Journal of Healthcare Quality Research最新文献

{"title":"Spanish adolescent patients with cancer and main caregivers: Using perceptions of care to drive change in healthcare.","authors":"A Molina-Prado, A Pérez de Albéniz, G Medin, V Pérez-Alonso, E Carceller, B Huguet-Rodríguez, C Garrido-Colino","doi":"10.1016/j.jhqr.2024.07.002","DOIUrl":"https://doi.org/10.1016/j.jhqr.2024.07.002","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether there are differences in care experience of adolescent cancer patients and their main caregiver, treated in Adolescent Cancer Units (ACUs), compared to those treated in Non-Adolescent Cancer Units (NACUs), including the COVID-19 pandemic period.</p><p><strong>Method: </strong>Measurement of Reported Experience in adolescent oncology patients (12-19 years old) and caregivers through ad hoc surveys. The responses of the study group of patients and caregivers treated in Adolescent Units were compared with the group not treated in them.</p><p><strong>Results: </strong>It is noted that many respondents consider that they have not been affected by the COVID-19 pandemic. Significant differences were seen in communication, with better perception by the group of patients treated in ACU (87.1%) and caregivers of ACU (97.3%) compared to patients and caregivers of NACU (53.3% and 68.2% respectively). Regarding information received about the side effects, a better perception was observed among patients treated in the ACU than in the NACU (p=0.247). In the transmission of information and the possibility of fertility preservation, a significant difference was observed in favour of ACU in patients and direct caregivers (p=0.010 and p=0.018).</p><p><strong>Conclusions: </strong>ACU represents an improvement in the quality perceived by patients and main caregiver on key points in the comprehensive care of the adolescent with cancer such as information, participation in the process and decision making, approach to side effects, psychological care and help in returning to normal life. However, fertility and strategies for talking about the cancer experience, were identified as areas for future improvement.</p>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753008","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 multicomponent intervention on hospitalized clinical patient outcomes: A pre-post study in a university hospital.","authors":"M R R Falcetta, F Pivatto Júnior, É P Cassol, A Boni, T Vaz, F M da Costa, D F do Canto, L M G Paskulin, J M Dora","doi":"10.1016/j.jhqr.2024.06.003","DOIUrl":"https://doi.org/10.1016/j.jhqr.2024.06.003","url":null,"abstract":"<p><strong>Background and objective: </strong>Hospitalization significantly interferes with the individual's well-being and it occurs both during and after the hospitalization period. Different approaches to minimize morbidity related to hospitalization and the post-discharge period have been proposed, especially to those aimed at reducing readmission rates. The aim of this study is to evaluate the effect of multicomponent intervention (MI) on operational indicators and continuity of care outcomes.</p><p><strong>Materials and methods: </strong>A quasi-experimental study conducted in a Brazilian university hospital in order to compare the impact of the intervention with usual care. The MI was the implementation of multidisciplinary rounds, the inclusion of the role of the navigator nurse, and care transition actions with half of the Internal Medicine teams in a clinical unit of a general hospital. Adult patients hospitalized were included in 2 periods and divided in 3 groups - Group A: before the intervention; Group B: after and with MI; Group C after and without MI.</p><p><strong>Results: </strong>A total of 2333 hospitalizations were evaluated. There was a reduction in the rate of intensive care transfers to intensive care unit (ICU) and in the length of stay (LOS). LOS, discharge before noon, and transfers to ICU improved when comparing before and after the intervention, but were not different in post-intervention groups with and without MI.</p><p><strong>Conclusion: </strong>These results reflect the improvement of care provided by MI, an effect that could be due to cross contamination also to teams without the intervention.</p>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591640","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":"Loneliness impact on healthcare utilization in primary care: A retrospective study","authors":"J.J. Mira ,&nbsp;D. Torres ,&nbsp;V. Gil ,&nbsp;C. Carratalá","doi":"10.1016/j.jhqr.2024.04.001","DOIUrl":"10.1016/j.jhqr.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><p>An increased number of patients seek help for loneliness in primary care.</p></div><div><h3>Objective</h3><p>To analyze whether loneliness was associated with a higher utilization of healthcare facilities.</p></div><div><h3>Methods</h3><p>Observational, retrospective study based on the review of routinely coded data in the digital medical record system in a random sample of patients aged 65 or older, stratified by population size of their residence area. A minimum sample size was estimated at 892 medical records. Loneliness was defined as the negative feeling that arises when there is a mismatch between the quantity and quality of a person's social relationships and those, they desire. Thirty-three primary care nurses (30 females and 3 males) were reviewing the data.</p></div><div><h3>Results</h3><p>A total of 932 medical records of patients were reviewed (72% belonged to female patients). Of these, 657 individuals were living alone (71.9%). DeJong Scale average scores was 8.9 points (SD 3.1, 95CI 8.6–9.1). The average annual attendance to primary care ranged from 12.2 visits per year in the case of family practice, 10.7 nurse, 0.7 social workers. The average number of home visits was 3.2, and the urgent consultations attended at health centers were 1.5 per year. Higher feelings of loneliness were associated with extreme values in the frequency of healthcare resource usage. Compared to their peers of the same age, the additional healthcare resource consumption amounted to €802.18 per patient per year.</p></div><div><h3>Conclusion</h3><p>Loneliness is linked to higher healthcare resource usage in primary care, with individuals experiencing poorer physical and mental health utilizing these resources up to twice as much as their peers of the same age.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765355","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":"Papel de enfermería en el cateterismo cardiaco derecho. Ventajas del acceso venoso periférico","authors":"J. González-Vela ,&nbsp;F. Toré-Meléndez ,&nbsp;R. Bravo-Marqués","doi":"10.1016/j.jhqr.2024.03.006","DOIUrl":"10.1016/j.jhqr.2024.03.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Pulmonary hypertension (PH) is a serious disease that requires early diagnosis to achieve a better patient prognosis. Right heart catheterization (RHC) has become the main diagnostic test for this disease, measuring the pressures from the right heart chambers invasively, using a catheter placed through venous access. Nursing performance has an important role in RHC through peripheral venous access due to its well-done skills for canalization and knowledge about the management and care of these accesses. RHC performed through peripheral venous access provide advantages over those performed through central venous access.</p></div><div><h3>Objective</h3><p>To analyze the benefits from RHC through peripheral venous access compared to those performed through central venous access, as well as highlighting the role of nursing during this type of procedures.</p></div><div><h3>Method</h3><p>A retrospective, descriptive, and observational study was performed for patients who underwent RHC in our center between January 2019 to January 2023. We analyzed clinical characteristics, access, fluoroscopy parameters, periprocedural complications, and hospital admissions.</p></div><div><h3>Result</h3><p>A total of 115 patients were included. The average age was 65<!--> <!-->±<!--> <!-->12 years, with 58.1% of females. Risk stratification of PH was the reason for conducting RHC in 82.9%. The anterocubital veins became the main approach (72.2%), performed by hemodynamics nurses, while the central venous ones composed the rest (27.8%), which were done by cardiology specialized doctors. We observed a significant reduction in radiation dose in RHC via anterocubital route compared to central venous access (4.4<!--> <!-->Gycm² vs 12.5<!--> <!-->Gycm² [IQR: 4.5]; <em>P</em> <!-->&lt;<!--> <!-->.001), and it does also in fluoroscopy times (2.3<!--> <!-->minutes vs 4.6<!--> <!-->minutes [IQR: 2.6]; <em>P</em> <!-->&lt;<!--> <!-->.001). No complications were recorded, independently of the approach. Patients who underwent a scheduled catheterization were discharged more frequently on the same day of the procedure whether a peripheral approach was performed (77.2%, 44 of 57 patients), in comparison with the central one (28.6%) (<em>P</em> <!-->=<!--> <!-->.001).</p></div><div><h3>Conclusions</h3><p>The RHC is an essential tool for the diagnosis of PH, achieving nursing such an important role for those performed by peripheral venous access. Peripheral venous access provides benefits and advantages like the reduction of radiation exposure and scan times, reduced hospital stay. All this could bring greater comfort, safety and better quality of care to the patient.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140769716","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":"Prevenir, controlar y gestionar las enfermedades infecciosas: ISO 45006:2023","authors":"M. López-Gobernado ,&nbsp;D. Villalba Gil ,&nbsp;J. Hernández Bartolomé","doi":"10.1016/j.jhqr.2024.03.005","DOIUrl":"10.1016/j.jhqr.2024.03.005","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779564","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 quality improvement intervention on surgical prophylaxis impact in antibiotic consumption and cost in selected surgical procedures","authors":"H. Guanche Garcell ,&nbsp;F.J. Aragón Palmero ,&nbsp;D.A. Marquez Reyna ,&nbsp;N. Seoane Perez ,&nbsp;R.M. Desdin Rodriguez ,&nbsp;O.R. Exposito Reyes ,&nbsp;W. Martinez Martinez ,&nbsp;A. Villanueva Arias ,&nbsp;S.I. Gonzalez Perez ,&nbsp;T.M. Fernandez Hernandez ,&nbsp;A.M. Felipe Garmendia","doi":"10.1016/j.jhqr.2024.03.003","DOIUrl":"10.1016/j.jhqr.2024.03.003","url":null,"abstract":"<div><h3>Background</h3><p>Improper compliance with antibiotic prophylaxis (AP) in surgery is associated with an increased risk of surgical site infection (SSI), and impacts the efficiency of healthcare.</p></div><div><h3>Objective</h3><p>Evaluate the impact of an intervention in compliance with AP in selected surgical procedures and its effect on antibiotic consumption and cost.</p></div><div><h3>Methods</h3><p>A prospective interventional study was performed in a community hospital from January to December 2022. The baseline period was considered January–April 2022 and the intervention period May–December 2022. All patients who underwent cesarean section, appendectomies, hernia surgery, open reduction and internal fixation (ORIF), abdominoplasty, and cholecystectomy during the study period were selected. The intervention includes staff education, pharmacy interventions, monitoring the quality of prescriptions and feedback, and improved role of anesthesia staff, and department champions.</p></div><div><h3>Results</h3><p>The study involved 192 and 617 surgical procedures in the baseline and intervention periods respectively. The compliance with timing, selection, dose, and discontinuation achieved 100%, 99.2%, and 97.6% from baseline figures of 92.7%, 95.8%, and 81.3%, respectively. The antibiotic consumption was reduced by 55.1% during the intervention with a higher contribution of other antibiotics (94.1% reduction) in comparison with antibiotics as per policy (31.2% reduction). The cost was reduced by 47.2% (antibiotic as per policy 31.9%, other antibiotics 94.2%).</p></div><div><h3>Conclusion</h3><p>The implemented strategy was effective in improving the quality of antibiotic prophylaxis with a significant impact in reducing antibiotic consumption and cost.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785919","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":"Desafíos y consideraciones ante la discontinuación de la producción de respiradores por parte de fabricantes líderes","authors":"A. González-Castro ,&nbsp;A. Fajardo Campoverdi","doi":"10.1016/j.jhqr.2024.03.008","DOIUrl":"10.1016/j.jhqr.2024.03.008","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792994","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":"Indicador sintético de cumplimiento de estándares para Unidades de Calidad de centros sanitarios y estudio de pilotaje prospectivo multicéntrico","authors":"A. Aloy-Duch ,&nbsp;M. Santiñà Vila ,&nbsp;F. Ramos-d’Angelo ,&nbsp;L. Alonso Calo ,&nbsp;M.E. Llaneza-Velasco ,&nbsp;B. Fortuny-Organs ,&nbsp;A. Apezetxea-Celaya","doi":"10.1016/j.jhqr.2024.03.007","DOIUrl":"10.1016/j.jhqr.2024.03.007","url":null,"abstract":"<div><h3>Background and objective</h3><p>In Spain, Quality Units play a key and unique role in advising healthcare centers on the methodology of healthcare quality. The objectives of the study were to develop computer algorithms to obtain a synthetic indicator of standard compliance for Quality Units and to pilot its functioning in these units.</p></div><div><h3>Materials and methods</h3><p>The Excel program was used to establish evaluation algorithms, and quantitatively interrelate and weight various categories of standards, as a computer evaluation tool, to build a continuous improvement cycle system, and offer a global synthetic indicator of compliance. The tool was tested in a prospective multicenter pilot study, in which coordinators of Quality Units from different health centers and care settings participated, to evaluate the usefulness of the tool and compliance with the standards, in addition to analyzing the content validity of each standard.</p></div><div><h3>Results</h3><p>The formulas for the structured computer algorithms were developed, consecutively, in a «PLAN-DO-CHECK-ACT» improvement cycle for the 9 categories of standards, resulting in a single synthetic indicator of compliance. Twenty-one Quality Units participated in the piloting. The overall average compliance rate for the synthetic indicator was 55.63% with differences between centers (<em>P</em> <!-->=<!--> <!-->.002) and between categories (<em>P</em> <!-->&lt;<!--> <!-->.0001), but not by autonomous communities (<em>P</em> <!-->=<!--> <!-->.86) or by areas (<em>P</em> <!-->=<!--> <!-->.97). Content validity was ensured through the variable of «understanding» of the standards (<em>P</em> <!-->&lt;<!--> <!-->.001), and through their «justification» with documentary evidence (<em>P</em> <!-->&lt;<!--> <!-->.001).</p></div><div><h3>Conclusions</h3><p>The computer tool with the synthetic indicator have allowed for the evaluation of standard compliance in Quality Units of healthcare centers.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140770585","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":"Revisión sistemática sobre la influencia del estilo de liderazgo en la satisfacción laboral de los profesionales de la salud","authors":"S. Leal Murillo ,&nbsp;D. Gutiérrez Arambula ,&nbsp;J.F. Gerber ,&nbsp;J. Souto Higueras ,&nbsp;R. Simón Perez","doi":"10.1016/j.jhqr.2024.04.003","DOIUrl":"10.1016/j.jhqr.2024.04.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Healthcare organisations are highly complex entities that live with a high risk of instability. In order to minimise this instability, interactions and personal relationships play a major role and accordingly the figure of the leader gains full significance.</p><p>The leadership style used can produce different reactions and lead to multiple outcomes, including job satisfaction. The aim of the present review is to correlate leadership style with job satisfaction in healthcare professionals.</p></div><div><h3>Material and methods</h3><p>A systematic review was carried out in BVS, Cochrane plus, CINAHL, ApaPsycinfo and Pubmed, selecting publications that mentioned leadership styles and job satisfaction in healthcare professionals. Publications search strategy were limited for the 5-10<!--> <!-->last years, full text availability and language of writing: English, French and Spanish. Review-type publications were excluded. Of the 1566 initial titles, 15 were selected for analysis.</p></div><div><h3>Results and conclusions</h3><p>The transformational style showed the highest number of positive correlations, followed by the authentic and transactional styles. On the other hand, the passive and laissez-faire styles showed a negative correlation regardless of the professional category to which they belonged.</p><p>The results of this study provide a starting point for adopting effective leadership styles to optimise the recruitment and training processes of staff in management and coordination roles.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923383","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":"Análisis de coste-efectividad de las Unidades de Coordinación de Fracturas en Cataluña","authors":"X. Surís ,&nbsp;M.J. Pueyo-Sánchez ,&nbsp;A. Ricart ,&nbsp;A. Naranjo ,&nbsp;T. Casanova ,&nbsp;C. Gómez-Vaquero ,&nbsp;E. Duaso ,&nbsp;J.M. Cancio-Trujillo ,&nbsp;J. Sánchez-Martín ,&nbsp;A. Pérez-Mitru","doi":"10.1016/j.jhqr.2024.03.004","DOIUrl":"10.1016/j.jhqr.2024.03.004","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the cost-effectiveness of Fracture Liaison Service (FLS) compared to the standard of care for secondary prevention of fragility fractures form the perspective of the Catalan Health Service.</p></div><div><h3>Methods</h3><p>Cost-utility assessment through a Markov model that simulated disease progression of a patients’ cohort candidates to initiate antiosteoporotic treatment after a fragility fracture. A time horizon of 10 years and a 6-month duration per cycle was established. Clinical, economics and quality of life parameters were obtained from the literature and derived from four Catalan FLS. The Catalan Health Service perspective was adopted, considering direct health costs expressed in 2022 euros. A 3% discount rate was applied on costs and outcomes. Uncertainty was assessed through multiple sensitivity analyses.</p></div><div><h3>Results</h3><p>Compared to the standard of care, FLS would promote antiosteoporotic initiation and persistence, reducing the incidence and mortality associated with subsequent fragility fractures. This incremental clinical benefit was estimated at 0.055 years and 0.112 quality-adjusted life years (QALYs) per patient. A higher cost (€1,073.79 per patient) was estimated, resulting into an incremental cost-utility ratio of €9,602.72 per QALYs gained. The sensitivity analyses performed were consistent, corroborating the robustness and conservative approach of the base-case.</p></div><div><h3>Conclusions</h3><p>The introduction of FLS for the secondary prevention of FF would represent a cost-effective strategy from the Catalan Health Service perspective.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759695","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}