جستجوی مقالات مرتبط با کلیدواژه « Patient safety » در نشریات گروه « پزشکی »

In global health crises, there is a heightened risk to patient and professional safety. Several studies have evaluated the safety climate, revealing different perceptions among healthcare professionals, often influenced by demographic characteristics. This study aimed to assess the percentage of problematic responses (PPR) for the patient safety climate dimensions and verify whether they differ regarding personal, professional and work unit variables. 

A cross-sectional study was conducted on 325 nursing professionals from a teaching hospital in São Paulo, Brazil, considering a significance level and sampling error of 5%. The subjects were invited through posters with QR codes placed in different units that directed the volunteers to the Google Forms questionnaire. The online format of patient safety climate in healthcare organizations (PSCHO), the Brazilian version and demographic variables were used for data collection from July to October 2021. The data were analyzed using SAS software, version 9.4. A descriptive analysis of the variables and comparison tests such as the Mann-Whitney test, analysis of variance, or the Kruskal-Wallis test were performed, followed by Dunn or Tukey post hoc tests. The data distribution was assessed using the Shapiro-Wilk test at a significance level 0.05. 

The nursing professionals reported a high PPR for most dimensions in the overall results, except for the fear of shame, similar to the findings in the adult intensive care unit. The pediatric unit reported lower PPR for fear of shame, overall emphasis on patient safety, psychological safety, collective learning, unit safety norms and senior managers’ engagement. Some dimensions of problematic responses differed according to sex, nursing professional category, work unit, work shift, absence due to health reasons and other employments (P<0.05).

Recognizing and valuing the perception of nursing professionals during the pandemic can offer valuable insights for managers in healthcare organizations. This understanding can assist in enhancing hospital culture and fostering a safer environment for patients and healthcare providers.

Integrating artificial intelligence (AI) in healthcare can significantly enhance diagnostic precision, therapeutic effectiveness, and healthcare administration. However, as AI has become more widespread recently, it raises several legal and ethical concerns that require meticulous consideration. A primary concern is determining liability when AI systems commit errors, such as misdiagnosing diseases or prescribing treatments. The legal framework to address this issue is currently unclear, and establishing guidelines for accountability is crucial to ensure patient safety and trust (1).   A critical concern is safeguarding patients' privacy and ensuring their data's security. Maintaining the confidentiality of sensitive medical information and protecting it from unauthorized access or misuse is paramount. This issue involves implementing robust data management protocols, encryption techniques, and access controls to prevent breaches and uphold patients' trust in healthcare providers. Addressing these privacy and security challenges is essential to delivering high-quality, ethical, and responsible patient care. AI systems rely heavily on large datasets for training and decision-making, which raises concerns about unauthorized access or breaches that could compromise patient confidentiality. To effectively address the concerns of patient privacy and data security, healthcare providers must adhere to strict regulations like the Health Insurance Portability and Accountability Act (HIPAA). It ensures that patient data is properly managed and protected from unauthorized access or misuse. Additionally, AI systems used in healthcare must be designed with robust security measures to prevent data breaches and ensure the integrity of patient information (1). AI algorithms are often perceived as unbiased tools, but if trained on biased or incomplete data, they can inadvertently perpetuate discrimination or inequality in healthcare outcomes (2). Addressing algorithmic bias and ensuring fairness of AI systems through ongoing oversight and regulation is essential to mitigate this risk and prevent the perpetuation of health disparities. In emergencies, timely decisions are crucial for saving patients. When AI is involved in high-pressure decision support systems, concerns inevitably arise about liability when mistakes occur (3). The challenge lies in determining who is accountable for AI-driven decisions in healthcare emergencies, which needs clear guidelines and protocols to ensure accountability and patient safety. The integration of artificial intelligence (AI) into the medical field has the potential to significantly improve patient care and healthcare outcomes. However, the legal hurdles associated with AI in medicine are substantial and cannot be ignored. To ensure the responsible and ethical implementation of AI systems in healthcare, it is essential to address legal issues such as liability, data privacy, bias, regulatory compliance, and informed consent. A collaborative approach involving healthcare professionals, policymakers, and legal experts is not just beneficial, but necessary to develop comprehensive legal frameworks that protect patient rights while promoting innovation in this transformative field.

Acute kidney injury (AKI) is one of the potential side effects of vancomycin in children with systemic infections. We aimed to evaluate the effect of selenium on the prevention of Vancomycin-associated AKI (VA-AKI) This study is a parallel randomized controlled trial in Heshmatieh Hospital, Sabzevar, Iran. According to the simple random sampling method, thirty patients between 1 month and 18 years old with systemic infections were randomly assigned to two groups. The intervention and control groups were treated with vancomycin plus selenium and vancomycin alone, respectively. Urine and blood samples were obtained from patients at the beginning and seven days after the treatment to evaluate AKI among patients. We found no significant difference between baseline BUN, creatinine, and microalbumin in the two groups (P>0.05). There was a significant difference between the two groups post-treatment urine microalbumin (P= 0.045). The frequency of AKI in the intervention group [5(33.3%)] was lower than the control group [11(73.3%)] (P = 0.02). There were few changes between the mean difference baseline and post-treatment Cr (0.1mg/dl) and BUN (2.9mg/dl). Drug efficacy was 66%, and the number needed to treat (NNT) was equal to 2.In the present study, we concluded that selenium could prevent vancomycin-induced AKI. Future investigations on the higher numbers of patients are needed.

This study aimed to assess the operating room (OR) staff’s perception of patient safety culture in a dynamic and demanding setting where reducing human errors is critical.
This cross-sectional, descriptive study was conducted between June and October 2022, employed a census sampling method involving surgical technologists and anesthesia technicians. Data collection instruments included the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire and demographic information. Data analysis was performed using SPSS version 22.
The findings revealed a moderate level of patient safety culture, with 85.4% of respondents reporting no errors in the past year. Supervisor/manager expectations and actions received the highest mean score, while non-punitive response to errors scored the lowest. The overall patient safety culture was determined to be at a moderate level, with an average score of 116.26 ± 12.98.
This study highlights the crucial need for strategic management interventions to improve patient safety culture, particularly in operating rooms. Health policymakers and nursing managers must prioritize implementing standardized and updated checklists for every surgical procedure, promoting a culture of transparency and accountability. By fostering cooperation, empathy, and a non-punitive response to errors, significant improvements in patient safety can be achieved. Recognizing and addressing these needs is essential for health policymakers and nursing managers to ensure safer operating environments and enhance overall healthcare quality.

Handling, transferring, and handing off trauma patients impose risks on patients and transfer teams. Therefore, pre-hospital staffs require a high skill to perform these processes simultaneously in critical situations.

The present study was performed with aim to examine the role of demographic factors and skills of pre-hospital staff in the handling and movement of trauma patients to hospitals.

This cross-sectional study was performed by the proportional stratified random sampling method on 151 pre-hospital emergency staff. For data collection, in addition to a demographic information questionnaire, the researcher completed a valid and reliable checklist based on 300 hours of direct observation for assessing staff skills. The data were analyzed by SPSS software (version 20) using descriptive and inferential statistics. p<0.05 was considered statistically significant.

The mean score of staff skills was 77.80±7.84. The lowest scores were related to the stage of “transfer to hospital” (72.04±8.41) and the dimension of “using body mechanics” (67.57±10.42). There was an inverse correlation between staff body mass index and the mean score of staff skills (r= -0.19, p<0.05). Besides, the staff’s skill mean score was correlated with patients’ age (r=0.18) and weight (r=0.16) (p<0.05).

Implications for Practice: 

Retraining courses covering driving, managing pediatric patients, healthy diet and exercise, proper use of equipment, and body mechanics should be implemented for pre-hospital staff. Also, authorities should take measures to control infection and improve patient handoff.

Assessment of safety culture and nursing students’ competencies in patient safety is essential for readiness to provide quality and safe care. The objectives of the study are to examine how nursing students perceive patient safety culture and to evaluate factors that may influence their perceptions.

Methods & Materials: 

A descriptive cross-sectional study was conducted using the Slovak version of the Hospital Survey on Patient Safety Culture for Nursing Students and the Questionnaire for Measuring Demographic Variables and Information on the Education Process. The study involved 242 nursing students from two faculties in Slovakia. Data were analyzed using descriptive and inferential statistics.

None of the dimensions of patient safety culture was rated by the nursing students above the necessary level of 75 %. Statistically significant correlations and differences were found between the nursing students’ perceptions of patient safety culture and some selected sociodemographic variables. Multiple regression analysis revealed significant associations between the nursing students’ perceptions of patient safety culture and overall patient safety grade, the number of reported events in the workplace, and the number of reported events by nursing students.

Recognising nursing students’ perceptions of patient safety culture enables identification of weaknesses, and early implementation of targeted interventions and educational initiatives to increase overall patient safety in care provision. Future research should focus on recognizing relationships between perceived patient safety culture, teamwork, education, and indicators of safe and quality care during clinical training from nursing students’ perspective.

Injuries caused by sharp objects are a major health risk for nurses. These injuries can be extremely dangerous and lead to various diseases. The purpose of this study was to establish the pooled prevalence of Needle Stick Injuries (NSIs) among nurses in Iran.

This study was a systematic review and meta‑analysis. Eligible articles were searched from five electronic databases (Scientific Information Database (SID), Magiran, Web of Science, PubMed, and Scopus) and one search engine. A random effects model was conducted to estimate the pooled prevalence. The heterogeneity of the sample was tested using the I2 index, and the meta‑regression function was used to evaluate variables suspected of heterogeneity at the 0.05 significance level. Finally, 21 articles were analyzed using the Comprehensive Meta‑Analysis software (ver. 2.2.064).

Based on the random‑effects model, the frequency of NSIs among Iranian nurses is 18.70% (95% CI: 15.10%–22.90%). The highest frequency is recorded in a teaching hospital in Tehran in 2007 (19.80%; 95% CI: 16.40%–23.70%), and the lowest frequency was recorded in a teaching hospital in Tehran in 2008 (17.90%; 95% CI: 14.60%–21.80%). Sample size, mean age, and work experience were significantly associated with and mean and frequency of NSIs in nurses (p < 0.05).

NSIs occur in about one‑fifth of nurses in Iranian hospitals. In addition to its cost burden, the increase in NSIs has negative consequences for nurses. Therefore, health policymakers and managers must take serious action to reduce these injuries.

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.

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.

Patient safety is one of the main elements of the quality of health services. Our aim of this study was to compile a complete checklist for the three stages of anesthesia.

This research was a cross-sectional descriptive-analytical study. First, an internet search was conducted in databases to identify checklists related to safe Anesthesia. The WHO Safe Anesthesia Checklist was designated as the main checklist. Then, a brainstorming session was held with experts and according to the determined fields, the initial draft was compiled. Face and content validity were conducted. The reliability of the checklist was measured with Cronbach's alpha and intra class correlation index (ICC) methods.

The initial draft was compiled with 34 items. 29 items scored higher than 0.79 in terms of CVI (content validity index) The value of CVI of 5 items was less than the permissible limit and the edge of the border, which was revised and corrected by the research group. 2 items were returned to the research process according to the survey of experts and their necessity CVR (content validity ratio) (value >0/62) and 3 items were removed from the research process. Cronbach's alpha was calculated as 0.876 for the first evaluator and 0.870 for the second evaluator, and the percentage of agreement between the evaluators was 0.956 (P<0.001).

We developed and evaluated a checklist for the three stages of anesthesia through an evidence-based study. We hope this checklist can reduce and prevent clinical errors.

Drug-disease interactions (DDSIs) are associated with increasing morbidity, mortality, and healthcare costs. These interactions are preventable if recognized and managed properly. Medication safety is critical in kidney transplant patients due to polypharmacy, co-morbidities, and susceptibility to adverse events. Clinical decision support systems (CDSSs) can play a key role therein. Therefore, this study aims to report on the process of developing an innovative, patient-centered, context-aware CDSS for managing DDSIs in kidney recipients.

Clinically important DDSIs were identified in the medications of patients at a kidney transplant outpatient clinic. Subsequently, rules for their detection and management were extracted based on pharmacology references and clinical expertise. A CDSS was developed and piloted following recommendations on medication CDSS design principles.

The knowledge base for this CDSS was developed with clinical context sensitivity. We defined priority levels for alerts, established associated display rules, and determined necessary actions based on the transplantation clinical workflow. The DDSI-CDSS correctly detected 37 DDSIs and displayed nine warnings and 28 cautionary alerts for the medications of 113 study patients (32.7% DDSI rate). The system fired three warnings for diltiazem in bradyarrhythmia, and two for each of the following medications and underlying diseases: aspirin in asthma, erythropoietin alfa in hypertension, and gemfibrozil in gall bladder disease. The potential consequences of the identified DDSIs were GI complications (17%), deterioration of the existing disease/condition (6.1%), and an increased risk of arrhythmias (2.6%), thrombosis (2.6%), and hypertension (1.7%). Complying with system alerts and recommendations would potentially prevent all these DDSIs.

This study delineates the process of developing an evidence-based DDSI-CDSS for kidney transplantation, laying the groundwork for future advancements. Our results underscore the clinical significance of these interactions and emphasize the imperative for their accurate and timely detection, particularly in these vulnerable patients.

Patient safety is one of the most critical factors influencing the quality of nursing care, but some challenges cause failure to maintain patient safety. This study was conducted to identify the challenges that clinical nurses face in maintaining patient safety. This qualitative study was completed in 2021-2022 on clinical nurses of public and private hospitals in selected cities of Iran. Purposive sampling was used to select participants and data were collected through semi-structured in-depth interviews. The interviews were analyzed using Lindgren, Graneheim and Lundman content analysis method. Three categories of "organizational challenges," “work-related and individual challenges,” and “challenges raised by patients or companions” emerged from the data as factors leading to failure in maintaining patient safety. Nurses, nursing managers at the organizational level, and nursing policymakers at the national level should be aware of their role in patient safety violations and then manage these challenges by formulating appropriate programs, policies, and interventions.