Journal of Healthcare Quality Research最新文献

{"title":"Strengthening safety for informal caregivers in home care","authors":"N. Abed , C. Perez Esteve , H. Knežević-Krajina , S.C. Buttigieg , S. Tella , E. Srulovici , P. Sousa , B. Knezevic , J.J. Mira","doi":"10.1016/j.jhqr.2025.101183","DOIUrl":"10.1016/j.jhqr.2025.101183","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101183"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927519","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":"Programa domiciliario de terapia ocupacional y enfermería de atención primaria AToDOM","authors":"N. Plaza-Briones ,&nbsp;M. Carrete-Gómez ,&nbsp;L. Secanell-Capdevila ,&nbsp;J.A. López-Segura ,&nbsp;J. Grau-Sánchez ,&nbsp;L. Vidaña-Moya","doi":"10.1016/j.jhqr.2025.101155","DOIUrl":"10.1016/j.jhqr.2025.101155","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>To determine the impact of a home-based occupational therapy and nursing program, on autonomy in activities of daily living, quality of life, and falls in people with chronic diseases and complex needs.</div></div><div><h3>Material and methods</h3><div>A pre-post quasi-experimental quantitative study with a consecutive sample based on the usual clinical practice of home care teams. The Barthel Index, Lawton &amp; Brody Scale, Short Falls Efficacy Scale, Life Space Assessment, Quality of Life Index, and falls in the last two months were assessed. A paired sample pre-post hypothesis contrast analysis was performed, stratified by sex and care profile.</div></div><div><h3>Results</h3><div>A total of 115 participants were recruited, of whom 8 were dropouts. The program showed statistically significant improvement in all indicators. Notably, the Barthel Index increased by 10,0 (IC 95%: 8.2; 11.8) (p<!--> <!-->≤<!--> <!-->0.001), reducing the level of dependency from severe to moderate. The Lawton &amp; Brody scale increased by 0.6 (IC 95%: 0.4; 0.8) globally, and the percentage of participants with at least one fall in the past two months decreased from 40.4% to 2.0%.</div></div><div><h3>Conclusions</h3><div>The intervention performed by the occupational therapist is key in the promotion of autonomy, falls prevention and quality of life. It is a value to be taken into account in the configuration of home care teams in primary care.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101155"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875662","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":"Impacto del test de reserva sanguínea en cirugía bariátrica. ¿Cuánto de necesario y cuánto de rutina?","authors":"M.L. Garcia Garcia ,&nbsp;E. Rognoni Martinez ,&nbsp;J.A. Torralba Martinez ,&nbsp;M. Baeza Murcia ,&nbsp;A. Heredia Cano ,&nbsp;V. Soria Aledo","doi":"10.1016/j.jhqr.2026.101193","DOIUrl":"10.1016/j.jhqr.2026.101193","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative blood ordering is frequently in bariatric surgery, even for procedures that rarely require blood transfusion. The aim of this study was to evaluate the patients who receive transfusion and determining their associated factors and assess the need to make a pre-operative blood reserve test in elective bariatric surgery based on the rational analysis of over-reserve, risk-benefit and cost-effectiveness.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on consecutive patients who underwent bariatric surgery between 2020 and 2024. Clinical-pathological and surgical variables were analyzed. The crossmatch-to-transfusion ratio, probability of transfusión, and transfusion index were calculated.</div></div><div><h3>Results</h3><div>A total of 174 patients underwent bariatric surgery. Only one patient required a blood transfusion, yielding a transfusion probability of 0.57%, a crossmatch-to-transfusion ratio of 88, and a transfusion index of 0.02. None of the analyzed variables were associated with hemoglobin loss. The total cost of preoperative blood screening for these patients was €842.16.</div></div><div><h3>Conclusions</h3><div>Likelihood of receiving perioperative transfusion in bariatric surgery is very low. All blood reserve parameters show over-reserve in these surgeries. Data obtained allowed us to remove the blood reserve test in bariatric surgery of our protocol.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101193"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214160","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":"Proceso de definición de prestaciones asistenciales: una guía práctica basada en las lecciones aprendidas","authors":"M. Pons-Vigués ,&nbsp;C. Casanovas-Guitart ,&nbsp;J. Reynolds ,&nbsp;A. Pozuelo Garcia ,&nbsp;X. Suris Armangué ,&nbsp;A. Ricart Conesa","doi":"10.1016/j.jhqr.2025.101184","DOIUrl":"10.1016/j.jhqr.2025.101184","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101184"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927520","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":"Medication incidents and informal caregiver burden: A cross-sectional study","authors":"P. Ballester ,&nbsp;E. Gil-Hernández ,&nbsp;C. Pérez-Esteve ,&nbsp;M. Guilabert ,&nbsp;I. Carrillo ,&nbsp;A. Arroyo ,&nbsp;A. Cobos ,&nbsp;J.J. Mira","doi":"10.1016/j.jhqr.2025.101175","DOIUrl":"10.1016/j.jhqr.2025.101175","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to evaluate the potential association between medication-related safety incidents in home care settings reported by informal caregivers and their emotional burden levels.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among informal caregivers of senior patients aged over 65 years requiring daily care. Participants completed the 7-item Zarit Caregiver Burden Scale and self-reported medication safety incidents.</div></div><div><h3>Results</h3><div>In total, 176 participants responded. Medication safety incidents were reported by 25.6% of them. Caregiver burden was independently associated with a higher likelihood of self-reported medication safety incidents, with an odds ratio of 2.16 (95% CI: 1.03–4.50), after adjusting for caregiving hours. In addition, male sex was also independently associated with increased risk, with an odds ratio of 2.29 (95% CI: 1.06–4.98).</div></div><div><h3>Conclusions</h3><div>This study shows that caregiver burden is associated with self-reported medication-related incidents in home care. Targeted interventions that promote informal caregiver well-being may reduce safety incidents and enhance the sustainability of informal care. This study suggests that training programs should address medication safety using gender-sensitive strategies and incorporate tools to alleviate caregiver burden.</div><div>Trial registration <span><span>NCT05885334</span><svg><path></path></svg></span> (date 2023-06-01).</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101175"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834806","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":"Seguridad del paciente en salud mental: una deuda pendiente","authors":"S. Tomás-Vecina ,&nbsp;E. Vicens-Pons ,&nbsp;B. Blanquez-Gómez","doi":"10.1016/j.jhqr.2025.101186","DOIUrl":"10.1016/j.jhqr.2025.101186","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101186"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979065","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":"Adequacy of anticoagulation in patients with nonvalvular atrial fibrillation","authors":"M. Fernández-Pérez,&nbsp;Á. Pereda,&nbsp;M. Gabilondo,&nbsp;C. Pisón","doi":"10.1016/j.jhqr.2026.101194","DOIUrl":"10.1016/j.jhqr.2026.101194","url":null,"abstract":"<div><h3>Objective</h3><div>Fewer benefits are obtained from antithrombotic therapy in nonvalvular atrial fibrillation (NVAF) in routine practice than in clinical trials due to inadequate prescribing. This study aimed to assess the adequacy of anticoagulation therapy in clinical practice in patients with newly diagnosed NVAF.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted to assess treatment adequacy in patients with newly diagnosed NVAF in Alava. The adequacy of direct-acting oral anticoagulant (DOAC) therapy was classified according to the dose specified in the summary of product characteristics. In patients treated with vitamin K antagonists (VKAs), anticoagulation therapy quality was considered good when the time in the therapeutic range (international normalised ratio: 2.0–3.0) was ≥60%. Univariate and multivariate logistic regression analyses were performed to analyse the probability of inadequacy.</div></div><div><h3>Results</h3><div>Overall, 1446 patients with NVAF were included: 408 (28%) were treated with DOACs, and 856 (59%) with VKAs, while 182 (13%) received no anticoagulation therapy. The treatment was considered adequate in 75% of the DOAC group, 33% of the VKA group, and 57% of the no-anticoagulant group. The reason for inadequacy in treated patients was receiving an inappropriate dose of DOACs (25%) or VKAs (67%), while in the untreated group, 78 cases (43%) were classified as inadequate due to lack of anticoagulation with no clinical justification.</div></div><div><h3>Conclusions</h3><div>There is marked variability in the adequacy of anticoagulation in patients with NVAF. Guideline recommendations should be strictly followed to improve treatment adequacy, as it is unacceptable that half of these patients are inadequately anticoagulated.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101194"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198099","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":"Back to basics: Why quality and patient safety tools still matter","authors":"S. Lorenzo Martínez,&nbsp;D. Parés Martínez,&nbsp;C. Natal Ramos","doi":"10.1016/j.jhqr.2026.101198","DOIUrl":"10.1016/j.jhqr.2026.101198","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101198"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310799","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":"Surveillance of healthcare-associated infections and antimicrobial use in long-term care facilities in the Community of Madrid","authors":"M. Mosquera-González,&nbsp;M. Alonso-García,&nbsp;S. Jiménez-Bueno,&nbsp;A. Arce-Arnáez","doi":"10.1016/j.jhqr.2026.101191","DOIUrl":"10.1016/j.jhqr.2026.101191","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Healthcare-associated infections (HAIs) in long-term care facilities (LTCFs) represent a significant public health concern. This study aims to estimate the prevalence of HAIs and antimicrobial use in LTCFs in the Community of Madrid (CM), and to assess infection prevention and control (IPC) indicators within the framework of the fourth point prevalence survey of HAIs and Antimicrobial use in European LTCFs (HALT-4).</div></div><div><h3>Materials and methods</h3><div>A descriptive cross-sectional study was conducted between 20th and 30th of May 2024 across nine public LTCFs in the CM. Standardised questionnaires from the HALT-4 protocol were used to collect data on clinical characteristics, risk factors, active HAIs and antimicrobial use. Associations between HAIs, risk factors, IPC indicators and antimicrobial use policies were analysed.</div></div><div><h3>Results</h3><div>1076 residents were included. HAIs prevalence was 6.0% (95% CI: 4.6–7.5) including outbreaks-associated infections and 4.1% (95% CI: 2.9–5.3) excluding them. Respiratory tract (36.4%), urinary tract (34.1%) and skin (20.5%) infections were the most frequent, excluding gastrointestinal infection outbreaks. Antimicrobial treatment was administered to 3.8% of residents, primarily via the oral route and for therapeutic purposes. Beta-lactams were the most widely used antimicrobials, and <em>Enterobacteriaceae</em> were the most prevalent microorganisms. Significant associations were found between HAIs and disorientation (prevalence ratio [PR]: 2.0, 95%CI: 1.1–3.8) and reduced mobility (PR: 1.9, 95%CI: 1.0–3.5). Areas of improvement included effective infection surveillance programmes and antimicrobial prescription training.</div></div><div><h3>Conclusions</h3><div>The prevalence of HAIs in the CM was higher than the European average, while antimicrobial use was lower than both national and European averages.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101191"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182886","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":"Impacto de la frecuentación en la calidad asistencial en un Servicio de Urgencias Pediátricas","authors":"L. de la Sen de la Cruz,&nbsp;A. Palacios Bermejo,&nbsp;S. Amorós Villaverde,&nbsp;M. Escobar Castellanos,&nbsp;C. Ferrero García-Loygorri,&nbsp;A. Rivas García","doi":"10.1016/j.jhqr.2025.101174","DOIUrl":"10.1016/j.jhqr.2025.101174","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Overcrowding in Pediatric Emergency Departments(PED) have a negative impact in waiting times. External factors such as the SARS-CoV-2 pandemic can change the incoming volume of patients. The aim of this study is to quantify the extent to which the quality indicators are impacted by overcrowding and the extent to which the pandemic has impacted them.</div></div><div><h3>Material and methods</h3><div>Retrospective study in the PED of a high complexity hospital. Quality indicators from the PED dashboard are collected weekly for the period 2018-2022, excluding the pandemic year 2020. A univariate and multivariate analysis of the association between the variation of the indicators for every 100 additional emergencies was performed, expressing it using the regression coefficient B and its 95% CI.</div></div><div><h3>Results</h3><div>A median of 1105 emergencies were attended each week(876-1262). The adjusted multivariate analysis showed differences in the indicators for every 100 additional weekly emergencies of: triage delay time(B<!--> <!-->=<!--> <!-->0.23; 95%CI:0.17-0.29.p&lt;<!--> <!-->0.001), delay time in care(B<!--> <!-->=<!--> <!-->1.84; 95%CI:1.58- 2.10.p&lt;<!--> <!-->0.001); percentage of patients under observation(B<!--> <!-->=<!--> <!-->-0.13;95%CI:-0.24--0.02).p<!--> <!-->=<!--> <!-->0.017), percentage of admissions(B<!--> <!-->=<!--> <!-->-0.13;95%CI:-0.23--0.03.p<!--> <!-->=<!--> <!-->0.011), percentage of patients waiting ≥1 hour for admission(B<!--> <!-->=<!--> <!-->0.89;95%CI:0.06-1.73.p<!--> <!-->=<!--> <!-->0.036) and percentage of return visit(B<!--> <!-->=<!--> <!-->0.22;95%CI:0.11-0.34.p&lt;<!--> <!-->0.001).</div><div>The analysis by pre-post pandemic periods showed differences: in the percentage of patients with priority≤3(B<!--> <!-->=<!--> <!-->-3.8;95%CI: -4.7- -2.9.p&lt;<!--> <!-->0.001), length of stay in the PED(B<!--> <!-->=<!--> <!-->0,24;95%CI:0,12-0,36.p&lt;<!--> <!-->0,001), percentage of patients in observation(B<!--> <!-->=<!--> <!-->-2.6;95%CI:-3.2--1.9.p&lt;<!--> <!-->0.001), length of stay in observation(B<!--> <!-->=<!--> <!-->0.68;95%CI:0.51-0.86.p&lt;<!--> <!-->0.001), percentage of admissions(B<!--> <!-->=<!--> <!-->0.8;95%CI;-1.4--0.2.p<!--> <!-->=<!--> <!-->0.006), percentage of patients waiting ≥ 1 hour for admission(B<!--> <!-->=<!--> <!-->30.5;95%CI:26.9-34.p&lt;<!--> <!-->0.001) and percentage of voluntary discharges (B<!--> <!-->=<!--> <!-->0,3;95%CI:0,1-0,6.p<!--> <!-->=<!--> <!-->0,013).</div></div><div><h3>Conclusion</h3><div>Overcrowding impacts the quality of care in our center, increasing the waiting times for triage, care and admission, and increasing the proportion of visit return.</div></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"41 2","pages":"Article 101174"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834844","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}