@article { author = {O’Donoghue, Andrew and Mannion, Stephen}, title = {An Anesthesia Checklist: A Survey of Compliance and Attitudes}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {8}, number = {2}, pages = {69-76}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2020.48968.1275}, abstract = {Introduction: While anesthesia is regarded as one of the safest clinical specialties, continuing to ensure patient safety requires vigilance. The growing complexity of modern medicine makes it extremely dangerous to rely on the absence of human error. There is evidence to suggest that anesthesiologists are less inclined to use checklists than surgeons and nurses. Seniority has also been shown to dictate the acceptance of checklists. Materials and Methods: We assessed compliance with, and attitudes to an anesthesia checklist, comparing by seniority. 1. Analysed a representative sample (n=247, 95% CI, 5% ME) of general anesthesia cases performed in one year (n=747), calculating percentage compliance in each case. We compared groups by seniority with Mann-Whitney U testing using SPSS. 2. We assessed attitudes using a 20-item questionnaire, consisting of five themed sub-scales. Descriptive statistics were generated. Results: Mean total compliance with the checklist was 91.6% (95% CI: 90.6-92.6%). Non-Consultant compliance was estimated at 94.4% (95% CI: 93.0-95.8%), compared to 91.6% (95% CI: 89.5-93.7%) in the Consultant group. Higher Non-Consultant compliance was significant, compared to the Consultant group (P=0.045). Conclusion: The Non-Consultant group demonstrated greater compliance. Attitudes to the checklist were similar amongst the two groups with lack of time and lack of training cited as two major barriers to use. Both senior and junior anesthesiologists felt it had a positive impact on patient safety.}, keywords = {Checklist,crew resource management,Patient safety}, url = {https://psj.mums.ac.ir/article_15840.html}, eprint = {https://psj.mums.ac.ir/article_15840_b4947249fede372c16da9f4439963d9b.pdf} } @article { author = {Faraji-Fard, Maryam and Amani, Firouz and Zeynizadeh Jeddi, Somayeh and Mobaraki, Noushin and Yousefian, Mahzad}, title = {Frequency of Registered Medical Errors in a Hospital in Ardabil, Iran, Within 2017-18}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {8}, number = {2}, pages = {77-83}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2020.46962.1264}, abstract = {Introduction: Patient safety is one of the main goals in a health system trying to reduce patient problems during hospitalization. These problems can be due to unintentional errors made by clinical staff the recognition and management of which are very important. The present study aimed to investigate the registered medical errors in Alavi hospital in Ardabil, Iran, during 2017-2018. Materials and Methods: In this cross-sectional study, all the wards were studied in Alavi hospital, and the data were collected by the evaluation of reported errors made by clinical staff and completion of the registered medical error forms. The collected data were analyzed through descriptive statistics. Results: During the study period, 1,050 registered errors were evaluated. Most errors (n=482; 45.9%) were detected in the women’s surgery ward. According to the number of errors made by nurses in the hospital in comparison to those reported for other clinical groups, the nurses with 464 cases (44%) had the highest frequency of medical errors, and the caring errors (29%) were the most frequently committed type of errors. Conclusion: Based on the obtained results of the current study, it was shown that caring errors were the most frequently committed errors, and the highest frequency of medical errors occurred in the women’s surgery ward. Therefore, providing educational training, emphasizing on doing hospital process, reducing the duration of work shifts, and increasing the number of personnel in hospitals, could be effective in decreasing errors and associated consequences.}, keywords = {Ardabil,Hospital,Medical errors,nurse}, url = {https://psj.mums.ac.ir/article_16002.html}, eprint = {https://psj.mums.ac.ir/article_16002_7a9f529dd6c38242bd1fe4ecdb23f14e.pdf} } @article { author = {Toghian Chaharsoughi, Narges and Nasr- Esfahani, Mohammad and Sodoury, Marzieh Sadat}, title = {Prevalence and Types of Medical Errors at a Trauma Center in Isfahan, Iran (2018-2019)}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {8}, number = {2}, pages = {85-91}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2020.47570.1269}, abstract = {Introduction: Clinical errors can affect patient safety, reduce the quality of care, or even cause irreparable harm to the patients. Attention has been primarily tended to be directed toward medication errors; accordingly, limited focus has been placed on other clinical errors, such as caring, therapeutic, and blood transfusion errors. Regarding this, the present study was aimed to perform a comprehensive investigation of the type and prevalence of different clinical errors in a teaching trauma hospital. Materials and Methods: This descriptive study was targeted toward the evaluation of the types and frequency of medical errors in the Trauma Center of Ayatollah Kashani Hospital in Isfahan, Iran, during 2018 and 2019. The data were collected using a clinical error reporting form, covering such data as the type of error, error severity, and associated ward. The data were analyzed in SPSS software, version 16. Results: A total of 375 errors were reported, the majority of which were related to imaging and radiology domains (26.7%), followed by laboratory and blood bank (22.9%). In terms of job position, nurses (42.6%) and physicians (29.5%) made the majority of the errors. Furthermore, most of the errors occurred in the morning shifts (57.3%) and at the hospital emergency department (28.9%). Conclusion: According to the results of the present study, the emergency department requires more attention to reduce the documentation errors of radiology and imaging.  }, keywords = {Medical error,Prevalence,Trauma}, url = {https://psj.mums.ac.ir/article_16019.html}, eprint = {https://psj.mums.ac.ir/article_16019_62bec6333f033e207c813603e364c0d2.pdf} } @article { author = {Jahanshahi, Amirreza and Rahkar Farshi, Mahni and Saed Moocheshi, Rojhin and Ebadi, Zakieh and Abdinia, Babak}, title = {Investigation of the Chest Radiograph Findings in Children with Pneumonia Hospitalized in a Children's Hospital, Tabriz, Iran}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {8}, number = {2}, pages = {93-98}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2020.46794.1263}, abstract = {Introduction: Pneumonia has been regarded as the leading cause of death among the elderly, very young children, and those who suffer from chronic diseases. Among the underlying causes, viral infections have been addressed as the most frequent cause of pneumonia in children. Materials and Methods: This study investigated a total of 300 subjects with pneumonia hospitalized in Tabriz Children's Hospital, Tabriz, Iran. Moreover, a comparison was made between the type of pneumonia and associated radiologic features. Age, gender, performed laboratory tests, symptoms, and final interpretations of the chest x-ray (CXR) images were included in the checklist. Results: The mean age of the patients was 6.09 2.45 years. Moreover, the mean erythrocyte sedimentation rate was estimated at 27.86±22.73 mm/h. In this study, 174 (58%), 57 (19%), 50 (16.7%), and 19 (6.3%) patients were C-reactive protein (CRP) negative, CRP (+), CRP (++), and CRP (+++), respectively. Furthermore, in 238 (79.3%) patients, white blood cell (WBC) count in serum was within the normal range, whereas high WBC count was reported in 62 individuals (20.7%). In addition, four positive blood cultures as well as 27 (9%) cases with pleural effusion were identified in this study. Reticulonodular involvement was recognized in up to 246 (82%) subjects. It should be noted that 63 (21%) and 237 (79%) patients showed unilateral and bilateral involvement in chest radiography, respectively. Regarding the frequency of radiographic evidence, the most common patterns of involvement in descending frequencies were reticulonodular and lobar alveolar. Conclusion: The most common pattern of involvement in children's CXRs with pneumonia is a reticulonodular pattern associated with bilateral peribronchial cuffing.}, keywords = {Chest,Children,Radiograph}, url = {https://psj.mums.ac.ir/article_16006.html}, eprint = {https://psj.mums.ac.ir/article_16006_a6fd76eac754cdb765276d7abb09802a.pdf} } @article { author = {Chakraborty, Ananya and Riyash, Mohammad and Srinivasan, Kumar and Lakshmi, Vijaya}, title = {Prescription Audit towards Quality Indicators at a Tertiary Care Teaching Hospital in South India}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {8}, number = {2}, pages = {99-105}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2020.45796.1260}, abstract = {Introduction: The World Health Organization has laid down guidelines for rational prescriptions. Adherence to those guidelines is an important aspect of medication safety. In India, such adherence is mandatory towards National Accreditation Board for Hospitals and Health-care Providers (NABH) accreditation of health-care facilities. The audition of the prescriptions is therefore a quality improvement process that indirectly benefits the health-care stakeholders. Such an audit is part of the NABH Management of Medication and is monitored by the Pharmacy and Therapeutics (P&T) committee in most hospitals. Materials and Methods: This prospective study was conducted between December 2018 and November 2019. An audit was carried out using 4800 case sheets from different in-patient departments of Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, India. The data were recorded in a predefined audit form. Results: Out of 4800 prescriptions, 71% (n=3408) of the audited orders had drugs written down in the capital; moreover, 97% (n=4656) and 47% (n=2256) of the prescriptions were legible and were written in generics, respectively. Furthermore, 97% (n=4656) of the orders had a physician’s signature, and 70% (3360) of them had a clinical review. It should be noted that only 1% (n=48) of the orders had drug-drug and drug-food documented interactions. Conclusion: According to the results of this study, physicians did not document suggestions regarding drug-drug and drug-food interactions. Moreover, there were fewer numbers of prescriptions written in generics. In addition, the majority of the medication orders were legible and adhered to standards in the 12th month. This may be due to sharing the monthly audit reports with various departments and the continuous feedback process involving the P&T committee.}, keywords = {Medication order,NABH,Management of medication,Prescription audit}, url = {https://psj.mums.ac.ir/article_16085.html}, eprint = {https://psj.mums.ac.ir/article_16085_29c7485f466f53ef5e8921d42662f386.pdf} } @article { author = {Amini, Maryam and Mahmoudi, Mahmoud and Jafari, Mehdi and Amini, Marzyeh}, title = {Effect of Nurse’s Characteristics on Their Willingness to Involve Patients in the Care Process in Hospitals in Tehran, Iran}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {8}, number = {2}, pages = {107-115}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2020.42788.1242}, abstract = {Introduction: Patient involvement in the care process is a widespread concept, which is considered an important issue to improve the quality of healthcare. This study aimed at assessing the effect of nurses’ characteristics on their willingness to involve patients in the care process in hospitals in Tehran, Iran. Materials and Methods: This study utilized the patient participation culture tool for healthcare workers to measure patient participation behavior. The cross-sectional data were collected from randomly selected nurses who were working in 11 hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran. Furthermore, the data were analyzed using a linear mixed model to analyze the differences among the nurses’ characteristics. Moreover, the data were adjusted by the random effects of differences between hospitals and wards. A P-value less than 0.05 was considered statistically significant. Results: In total, 220 nurses from 18 wards participated in this study. The results showed that male nurses had a higher tendency to answer challenging questions (β=1.4; P=0.04), and younger nurses had significantly lower perceptions on coping with notifying questions asked by the patients (β=-1.7; P=0.02). In addition, nurses with Bachelor's degrees felt more support (β=2.8; P=0.02) and were more engaged in information sharing and dialogue (β=5.0; P=0.03). Furthermore, the full-time employed nurses perceived a lower lack of time (β=-1.2; P=0.002), compared to part-time peers. Conclusion: The findings indicate that the features and characteristics of the nurses might have an essential influence on patient involvement. Therefore, attention must be paid to these factors to overcome problems and obstacles that are encountered on the way of achieving effective patient involvement.}, keywords = {Characteristics,Quantitative research,nurse,Patient involvement}, url = {https://psj.mums.ac.ir/article_16091.html}, eprint = {https://psj.mums.ac.ir/article_16091_0fb700950dd43265fb9598bb16135c8f.pdf} } @article { author = {Tabatabaee, Seyed Saeed}, title = {Modified Workload Indicators of Staffing Need to Estimate Human Resources at a Health Facility}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {8}, number = {2}, pages = {117-121}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2020.43932.1247}, abstract = {Introduction: Human resources planning is known as the most essential limitation in achieving health care quality in the world. The main component of health human resource planning is to determine the required staff. There are several methods for determining required staff in a health facility. In this regard, one of the most widely used methods is the workload indicator of staffing need (WISN) method. In 1998, the World Health Organization announced the WISN as a human resource planning tool for the rational distribution of staff at health centers at all levels. It has been used in some countries since then. There is a recommendation on the division of the workload components. According to the modified workload indicator of staffing need (MWISN), there are four kinds of workload component. The first one is common main activity accomplished by all employees of the job category and for which periodic statistics are regularly collected. Uncommon main activity is the second one performed by a limited number of employees of the job category and for which periodic statistics are regularly collected. Moreover, support activities performed by all employees of the job category but for which periodic statistics are not regularly collected. The last one is additional activities performed only by some employees of the job category and for which periodic statistics are not regularly collected. Following the new division of the workload components, the final formula for the estimation of required workforce requirements is modified. Therefore, the MWISN can increase the accuracy and precision of the measurement of the workload and determine the number of workforces required.}, keywords = {human recourse planning,Estimation,health,wisn}, url = {https://psj.mums.ac.ir/article_15817.html}, eprint = {https://psj.mums.ac.ir/article_15817_a936479b3f68a665330472efe20ef369.pdf} } @article { author = {Zarrinfar, Hossein and Bathla, Chhavi}, title = {Is Phaeohyphomycosis an Emerging Fungal Infection in Iran? A Short Communication}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {8}, number = {2}, pages = {123-126}, year = {2020}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2020.46271.1262}, abstract = {Introduction: Phaeohyphomycosis is a rare opportunistic fungal infection that can be caused by dematiaceous fungi. The clinical manifestations of this disease are highly diverse and include cutaneous, subcutaneous, and systemic forms. However, the mortality rate of this infection depends on the immune status of patients. Although infections caused by black fungi have been on an increasing trend during the past decade, infections with dematiaceous fungi have rarely been reported in the Middle East. However, some fungal species are associated with a disseminated disease without the known clinical and pathologic risk factors. The analysis of DNA sequence is a highly effective method for differentiating various species among some genera, due to the variable cultural and morphological characteristics of DNA. Despite the presence of therapeutic methods, there are numerous reports regarding the high mortality rate of this infection. Published studies indicate no specific risk factors for phaeohyphomycosis and report the incidence of this disease in immunocompetent individuals. Moreover, selective treatment for these rare infections has not even been defined in clinical studies. However, the clinical syndromes associated with dematiaceous fungi should be considered in the Middle East, Iran.}, keywords = {Fungus,Phaeohyphomycosis,The Middle East,Iran}, url = {https://psj.mums.ac.ir/article_15537.html}, eprint = {https://psj.mums.ac.ir/article_15537_44bbc8b73b41d14019b308e30228065f.pdf} }