ORIGINAL_ARTICLE
Patient Safety from a Different Perspective: An Evaluation of the Type of Foods and Drinks Visitors Bring for Postoperative Patients
Introduction: To introduce different types of foods and beverages visitors bring for postoperative patients.
Materials and Methods: This descriptive study was conducted on 96 visitors of postoperative patients at Trakya University Hospital in Edirne, Turkey. Data were collected in face-to-face interviews (15 min) during visiting hours (02:00-04:00 p.m.) between August and September, 2015. The questionnaire included 15 questions on demographic characteristics, patient/visitor relation, visitor's knowledge of the type of patient's surgery, date of surgery, and the onset of patient's oral intake, the selected foods and/or drinks, and cause of such selection.
Results: Based on the findings, 72.9% of the visitors had brought food for the patients, and soup was the most frequently selected food type (25.7%); also, 41.4% of the visitors had brought the food the patient had requested. In total, 74% of the visitors had brought drinks, with fruit juice accounting for 63.4% of the selected beverages; also, 53.5% of the visitors had brought the drink the patient had requested. By comparing the type of foods and drinks with the type and date of surgery, it was revealed that some visitors had brought pastries and biscuits for patients undergoing gastrectomy on the first postoperative day.
Conclusion: It is recommended to control and manage the type of food products visitors bring for the patients during visiting hours. Moreover, visitors should be instructed on how to select foods or drinks for the patients.
https://psj.mums.ac.ir/article_6684_51ff765c29b801544d5e7363f3ffc41a.pdf
2016-04-01
346
350
10.22038/psj.2016.6684
Drinks
Food
Patient safety
Surgery
Visitors
Seher
Ünver
seher.unver@hotmail.com
1
Department of Surgical Nursing, Faculty of Health Sciences, Trakya University, Edirne/Turkey.
LEAD_AUTHOR
Zeynep
Kızılcık Özkan
zeynepkizilcik26@hotmail.com
2
Department of Surgical Nursing, Faculty of Health Sciences, Trakya University, Edirne/Turkey.
AUTHOR
Hatice
Merve Alptekin
imervealptekini@hotmail.com
3
Department of Surgical Nursing, Faculty of Health Sciences, Trakya University, Edirne/Turkey.
AUTHOR
Sacide
Yıldızeli Topçu
sacideyildizeli@yahoo.com
4
Department of Surgical Nursing, Faculty of Health Sciences, Trakya University, Edirne/Turkey.
AUTHOR
ORIGINAL_ARTICLE
Assessment of Patient Safety for Quality Improvement Based on Joint Commission International Accreditation Standards in Farabi Eye Hospital of Tehran University of Medical Sciences
Introduction: Quality improvement and patient safety are the most important aspects of health care delivery systems. Improving quality and safety in health care organizations is assured through accreditation. To evaluate patient safety in Farabi Eye Hospital by Joint Commission International (JCI) accreditation standards for quality improvement. Materials and Methods:This descriptive-analytical study was carried out in 2014. The data collection instrument was the translated version of JCI checklist, the validity of which was confirmed by a panel of Iranian experts. The data were obtained through interviews with all heads of departments (n=80) and observation of documentation in each department by appraisers in Farabi Hospital. To analyze the data, Spearman\'s rank correlation coefficient and Mann-Whitney U tests were run using SPSS Version 16. Results: The highest rate of compliance with JCI standards was 91.1%, pertaining to infection control and adopting an approach to reduce contamination. The lowest rate was associated with management monitoring of patients’ demographic information. In general, Farabi Eye Hospital observed the standards to a high level. Conclusion: Our findings exhibited that Farabi Eye Hospital is relatively efficient as to patient safety as a quality improvement factor. However, there were some shortcomings regarding some standards, which indicate deficient compliance with the JCI standards in this hospital. Absence of comprehensive training programs and defective policies and documentation are the key factors for patient safety quality improvement.
https://psj.mums.ac.ir/article_6689_5c6d0252c07393bb74a6d41737d595de.pdf
2016-04-01
351
357
10.22038/psj.2016.6689
Accreditation
Farabi Eye Hospital
Join Commission International
Patient safety
Quality Improvement
Seyed Mohammad Hadi
Musavi
mohammad.hadi.mousavi@gmail.com
1
Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran.
AUTHOR
Hojjat
Zeraati
hdargahi@sina.tums.ac.ir
2
Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
AUTHOR
Mahmoud
Jabbarvand
salamat@tums.ac.ir
3
Department of Ophthalmology, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
AUTHOR
Hadi
Mokhatre
salamat@sina.tums.ac.ir
4
Department of Health Care Management, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
AUTHOR
Akram
Asadollahi
golsashaham@yahoo.com
5
Department of Health Care Management, School of Allied Medicine, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
AUTHOR
Hossein
Dargahi
hdargahi@tums.ac.ir
6
Department of Health Care Management, School of Allied Medicine, Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran.
LEAD_AUTHOR
ORIGINAL_ARTICLE
The Relationship between Organizational Justice and Turnover Intention: A Survey on Hospital Nurses
Introduction: High organizational justice and its factors are associated with reduced turnover intention. Therefore, in this study, we aimed to examine the relationship between organizational justice and turnover intention among hospital nurses. Materials and Methods: This descriptive, analytical study was conducted on 135 nurses working in Labafi Nejad Hospital in Tehran, Iran, 2015. The data were collected using Beugre's (1998) questionnaire of organizational justice questionnaire. To analyze the data, Pearson’s correlation and ANOVA tests were performed using SPSS, version 20. Results: Mean organizational justice and turnover intention scores were 68.85±7.67 and 47.8±12.47, respectively. Among the different types of organizational justice, the highest mean score was pertinent to interactional justice (75.24±16.68). A significant inverse correlation was observed between turnover intention and organizational justice (r=-0.36), interactional justice (r=-0.38), and procedural justice (r=-0.36), while no association was noted between turnover intention and systemic and distributive types of justice. Furthermore, there was no link between demographic variables, organizational justice, and turnover intention. Conclusion: Considering the prominent role of organizational justice in personnel’s intention to leave their job, and given high costs of recruiting and training new staff, managers should pay especial attention to promoting justice and employees’ satisfaction and enhancing stability in their organizations by reinforcing positive attitudes in the employees.
https://psj.mums.ac.ir/article_6690_b1b430575e246f408326e6d09d33710f.pdf
2016-04-01
358
362
10.22038/psj.2016.6690
Nurses
Organizational justice
Turnover intention
Mobin
Sokhanvar
mobinsokhanvar@yahoo.com
1
Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran.
AUTHOR
Edris
Hasanpoor
edihasanpoor@yahoo.com
2
Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran.
AUTHOR
Soodeh
Hajihashemi
shajihashemi@yahoo.com
3
School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
AUTHOR
Edris
Kakemam
edris_kakemam@yahoo.com
4
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
LEAD_AUTHOR
ORIGINAL_ARTICLE
Attitude toward the Patient Safety Culture in healthcare systems
Introduction: Patient Safety Culture (PSC) involves a harmonious pattern of individual and organization behaviors based on common beliefs and values. This study aimed to evaluate the attitude of healthcare providers toward PSC in the hospitals and clinics of Zabol city, Iran. Materials and Methods: This descriptive cross-sectional study was conducted in 2015. Sample population consisted of the physicians, nurses, and paraclinical staff (radiologists and laboratory experts) engaged in different healthcare centers of Zabol city, Iran. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. Data analysis was performed in SPSS V.22 at the significance level of 0.05. Results: In total, 231 healthcare practitioners were enrolled in this study. Participants were divided into three groups of physicians, nurses, and paraclinical staff (n=77, 33.33%). Mean of age and clinical experience was 29.94 and 6.23 years, respectively. Among the main aspects of PSC, “general understanding of patient safety” had the highest mean score (13.53), and the lowest mean score was achieved in “non-punitive response to error” (8.89). In the aspect of “manager expectations and actions promoting safety”, a significant difference was observed in the mean scores of the study groups (P=0.030). Moreover, our results showed a significant difference between the mean scores of physicians and nurses in the aspect of “openness and honesty in communication” (P=0.023). Conclusion: According to the results of this study, improvement of PSC is necessary for the efficient management of hospitals and clinics. This is attainable through collaborative and instructive workshops, developing educational programs, and designing incident reporting systems.
https://psj.mums.ac.ir/article_6691_a1622af951c4083c43e1f41016571d66.pdf
2016-04-01
363
368
10.22038/psj.2016.6691
Health and medical staff
Hospital
Patient Safety Culture
Fereydoon
Laal
fereydoonlaal@gmail.com
1
Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
AUTHOR
Babak
Fazli
2
Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
AUTHOR
Davoud
Balarak
3
Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
AUTHOR
Forouzan
Dalir
4
Zahedan University of Medical Sciences, Zahedan, Iran.
AUTHOR
Mahdi
Mohammadi
5
Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
AUTHOR
Ramazan
Mirzaei
rammir277@gmail.com
6
Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
LEAD_AUTHOR
ORIGINAL_ARTICLE
Confirmatory Factor Analysis of Patient Safety Culture in an Iranian Hospital: A Case Study of Fatemeh Zahra Hospital in Najafabad, Iran
Introduction: Transformation of patient safety culture towards developing an open culture can be the greatest challenge for achieving a safe healthcare system. This study aimed to carry out a structural analysis of the Persian translation version of a questionnaire assessing patient safety culture. Materials and Methods: The study was conducted to evaluate the Persian translation of patient safety culture questionnaire, developed by the National Patient Safety Agency. The questionnaire includes seven sections and 43 items investigating 12 dimensions of patient safety culture. The reliability of this questionnaire was confirmed with Cronbach's alpha (α>0.8). The questionnaire was distributed among employees of the Fatemeh Zahra Hospital in Najafabad, Iran, 2015. The collected data were analyzed using SPSS 18 and Amos 18. Results: Sufficiency of the sample size, as determined by Kaiser-Meyer-Olkin measure, was 0.809, which was significantly associated with zero; therefore, performing factor analysis was acceptable and justifiable. The value of Bartlett's test was 696, P-value was less than 0.001, and degree of freedom was equal to 91. In the final model, the relative Chi-square was equal to 1.75 and P-value was less than 0.001. Also, parsimony normed fit index, parsimony-adjusted comparative fit index, and root mean square error of approximation were equal to 0.571, 0.621, and 0.065, respectively. Conclusion: Based on the results of fitting indices for the model and the questionnaire used in the present study for assessing patient safety culture, it can be stated that the Persian translation of this instrument is valid and hospitals can use it to monitor patient safety culture improvement.
https://psj.mums.ac.ir/article_6692_81ffab8587069a2c5e8fbfaf9f226b7f.pdf
2016-04-01
369
374
10.22038/psj.2016.6692
Factor Analysis
Hospital
Patient Safety Culture
Structural equation modeling
Mohammadkarim
Bahadori
bahadorihealth@gmail.com
1
Health Management Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran.
AUTHOR
Ahmad Reza
Izadi
ahmad.izadi@gmail.com
2
Health Management Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran.
LEAD_AUTHOR
Ramin
Ravangard
ra_ravanagardd@yahoo.com
3
School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
AUTHOR
Seyed Mojtaba
Hosseini
dr_hosseini82@yahoo.com
4
Department of Health Services Management, Tehran North Branch, Islamic Azad University, Tehran, Iran
AUTHOR
ORIGINAL_ARTICLE
Comparison of Patient-Controlled Analgesia Using Morphine With and Without Paracetamol in Postoperative Pain Control
Introduction: Postoperative pain control plays a pivotal role in reducing postoperative complications, hospitality time, and increasing satisfaction. This study aimed to evaluate the effect of paracetamol on the pain and complications caused by gastrectomy. Materials and Methods: This randomized prospective study was conducted on 60 patients (two same group) who were candidate for gastrectomy in Imam Reza Hospital of Mashhad, Iran during August-September 2015. The first group received Patient-Controlled Analgesia (PCA) with morphine only, and in the second group, paracetamol (1 gram) infused with morphine every six hours. Level of pain, morphine intake, and side effects were evaluated in both groups. Results:No significant difference was observed in the four-scale score of pain in the patients (morphine group: 0.64±0.1, morphine-paracetamol group: 0.6±0.1) (P=0.72). During the first 24 hours after the surgery, the morphine group had lower consciousness level (2.3±0.2) compared to the morphine-paracetamol group (1.7±0.3) (P=0.001). Moreover, infusion of paracetamol with morphine to control the pain after gastrectomy reduced the need for morphine analgesia. Morphine intake was 21.4±7.7 in morphine group, while it was 14.3±5.8 in the morphine-paracetamol group within the first 24 hours after the surgery (P=0.001). However, this level had no significant effect on postoperative complications such as itching, nausea, and arterial oxygen saturation. Conclusion: According to the results of this study, intravenous paracetamol (one gram) administered every six hours with PCA using morphine could decrease morphine intake leading to better consciousness level during the first 24 hours after gastrectomy without further complications.
https://psj.mums.ac.ir/article_6693_dc351b6bac07cfb6901fe8fa0300bfa6.pdf
2016-04-01
375
378
10.22038/psj.2016.6693
Morphine
Paracetamol
Patient-controlled analgesia
Mehryar
Taghavi Gilani
taghavim@mums.ac.ir
1
Cardiac Anesthesia Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
LEAD_AUTHOR
Alireza
Bameshki
bameshkia@mums.ac.ir
2
Cardiac Anesthesia Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
AUTHOR
Arash
Peivandi Yazdi
peivandia@mums.ac.ir
3
Cardiac Anesthesia Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
AUTHOR
Reihaneh
Hasanzadeh
reihaneh.hassanzadeh@yahoo.com
4
Cardiac Anesthesia Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
AUTHOR
ORIGINAL_ARTICLE
Safety and Efficacy of Intracoronary Vasodilators in the Treatment of No-Reflow after Primary Percutaneous Intervention in Patients with Acute ST-Elevation Myocardial Infarction: A Literature Review
Introduction: The investigation of no-reflow phenomenon after Percutaneous Coronary Intervention (PCI) in patients with acute ST-segment Elevation Myocardial Infarction (STEMI) has therapeutic implications. Several vasodilators were administered through intracoronary injection to treat this phenomenon. We aimed to elucidate the risk factors, predictors, and long-term effects of no-reflow phenomenon, and to compare the effects of various vasodilators on re-opening the obstructed vessels. Materials and Methods: All the reviewed articles were retrieved from MEDLINE and Science Direct (up to October 2014). All no-reflow cases were determined through Thrombolysis in Myocardial Infarction grading (TIMI) system. Results: Four articles were included, two of which mainly focused on risk factors, predictors, and long-term prognosis of no-reflow phenomenon, and its association with patient mortality and morbidity. The other two articles evaluated therapeutic interventions and compared their efficacy in treating no-reflow. Conclusion: Development of no-reflow in patients with STEMI after primary PCI is associated with low myocardial salvage by primary PCI, large scintigraphic infarct size, deteriorated left ventricle ejection fraction at six months, and increased risk of first-year mortality. During primary PCI, intracoronary infusion of diltiazem and verapamil can reverse no-reflow more effectively than nitroglycerin.
https://psj.mums.ac.ir/article_6694_068473d25d098ae48fbc9b4fd033c14f.pdf
2016-04-01
379
384
10.22038/psj.2016.6694
No reflow phenomenon
Risk Factor
TIMI grading system
Vasodilators
Mostafa
Dastani
dastanim@mums.ac.ir
1
Department of Cardiology, Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Somaye
Alirezaei
somaye.alirezaei93@gmail.com
2
Department of Cardiology, Quaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
LEAD_AUTHOR
ORIGINAL_ARTICLE
A Case of Mitral Valve Replacement with Neurologic Manifestations during Pregnancy
Introduction: Cardiopulmonary bypass in pregnant patient is considered a high-risk procedure. Maternal mortality is similar to that of the non-pregnant females about 1.5-5%. Variations in the timing of surgical intervention, gestational age, maternal health status, perfusion protocol, and pharmacologic therapy are all factors that can influence fetomaternal outcome. Case Report: We present a case of 26- year- old pregnant woman (G1, Ab0, D0) in gestational age of 36 weeks with sudden CVA and neurological sequelae (disartheria, paresthesia of right side of face). In her past medical history, she had no positive history of neurologic problems, diabetes mellitus, hyperlipidemia or cardiovascular diseases. Left perisylvian encephalitis was reported in her brain MRI. In trans-thoracic echocardiography moderate Mitral Regurgitation (MR), severe mitral stenosis with gradient of 9mmHg, and valve surface of 1cm2 was observed. In obstetrics consultation, a healthy male fetus with approximate gestational age of 37 weeks was reported. Finally the pregnancy ended by caesarean section under general anesthesia, with presence of cardiologist and a healthy newborn was delivered at age of 37 weeks. Four days after caesarean section, Mitral Valve Replacement (MVR) was measured which proceeded successfully. Conclusion:Due to the risk of further neurological complications in a pregnant mother who suffers from mitral valve stenosis, provided the gestational age permits harmless termination of pregnancy, it is possible to perform the mitral valve replacement procedure during the same hospital stay after termination of pregnancy.
https://psj.mums.ac.ir/article_6695_4418c29562867a0716e1c2dcc20c7da1.pdf
2016-04-01
385
387
10.22038/psj.2016.6695
Mitral Valve Replacement
pregnancy
Kambiz
Alizadeh
alizadehk@mums.ac.ir
1
Department of Cardiac Surgery, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
AUTHOR
Masoomeh
Tabari
tabarim@mums.ac.ir
2
Department of Anesthesiology, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
LEAD_AUTHOR