fung and Tsang, Wai Yi and Yiu, Ka Chun and Tang, Siu Keung and Sham, So Yuen Alice}, title = {Using the PDSA Cycle for the Evaluation of Pointing and Calling Implementation to Reduce the Rate of High-Alert Medication Administration Incidents in the United Christian Hospital of Hong Kong, China}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {5}, number = {3}, pages = {577-583}, year = {2017}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2017.9043}, abstract = {Introduction: The present study aimed to adopt a Plan-do-Study-Act (PDSA) cycle to monitor the implementation of Pointing and Calling (P&C) in the United Christian Hospital of Hong Kong, China. Materials and Methods: A workgroup was formed to evaluate the approaches to apply P&C in high-alert medication administration using infusion and syringe devices. A series of promulgations and strategies were implemented to increase the probability of its success and sustainability. In addition, pretest and posttest evaluation was performed to monitor the incident rate associated with high-alert medication administration using infusion and syringe devices. Results:Over 100 briefing sessions were conducted in the hospital wards, and 145 senior managers, ward managers, and advanced practice nurses completed the training and assessment. In total, 217 questionnaires, which were scored based on a six-point Likert scale, were collected from 21 wards, with the response rate estimated at 26.53%. Moreover, an audit was performed to obtain 98.1-100% of the compliance rate of using the P&C for evaluation. Since June 2016, the incident rate due to inaccurate device setting decreased from 0.21 to 0.13 after the P&C implementation. Conclusion: According to the results, P&C is a simple method to facilitate the meticulous assessment of high-alert medication administration by nurses. It is recommended that further improvement be made in this regard in order to address the unidentified other areas. Of note, counter measures were proposed to strengthen P&C compliance.}, keywords = {High alert medication,Human error,Infusion and syringe device,Medication administration incident,Pointing and calling}, url = {https://psj.mums.ac.ir/article_9043.html}, eprint = {https://psj.mums.ac.ir/article_9043_b0dccd242483c1da542b327b6ce81ddd.pdf} } @article { author = {Darchini-Maragheh, Emadodin and Salehi, Maryam and Payandeh, Abolfazl and Behdani, Fatemeh and Ghasemzadeh Kolagar, Hossein}, title = {Evaluation of the Correlations between Depression, Anxiety, and Stress as DASS-21 Subscales and High-Risk Behaviors in the Adolescents in Torghabeh and Shandiz Towns, Iran}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {5}, number = {3}, pages = {584-590}, year = {2017}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2017.9479}, abstract = {Introduction: Adolescence is a critical period in life, which is associated with tumultuous transitions and “storm and stress. The present study aimed to evaluate the correlation between depression, anxiety, and stress with the high-risk behaviors among the adolescents in Torghabeh and Shandiz towns, Iran. Materials and Methods: This cross-sectional study was conducted on 90 adolescents from the high schools. Participants were selected via two-stage sampling. Data were collected using the validated Depression, Anxiety, and Stress Scale (DASS-21) and history of high-risk behaviors in the students. Data analysis was performed in SPSS version 16. Results:Variable degrees of depression, anxiety, and stress were reported in 43.3%, 43.3%, and 38.9% of the students, respectively. Although the difference was not statistically significant, female students were more affected by the mentioned disorders compared to the male students. Among the high-risk behaviors, smoking cigarettes was significantly correlated with the depression, anxiety, and stress subscales. In addition, a significant association was observed between opium consumption and stress. However, no significant correlation was observed between smoking hookah and the DASS-21 subscales. Regular alcohol consumption was found to be significantly correlated with the higher rate of depression in the studied adolescents. Also, premarital sexual behaviors had a significant association with the stress and depression subscales. Conclusion: Lack of attention to depression, anxiety, and stress and their risk factors in adolescents may lead to variable degrees of life dissatisfaction in the community. Therefore, it is recommended that on-school mental screening programs be performed for high-school students in order prevent these complications.}, keywords = {adolescence,Anxiety,Depression,High-Risk Behaviors,stress}, url = {https://psj.mums.ac.ir/article_9479.html}, eprint = {https://psj.mums.ac.ir/article_9479_eadcdc3d4e124f936340e15968e31779.pdf} } @article { author = {Alassaf, Omar}, title = {Patient Misidentification in Medical Organizations: A Case Report}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {5}, number = {3}, pages = {590-591}, year = {2017}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2017.9041}, abstract = {Introduction: Patient identification is a significant area in every medical field. Misidentification of patients leads to various challenges, such as surgical operation on the wrong patient, erroneous prescription of medications, and mistakes in performing the treatment procedures. Therefore, patient misidentification is associated with significant malpractice and economic loss. Healthcare providers and staff members are responsible for the management of the patients’ information and their proper identification. Case: We presented a typical case of misidentification, which might have led to performing a surgical procedure on a misidentified patient. In this report, we have discussed the outlines of the misidentified case, contributing factors leading to the incident, and provided recommendations on the potential solutions that could be considered to avoid similar incidents and enhance patient safety. In addition, the presented case has been compared with the World Health Organization (WHO) protocols and guidelines on the prevention of patient misidentification and proper communication within the medical team. Conclusion: Adopting a technologically advanced system and proper training of healthcare providers are essential to improving patient safety and diminishing legal challenges in the field of medicine.}, keywords = {Emerging technologies, Misidentification,Near miss,Patient safety}, url = {https://psj.mums.ac.ir/article_9041.html}, eprint = {https://psj.mums.ac.ir/article_9041_0fe06617181ae96e70ae20b39a8c9f7f.pdf} }