Journal of patient safety and quality improvement最新文献

{"title":"Language Miscommunication in the Healthcare Sector: A Case Report","authors":"A. Saqer, Alaa Qanbar","doi":"10.22038/PSJ.2019.36761.1197","DOIUrl":"https://doi.org/10.22038/PSJ.2019.36761.1197","url":null,"abstract":"Introduction: Effective communication is of paramount importance to the safety of patients and quality of care. With all the racial and ethnic diversity in the United Arab Emirates (UAE), the language barrier is a hurdle that healthcare providers have to handle. Such barrier affects various aspects of healthcare for non-native speakers, including health status, access to care, and use of health services. Language barriers impair the clerking process, resulting in misdiagnoses or poor management decisions. Case:We presented a typical case of language miscommunication, which led to an improper management decision that could have led to serious complications to the patient. In this report, we have discussed the outlines of the case and the mistakes that led to its occurrence. We also provided recommendations to prevent the occurrence of similar incidents in our environment and elsewhere based on the United States (U.S) Department of Health and Human Services (HHS) language access plan.Conclusion: Patient safety, quality of care, and patient rights, each in themselves, are sufficient to justify commitment to optimum communication. Together, they make effective communication with patients obligatory.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"1 1","pages":"33-35"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74962054","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":"A Case Report of a Successful Allergen Immunotherapy with Candida Albicans in Patient with Sever Atopic Dermatitis Sensitive to Candida Albicans","authors":"F. Azad, P. Payandeh, P. Layegh, Javad Fadaee","doi":"10.22038/PSJ.2019.37105.1202","DOIUrl":"https://doi.org/10.22038/PSJ.2019.37105.1202","url":null,"abstract":"Introduction: Atopic dermatitis (AD) is an inflammatory, chronic, relapsing, itchy skin disease with an immunologic basis. This disease is associated with itchy skin lesions (pruritus), dry skin (xerosis) and plaques of eczema. The role of aeroallergens, such as house dust mite (HDM) and food allergens has been proven to exacerbate skin eczema lesions. Alongside drugs such as corticosteroids, topical emollients, antihistamines, tacrolimus, and immune suppressants, phototherapy and subcutaneous immunotherapy (SCIT) also done. SCIT is mostly using for sensitization to mite allergens.Case Presentation: We present a 30 y/o Iranian woman with severe atopic dermatitis and sensitization to Candida allergens. We initiated SCIT with candida allergen and the patient had obvious improvements in her signs and symptoms 3 months after starting SCIT.Conclusion: Although subcutaneous immunotherapy was only approved for mite sensitization in atopic dermatitis, it should be considered in other aeroallergen sensitizations.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"46 1","pages":"24-26"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75997068","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":"Relationship between Psychological Empowerment of Managers with Performance Accountability in Hospitals Affiliated to Tehran University of Medical Sciences, Tehran, Iran","authors":"M. Mohseni","doi":"10.22038/PSJ.2019.33915.1188","DOIUrl":"https://doi.org/10.22038/PSJ.2019.33915.1188","url":null,"abstract":"Introduction: The most important functions of the organization are accountability. The only sustainable competitive advantage in any organization, is its employee and their role in the success of the organization that it is possible through empowerment and job satisfaction. The aim of this study was to determine the relationship between psychological empowerment of managers with performance accountability in Hospitals at Tehran University of Medical Sciences.Material and Methods:This cross-sectional analytic study was performed in 2014 among 110 top and middle managers in 12 hospitals at Tehran University of Medical Sciences. The sample size was calculated based on the formula for determining sample size in correlation studies. The data were collected via the psychological empowerment questionnaire and performance accountability checklist. The analysis was carried out with the SPSS 18 software and Statistical methods used are descriptive (frequency, mean, percent) and analytical statistics (Pearson correlation).Results: In general, the condition of performance accountability of hospitals and managers' psychological empowerment was \"good\". The total mean on feeling of meaningful (4.33±0.72), competence (4.29±0.62) and impact of managers (3.81±0.78) was 'high' but on feeling of self determination (3.62±0.80) and trust (3.47±0.82) was average. There was no significant correlation between the psychological empowerment and performance accountability (P>0/05).Conclusion: In order to improve the conditions in health sectors, more attention to weaknesses in accountability should be a priority for managers to deal with the problems. Empowerment of managers can play an important role in implementation of tasks and thus reaching the level of the logical and appropriate accountability.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"76 1","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83850081","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":"Epidemiology, Clinical Manifestations, Laboratory Findings and Outcome of Brucellosis in Hospitalized Children in Northwest of Iran","authors":"Iman Vafaei, M. Rezaee, B. Abdinia, Kasra Kolahdouzan","doi":"10.22038/PSJ.2019.34962.1192","DOIUrl":"https://doi.org/10.22038/PSJ.2019.34962.1192","url":null,"abstract":"Introduction: Brucellosis is a zoonotic disease, which is associated with great economic and general health concerns. This is an endemic disease in Iran, and thus this study aimed to investigate its epidemiology and trend over a ten-year period in children hospitalized in northwest IranMaterial and Methods: A retrospective study was conducted on children hospitalized with brucellosis diagnosis in the Children's Hospital. Information of the patients, such as type of living place, age, history of consuming unpasteurized dairy products, family history of brucellosis in the past year, type of contact patterns with livestock, clinical symptoms, Wright's test, 2-mercaptoethanol test, Coombs Wright test and treatment failure, was collectedResults: Over a ten-year period, 59 medical records were extracted, out of which 21 subjects (35.6%) were female and 38 (64.4%) male. The mean age of involvement was 80.5 months. In addition, 16.9% and 22% of patients had a history of contact with livestock, and 22% had a history of consuming unpasteurized dairy products. Moreover, 78.6% of patients had Wright’s test titers of ≥1:160 and 91.8% had Coombs test titers of ≥1:160. Blood culture results of 19 patients were available, out of which 21.1% were culture-positiveConclusion: Epidemiological studies assessing important risk factors for the spread of brucellosis in different regions across the world are very effective in disease control. Moreover, the results revealed that the serological tests can be used to diagnose brucellosis. To the best of our knowledge, this is the first report about epidemiology of children brucellosis in northwest Iran.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"152 1","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79585123","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":"Measured Time and Perceived Time: Crucial Data in Reducing and Managing the Time Spent at the Emergency Department","authors":"Mohd Nasir Mohd Ismail, V. Seow","doi":"10.22038/psj.2019.36014.1196","DOIUrl":"https://doi.org/10.22038/psj.2019.36014.1196","url":null,"abstract":"Introduction:Wait time at the emergency department is a global issue. However, most studies have relied on measured times to reduce and manage wait times at the emergency department. Material and Methods: A quality improvement project using a mixed-method was conducted to reduce and manage the time patients spent at the emergency department. Results: In-depth interviews with the business team staff showed that pharmacy was perceived by them as taking 30 minutes to complete the medication orders. Pharmacy was therefore seen as the bottleneck within the patient flow at the emergency department by these staff. However, when the times pharmacy completed the orders were measured using time stamps, the measured times were found to be 10 minutes. The business team staff found the measured time data as failing to capture their interactions with pharmacy. Hence, observations were further conducted with the business team staff to understand their perceptions. These observations found that patients were constantly approaching the business team staff for updates on their pharmacy orders which added anxiety to the business team staff. The led them to continuously check the hospital information system for any updates on the completions of the pharmacy orders as this was needed to finalize the bills and discharge the patients from the emergency departments. These anxiety and workload led to the perceived time to be 30 minutes among the staff. Conclusion: The combinations of perceived time and measured time data were used in this quality improvement project to advocate to the nurses and emergency department physicians to inform the patients that pharmacy would take time to thoroughly check and complete the orders and that they would be called to the counter by the business team staff when the orders were completed. This helped to manage the expectations of the patients and reduce the anxiety and workload of the staff.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"45 1","pages":"9-12"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76165456","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":"Nursing students’ errors and their causes: A qualitative exploration of clinical instructors’ perspectives","authors":"S. Valiee, M. Fathi, R. Shahoei","doi":"10.22038/psj.2019.34505.1190","DOIUrl":"https://doi.org/10.22038/psj.2019.34505.1190","url":null,"abstract":"Introduction: Students may commit errors while learning and developing their clinical skills. This study was aimed to explore clinical instructors’ view about nursing students’ errors.Material and Methods: A descriptive qualitative study was conducted using a qualitative approach. Semi-structured interviews were conducted with twelve clinical instructors and analyzed using inductive content analysis.Results: Two main categories emerged from the data as “Nature of nursing students’ errors” (Acting against the instruction set and Repeating the same mistake) and “Causes of nursing students’ errors” (Personal characters and Educational characters).Conclusion: There is a need for a precise definition of nursing students’ errors to promote patients' safety. It is necessary to concentrate attention on the causes of the student’s error and improve preventive measures from the perspective of education practitioners such as clinical instructors and especially students. The presence of clinical instructor with the standard ratio to nursing students and proper communication with the nurses could prevent the occurrence of mistakes. Improvement of the educational condition of clinical teaching and making a calm and motivational clinical learning environment is necessary.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"63 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88840664","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 and Information Sources of Standard Precautions among Physicians in Mashhad, Iran","authors":"M. Sarbaz, Fereshte Manouchehri Monazah, Marzieh Ebrahimi, Khalil Kimiafar","doi":"10.22038/PSJ.2019.35711.1194","DOIUrl":"https://doi.org/10.22038/PSJ.2019.35711.1194","url":null,"abstract":"Introduction: Health care workers are exposed to percutaneous injuries. They are at risk of infection from bloodborne pathogens during routine clinical duties. Adherence to standard precautions can protect health care workers. The purpose of this study was to assess the level of knowledge of physicians about standard precautions and the use of information resources in the field of infection control. Material and Methods: A cross-sectional survey was conducted during January and March 2015, on 308 physicians working in the five academic hospitals affiliated with Mashhad University of Medical Sciences. Demographic and additional related data were obtained by questionnaire from all participants. Data were analyzed in SPSS 16. Result: most of the participants were Specialists and female (60.7%). Specialists for some items related to standard precautions scores were over 90%; However for items related to “knowing the standard precautions, a goal of standard precautions and washing hand after taking off the gloves” scores were below 70%. There was no significant difference in knowledge of standard precautions among different medical groups (p-value=0.87). The most frequently mentioned information sources by specialists (90%) were “local instructions” but residents and interns (76%) preferred “discussion with colleagues” as the first source information in relation to standard precautions. The most Specialists had not received enough training about standard precautions (52.2%). Conclusion: There is a need for guidelines for training the standard precautions among health care workers.","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"4 1","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91150189","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":"Leukocytosis in Diabetic Ketoacidosis; Whether the Time Has Come to Start Antibiotics? A Short Literature Review","authors":"S. Hosseini, M. Firooz, Bagher Moradi","doi":"10.22038/PSJ.2019.35823.1195","DOIUrl":"https://doi.org/10.22038/PSJ.2019.35823.1195","url":null,"abstract":"Article type: Letter to editor One of the most common risk factors of DKA is infections which are more prevalent in the urinary and respiratory system respectively. Therefore, it is essential to examine the patients with DKA at the arrival in term of presence or absence of infection. Leukocytosis is commonly seen in infectious diseases . The presence of leukocytosis can trigger an antibiotic in these patients. It is while the misuse of antibiotics in addition to the financial costs to patients can increase risk of resistance to antibiotic which is a global concern. In several studies, increased leukocyte in patients with diabetes has been attributed to various factors such as: lack of insulin, inflammatory processes activity, secretion of adrenaline and cortisol and infection. Also, The results of studies showed a strong direct relationship between blood pH and level of WBC; i.e. the severity of blood acidity increases with the amount of leukocytesTherefore, the medical team should take a history, physical or clinical examinations to make decision on the appropriate treatment including, prescribe or not prescribe an antibiotic. Article History: Received: 12-Oct-2018 Accepted: 04-Feb-2019","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"28 1","pages":"27-28"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74877918","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":"Satisfaction, Safety and Cost of the Treatment for Multiple Sclerosis Relapse with Intravenous versus Oral Methylprednisolone","authors":"M. González-Platas, Pérez Martín Maria Yaiza, Espinosa Bueno Inmaculada, González Perera Itamar, Díaz Stier Noemi, E. Pablo","doi":"10.22038/PSJ.2018.11702","DOIUrl":"https://doi.org/10.22038/PSJ.2018.11702","url":null,"abstract":"","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"15 1","pages":"0-0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81235724","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 Developmental Stimulation Program on Language Evolution Age in 1-3 Year-Old Children with Celiac Diseas","authors":"A. Rezaean, Elahe Ghayebie","doi":"10.22038/psj.2018.11705","DOIUrl":"https://doi.org/10.22038/psj.2018.11705","url":null,"abstract":"Article type: Original Article Introduction: Children younger than 5 years are in the fastest growth and developmental period of their lives. Regarding this, the present study was conducted to determine the effect of a developmental stimulation program on language evolution criteria in 1to 3-year-old children with celiac disease. Materials and Methods: This clinical trial was performed on two groups (i.e., intervention and control) of 50 children aged 1-3 years with celiac disease using random allocation technique. A developmental stimulation program was implemented for the children in the intervention group in two-hour sessions every week for 2 months. The language evolution age was evaluated by the Bayley Scales of Infant Development (Bayley-III). The data were analyzed using SPSS software (version 11.5). Results: The mean age of the participants was 20.6±4.4 months. Prior to the intervention, the mean age of receptive and expressive language development showed no significant difference between the two groups (P=0.672 and P=0.166, respectively). Similarly, immediately after the intervention, the mean age of expressive language development in the intervention group (21.5±3.8) underwent no significant increase, compared to that in the control group (19.1±4.5). This variable was not also significantly different between the groups in the four-month follow-up (P=0.076). Nonetheless, with regard to the mean age of receptive language evolution, this variable demonstrated a significant increase in the intervention group (24.2±4.8), compared to that in the control group immediately after the intervention (19.1±4.3; P=0.002). The results of the four-month follow-up were also indicative of a significant difference between the two groups in terms of the mean age of receptive language evolution (P<0.001). Conclusion: Based on the findings of the present study, the developmental stimulation program can be used for promoting receptive language skills in children with celiac or other chronic diseases. Article History: Received: 27-Sep 2020 Accepted: 28-Sep-2020","PeriodicalId":16681,"journal":{"name":"Journal of patient safety and quality improvement","volume":"207 1","pages":"0-0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76575194","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}