Global journal on quality and safety in healthcare最新文献

{"title":"Transforming Hospital Housekeeping: The Kayakalp Journey","authors":"J. Pillai, Biswajeevan Sahoo, M. C. Sahoo, B. Behera, R. Baby, Mariamma V. George, Jyotirmayee Rath, Chandramani Sahoo, Ashoka Mohapatra, Gaurav Chhabra, B. Behera, Arvind Kumar Singh, B. Patro, Ashok Kumar Jena","doi":"10.36401/jqsh-23-54","DOIUrl":"https://doi.org/10.36401/jqsh-23-54","url":null,"abstract":"\u0000 \u0000 The Kayakalp guidelines for public healthcare facilities under the Swachh Bharat Abhiyan (Clean India Mission) focus on improving sanitation, cleanliness, and infection control at public hospitals in India. This study was conducted in a 960-bed tertiary-level teaching hospital in eastern India. Housekeeping has been a challenge in public institutions, with factors like overcrowding and resource constraints. Tobacco and betel nut chewing, spitting, poor sanitation practices, and open urination are major challenges in ensuring sanitation at the hospital. The research objective was to study the implementation of the Kayakalp guidelines for quality improvement in housekeeping services at the institution.\u0000 \u0000 \u0000 \u0000 A pre- and post-interventional study was conducted using the Plan-Do-Check-Act (PDCA) quality tool. Plan phases included the gap assessment using the Kayakalp checklist with numerical scoring. Necessary interventions were done under three headings: structure, processes, and outcomes in the “Do” phase. The “Check” phase included monitoring of the activities followed by the “Act” phase, which included a review of the action plan. External experts nominated by the government conducted the final assessments and recommended it as one of the cleanest hospitals.\u0000 \u0000 \u0000 \u0000 A 360-degree improvement was observed in hospital services, with assessment score improvement from 73.68% to 95.0%. The institution received the first prize in 2020 and 2021 and runners-up Kayakalp National Award under category “B” (Institute of National Importance) Hospitals in 2019.\u0000 \u0000 \u0000 \u0000 The implementation of Kayakalp guidelines of the Government of India proved to be efficient in the improvement of housekeeping and infection control practices in the institution.\u0000","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817503","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":"Reply to Blom: Drugs Do Not Work in Patients Who Cannot Tolerate Them","authors":"Laila Carolina Abu Esba, Hani Alharbi","doi":"10.36401/jqsh-24-x1","DOIUrl":"https://doi.org/10.36401/jqsh-24-x1","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"51 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141660071","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":"Patient-Centered Healthcare: From Patient Experience to Human Experience","authors":"Muhammad Hasan Abid, Augustine Kumah, Ahmed Newera, Passant Hafez","doi":"10.36401/jqsh-24-x2","DOIUrl":"https://doi.org/10.36401/jqsh-24-x2","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"28 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141659485","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":"Using the Failure Mode and Effect Analysis Tool to Improve the Automatic Stop Order Process","authors":"Ghada Hussain Al Mardawi, R. Rajendram, Arwa Balharith, Abdulaziz Alomaim","doi":"10.36401/jqsh-24-9","DOIUrl":"https://doi.org/10.36401/jqsh-24-9","url":null,"abstract":"\u0000 \u0000 Automatic stop orders (ASOs) in computerized prescription order entry (CPOE) systems predefine the length of treatment. This can improve resource use for select therapies (e.g., empirical antibiotics). However, root cause analysis of dose omission errors identified inappropriate ASO-directed termination of medications without prescriber notification. This quality improvement initiative aimed to identify potential failures of the medication ASO processes to develop a new workflow and anticipate issues that may arise after implementation.\u0000 \u0000 \u0000 \u0000 A failure mode and effect analysis (FMEA) was conducted following Institute of Healthcare Improvement guidance. A multidisciplinary ASO-FMEA team reviewed the existing workflow. Failure modes, risk priority numbers (RPNs), and interventions were identified and assessed. The RPNs calculated for the proposed new workflow (assuming all recommendations were implemented) were compared with those of the existing workflow.\u0000 \u0000 \u0000 \u0000 Eight failure modes, 17 effects, and 31 causes were identified in the five workflow steps (mean RPN 365.4; median 280). Specific, measurable, achievable, realistic, and time-bound interventions were proposed. Assuming successful implementation of all recommendations, the RPNs of the proposed workflow (mean 117.6; median 112) were significantly lower (p < 0.05).\u0000 \u0000 \u0000 \u0000 When modifying existing CPOE systems, FMEA may identify possible failures that can be addressed before the implementation of a new process. This may prevent errors, improving medication safety. Regardless, continuous audit and monitoring are required to ensure the effectiveness of implemented changes.\u0000","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"7 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661644","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":"Letter in Response to “Lomitapide: A Medication Use Evaluation and a Formulary Perspective” by Esba and Alharbi","authors":"Dirk J. Blom","doi":"10.36401/jqsh-24-17","DOIUrl":"https://doi.org/10.36401/jqsh-24-17","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"3 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141661549","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":"Practical Application for the Theory of Profound Knowledge in a Quality Improvement Project","authors":"Hakem Alomani, F. A. Mostafa, Basim Felemban, Hani Redwan, Khaled Masaud, Khadijah Alshanqiti, Claudine Neff, Matea Vidovic","doi":"10.36401/jqsh-23-45","DOIUrl":"https://doi.org/10.36401/jqsh-23-45","url":null,"abstract":"","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"49 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141010128","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":"Evaluation of a Risk Screening Checklist for Venous Thromboembolism Prophylaxis in a Women and Newborn Hospital","authors":"Rebecca Lewis, Deborah Gordon, Julie Lam, S. Teoh, T. Lebedevs","doi":"10.36401/jqsh-23-51","DOIUrl":"https://doi.org/10.36401/jqsh-23-51","url":null,"abstract":"\u0000 \u0000 \u0000 The venous thromboembolism (VTE) risk screening forms were developed to allow for recording identified risk factors for VTE including thrombophilia, history of VTE, postpartum hemorrhage, and cesarean delivery, and documentation of specific actions taken to mitigate these risks and reduce complications due to VTE.\u0000 \u0000 \u0000 \u0000 Compliance with hospital guidelines in assessing VTE risk and appropriate prescribing of thromboprophylaxis was evaluated prior to the introduction of VTE risk screening forms (March 2022). Efficacy of the new VTE risk screening forms was also assessed (April 2023). Patient discharge summaries and patient medical records including medication charts were used to review the documentation of VTE risk assessments and details of thromboprophylaxis prescribing.\u0000 \u0000 \u0000 \u0000 Of 74 postnatal patients, 37.8% had VTE risk assessment documented prior to the introduction of VTE risk screening forms. Of 37 patients identified to be at moderate to high risk of VTE requiring pharmacological prophylaxis, 70.3% (n = 26) were appropriately prescribed pharmacological prophylaxis. After the risk screening forms were introduced, a total of 67 antenatal, postnatal, and gynecologic patients were studied. Of these, 32.8% (n = 22) of patients had all required fields completed appropriately. When using the forms, 26.9% (n = 7) of postnatal and 88% (n = 22) of gynecological patients were rated as medium or high risk, and all received medical review within 24 hours. Pharmacological prophylaxis was indicated in 88% (n = 22) of gynecological, 43.8% (n = 7) of antenatal, and 38.5% (n = 10) of postnatal patients, and all were appropriately prescribed.\u0000 \u0000 \u0000 \u0000 The guideline review and introduction of VTE risk screening forms was valuable to provide guidance in the risk assessment for VTE and to identify patients requiring prophylaxis.\u0000","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"98 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141016084","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":"Adherence to Infection Prevention Practice Standard Protocol and Associated Factors Among Healthcare Workers.","authors":"Getachew Ossabo Babore, Yaregal Eyesu, Daniel Mengistu, Sisay Foga, Asnakech Zekiwos Heliso, Taye Mezgebu Ashine","doi":"10.36401/JQSH-23-14","DOIUrl":"10.36401/JQSH-23-14","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare-associated infection affects more than 100 million patients annually. Healthcare workers' poor adherence to standard infection prevention and control procedures can result in many negative consequences, ranging from disability to death.</p><p><strong>Methods: </strong>A facility-based, cross-sectional study was conducted in June 2021 among 379 healthcare workers selected using a stratified random sampling technique. All types of healthcare providers except pharmacy professionals were included in the study. Standardization and validation of the study tool were performed ahead of data collection. Multivariable regression was used to assess the variables associated with adherence.</p><p><strong>Results: </strong>The study found that 60.2% of healthcare workers (95% CI, 55.1-65.2) had good adherence to infection prevention practices, and 68.7% and good knowledge of infection prevention practices. Training on infection prevention methods (adjusted odds ratio [AOR] = 1.68; 95% CI, 1.04-2.72), availability of water supply at hand washing station (AOR = 2.90; 95% CI, 1.62-5.31), and attitude toward infection prevention (AOR = 2.64; 95% CI, 1.65-4.24) were identified as predictors of adherence to infection prevention and control procedures.</p><p><strong>Conclusion: </strong>More than half of the participants had good adherence to infection prevention guideline practices. In-service infection prevention training, a consistent water supply at the hand washing station, and a positive attitude of participants were associated with good adherence to infection prevention practices.</p>","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"7 2","pages":"50-58"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900733","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":"Factors Affecting Pregnancy Complications in Ghana","authors":"Yaw K. Wiafe, Andrews Asamoah, P. Akweongo, Augustine Kumah","doi":"10.36401/jqsh-23-28","DOIUrl":"https://doi.org/10.36401/jqsh-23-28","url":null,"abstract":"\u0000 \u0000 \u0000 The prevalence of maternal mortality continues to be a significant health concern across the world. In Ghana, pregnancy-related complications in the previous 5 years account for 12% of all deaths among women 15 to 49 years. More than half of these deaths were avoidable if early assessment had been done. However, assessment of the pooled prevalence of pregnancy-related complications among pregnant women to inform policy is limited. This study sought to determine the factors contributing to pregnancy complications in Ghana. Methods: Using a systematic sampling technique, a facility-based cross-sectional study was conducted among 415 pregnant women who attended antenatal care (ANC) services at Mamprobi Hospital. Bivariate and multiple logistics regression analyses were conducted to test significant factors determining pregnancy complications. The results of regression analysis are reported in odds ratio. Statistical significance was set at p < 0.05. Results: The mean age of the participants was 31.6 ± 6.6 years. The incidence of pregnancy complications among the pregnant women was 51.8% (95% CI, 0.47–0.56) The incidence of pregnancy complications among the women was significantly determined by age (adjusted odds ratio [AOR], 6.1; CI, 1.19–30.76), record of pregnancy complication (AOR, 2.5; CI, 1.35–4.49), ANC visit (AOR, 6.1; CI, 2.14–17.70), and family history of pregnancy complication (AOR, 3.6; CI, 1.25–10.40). Other significant factors included a record of abortion (AOR, 7.8; CI, 4.21–14.32), knowledge about obstetric danger signs (AOR, 2.4; CI, 1.21–4.88), and experiencing at least one obstetric danger sign during pregnancy (AOR, 6.6; CI, 3.30–13.29). Conclusion: The incidence of pregnancy complications was comparatively high among the women who used ANC services at Mamprobi Hospital. Early initiation of ANC services for pregnant women is an essential tool for addressing some of the challenges of early onset of some pregnancy complications, including anemia in pregnancy and preeclampsia. Midwives and other health workers who engage pregnant women should encourage their clients to initiate ANC visits at an early stage.\u0000","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140666416","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 Assessment of Patient Experience Capacity-Building Program Using Kirkpatrick Model for Program Evaluation at a Regional Healthcare System","authors":"Muhammad Hasan Abid, Nada Al Shehri, S. S. Din, Mahmood Mir, Jamal Al Nofeye","doi":"10.36401/jqsh-23-4","DOIUrl":"https://doi.org/10.36401/jqsh-23-4","url":null,"abstract":"\u0000 \u0000 \u0000 The patient experience (PX) is central to improving the quality of healthcare services. We launched a PX capacity- and capability-building program at the Armed Forces Hospitals Taif Region, which is integral to our regional healthcare cluster transformation plans and is an initial step toward developing a culture of improvement in human experience in healthcare.\u0000 \u0000 \u0000 \u0000 A multidisciplinary PX committee recruited five frontline interprofessional PX heads, one from each of our regional healthcare hospitals. The Kirkpatrick model for program evaluation was used to assess the impact on four key levels: reaction, learning, behavior, and results. A pre-program competency assessment was conducted to evaluate the level of expertise across various PX competencies, and a program curriculum was developed accordingly. Participants underwent an intensive workshop-based PX capacity-building training program. A post-program competency assessment was performed along with a post-program survey. The PX-related activities led by interprofessional frontline PX heads at their respective hospitals’ post-programs were tracked. The impact on the regional PX mean score across various settings, including inpatient, outpatient, and emergency settings, was measured using Press Ganey PX surveys. Our work is reported in accordance with the SQUIRE-EDU guidelines of the EQUATOR network.\u0000 \u0000 \u0000 \u0000 The PX capacity-building program led to a significant improvement in participants’ expertise across various PX competencies. Significant improvements beyond the strategic targets were observed in the PX mean score in inpatient departments pre-program (83.31) vs. post-program (86.34), with a p-value of < 0.001 across the regional healthcare system.\u0000 \u0000 \u0000 \u0000 The PX capacity-building program is a first step toward major cultural change amid the healthcare cluster transformation in our regional healthcare system. The Kirkpatrick model helps evaluate the impact of PX capacity- and capability-building training programs comprehensively through an organizational approach. Sustainable improvements in PX over a long period through a capacity-building program alone remain challenging.\u0000","PeriodicalId":73170,"journal":{"name":"Global journal on quality and safety in healthcare","volume":"3 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140666473","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}