Journal Of Patient safety and quality improvement
Volume:12 Issue: 1, Winter 2024

Although there is a defined role for family members in the development of the hospital safety policies, family participation in the health care is a challenging concept and few studies have focused on its role in patient safety. This study designed to determine the effect of the participation of family member's in nursing care on patient safety in the intensive care unit (ICU). The study used a randomized controlled audit. Seventy one ICU nurses, patients and their relatives were selected purposefully, from October to December 2021, in Rafsanjan, Iran. Eligible nurses assigned into 2 study groups (with and without family members' participating in nursing care), by the random minimization method. The ICU nurses' compliance with patient safety standards in nursing care was measured by a checklist. Data were analyzed using SPSS software version 22, by Shapiro and Wilk tests, Chi-Square and t-test for independent groups. A significance level of 0.05 was considered. The study groups were similar in terms of demographic characteristics and baseline scores. The mean ±SD of nurses' observance of patient's safety score in with family participation group (119.20±13.64) was higher than in without family participation group(116.97±13.26), but no statistical difference was observed between the study groups (p=0.488) Also, in the subgroups, no significant statistical difference was observed between the two groups after the intervention (p>0.05).  ICU nurses observance of standards in patient safety during caring is not affected by the participation of family members in the nursing cares. These results guide managers and policymakers of the health system to find stronger influencing factors on the level of patient safety compliance during nursing care.

Allergic and non-allergic rhinitis are chronic upper airway inflammatory diseases. Iota carrageenan is an herbal extract of red algae used as a prophylactic treatment for rhinitis in the common cold and other viral infections. This study was designed to evaluate the clinical efficacy of Iota carrageenan in the treatment of allergic and non-allergic rhinitis. 

60 patients with allergic and non-allergic rhinitis clinical symptoms were randomly divided into carrageenan and placebo (control) groups. The Standard Sino-Nasal Outcome Questionnaire 22 (SNOT-22) and Rhino Juniper Mini Conjunctivitis Quality of Life Questionnaire (Mini-RQLQ) were completed for each patient before and after receiving the drug. Smear of nasal secretions and rhinomanometry were also performed for all studied participants. 

The mean score of SNOT-22 in the study group was 43.3 and 23.7 in the first and fourth weeks after therapy. The mean score of Mini RQLQ was 36.3 and 19.3 at the same time points (P< 0.001). SNOT-22 (P= 0.002) and Mini RQLQ (P= 0.005) scores showed a statistically significant decrease in the study group compared to the control group. The decrease in the eosinophil count and rhinomanometry results following treatment in both groups was statistically insignificant. 

Our findings showed a positive effect for carrageenan over placebo in the management of both non-allergic and allergic rhinitis in symptom control. However, non-allergic rhinitis patients’ symptoms may improve better with this drug.

Medical mistakes cause injury to patients and raise the expenses of treatment and hospital stays. The current study aimed to identify medical errors in the field of gastroenterology and propose a prevention strategy.The study was carried out through a mixed method (quantitative, qualitative) in a sequential manner. In the first stage (quantitative), common errors in the department were identified. In the second stage (qualitative stage), data gathering was done by interviewing nurses and doctors. The collected data was analyzed using content analysis method and error prevention strategies were identified.The mean (standard deviation) score of patients in the departments were 66.28 (98.7), and the mean number of nurses was 4.83 (26.3). It was found that the most medical errors were not serious, and the most errors in drug registration were drug card registration (42.9%), drug preparation (38.1%), and drug prescription (33.3%). Medical errors resulting in severe complications due to incorrect patient identification accounted for 2% of the total errors. The suggested prevention strategies included: adjusting department supervision processes, ensuring proper training, enhancing patient education, and developing a culture of error reporting.The study's findings revealed a high frequency of errors that were largely benign and identified before they occurred. Nevertheless, given their potential to inflict harm, it is essential to implement effective error detection and reporting system.

Primary ciliary dyskinesia (PCD) is a rare genetic disease that is estimated to occur in about 1 in 15,000 people. A patient registry is a well-known tool for collecting a sufficient number of patients with a rare disease to evaluate and monitor the patient’s information in a standard and continuous way, as well as to conduct clinical research on the disease, which can be used for early diagnosis. Standard treatment and follow-up of PCD patients will help us. In this study, we developed a PCD registry for the Iranian population.   In this study, for the first time in Iran, the PCD Registry was presented to record demographic information, clinical diagnostic symptoms, diagnosis method, management, and follow-up of patients called IPOLD (Iranian Pediatric Orphan Lung Disease). This PCD Registry can be used in all provinces of Iran, and a network of PCD treatment centers can be established. Two hundred fifty-six patients diagnosed with PCD, regarding demographic information, diagnostic clinical symptoms, disease diagnosis method, imaging, spirometry, and microbiological findings, were referred to university hospitals and clinics covered by the Tehran University of Medical Sciences from April 1401 to April 1402. We used SPSS to analyze data and performed descriptive tests.   In this study, the average age of disease diagnosis was 5.7 years. The most common diagnostic symptom of the patients was chronic cough, with the belief of 94.3%. 56.7% of patients with distress were hospitalized and hospitalized in infancy. Bronchiectasis was seen in CXR or Chest CT in 28 patients (11%), and the severity of bronchiectasis was evaluated using the Bronchiectasis Severity Index (BSI); 13 cases have mild bronchiectasis (46%) and 15 moderate cases (53%). Atelectasis was seen in 47% of patients, with the predominance of RML involvement in 35%. Lung infiltration was reported in 15% of patients. PCD diagnosis method in 46 patients was based on PICADAR clinical diagnosis, 173 patients by nasal nitric oxide test, 31 by genetic test, and six by TEM.  The patients’ information was registered in the registration system, IPOLD, Iran, for children's orphan lung disease.

Medical errors are problematic in the health system and can seriously affect patients' safety. The cause is not reporting, giving appropriate feedback, and taking action about them. This study aimed to investigate the factors associated with the lack of medical error reporting from the perspective of nurses at Shahid Motahari Hospital, in Tehran, Iran. 

This cross-sectional descriptive study was conducted in 2019 with the participation of 131 nurses working in different wards at Shahid Motahari Hospital in Tehran, Iran. The data were obtained using a questionnaire, whose validity was examined by ten nursing and health service management experts. Also, its reliability was confirmed (Cronbach's alpha = 0.83). Data were analyzed using descriptive and inferential statistics in SPSS-19. 

The participants in the study had a mean age of 35 years; 77.9% were women and 22.1% were men. From the perspective, the main factors behind medical errors not being reported by nurses were the fear of reprimand by managers (legal factor), heavy workload (organizational culture factor), being charged (supervisory regulation factor), and recognizing error reporting as extra work (financial factor). 

Accurate human resource management planning to reduce nurses’ workload can be essential in promoting error reporting by creating an integrated system and organizing the process of error reporting and feedback.

Today the main question is whether all nurses working in the Covid and non-Covid hospitals departments were equally affected by stressors and anxiety producing during the corona pandemic. Therefore, this research is aimed to investigate the occupational stress and depression rate in Coveid-19 wards compared to other words during the corona virus pandemic. 

This research was descriptive-analytical study conducted in Imam Reza hospital of Mashhad, Iran during 2019-2022. The sample size was 144 nurses, including 72 nurses worked in Covid-19 wards and 72 nurses from the other wards. The research tools were two questionnaires including Expanded Nursing Stress Scale (ENSS), and Depression Short Inventory (BDI) which their validity and reliability were confirmed. Chi-square and two- sample T-test, and Kolmogrov-Smirnov test was utilized for analytical results employed. Inferential statistical methods were used for analytical results by SPSS software. 

No differences was reported between stress rate among two groups nurses. Moreover, despite the higher average of depression score among nurses worked in the Covid wards, the difference was not statistically significant. 

It is not possible to comment with certainty about the differences in the level of stress, anxiety and depression between nurses who worked in the Covid wards compared to other hospital wards. But all nurses worked in hospitals were exposed to physical, and mental problems during Covid pandemic period. Therefore, we suggest the nursing policymakers and senior managers to allocate the comprehensive support program for nurses to improve their quality of work life.

The aim is to conduct an initial evaluation of Baharloo Hospital to assess its adherence to patient safety standards, laying the groundwork for the adoption of the WHO/EMRO Patient Safety Friendly Hospital Initiative (PSFHI). The overarching objective is to elevate the standard of patient safety and foster a culture of safety among both hospital staff and patients. The evaluation process utilized the PSFHI assessment manual, which includes a comprehensive collection of critical, core, and developmental standards. Three primary review tools were employed for the assessment: document review, face-to-face interviews, and observation. The leadership and management domain exhibited the highest scores in critical criteria, reaching 89%, while the safe evidence-based clinical practice measures domain followed closely with 58%. The hospital demonstrated implementation of the majority (71%) of critical standards, over half (60.5%) of the core standards, and more than a quarter (28%) of the developmental standards. The baseline assessment reveals that Baharloo Hospital exhibited partial adherence to the patient safety standards mandated by the PSFHI. There exists an opportunity for enhancement to ensure the fulfillment of 100% of critical requirements, a fundamental prerequisite for achieving the status of a Patient Safety Friendly Hospital.

To investigate the frequency of nasal and sinus problems in patients with acquired nasolacrimal duct obstruction. The prospective case-control study was performed on 44 patients with primary acquired nasolacrimal duct obstruction, who were referred to oculoplastic clinics for surgery, and 50 healthy controls. All patients were evaluated with nasal endoscopy by an otolaryngologist. All endoscopic data were reported, including secretion from the middle meatus, nasal deviation, presence of a mass or polyp, turbinate hypertrophy, and concha bollosa. The mean age of the patients was 42.02±12.04 years. The majority of participants were female (70.45%). 72.7% (32/44) of the PANDO group had varying sinus and nasal disorders. Septal deviation was the most common accompanying disorder, and it was found to be in 61.4 % (27/44) of the PANDO group compared to 36% (18/50; P=0.03) of the controls. 77.77% (28/36) of patients with unilateral nasolacrimal duct obstruction had been associated with sinus and nasal disorders.Due to the high frequency of nasal and sinus disorders in patients with acquired nasolacrimal duct obstruction, otolaryngology consultation before surgery is recommended.