Journal of Healthcare Quality Research最新文献

{"title":"Concordancia de los registros de prescripción de medicamentos en el paciente quirúrgico hospitalizado","authors":"O. Guillén Martínez,&nbsp;M.J. Lucas Mayol,&nbsp;M. Rodríguez Morote,&nbsp;L. Soriano-Irigaray,&nbsp;C. Matoses-Chirivella,&nbsp;A. Navarro Ruiz","doi":"10.1016/j.jhqr.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.jhqr.2024.03.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Electronic prescription is the prescription system that allows healthcare professionals to send medication prescriptions directly to community pharmacies and the outpatient unit of Hospital Pharmacy Services for dispensing. However, there is difficulty in obtaining a reliable pharmacotherapeutic history in chronic patients through electronic prescription upon hospital admission as a critical point for adequate treatment adaptation. Therefore, the pharmacist as a member of the multidisciplinary team must ensure, through medication conciliation, an adequate transition of care through the correct management of the treatment that the chronic patient requires during their hospitalization.</p></div><div><h3>Objectives</h3><p>To evaluate the quality of electronic prescription records for routine chronic treatment by analyzing the concordance of the electronic prescription.</p></div><div><h3>Material and methods</h3><p>Observational, cross-sectional and retrospective study at the General University Hospital of Elche. Hospitalized patients in charge of the Orthopedic Surgery and Traumatology, Urology and Neurosurgery Services in which the responsible doctor requested medication reconciliation by the Pharmacy Service between January 2022 - December 2022 were included.</p></div><div><h3>Results</h3><p>378 patients, 209 (55.3%) women and 169 (44.7%) men, with a mean age<!--> <!-->±<!--> <!-->standard deviation of 71.0<!--> <!-->±<!--> <!-->11.6 years and 69.0<!--> <!-->±<!--> <!-->11.8 years, respectively. The total percentage of patients with discrepancies in the electronic prescription with respect to the usual chronic treatment was 60.6%, reflecting that only 39.4% of the patients had non-discordant electronic prescriptions.</p></div><div><h3>Conclusions</h3><p>More than half of hospitalized surgical patients present discrepancies in the medications prescribed in the home electronic prescription, which justifies the importance of treatment reconciliation upon admission carried out by hospital pharmacists.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 3","pages":"Pages 163-167"},"PeriodicalIF":1.2,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645267","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":"Intraoperative scrub nurse turnover in orthopaedic surgery procedures: An opportunity for improved operating room efficiency","authors":"J.R. Lex ,&nbsp;B. Entezari ,&nbsp;J. Toor ,&nbsp;A. Abbas ,&nbsp;M. Nousiainen ,&nbsp;C. Rahman ,&nbsp;C. Whyne ,&nbsp;B. Ravi","doi":"10.1016/j.jhqr.2024.03.002","DOIUrl":"https://doi.org/10.1016/j.jhqr.2024.03.002","url":null,"abstract":"<div><h3>Background</h3><p>Scrub nurses play a crucial role in facilitating orthopaedic surgeries, and thus intraoperative scrub nurse turnover may disrupt the workflow of the surgical team and prolong duration of surgery (DOS). The purpose of this study was to quantify the impact of intraoperative scrub nurse turnover on operative time of orthopaedic surgeries lasting less than 3<!--> <!-->h in duration.</p></div><div><h3>Methods</h3><p>Prospectively collected databases from two institutions were retrospectively queried to identify all orthopaedic procedures of maximum mean duration of 180<!--> <!-->min from March 4th, 2018 to August 31st, 2022. Cases were divided into two groups, those with scrub nurse turnover and those without. Propensity score matching was conducted to match groups by surgeon, hospital, patient age, gender, and ASA classification. Unpaired <em>t</em>-tests were used to compare mean DOS for each surgical procedure. Average treatment effect on treated (ATET) with 95% confidence intervals (CIs) were calculated.</p></div><div><h3>Results</h3><p>Scrub nurse turnover significantly prolonged DOS for both bone forearm facture open reduction and internal fixation (ORIF) (ATET<!--> <!-->=<!--> <!-->21.08, <em>p</em> <!-->=<!--> <!-->0.001), ankle ORIF (ATET<!--> <!-->=<!--> <!-->21.26, <em>p</em> <!-->&lt;<!--> <!-->0.001), clavicle ORIF (ATET<!--> <!-->=<!--> <!-->16.16, <em>p</em> <!-->=<!--> <!-->0.028), femur intramedullary nail (ATET<!--> <!-->=<!--> <!-->11.52, <em>p</em> <!-->=<!--> <!-->0.003), rotator cuff repair (ATET<!--> <!-->=<!--> <!-->16.88, <em>p</em> <!-->&lt;<!--> <!-->0.001), partial discectomy (ATET<!--> <!-->=<!--> <!-->10.52, <em>p</em> <!-->=<!--> <!-->0.001), total knee arthroplasty (TKA) (ATET<!--> <!-->=<!--> <!-->5.69, <em>p</em> <!-->&lt;<!--> <!-->0.001), anterior total hip arthroplasty (THA) (ATET<!--> <!-->=<!--> <!-->8.80, <em>p</em> <!-->&lt;<!--> <!-->0.001), lateral THA (ATET<!--> <!-->=<!--> <!-->7.02, <em>p</em> <!-->&lt;<!--> <!-->0.001), and uncemented hip hemiarthroplasty (ATET<!--> <!-->=<!--> <!-->16.79, <em>p</em> <!-->=<!--> <!-->0.049).</p></div><div><h3>Conclusion</h3><p>Intraoperative scrub nurse turnover significantly prolongs surgical times in orthopaedic surgeries lasting up to 3<!--> <!-->h in duration. This highlights the importance of developing strategies to prevent intraoperative scrub nurse turnover to improve OR efficiency and decrease healthcare costs.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 3","pages":"Pages 155-162"},"PeriodicalIF":1.2,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645269","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":"Manejo del dolor crónico no oncológico con programas multicomponentes de terapias no farmacológicas: revisión sistemática de la literatura","authors":"M.V. Ruiz Romero ,&nbsp;E. Lobato Parra ,&nbsp;A. Porrúa del Saz ,&nbsp;M.B. Martínez Monrobé ,&nbsp;C.M. Pereira Delgado ,&nbsp;M.B. Gómez Hernández","doi":"10.1016/j.jhqr.2024.02.004","DOIUrl":"10.1016/j.jhqr.2024.02.004","url":null,"abstract":"<div><p>Chronic pain is a public health problem suffered by 20% of the world's population. Pharmacological approaches are insufficient, so a multi-therapeutic approach that also includes non-pharmacological therapies (psychological therapies, meditation, physical exercise, healthy habits, etc.) is proposed. The aim of this review was to review the existing scientific evidence on the effect of multicomponent programs with non-pharmacological therapies in people with chronic non-oncologic pain. To this end, a search for scientific articles was carried out in three databases (PubMed, Web of Science and PsycINFO) and 17 articles were selected, following the PRISMA recommendations. The patients who participated in these programs were mostly women, aged 18 to 80<!--> <!-->years, working or on sick leave due to pain, with secondary education or less and married. The most frequent pain was musculoskeletal, mainly low back pain. All the articles studied the effectiveness of two or more therapies, highlighting psychological therapies, physical exercise and education. Positive results were obtained in the reduction of different variables such as pain, pain catastrophizing, anxiety and depression, in addition to improving functionality and quality of life. It has also been shown that patients’ prior expectations regarding the intervention influence its effectiveness. Although throughout the review there was great heterogeneity in the interventions, in the evaluation methods and in the results themselves, it can be concluded that multicomponent programs show positive results in the management of chronic pain, and should therefore be incorporated as a routine therapeutic treatment.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 3","pages":"Pages 168-187"},"PeriodicalIF":1.2,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332141","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":"Association between socioeconomic status and hospitalisation requirement in older patients attended at the emergency department: A retrospective cohort study","authors":"A. García-Martínez,&nbsp;L. Artajona,&nbsp;G. Osorio,&nbsp;E. Bragulat,&nbsp;S. Aguiló","doi":"10.1016/j.jhqr.2024.02.003","DOIUrl":"10.1016/j.jhqr.2024.02.003","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>A low socioeconomic status (SES) has been associated with poor health results. The present study aimed to investigate if SES of older patients attending the emergency department is associated with the use of healthcare resources and outcomes.</p></div><div><h3>Patients and methods</h3><p>Observational, retrospective study including consecutive patients 65 years or older admitted to the emergency department. Variables at baseline, index episode, and follow-up were recorded. SES was measured using an indirect theoretical index and patients were categorised into two groups according to whether they lived in a neighbourhood with a low or high SES. Primary outcomes included hospitalisation after the emergency department visit and prolonged hospitalisation (&gt;7 days) at index episode. Secondary outcomes included emergency department re-consultant and hospital admission in the following 3 months after the index episode, and all-cause mortality after long-term follow-up. Logistic regression and cumulative hazards regression models were used to investigate associations between SES and outcomes.</p></div><div><h3>Results</h3><p>The cohort included 553 patients (80 years [73–85], 50.5% female, 55.9% with low SES). After the emergency department visit, 234 patients (42.3%) required hospital admission. A low SES was inversely associated with hospitalisation with an adjusted odds ratio<!--> <!-->=<!--> <!-->0.654 (95% CI 0.441–0.970). Among hospitalised patients, a low SES was associated with prolonged hospitalisation (adjusted odds ratio<!--> <!-->=<!--> <!-->2.739; 95% CI 1.470–5.104). Follow-up outcomes, including all-cause mortality, were not associated with SES.</p></div><div><h3>Conclusions</h3><p>Older patients living in more deprived urban areas were hospitalised less often after emergency department care, but hospital stays were longer. Understanding the effect of social determinants in healthcare use is mandatory to tailor resources to patient needs.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 3","pages":"Pages 139-146"},"PeriodicalIF":1.2,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307248","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":"Resident scientific meetings as part of the residency training curriculum: Just a hassle for the resident?","authors":"Í. Aragón Niño,&nbsp;C. Cuesta Urquía,&nbsp;A. García López Chicharro,&nbsp;C. López Martínez,&nbsp;J. González Martín Moro,&nbsp;J.L. Cebrián Carretero","doi":"10.1016/j.jhqr.2024.02.002","DOIUrl":"10.1016/j.jhqr.2024.02.002","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 3","pages":"Pages 199-201"},"PeriodicalIF":1.2,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307249","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 un programa multicomponente con terapias no farmacológicas para pacientes con dolor crónico","authors":"M.V. Ruiz Romer ,&nbsp;A. Porrúa del Saz ,&nbsp;M.B. Gómez Hernández ,&nbsp;E. Lobato Parra ,&nbsp;A. Soler Jiménez ,&nbsp;C. Pereira Delgado","doi":"10.1016/j.jhqr.2024.01.005","DOIUrl":"10.1016/j.jhqr.2024.01.005","url":null,"abstract":"<div><h3>Introduction</h3><p>25.9% of Spanish people suffer from chronic pain. An integrated, interdisciplinary approach is recommended, with pharmacological and non-pharmacological therapies, involving patients in their self-care.</p></div><div><h3>Objective</h3><p>To evaluate the effectiveness and impact on resources of a program with non-pharmacological therapies in the control of non-oncological chronic pain in the short and medium term.</p></div><div><h3>Material and methods</h3><p>Quasi-experimental before-after study, follow-up 3-6 months, measuring: pain, well-being, quality of life, self-esteem, resilience, anxiety/depression (validated scales); patient-reported outcomes of workshop impact on pain management, habits and mood; ED and office visits; drug consumption and employment status.</p></div><div><h3>Results</h3><p>One hundred and forty-two patients completed the program; 131 (92.3%) were women, age: 56.0. Decreased: pain (scale 0-10) (start: 6.0; end of workshop: 4.0; 3 months: 5.0); anxiety (12.9; 10.4; 8.8) and depression (12.3; 7.23; 6.47) (scales 0-21). They increased: well-being (scale 0-10) (4.0; 6.0; 4.0); quality of life (scale 0-1) (0.418; 0.580; 0.536); health status (scale 0-100) (47.5; 60.0; 60.0); self-esteem (scale 9-36) (24.1; 27.5; 26.7); resilience (scale 6-30) (14.8; 17.4; 18.6). Patient-reported outcomes were performed by 136 patients at the end of the workshop and 79 at 3 months: pain decreased (end of program: 104, 76.5%; 3 months: 66, 83.5%); medication decreased (96, 76.2%; 60, 78.9%); habits improved (112, 88.2%; 69, 90.8%). Forty patients (37.4%) reduced visits to the emergency room, 40 (37.4%) reduced scheduled visits. Overall satisfaction: 9.8 out of 10.</p></div><div><h3>Conclusions</h3><p>Patients learn to mitigate their pain, participate in their self-care and improve their quality of life, self-esteem and emotional state. The effects remained for 3-6 months.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 2","pages":"Pages 109-119"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944485","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":"Propuesta de un indicador de cargas de trabajo en la atención de pacientes en hospitalización a domicilio de Osakidetza – Servicio Vasco de Salud","authors":"J. Regalado de los Cobos ,&nbsp;K. Vrotsou ,&nbsp;M.J. Onaindia Ecenarro ,&nbsp;J. Isasi Otaolea ,&nbsp;M. Aramburu Zubiaurre ,&nbsp;M. Millet Sampedro ,&nbsp;Grupo PCTHaD","doi":"10.1016/j.jhqr.2023.11.004","DOIUrl":"10.1016/j.jhqr.2023.11.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>The Hospital at Home (HaH) setting currently lacks adequate workload indicators. This study suggests an indicator that can help in improving professional resources allocation.</p></div><div><h3>Materials and methods</h3><p>Prospective data was collected during May 2021 from patients treated in nine HaH units of Osakidetza-Basque Health Service (North of Spain). Direct care and travel times of healthcare staff was recorded. Data on inpatient days, number of visits, sociodemographic variables, health status, and patient pathologies, among others, were collected. The proposed indicator encompasses both the average visit time and the visit rates. It is called intensity and represents the average daily workload time per patient.</p></div><div><h3>Results</h3><p>A total of <em>n</em> = 1,171 users were included in the analyses. Their mean age was 69.8 years, 45.5% were women and 25% lived more than 12 km away from the corresponding HaH unit. Workload variations were observed for nursing-only and medical-nursing teams, depending on the type of day and patient classification group. The average nursing-only teams workload time on working days was 10.82 min and on non-working days it was 14.78 min. The average workload time for medical-nursing teams, during the same days, was 20.40 min and 4.59 min, respectively. It was observed that certain patient types, like those in palliative care, represented a high workload for medical-nursing teams on working days.</p></div><div><h3>Conclusions</h3><p>The intensity indicator can help answering the question of how many patients can be assigned to a professional. It can also be used to adjust the staffing needs of the HaH units.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 2","pages":"Pages 80-88"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832054","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":"Equidad de acceso en el Sistema Nacional de Salud: algunos puntos débiles y propuestas para la acción","authors":"Rosa M. Urbanos-Garrido","doi":"10.1016/j.jhqr.2023.11.001","DOIUrl":"10.1016/j.jhqr.2023.11.001","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 2","pages":"Pages 63-64"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138300274","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":"Acknowledgment to the Journal Reviewers for their contributions","authors":"","doi":"10.1016/j.jhqr.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.jhqr.2024.02.001","url":null,"abstract":"","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 2","pages":"Page 135"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S260364792400006X/pdfft?md5=54a1a23edd9508e5aed346a8f6cd8d94&pid=1-s2.0-S260364792400006X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140042785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why do physicians go to work when they are sick? Presenteeism at different career stages","authors":"O. Urbano Gonzalo ,&nbsp;B. Marco Gómez ,&nbsp;C. Pérez Álvarez ,&nbsp;A. Gállego Royo ,&nbsp;I. Sebastián Sánchez ,&nbsp;M.P. Astier Peña","doi":"10.1016/j.jhqr.2024.01.004","DOIUrl":"10.1016/j.jhqr.2024.01.004","url":null,"abstract":"<div><h3>Introduction and Objective</h3><p>Physicians find it difficult to take on the role of the patient and they show unusual behaviors when ill. One of these behaviors is presenteeism, which is working while sick. The objective of this research is to analyze the factors that contribute to the phenomenon of presenteeism in Spanish physicians.</p></div><div><h3>Material and methods</h3><p>Mixed methodology study: one national survey through the General Council of Medical Associations website (quantitative part), 22 semistructured interviews with sick residents and practicing physicians, and three focus groups involving professionals from the occupational health services (qualitative). A bivariate analysis using parametric and non-parametric tests. The significance level was <em>p</em> <!-->&lt;<!--> <!-->0.05 (95% confidence interval). Qualitative analysis using the comparative-constant method until saturation of information.</p></div><div><h3>Results</h3><p>Presenteeism is reported by 89.4% of doctors who responded to the survey, and it is more common among women. Contributing factors include fear of overburdening colleagues (the main reason and more common among women 58.14% vs 48.35%), self-perception of doing one's duty (the second reason and more common among men, 44.63% vs 33.14%) and economic impact and difficulty in accepting the role of a sick person. This behavior has an impact on patient safety, and is part of the hidden curriculum that also affects the training of medical professionals.</p></div><div><h3>Conclusions</h3><p>Presenteeism is a widespread and accepted practice among medical professionals. Although normalized, and even appreciated as a way to avoid overburdening colleagues, presenteeism has important implications for clinical ethics and patient safety.</p></div>","PeriodicalId":37347,"journal":{"name":"Journal of Healthcare Quality Research","volume":"39 2","pages":"Pages 100-108"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139944486","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}