Risk Management and Healthcare Policy最新文献

{"title":"Does the Implementation of a Telestroke Program Play a Role in Improving the Clinical Outcomes of Acute Stroke Patients in South East Asian Region?: A Literature Review.","authors":"Lisda Amalia","doi":"10.2147/RMHP.S517766","DOIUrl":"https://doi.org/10.2147/RMHP.S517766","url":null,"abstract":"<p><p>Telestroke is an innovation in telemedicine, in the form of a method for identifying, assessing, treating, and monitoring stroke patients remotely using internet technology. Telestroke can speed up diagnosis and treatment in acute stroke by allowing direct video consultations between doctors and patients separated by distance. The Southeast Asia Region (SEAR) accounts for nearly 50% of the developing world's stroke burden. With various commonalities across the countries regarding health services, user awareness, and healthcare-seeking behavior, SEAR still presents profound diversities in stroke-related services across the continuum of care. With telestroke, \"door-to-needle time\" can be reduced without additional costs, thereby reducing morbidity/mortality due to stroke. In the context of telestroke, the objective is a real-time clinical assessment by a stroke specialist-test review, diagnosis, and emergency management plan-in consultation with local healthcare providers. The increased access to stroke care through telestroke provides a promising innovation for the rural area. It is envisaged that telestroke will bridge this gap, enabling hospitals in rural areas to give care equal to hospitals that have stroke specialists, especially in SEAR.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2461-2468"},"PeriodicalIF":2.7,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Landscape and Multidimensional Determinants of Spiritual Coping Mechanisms Among Tuberculosis Patients in Zhejiang, China: A Population-Based Cross-Sectional Investigation.","authors":"Lifen Lu, Luman Zheng, Qiongyi Zhu, Qi Qiu, Tianping Zhou, Jing Fu, Xiao Pan, Gui Zheng, Yan Xu","doi":"10.2147/RMHP.S532707","DOIUrl":"10.2147/RMHP.S532707","url":null,"abstract":"<p><strong>Aim: </strong>Investigate the different spiritual coping strategies employed by tuberculosis patients during their illness and determine the multidimensional determinants influencing these adaptive strategies.</p><p><strong>Design: </strong>Online cross-sectional design.</p><p><strong>Methods: </strong>Between January and September 2024, 448 tuberculosis (TB) patients in Zhejiang Province, China, were recruited via WeChat-based outreach. Data collection was implemented through a digitally administered, self-report survey platform. Comprehensive statistical analyses were performed, including independent samples <i>t</i>-tests, one-way ANOVA for group comparisons, Pearson correlation coefficients for bivariate associations, and hierarchical multiple linear regression modeling to identify predictor clusters. This cross-sectional investigation rigorously adhered to the STROBE guidelines throughout its design, execution, and reporting phases.</p><p><strong>Results: </strong>Among the 448 patients, 255 were male and 193 were female, with an average age of 47.45 (SD = 18.23) years. The factors influencing the level of Positive Spiritual Coping (PSC) were sex (t = -2.593, p = 0.010), residence (t = 2.317, p = 0.021), marital status (t = -2.485, p = 0.013), and economic indicators (F = 2.951, p = 0.032). The factors influencing the level of Negative Spiritual Coping (NSC) were age (F = 3.226, p = 0.041), marital status (t = 2.635, p = 0.009), alcohol consumption (t = 2.840, p = 0.005), number of children (t = 2.022, p = 0.044), and TB diagnosis type (t = -2.323, p = 0.021). The PSC level was negatively correlated with depression (p < 0.01) and positively correlated with the Brief Resilience Scale (BRS), Family APGAR Index (APGAR), and Personal Mastery Scale (PMS) (p < 0.01). The NSC level was positively correlated with depression, anxiety, and stress (p < 0.01) and negatively correlated with BRS, APGAR, and PMS (p < 0.01). Multivariate linear regression analysis indicated that PMS (2.852, P=0.005), APGAR (3.740, P<0.0001), BRS (3.457, P=0.001), and gender (3.343, P=0.001) significantly affected the PSC level in TB patients. Depression (10.112, P < 0.0001), APGAR (-4.571, P < 0.0001), BRS (-3.084, P = 0.002), number of children (-2.315, P = 0.021), and type of TB diagnosis (2.217, P = 0.027) were factors that independently affected the NSC level of TB patients.</p><p><strong>Conclusion: </strong>TB patients exhibit better PSC levels in female patients, and higher PMS, BRS, and APGAR levels correlate with higher PSC levels. NSC levels are higher in patients without children and pulmonary TB, while higher BRS and APGAR levels are associated with lower NSC levels. These findings can help healthcare providers tailor person-centered spiritual care strategies for TB patients based on factors influencing spiritual coping, thereby improving their mental health during illness, reducing psychological distress, and facilitating earlier recovery.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2445-2459"},"PeriodicalIF":2.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization and Determinants of Anticancer Drugs Under China's National Drug Price Negotiation Policy.","authors":"Bingbing Tuo, Haokai Zhao, Anxin Hu, Junnan Jiang","doi":"10.2147/RMHP.S527194","DOIUrl":"10.2147/RMHP.S527194","url":null,"abstract":"<p><strong>Purpose: </strong>The Chinese government began to take national drug price negotiation (NDPN) in 2016, aiming to enhance the accessibility and affordability of anticancer drugs. This study aims to assess the utilization and influence factors of anticancer drugs under NDPN policy in China.</p><p><strong>Patients and methods: </strong>Gastric cancer patients within chemotherapy were included. Independent variables were measured by age, gender, insurance type, total medical expenditure (THE), length of stay (LOS), drug-to-total-expense ratio (DTR). The primary outcomes were negotiated drugs usage, costs and treatment outcome. Two-part model was used to identify influence factors of anticancer drugs utilization. Propensity Score Matching (PSM) was employed to evaluate the impact of negotiated drug utilization on treatment outcomes among inpatients.</p><p><strong>Results: </strong>The sample included 9868 gastric cancer patients from three cities. Outpatient patients demonstrated limited utilization of negotiated drugs (1.33%). Patients aged 61-75 (β=0.923, P < 0.01) and over 75 years (β=0.946, P < 0.05) were more likely to use negotiated drugs. Key factors influencing inpatient drug utilization included medical insurance type (β=-0.245, P<0.01), LOS (β=-0.122, P<0.001), and the DTR (=0.037, P<0.001). The use of negotiated drugs had no significant effect on treatment outcomes.</p><p><strong>Conclusion: </strong>Their limited utilization of negotiated drugs for outpatients arises an urgent necessity for more comprehensive insurance coverage, and the no significant outcome effect dedicated the importance to rigorously validate the effectiveness of these drugs with abundant real-world evidence in the foreseeable future.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2435-2443"},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Community Health Program: Perspective of Community Health Workers in the Eastern Cape, South Africa.","authors":"Uchenna Benedine Okafor, Iyabo Obasanjo, Daniel Ter Goon","doi":"10.2147/RMHP.S488249","DOIUrl":"10.2147/RMHP.S488249","url":null,"abstract":"<p><strong>Introduction: </strong>One of the challenges CHWs face in their profession is their underrepresentation in program advancement. Despite the importance of community health workers as an adjunct health workforce providing crucial healthcare services to the rural, marginalized, and underserved populations, their opinions on strengthening the CHW program remain understudied in certain geographical contexts. Consequently, this study explores the opinions of community health workers regarding the support systems desirable for their effective delivery of healthcare support services in the Buffalo Municipality City, Eastern Cape Province of South Africa.</p><p><strong>Methods: </strong>In-depth individual, semi-structured interviews (n=10) as well as focus groups interviews (n=13) were conducted with 23 community health workers, using an audio recorder with their permission to record the interviews. Content and thematic data analysis was applied.</p><p><strong>Results: </strong>The CHWs made several suggestions to assist them serve the community better and improve the community health program. These include provision of transportation, constant training workshops to enhance and maintain their skills and knowledge, support to improve communication with clients, provision of work identifiers to earn community's recognition, respect, and trust, and improvement in human and material resources to mitigate the overwhelming workload. In addition, they emphasised the need to address job insecurity by offering them with permanent, salaried positions, as well as the safety concerns posed by violent crimes in the communities they served.</p><p><strong>Conclusion: </strong>The findings of this study have implications for improving the practise of CHW programs, policies, and future research recommendations, emphasising the need to take into considerations, the suggestions of the CHWs in improving the CHW program to enable them to provide effective and optimal healthcare support services to clients and the community. We advocated for the integration of community health workers into the larger healthcare system.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2413-2422"},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Weight-Adjusted Waist Circumference Index and Metabolic Disease-Associated Fatty Liver Disease: A Retrospective Study.","authors":"Ting Tang, Hua Fan, Qingwen Yu, Xiyun Rao, Yongmin Shi, Xuhan Tong, Lanlan Feng, Zhao Xu, Xinyan Fu, Juan Chen, Xingwei Zhang, Jiake Tang, Hu Wang, Mingwei Wang","doi":"10.2147/RMHP.S524872","DOIUrl":"10.2147/RMHP.S524872","url":null,"abstract":"<p><strong>Background: </strong>Metabolic disease-associated fatty liver disease has brought significant challenges to public health and social-economics. There is a need for a straightforward and effective method to screen for metabolic disease-associated fatty liver disease. The weight-adjusted waist circumference index offers a comprehensive reflection of visceral fat accumulation and skeletal muscle loss. This study aims to explore the relationship between weight-adjusted waist circumference index and hepatic steatosis and hepatic fibrosis.</p><p><strong>Methods: </strong>This single-centered study screened 288 participants from the outpatient department of the Affiliated Hospital of Hangzhou Normal University (Hangzhou, China). Multiple linear regression models were utilized to assess the association between weight-adjusted waist circumference index and hepatic steatosis and hepatic fibrosis. The subgroup analysis was carried out according to sex, smoking, drinking, BMI, cardiovascular disease, diabetes and hypertension.</p><p><strong>Results: </strong>Metabolic disease-associated fatty liver disease was diagnosed in 185 out of 288 patients. Multivariate linear regression analysis indicated a positive linear correlation between weight-adjusted waist circumference index and hepatic steatosis and hepatic fibrosis (P < 0.05). Analysis of subgroups revealed a stronger positive correlation between weight-adjusted waist circumference index and controlled attenuation parameter among participants aged 18-59 years and smokers (P < 0.05). Positive correlations between weight-adjusted waist circumference index and hepatic fibrosis were observed in participants who were alcohol consumers, male, had a body mass index of >28, and with diabetes (P < 0.05).</p><p><strong>Conclusion: </strong>We report a significant linear positive correlation between weight-adjusted waist circumference index and metabolic disease-associated fatty liver disease, suggesting that weight-adjusted waist circumference index is a potential indicator for metabolic disease-associated fatty liver disease screening.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2387-2399"},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effectiveness of Spousal Testing Among Syphilis-Infected Pregnant Women in the Context of Mother-to-Child Transmission Elimination: A Multicenter Study in Southeastern China.","authors":"Xiaomeng Xue, Xinxin Huang, Guihua Liu, Xiumin Jiang, Wenzhao Lin, Yongfan Chen, Chengyu Huang","doi":"10.2147/RMHP.S531584","DOIUrl":"10.2147/RMHP.S531584","url":null,"abstract":"<p><strong>Purpose: </strong>Syphilis during pregnancy poses significant risks to maternal and neonatal health. Spousal testing is crucial for preventing congenital syphilis transmission. This study assessed spousal testing rates among syphilis-positive pregnant women to guide public health interventions.</p><p><strong>Methods: </strong>This multicenter effectiveness study was conducted in Southeast China, utilizing data from the Chinese HIV/AIDS, Syphilis, and Hepatitis B Prevention Information System between 2018 to 2024. Proportions were used to describe the sociodemographic characteristics of pregnant women with syphilis. Univariate and multivariate unconditional logistic regression models were used to analyze the factors associated with the testing status of spouses of pregnant women with syphilis.</p><p><strong>Results: </strong>A total of 4,875 spouses were tested for syphilis. Older gestational age at the first prenatal visit (aOR = 1.014, 95% CI: 1.007-1.022) and at delivery (aOR = 1.273, 95% CI: 1.011-1.602) were associated with lower rates of spousal testing. Spouses of women reported in 2022-2023 (aOR = 1.840, 95% CI: 1.465-2.311) had a higher likelihood of being untested. Unmarried status (aOR = 1.181, 95% CI: 1.022-1.364), junior high school education and below (aOR = 1.244, 95% CI: 1.121-1.381), no history of infection (aOR = 2.281, 95% CI: 2.073-2.510), and prenatal care in Grade II hospitals (aOR = 0.1.292, 95% CI: 1.140-1.464) were risk factors for spousal testing.</p><p><strong>Conclusion: </strong>From 2018 to 2024, the spousal testing rate was 60%, with a syphilis positivity rate of 14.7%. Data revealed multiple risk factors, such as a late first pregnancy test, advanced age, unmarried status, lower education level, no history of syphilis infection, and selection of prenatal care in Grade II hospitals as delivery facilities. Recommendations include establishing specialized clinics, post-test spousal counseling, and routine spousal testing.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2423-2433"},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of DRG Reform Policies on Hospitalization Costs of Stroke Patients in Western China: Wisdom from Traditional Chinese Medicine.","authors":"Jiayi Wang, Mengen Chen, Jingyu Yang","doi":"10.2147/RMHP.S525667","DOIUrl":"10.2147/RMHP.S525667","url":null,"abstract":"<p><strong>Background: </strong>Stroke presents a significant economic burden worldwide, with the impact being especially pronounced in developing countries. China is currently implementing Diagnosis-Related Group (DRG) reforms, attempting to use more traditional Chinese medicine (TCM) modalities to alleviate the economic burden on stroke patients.</p><p><strong>Methods: </strong>This retrospective study extracted the medical records of stroke inpatients at Qingyang City Hospital of TCM from 2017 to 2022 from China's Gansu National Health Big Data Platform. A single-group interrupted time series (ITS) design was employed to assess the impact of DRG reform on patients' hospitalization costs and length of stay (LOS). Additionally, a two-group ITS was utilized to evaluate treatment costs and medicine costs.</p><p><strong>Results: </strong>The single-group ITS analysis indicated that the average LOS decreased by 0.06 days per month following the reform (P < 0.05), while the average hospitalization cost declined by 48.92 yuan per month (P < 0.05). The two-group ITS results revealed a significant reduction in the average monthly cost of Western medicine by 22.67 yuan post-reform (P < 0.05), whereas the average monthly cost of Chinese medicine increased by 2.93 yuan, though this change was not statistically significant (P > 0.05). Additionally, the average monthly cost of Western medical treatment decreased by 11.24 yuan (P < 0.05). Acupuncture and massage treatment costs exhibited an initial sharp increase followed by a downward trend, with an average monthly decrease of 9.53 yuan (P < 0.05).</p><p><strong>Conclusion: </strong>DRG reduced hospitalization costs and shortened the LOS of stroke patients, which may be related to the increased use of TCM in stroke treatment.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2401-2411"},"PeriodicalIF":2.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Burden and Prevention Strategies for Nosocomial Infections in Ophthalmic Surgery Under the Diagnosis-Related Group Payment Model.","authors":"Xin Zhang, Zhenwu Gao, Yanbin Niu, Ruixia Hao, RongQian Zhang, Yanqing Duan","doi":"10.2147/RMHP.S524178","DOIUrl":"10.2147/RMHP.S524178","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the economic burden of ophthalmic surgery-related nosocomial infections under the diagnosis-related group (DRG) model payment mode and optimise prevention and control strategies.</p><p><strong>Methods: </strong>Retrospective analysis was used to analyse the hospitalisation days and expenses of patients with nosocomial infection after cataract surgery in our hospital in 2020 and 2021 and compared with patients without infection in the same group of DRGs in the same period.</p><p><strong>Results: </strong>In terms of hospitalisation days and expenses, the average hospitalisation time and average hospitalisation expenses of the infection group in 2020 were higher than those of the non-infection group. In 2021, the average hospitalisation time and the average hospitalisation expenses in the infected group were also higher than those in the non-infected group. The results of the root cause analysis showed that there were many issues in the infection-after-cataract-surgery group in the hospital related to hand hygiene and environmental cleaning and disinfection. Targeted improvement programmes were formulated accordingly, including attaching great importance to the prevention and control of infection after cataract surgery and implementing the full infection prevention and control training system. The adenosine triphosphate fluorescence detection and video surveillance methods were used to monitor the hand hygiene status of medical staff.</p><p><strong>Conclusion: </strong>Diagnosis-related grouping puts forward higher requirements for both hospital costs and quality management. Hospital infection after cataract surgery can significantly affect treatment quality, increase medical costs and increase the economic burden of patients.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2351-2360"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Controlled Study on the Application of LEARNS Health Education Combined with Intelligent Follow-up Management in Secondary Prevention of Ischemic Stroke and Its Impact on Patient Compliance and Neurological Function.","authors":"Rui Chu, Xue Zhen, Lei Wang, Min Zhang, Min Shang, Chao Wang, Jia Liu","doi":"10.2147/RMHP.S516608","DOIUrl":"10.2147/RMHP.S516608","url":null,"abstract":"<p><strong>Objective: </strong>This randomized controlled study aimed to evaluate the effectiveness of LEARNS health education combined with intelligent follow-up management in the secondary prevention of ischemic stroke (IS), focusing on patient compliance and neurological function outcomes. The LEARNS model is a structured patient education framework encompassing Listen, Establish, Adopt, Reinforce, Name, and Strengthen, aiming to support individualized and interactive patient learning.</p><p><strong>Methods: </strong>A total of 120 first-episode IS patients admitted to the Neurology Department of our hospital from April to June 2024 were enrolled and randomly assigned to either a control group (n = 60), receiving conventional health education plus intelligent follow-up, or an observation group (n = 60), receiving LEARNS health education combined with intelligent follow-up management. Patient outcomes were assessed using the General Medication Adherence Scale (GMAS), secondary prevention control measures (including blood glucose, blood pressure, lipid control, smoking/alcohol cessation, obesity control, and exercise adherence), the Barthel Index (BI) for neurological function, and ischemic stroke recurrence. Evaluations were conducted at discharge and at all follow-up time points within six months post-discharge.</p><p><strong>Results: </strong>Compared to the control group, the observation group showed significantly higher medication adherence rates, better control in all secondary prevention measures, and higher neurological function recovery rates at all follow-up time points (P < 0.05). Additionally, the 6-month recurrence rate was significantly lower in the observation group (1.67%) than in the control group (13.33%) (P < 0.05).</p><p><strong>Conclusion: </strong>LEARNS health education combined with intelligent follow-up management effectively enhances patient compliance, improves secondary prevention outcomes, supports neurological recovery, and reduces recurrence risk in patients with ischemic stroke.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2377-2386"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Pressure Steam Sterilization Quality Through Healthcare Failure Mode and Effects Analysis: A Pre-Post Intervention Study in Central Sterile Supply Departments.","authors":"Yanrong Zhang, Ruixue Hu, Yanhua Chen, Xiaoxiao Liu, Jin Wu, Liangying Yi","doi":"10.2147/RMHP.S516409","DOIUrl":"10.2147/RMHP.S516409","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of Healthcare Failure Mode and Effects Analysis (HFMEA) in reducing quality defects during pressure steam sterilization in the Central Sterile Supply Department (CSSD).</p><p><strong>Methods: </strong>The study followed a structured HFMEA framework: (1) A multidisciplinary team (n=7) with CSSD expertise was established to analyze sterilization workflows, including instrument scanning, sterilization verification, and post-sterilization cooling. (2) Process mapping and risk prioritization were conducted using a 4-level severity/occurrence matrix (adapted from Australian clinical risk criteria) to calculate Risk Priority Numbers (RPN=Severity×Occurrence). High-risk failure modes (RPN≥8 or severity=4) were identified, including unlabeled \"non-sterilized\" packages (due to incomplete scanning), wet packages (from insufficient cooling<30 minutes), and unverified sterilization information. (3) Root causes were analyzed via fishbone diagrams (human, machine, material, environment, method). Targeted interventions included: optimizing the traceability system with department-specific alerts, standardizing scanning protocols, staff retraining on verification procedures, increasing instrument inventory and sterilizer racks, and implementing performance monitoring with 5W1H checklists.</p><p><strong>Results: </strong>Pre-intervention, 87 defects were identified among 185,382 sterilization packages (32 unlabeled \"non-sterilized\", 10 wet packages). Post-intervention, defects decreased to 11/189,531 packages (χ²=115.556, P<0.001), including 4 unlabeled (χ²=374.951, P<0.001) and 2 wet packages (χ²=8.889, P=0.003).</p><p><strong>Conclusion: </strong>Systematic HFMEA application reduced sterilization defects by addressing critical workflow gaps, demonstrating its value in enhancing CSSD quality control and patient safety.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2313-2321"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}