Journal of patient safety and quality improvement最新文献

{"title":"Factors Associated with Antihypertensive Medication Adherence among Diabetic Patients with Coexisting Hypertension in a Tertiary Care Centre from a Low Middle Income South Asian Country","authors":"Upathissa Ratnayake, T. Kumanan, R. Nadarajah","doi":"10.22038/PSJ.2021.50479.1283","DOIUrl":"https://doi.org/10.22038/PSJ.2021.50479.1283","url":null,"abstract":"Introduction: Poor medication adherence is a known preventable factor which can adversely affect   desired achievable blood pressure (BP) target. Strict control of blood pressure is essential among patients who have diabetes and hypertension (HT) in order to prevent complications. This is the first study conducted among 371diabetic patients with co-existing HT to examine the antihypertensive medication adherence in Sri Lanka to date. Materials and Methods:  This cross-sectional study was done in the general medical clinics of Jaffna Teaching Hospital from October 2019 to November 2019. Results:  The majority (66.6%) of the patients were female. Mean age of the participants was 60.93 ± 9.77. The total mean score for modified MASES (Medication Adherence Self Efficacy Scale) was 48.1 ± 3.81. A negative correlation was noted between MASES scores and systolic (r= -0.033) and diastolic (r=- 0.083) blood pressure. Median score 49 was used to classify the patients into optimal or suboptimal adherence to antihypertensive medication. A significant percentage (43.4%CI: 38.4-48.5) of research participants were sub optimally adhered to antihypertensive medication. Among the associated factors explored, gender (P-0.007), low-income (P-0.002) and employed people (P-0.046) showed significant association with poor adherence. However, the number of co-morbidities (P-0.335), number of medications (P-0.454), duration of hypertension (P-0.440), and frequency of clinical visits (P-0.373) were not significantly associated with anti-hypertensive medication adherence. Conclusion: This finding has an implication in clinical practice to improve the quality of care. Professionals should give consideration to above socio-demographic factors (gender, income, and occupation) before prescribing appropriate medication and its dosing schedule for hypertension.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"10 1","pages":"29-39"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86622133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous Use of Metoclopramide and Sustained Hypotension: A Case Report","authors":"Mulugeta Russom, Okbu Frezgi","doi":"10.22038/PSJ.2021.54936.1306","DOIUrl":"https://doi.org/10.22038/PSJ.2021.54936.1306","url":null,"abstract":"Introduction: Transient hypotension has been commonly associated with metoclopramide hydrochloride, particularly with intravenous use. However, the risk of sustained hypotension that lasts for hours has not been previously associated with metoclopramide, except for one published case report. This case report is aimed at documenting the second case of unusual and serious sustained hypotension that lasted for more than six hours following rapid intravenous use of metoclopramide prescribed for the prevention of cesarean section delivery related intra/postoperative nausea and vomiting. Case Report: A 33-year-old gravida III and para II woman was admitted to a hospital for an elective cesarean section delivery with normal baseline blood pressure. Following metoclopramide 10 mg intravenous push administration, over 5-10 seconds, the mother encountered sustained hypotension (60/40 mmHg) that lasted for 120 minutes. After resuscitation, her blood pressure raised to 105/60 mmHg. However, after spinal anesthesia with bupivacaine hydrochloride, her diastolic arterial blood pressure dropped back again to 40 mmHg which persisted for about six hours post-operation. Upon investigation, the sustained hypotension was found to be probably related to inappropriate and rapid administration of intravenous bolus dose of metoclopramide hydrochloride that could have been prevented since it should be administered slowly over at least three minutes. Conclusion: The risk of metoclopramide-induced hypotension should not be underestimated as it sometimes might be much severe than the risk of nausea and vomiting that warrants immediate attention from healthcare professionals and program managers.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"3 1","pages":"65-68"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75236679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Errors Committed By New Graduate Nurses with Developmental Disorder Tendencies in Japan","authors":"Y. Ikematsu, Koji Egawa, M. Endo","doi":"10.22038/PSJ.2021.47160.1268","DOIUrl":"https://doi.org/10.22038/PSJ.2021.47160.1268","url":null,"abstract":"Introduction: The present nationwide survey was carried on new graduate nurses in Japan who were identified with difficulties in acquiring occupational skills in their first year of employment by their nursing managers. The characteristics of the nurses in their first year of employment, reported by their direct supervisors, were assessed to identify developmental disorder tendencies (DDT). The errors committed during the first year of employment were compared between the nurses with and without DDT. The level of incident aftermath, developed by the National University Hospital Council of Japan, was used for comparison. The nurses with DDT committed higher levels of clinical errors, compared to those without DDT; however, mild levels of sequential injuries were reported. The results of this study indicated that support provided to such nurses may be insufficient. Support programs particularly focusing on DDT may reduce the clinical errors committed by new graduate nurses. Additionally, the determination of specific tendencies contributing to clinical errors is warranted.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"119 1","pages":"61-64"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77964359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Pharmacy-Driven Medication Reconciliation upon Admission to Improve Patient Safety in a Family Medicine Unit","authors":"Emily G. Messing, Keith T. Veltri, M. Sinnett, R. Abraham","doi":"10.22038/PSJ.2021.47156.1267","DOIUrl":"https://doi.org/10.22038/PSJ.2021.47156.1267","url":null,"abstract":"Introduction: Medication reconciliation is the process of comparing a patient’s ordered medications to what the patient is actually taking. For several years, it has been included as part of The Joint Commission National Patient Safety Goals for improving medication safety.  Our study investigated the impact of pharmacy personnel involvement in the medication reconciliation process on a family medicine unit in a large, urban, academic medical center. Materials and Methods: A prospective, non-randomized, cross-sectional study was conducted from November 2017 through March 2018. The number of medication discrepancies identified as well as the characteristics of the patients, types and medication classes most commonly associated with discrepancies were assessed. Results: Approximately 104 out of 134 or 78% of patients had at least one discrepancy at the time of admission. The most common discrepancy type was related to the electronic medical record followed by omissions, patient non-compliance and the drug being held.  The medication classes mostly commonly associated with discrepancies were over the counter medications, cardiac medications and analgesics. Of the 104 patients that had at least one discrepancy, 31 (30%) required an intervention by a member of the pharmacy team. Conclusion: Pharmacy interns identified additional prescription and non-prescription medication discrepancies after the medication reconciliation process had already been completed. Involving pharmacy interns in a formal, standardized medication reconciliation process can help maintain and communicate accurate patient information.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"49 1","pages":"47-53"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79374171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematological and Biochemical Parameters Associated with Mortality in COVID-19 Infection and Their Correlation with Smoking","authors":"S. Sobhani, A. Kazemi, Forough Kalantari, Salman Soltani, S. Vakili, A. Yarahmadi, M. Rahimi, Atena Aghaee","doi":"10.22038/PSJ.2021.54097.1301","DOIUrl":"https://doi.org/10.22038/PSJ.2021.54097.1301","url":null,"abstract":"Introduction: Coronavirus disease 2019 (COVID-19) initially appeared in China, in December 2019 and has already evolved into a pandemic spreading rapidly throughout the world. The present study aimed to determine the relationship between hematologic and biochemical parameters associated with the mortality rate in COVID-19 infection and their correlation with smoking. Materials and Methods: This study was performed on 388 patients affected by COVID-19 who were admitted to Imam Reza Hospital in Mashhad, Iran from February 20, 2020, to May 21, 2020. Results: The patients were within the age range of 18-94 years old, and 341 of them were nonsmokers, while 47 of them were smokers. Moreover, chronic obstructive pulmonary diseases were more frequent among smokers. The mean of initial (on admission) white blood cell (WBC) count in smokers was significantly higher than nonsmokers (P=0.015). Males were more prone to death due to COVID-19 infection than females (P=0.035). In total, 60 (15.46%) out of 388 patients died because of COVID-19, while 84.5% of them survived. Conclusion: The results indicated a higher WBC count among smokers. Moreover, a higher WBC count on admission was associated with higher mortality. However, hospitalization duration was not different among smokers and nonsmokers groups. It was found that higher CRP levels and hospitalization periods were associated with an increased risk of death. The COVID-19 mortality rate was higher in men, compared to women. Eventually, no significant correlation was found between smoking and the mortality of patients with COVID-19.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"6 1","pages":"41-46"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82868081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “is Phaeohyphomycosis an emerging fungal Infection in Iran? A Short Communication","authors":"A. Hakamifard","doi":"10.22038/PSJ.2020.50169.1282","DOIUrl":"https://doi.org/10.22038/PSJ.2020.50169.1282","url":null,"abstract":"Dear editor We recently read an interesting article entitled “Is Phaeohyphomycosis an emerging fungal Infection in Iran? A Short Communication” [1] which is published in your journal. This article discusses the prevalence of Phaeohyphomycosis cases in Iran. We published an article entitled “Cerebral Phaeohyphomycosis due to Rhinocladiella mackenziei in Persian Gulf region: A case and review” in 2018 [2]. Our case was a diabetic patient with the history of behcet's disease and with the diagnosis of brain abscesses due to Rhinocladiella mackenziei. For the patient we prescribed voriconazole at first then change the regimen to amphotericin b liposomal (5 mg/kg/day) with combination of posaconazole (200 mg every 6 hours). In the article published by zarrinfar et al recently [1], the authors have referenced our article [2] and instead of the original dose for posaconazole (200 mg every 6 hours), which we also had stated the dose in our article (200 mg every 6 hours), the authors have written wrong dose (200 mg daily) in the table. The dose of posaconazole for treatment is 200 mg every 6 hours and for prophylaxis is 200 mg every 8 hours. We request that this wrong dose be corrected in the table of article published in your journal.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75749601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude, and Practice of Self Medication among Medical Students of Mashhad University of Medical Sciences, Mashhad, Iran","authors":"Seyedeh Motahareh Mirdoosti, M. Mirzaei, A. Saadati, Mohadeseh Rahimi Hendavalan, Vida Vakili","doi":"10.22038/PSJ.2020.49713.1278","DOIUrl":"https://doi.org/10.22038/PSJ.2020.49713.1278","url":null,"abstract":"Introduction: Self-medication is a double-edged sword the proper application of which is appreciated by the World Health Organization (WHO) guidelines since it can reduce the unnecessary pressure on the health care system. However, self-medication can lead to severe consequences if utilized inappropriately. Furthermore, self-medication practice is an important social health issue in medical students as educated people and would-be physicians. This study aimed to determine the knowledge, attitude, and practice of self-medication in medical students of Mashhad University of Medical Sciences, Mashhad, Iran. Materials and Methods: This cross-sectional questionnaire-based study included 296 medical students at distinct levels of education. The data were analyzed in SPSS software (version 26). Results: Based on the findings, more than 80% of the students were aware of the complications, drug interactions, and importance of accurate use; however, only 9.1% and 27% of the participants were aware of the side-effects of herbal medicine and dietary supplements, respectively. Out of the total 296 participants, 83.5% of the cases declared that they did care about the side effects of medicines, and 81.3% of the students believed that a medical degree was essential for medicine prescription. In a confrontation with minor ailments, 21.9% of the cases practiced self-medication, and the majority (57.4%) of the used medicines were painkillers. The main reasons for self-medication was the underestimation of the disease (57.8%). Moreover, positive attitudes toward the safety of self-medication (P=0.04) and knowledge about medicine (p <0.001) were the major reasons for the self-medication practice in senior students, compared to juniors. However, no significant difference was found between seniors and juniors in terms of self-medication practice (P=0.85). Conclusion: Regarding the adverse effects of self-medication, drug dependency, microbial resistance, and high prevalence of self-medication among participants, it is suggested to provide educational programs on the adverse effects of self-medication. In addition, appropriate measures should be taken to control and prevent an easy access to medications.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"51 1","pages":"193-201"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78632948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Patient Fall Prevention Program on Nurses' Knowledge and the Number of Patient Falls in one of the Teaching Hospitals in Mashhad during 2019","authors":"Z. Saadati, Maliheh Sadeghnezhad, Maliheh Siasar, Marzieh Rajaeinasab, Maryam Touri","doi":"10.22038/PSJ.2020.48423.1272","DOIUrl":"https://doi.org/10.22038/PSJ.2020.48423.1272","url":null,"abstract":"Introduction: This study aimed to evaluate the effect of a patient fall prevention program on nurses’ knowledge and number of patients falls in one of the teaching hospitals in Mashhad, Iran. Materials and Methods: This quasi-experimental study was conducted on 600 nurses working in a hospital affiliated with Mashhad University of Medical Sciences, Mashhad, Iran. The participants were selected via a proportionate stratification sampling method. The fall prevention program included two educational posters and a booklet that introduced key points regarding the prevention of patient falls based on the standard guidelines. The participants were asked to respond to a researcher-made questionnaire that measured their knowledge of patient fall prevention at pretest and posttest. The number of patient falls was evaluated before and after the prevention program. Data were analyzed using SPSS software (version 25) through descriptive and inferential (Wilcoxon test). A p-value less than 0.05 was considered statistically significant. Results: There was a significant difference between the scores of pretest and posttest regarding the nurses’ knowledge (p <0.001). Moreover, the examination of the number of falls in three months before and after the patient fall prevention program showed a significant decrease (63%) in the patient falls. Conclusion: The results demonstrated that the provision of prevention programs in this study had a significant impact on the improvement of patient safety level by reducing the number of patient falls through increasing the knowledge of nurses and awareness of patients.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"42 1","pages":"187-192"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79542160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Preoperative Administration of Rectal Indomethacin in Reducing the Severity of Ileus after Open Cholecystectomy","authors":"E. Soltani, A. Jangjoo, M. M. Bahar, M. Afzalaghaee","doi":"10.22038/PSJ.2020.50108.1281","DOIUrl":"https://doi.org/10.22038/PSJ.2020.50108.1281","url":null,"abstract":"Introduction: Ileus or transient intestinal motility disorder is one of the problems after surgery, which poses challenges facing the medical team. Previous studies approved the preemptive effects of non-steroidal anti-inflammatory drugs (NSAIDs) on ileus; however, the majority of them have focused on animal models. This study aimed to investigate the effects of administration of rectal indomethacin in reducing ileus in patients who underwent cholecystectomy. Materials and Methods: This randomized controlled trial included 40 patients with cholelithiasis who were divided into two groups of indomethacin (n=20) and placebo (n=20). The indomethacin group received 100 mg rectal indomethacin before the operation. Cholecystectomy was performed using an open technique. The recovery of bowel functions (i.e. the time of the first flatus passage, return of appetite, and total dosage of opioid analgesic medications) was evaluated in this study. Results: Time of the first ileus passage (P=0.004), return of appetite time (P=0.06), and reduction of opioid usage (65.62±5.5 mg/day versus 93.26±2.56) were significantly shorter in the indomethacin group, compared to the placebo group. Furthermore, none of the patients had any significant indomethacin-related complications. Conclusion: According to the outcomes of this study, it is concluded that preoperative administration of NSAIDS can be helpful in postoperative ileus reduction.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"121 1","pages":"207-211"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78428882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Urticaria Spray on the Pain Severity in Chronic Low Back Pain Patients Referring to an Orthopedic Clinic","authors":"M. Koushan, A. Khani, S. Nodehi, Sayed Mahdi Mirhamidi, R. Akrami","doi":"10.22038/PSJ.2020.51808.1287","DOIUrl":"https://doi.org/10.22038/PSJ.2020.51808.1287","url":null,"abstract":"Introduction: Regarding serious impact of chronic back pain in quality of life of people, patients looking for treatment to relieve back pain. The anti- inflammatory properties of nettle plant (Urtica dioica) as spray in reducing severity of low back pain was investigated. Materials and Methods: This study as a registered controlled clinical trial (IRCT: 20171217037930N1) recruited 40 patients with chronic back pain who referred to Orthopedic clinic of Sabzevar Shahid Beheshti Hospital, Sabzevar, Iran by available sampling method. Patients were divided randomly into two groups; group A: treatment with utricaria spray and usual medical treatment (20 persons), group B: patients under just usual medical treatment (20 persons). Pain measurement tool carried out under the visual analog scale (VAS) after intervention into both groups, and data were analyzed by SPSS software. Results: Both studied groups had the similar VAS before the study (P=0.15). Analysis of VAS showed that the average pain severity after intervention was decreased significantly into both studied groups (P=0.01). However these decrements in VAS were not statistically significant between two studied groups (P=0.06). Multiple linear regression analysis determined that utricaria spray could be decreased pain severity to averagely till 0.79%. Conclusion: We concluded that adding utricaria spray to usual treatment has no effect into decreasing chronic low back pain.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"1 1","pages":"213-218"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77454283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}