Journal Of Patient safety and quality improvement
Volume:11 Issue: 4, Autumn 2023

The Patient Safety Huddle (PSH) is a daily brief multidisciplinary meeting to discuss patient safety threats and actions to mitigate risk. This paper reports on frontline staff perspectives from five UK hospitals across three National Health Service (NHS) trusts (provider organizations) on the impact of PSHs on communication and teamwork. Perspectives were collected at two points– before and after PSHs had been embedded.Frontline teams from 25 wards were invited to complete a paper-based Evaluation Survey. In the first survey, 21 wards participated, generating 137 responses, and in the second survey, five wards participated, eliciting 32 responses. Additional group interviews with five ward teams were conducted (n=19 participants).PSHs improved teamwork and communication, both in terms of quality and quantity. The evaluation survey reported improved teamwork (108/137 answered positively) and communication (121/137). In facilitating a non-hierarchical, easily accessible, and fear-free space for discussing patients at risk of harm, the PSH was perceived as engendering a supportive environment for all staff and contributing to an enhanced safety culture.Patient Safety Huddles – at both pre and post-embedded stages - were perceived as improving communication and teamwork, resulting in a safe and collegiate environment that facilitates successful information sharing, improved multidisciplinary working, and the development of collective situational awareness. These factors may contribute to enhanced patient safety and quality of care.

Patient safety and quality of care are among the most important points that hospitals should emphasize. Therefore, this study was conducted to evaluate the status of mandatory patient safety standards in teaching hospitals in Arak City.
This cross-sectional descriptive study was conducted from February to July 2023. The data collection tool was a checklist of mandatory standards from the Patient Safety Friendly Hospital Initiative (PSFHI). The required data were gathered by reviewing the documents, interviews, and observations in five teaching hospitals in Arak City. Data were analyzed using SPSS software and descriptive statistical methods. Based on the average compliance score, these hospitals were classified as weak (lower than 50%), moderate (50-70%), and good (higher than 70%).
These hospitals’ average compliance with mandatory patient safety standards was 89.48±4.82, indicating good compliance. The average compliance in the areas of leadership and management, patient and public involvement, safe and evidence-based clinical practices, and safe environment in teaching hospitals of Arak City, with a score of 93.28±2.5, 80±20.9, 84.65±6.14 and 100, respectively, are in good status.
Five teaching hospitals in Arak City comply well with mandatory patient safety standards. However, since achieving 100% compliance with the mandatory standards is necessary to obtain the title of Patient Safety Friendly Hospital, and none of the studied hospitals have acquired the necessary score to achieve this title, more effective managerial efforts s are crucial to full compliance with mandatory standards.

Due to the effect of COVID-19 on nursing care, the methods of communication with patients have changed and ultimately caused nursing care to be postponed or even removed. According to the decrease in COVID-19 patients, the effect of the pandemic has remained in the hospitals, which expressed the necessity of doing this study.  350 nurses from four teaching hospitals of the Medical Sciences University of Kurdistan participated in this cross-sectional (descriptive) study using random sampling. Two questionnaires were used: one for missed nursing care and the other for factors associated with missed nursing care. The independent t-test, one-way analysis, and chi-square test were employed in the data analysis using SPSS software version 16.  For missed nursing care in general, the study's score was 40.60. The patient's cooperation and supervision when using the restroom within the first 15 minutes of the request received a score of 2.39, whereas the patient's blood sugar management using a glucometer received a score of 1.24. Additionally, "lack of nursing staff" (score of 3.84) is the most significant instance in examining factors connected with missing nursing care from the perspective of the nurses. Given that the primary cause linked to nursing service gaps is a shortage of nurses, addressing this issue by providing human resources can help.

Headache is one of the most common causes of emergency hospitalizations in world. Different therapies are used in both acute and prophylactic phase of headaches, but some patients do not have great response to pharmaceutical therapies. These patients can benefit from injection of peripheral nerve blocks depending on the headache type. This study aimed to evaluate the effects of nerve blocks in treatment of patients with refractory primary headaches.
This cross-sectional study was done on 187 patients who refered to the emergency of Alavi hospital in Ardabil at year 2021 that hadnot response to the decrease in severity of headache up to 50% based on MIDAS and also cured with nerve blocks. The necessary cheklist were completed for all patients and the severity, frequency and the interval of headaches were registered and compared in one day, one week and one month after the blocks  and collected data were analyzed by statistical test like independent and Paired t-tests and Anova in SPSS version 21.
The mean severity of headache in patients significantly decreased during the study periods compared to before nerve blocker injection. The most common complications after nerve block in patients were anesthetized with 53%, followed by injection site pain and swelling each with 22.5% and then tachycardia with 19.8%.
Peripheral nerve block in patients with primary headache can reduce the severity of pain in one month after the block nerve injection and in acute phase it can improve symptoms in middle-term.

Patient identification, defined as the accurate matching of a patient to intended interventions while communicating identity information consistently throughout care, is critical for patient safety. Incorrect patient identification is a leading unintentional cause of patient harm and poses a significant safety challenge in healthcare facilities. This project aimed to enhance correct patient identification in the intensive care unit of a general hospital in Tabriz, Iran. A clinical audit, utilizing the JBI Practical Application of Clinical Evidence System (JBI PACES) tool, was conducted. Seven audit criteria, representing best-practice recommendations for correct patient identification, were employed. The project involved a baseline audit, the implementation of multiple strategies, and a follow-up audit to assess changes in practice.  Significant improvements were observed in the follow-up audit compared to the baseline audit, including the use of at least two identifiers to check patient identity before care (from 22% to 100%), provision of clear protocols for patients lacking identification or with similar identities (from 17% to 94%), labeling of containers in the presence of patients (from 33% to 89%), education of healthcare workers in correct patient identification procedures (from 33% to 94%), patient education on the importance of correct identification procedures (from 28% to 94%), and utilization of white identification bands or biometric technologies across healthcare facilities (from 6% to 22%).  The application of standard clinical audit tools in hospitals can enhance the quality of patient services and improve the effectiveness of interventions by identifying weaknesses in the patient care process.

Objective Eye injuries during general anaesthesia (GA) are not common, and are much easier to prevent than to treat, providing theatre staff take care to use correct eye protection. Some operations are at higher risk than others. Our hospital had a recent series of eye injuries which triggered action to investigate the route cause, improve prevention, and provide clinicians with a toolkit to manage those that do occur.SettingThis quality improvement project was done across two hospitals within one trust - Bristol Royal Infirmary and St Michael’s Hospital, both within University Hospitals Bristol and Weston NHS Foundation Trust.Intervention We introduced local training to raise awareness in eye injuries, and an eye guideline (standard operating procedure) which as uploaded onto the trust intranet to clarify eye protection measures for all staff, in addition to guiding management for eye injuries that occur.DiscussionOur guideline divided patients into 2 groups - high risk and low risk for eye injuries. Those with a low risk had their eyes taped. Those meeting criteria for “high risk” included operations on the head and neck, patients with positioning such as prone positioning, lateral positioning, or prolonged/steep head down positioning. These patients are treated with lubricant and dedicated eye tape. We introduced an “Eye Box” which resides in theatre recovery, which can be used by clinicians reviewing patients with a suspected eye injury. This streamlines the process of assessment by consolidating all required equipment and information in one box. The box contains the guideline, equipment to assess the eye (local anaesthetic, fluorescein, ophthalmoscope), as well as chloramphenicol ointment to allow clinicians to initiate treatment immediately.