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عضویت

جستجوی مقالات مرتبط با کلیدواژه "Patient safety" در نشریات گروه "پزشکی"

  • Peivand Bastani, Eshagh Barfar, Alireza Yusefi *, Ehsan Movahed, Neda Dastyar, Sisira Edirippulige
    Background

    Medication errors can lead to damage to patients with various disabilities or death. This study aims to identify factors affecting the incidence of medication error and its association with patient safety culture from the nurse’s perspective during the COVID-19 pandemic.

    Materials and Methods

    This cross-sectional study was conducted among 340 employed in the hospitals affiliated with Shiraz University of Medical Sciences in 2021. Data were collected by applying a questionnaire for medication error and the standard questionnaire of the Hospital Survey on Patient Safety Culture. Descriptive statistics, the independent t-test, ANOVA, and Pearson correlation were applied using SPSS software version 23.

    Results

    The main reasons for medication errors were fatigue due to the workload (3.13±1.16 out of 5), method of supervision in the hospital units (3.06±0.98 out of 5), and massive pile-up of duties (3.00±1.19 out of 5). Other results indicated a significant negative association between factors affecting medication error and patient safety culture (r=-0.574, p=0.002). A significant correlation was observed among factors affecting medication error and patient safety culture with demographic determinants of age and years of working experience (p<0.05). Significant differences were also observed among the two main studied variables, the number of monthly work shifts, and the number of patients (p<0.05).

    Conclusion

    Applying strategies for the reduction of physical fatigue and mental exhaustion along with balancing work shifts and managing the accumulative duties and massive tasks can help decrease the rates of medication errors.

    Keywords: Medication Errors, Patient Safety, Culture, Nurses, COVID-19
  • Mohammadreza Sheikhy-Chaman, Faride Sadat Jalali, Farzaneh Ghaleh Golab, Hadi Hamidi, Mostafa Gholami *

    Delivering healthcare is among the most complicated tasks in which humans engage. Medical errors are prone to arise during this process. This matter could compromise the patient's safety, likely leading to serious damage. Patient safety culture is an essential factor of patient safety, encompassing the organizational culture that fosters and advances patient safety. The concept of patient safety culture involves various aspects, with one prominent feature being the level of support offered through management towards ensuring patient safety. Healthcare managers are legally and ethically responsible for ensuring that patients receive high-quality treatment and making ongoing efforts to improve the quality of care provided. During the investigations based on the structure and conditions of Iran's health system, the situation of management's support for patient safety has been reported as unfavorable in some cases. In this paper, we tried to present Management Support actions that can improve patient safety culture by considering the structure and conditions of Iran's health system.

    Keywords: Patient Safety, Support, Management, Iran’S Health System
  • Mariana De Souza Esteves, Laura B. De Araujo Lourenço, Mariana De Jesus Meszaros, Michele, De Freitas Neves Silva, Thais São João
    Background

    Clinical deterioration occurs due to changes in vital signs, which can be identified early to prevent negative outcomes. We used the NEWS2 system to assess the potential for early clinical deterioration in adult inpatient units at a public university hospital in southeastern Brazil.

    Materials and Methods

    This was an exploratory study conducted at a public hospital in southeastern Brazil, following the guidelines of the Reporting of Strengthening Observational Studies in Epidemiology (STROBE) initiative. Data was collected from January to April 2021, involving 251 inpatients. A questionnaire was used to gather sociodemographic and clinical data, and the Brazilian version of NEWS2 was used to assess the risk of clinical deterioration. Data analysis included descriptive analyses, linear correlation tests, and comparative tests.

    Results

    The average NEWS2 score was 2.9 points among 251 patients, indicating a moderate level of care complexity and recommending assessment by a registered nurse every 4–6 hours. There was no significant correlation between age and NEWS2 score, but the NEWS2 score was significantly higher for men.

    Conclusions

    This study highlights the necessity of using robust assessment tools to evaluate the risk of early clinical deterioration, enabling clinicians to manage patient conditions effectively.

    Keywords: Clinical Deterioration, Hospitalization, Nursing, Patient Safety
  • Shahnam Sedigh Maroufi, Behnam Shiri Zilan, Parisa Moradimajd, Jamileh Abolghasemi
    Background

    Pre-anesthetic evaluation is the initial stage of anesthesia procedures for patients. This evaluation involves elucidating the patient's medical history, determining patient readiness, screening for undisclosed disorders, and identifying risk factors. Safety measures help mitigate patient-related risks within medical environments. The aim of this study is to investigate the role of Pre-anesthetic evaluation in patient safety.

    Methods

    The present study was a review conducted in the year 2024. Databases including PubMed, Direct Science, MEDLINE, Proquest, SID, Scopus, Google Scholar, Magiran, and library resources were searched using keywords such as Pre-anesthetic evaluation, pre-anesthetic visit, anesthesia clinic, patient safety, and their English equivalents. A logical combination of these keywords was performed using "OR," "AND," and "NOT" operators. The search was conducted in relevant articles from the year 2000 to January 2024.

    Results

    Initially, 22,000 articles were screened, and ultimately, 16 relevant articles were used for preparing this paper. In all the reviewed articles, pre-anesthetic evaluation played a key role in patient safety.

    Conclusions

    Studies indicate that pre-anesthetic evaluation is a key improver of surgical outcomes. These measures not only mitigate potential risks but also enhance surgical outcomes. Overall, pre-anesthetic evaluation has a direct correlation with patient safety, playing a significant role in postoperative improvement and elevating the quality of medical care.

    Keywords: Evaluation, Assessment, Anesthetic Clinic, Pre-Anesthetic Visit, Patient Safety, Systematic Review
  • Sara Salarian, _ Afsaneh Barabadi, Marjan Moradi Fath *, Niloufar Taherpour, Tayebe Molatayefe
    Background

    The aim of this study was to examine and compare the dimensions of patient safety culture in different departments of Imam Hossein Hospital before and after interventional management actions (IMA), as well as to identify issues related to patient safety culture based on data analysis.

    Methods

    This semi-experimental study was conducted from late December 2023 to early May 2024, with a random sample of 210 staff members from Imam Hossein Hospital in Tehran. The IMA consisted of an educational intervention on patient safety and quality of care, which took place over four months (February to May 2023). Patient safety culture in clinical and paraclinical departments was assessed twice: Once before the IMA and again after one year, using the hospital survey on patient safety culture (HSOPSC) tool.

    Results

    The overall mean score for safety culture after the IMA was significantly improved compared to before (mean difference = 13.16 ± 24.90, P-value < 0.001). These improvements were also reflected in the overall percentage of positive responses, which increased from 41.07% to 51.83%. The frequency of reported patient safety events increased from 50.95% to 61.90% following the IMA. The organizational learning-continuous improvement dimension (87.14%) received the highest positive score after the IMA, while staffing received the lowest positive score both before (15.83%) and after (17.13%) the IMA.

    Conclusions

    The improvement in patient safety culture, based on the results of this study, highlights the value of teamwork and underscores the importance of prioritizing this area for hospital managers. Addressing the challenges associated with providing safe healthcare requires proactive actions, including encouraging staff to report safety incidents and supporting organizational learning.

    Keywords: Patient Safety, Hospital Survey, Healthcare Quality, Safety Management, Nursing Care
  • Analysis of the Prognosis Outcomes and Treatment Delay Among ST-Segment Elevation Myocardial Infarction Patients in Emergency Department Based on the Presence of Symptoms Suggestive of COVID-19
    David Samuel Kwak, Joonbum Park *
    Background

     During COVID-19 pandemic, the emergency department (ED) was challenged to treat patients with COVID-19-related symptom. Therefore, the aim of this study was to investigate treatment delay and prognostic outcomes in ST-segment elevation myocardial infarction (STEMI) patients during COVID-19 pandemic due to isolation or precaution and compare it with pre-COVID-19 period.

    Methods 

    This was a retrospective observation study using multicenter data with different case mix. Anonymized data were collected through each center’s electronic medical data of common case report form. Primary outcomes were number and rate of in-hospital mortality within 28 days. Secondary outcomes were door-to-balloon time and length of stay in the ED. Kaplan-Meier estimation and Cox proportional hazard regression analysis were performed to determine impact of predictors on 28-day in-hospital mortality.

    Results 

    Door-to-balloon time was longer in STEMI patients with COVID-19-related symptom(s) than those without symptom during the COVID-19 period (97.0 [74.8, 139.8] vs. 69.0 [55.0, 102.0] minutes, P<.001). However, there was no significant statistical difference in door-to-balloon time between STEMI patients with and without COVID-19-related symptom(s) during the pre-COVID-19 period (73.0 [61.0, 92.0] vs. 67.0 [54.5, 80.0] minutes, P=.2869). The 28-day mortality rate did not show a statistically significant difference depending on symptoms suggestive of COVID-19 during the pre-COVID-19 period (15.4% vs. 6.8%, P=.1257). However, it was significantly higher during the COVID-19 period (21.1% vs. 6.7%, P=.0102) in patients with COVID-19 suggestive symptoms than in patients without the symptoms.

    Conclusion

     In Korea, symptoms suggestive of COVID-19 during the pandemic had a significant effect on the increase of door-to-balloon time and 28-day mortality in STEMI patients. Thus, health authorities need to make careful decision in designating symptoms indicated for isolation in ED based on opinions of various medical field experts.

    Keywords: Emergency Service, COVID-19, Patient Safety, Myocardial Infarction, Isolation, Korea
  • Kathryn M. Mcdonald *, Kelly T. Gleason, Anushka Jajodia, Helen Haskell, Vadim Dukhanin
    Background

     Diagnostic excellence refers to the optimal process to attain an accurate and precise explanation about a patient’s condition and incorporates the perspectives of patients and their care partners. Patient-reported measures (PRMs), designed to capture patient-reported information, have potential to contribute to achieving diagnostic excellence. We aimed to craft a set of roadmaps illustrating goals and guiding the development of PRMs for diagnostic excellence (“Roadmaps”).

    Methods

     We used iterative inputs from environmental literature scans, expert consultations, and patient voice and employed human-centred design (HCD) and equity-focused road-mapping. The culminating activity of these approaches was an Expert Convening.

    Results

     Use of PRMs can achieve multiple goals for diagnostic excellence, including but not limited to: (1) PRMs for diagnostic continuity, (2) diagnostic PRM alerts, (3) PRM-based quality improvement, (4) PRMs for research, (5) PRMs for routine screening, (6) PRM-based diagnostic excellence population-level patterns, and (7) PRMs supporting patient storytelling. Equity is considered as a cross-cutting goal. Altogether these and future goals support operationalising a vision of patient-reported diagnostic excellence. Roadmaps were developed as a dynamic tool to illustrate PRMs in relation to specific steps with feedback loops to accomplish goals, anticipated timeframes (8-15 years), synergies to foster, and challenges to overcome. Roadmaps are practical in their following PRMs through the stages of development, endorsement, implementation and scaling, and acting upon those measures. Timeframe estimates assume immediate transitions between these stages and no acceleration through incentives and active coordination.

    Conclusion

     PRMs for diagnostic excellence have potential to connect patient perspectives, equity, and achievable goals. Roadmaps offer a design approach to enable coordinating measurement activities among diverse stakeholders. Roadmaps also highlight versatility in ways patient-reported information can be collected and used, from clinical settings to public health contexts. Patient-reported diagnostic excellence cannot be established as a solely top-down endeavour, but inherently benefits from bottom-up approaches.

    Keywords: Diagnostic Errors, Patient Safety, Medical Errors, Human-Centered Design, Patient-Centered
  • مژگان مجاهد، سعید بشارتی، بهروز فرزانگان، سعید محمودیان، مستوره حسینی، مریم یاری نژاد، سیده کبری موسوی، اعظم رحیم زاده کلاله*

    سابقه و هدف :

    انتقال خون و فرآورده های آن یکی از مداخلات ضروری و نجات دهنده جان بیماران است که بروز خطا در آن می تواند تهدیدکننده حیات باشد. هدف از این مطالعه، شناسایی خطاهای اجرایی در انتقال خون و فرآورده های آن و مقایسه خطاهای گزارش شده داوطلبانه با میزان خطاهای شناسایی شده بر اساس راهنمایی ابزار سرنخ جهانی بود. 

    مواد و روش ها

    مطالعه از نوع توصیفی تحلیلی و کاربردی بود و به شیوه گذشته نگر در یکی از بیمارستان های تهران بر روی 88 پرونده با سابقه انتقال خون و فرآورده های آن با چک لیست انجام شد. مقایسه میانه تعداد خطا به تفکیک بخش، با استفاده از آزمون رتبه ای کروسکال والیس و هم چنین تجزیه و تحلیل مجذور کای با استفاده از نرم افزار 22 SPSS انجام شد. سطح معناداری 0/05>p در نظر گرفته شد.

    یافته ها

    از 88 پرونده، 346 مورد خطا از چک لیست به دست آمد که در مقایسه با 2 مورد خطاهای پزشکی گزارش شده داوطلبانه بسیار بیشتر بود. خطای گزارش شده منحصر به دسته  B و C بود که در آن حادثه ناگوار مرتبط با انتقال خون و فرآورده های آن گزارش نشده است. 

    نتیجه گیری  :

    شناسایی خطاها با استفاده از ابزار سرنخ جهانی بسیار بیشتر از گزارش دهی داوطلبانه خطاها بود که نشان داد  ابزار دقیق تری برای شناسایی حوادث ناگوار است. با استفاده از این ابزار و  برنامه ریزی و اقدامات پیشگیرانه می توان ایمنی بیماران و بهبود کیفیت مراقبت را در بیمارستان ها ارتقا داد.

    کلید واژگان: خون, انتقال خون, ایمنی بیمار, هموویژولانس
    M. Mojahed, S. Besharati, B. Farzanegan, S. Mahmoudian, M. Hosseini, M. Yarinejad, S.K. Mousavi, A. Rahimzadeh Kalaleh*
    Background and Objectives

    Transfusion of blood and its products is one of the necessary and life-saving interventions for patients, and errors in any of its steps can be life-threatening. The aim of this study was to identify operational errors according to the voluntary reported errors compared to the guidelines of the Global Trigger Tool.

    Materials and Methods

    The study is of a descriptive-analytical and applied type and was conducted retrospectively at one of the Hospital in Tehran on 88 cases with a history of blood transfusion and its products with a checklist. Comparison of the average number of errors by section was done using the Kruskal-Wallis rank test as well as chi-square analysis using SPSS22 software. A significant level p value <0.05 was considered.

    Results

    From the 88 cases, 346 errors were obtained from the checklist, which was much higher compared to 2 cases of voluntarily reported errors.The reported error was unique to category B and C, in which the accident related to blood transfusion and its products was not reported.

    Conclusions:

      Identification of errors using the global clue tool was significantly higher than voluntary reporting of errors, indicating that it is a more accurate tool for identifying adverse events. The use of this tool and planning and preventive measures can improve the safety of patients and improve the quality of care in hospitals.

    Keywords: Blood, Blood Transfusion, Hemovigilance, Patient Safety
  • Elham Pishbin, Shaghayegh Rahmani *, Maryam Panahi
    Background

    Patient safety remains a critical concern for healthcare systems, particularly in developed nations. A substantial proportion of patients experience complications and adverse events attributable to healthcare delivery, exacerbating their initial health issues. Many adverse events are likely to go unnoticed, unreported, and consequently unaddressed. This issue largely stems from inadequate surveillance methods that require significant improvement to achieve excellence in delivering safe, high-quality care for emergency patients.

    Objectives

    This study aimed to develop an emergency department trigger tool (EDTT) to identify adverse events in the emergency department (ED) to enhance patient safety and quality improvement.

    Methods

    Conducted under the supervision of Mashhad University of Medical Sciences, this study comprised four stages: (1) a systematic review, (2) refinement and automation of empirical triggers, (3) a modified Delphi process to compile a list of validated triggers from experts, and (4) final environmental data collection to determine the most effective triggers.

    Results

    The study included a systematic review of electronic resources, revealing no prior Persian equivalent of a trigger tool. A total of 502 articles were identified in PubMed, 100 in Google Scholar, and 410 in Scopus. After removing duplicates and adding four articles based on reference searches, 1,016 article titles were initially reviewed. Two independent researchers evaluated the articles on the same day in two locations. In cases of disagreement, a third researcher's opinion was sought. Ultimately, 295 articles were selected, with high inter-rater reliability (0.82). Forty-two articles were included in the final analysis. The developed tool contained 50 triggers organized into six groups. In a review of 100 ED cases, an average of 1.2 triggers was identified per patient file, with 99 (79.8%) of these triggers attributed to medical errors.

    Conclusion

    This study successfully designed an emergency department trigger tool (EDTT) utilizing a systematic review and the Delphi method. The resulting trigger tool can be employed to assess high-risk situations and potential emergency medical errors. A significant advantage of this tool over previous versions is its focus on high-risk conditions without relying solely on the absence of appropriate actions as indicators of danger.

    Keywords: Emergency Department, Trigger Tool, Patient Safety, Medical Error
  • Hossein Ali Danesh, Sina Mirtalebi, Nasser Keikha, Abdolahad Nabiolahi, Peyman Aslani
    Background

    Hospital-acquired fungal infections are becoming an increasingly significant cause of morbidity, mortality, and healthcare costs. Nurses play a pivotal role in preventing and managing these infections, yet their knowledge levels often remain unevaluated.

    Objectives

    This study aimed to assess the knowledge of nursing staff in educational-medical hospitals in Zahedan, Iran, regarding fungal infections in 2023.

    Methods

    This descriptive, cross-sectional study was conducted among nurses in three educational hospitals (Khatam Al Anbia, Ali ebn Abitaleb, and Bu Ali) in Zahedan. A total of 342 nurses with at least one year of work experience were included using convenience sampling. Data were collected using a two-part questionnaire: A demographic information form and a researcher-made questionnaire assessing knowledge about fungal infections across four domains—epidemiology, prevention, diagnosis, and treatment. Data were analyzed using SPSS software, with a P-value of less than 0.05 considered significant.

    Results

    The mean age of participants was 40.70 ± 8.36 years, with an average work experience of 237.85 ± 133.02 months. Of the 342 nurses, 52.92% were female. The mean total awareness score was 12.63 ± 4.53 out of 25. Overall, 19.30% had very low awareness, 52.05% had low awareness, 26.32% had moderate awareness, and only 2.34% had high awareness. In the epidemiology domain, 69.30% had very low or low knowledge. For prevention, 61.11% showed very low or low awareness. In diagnosis, 61.40% had very low or low knowledge, and in treatment, 63.45% demonstrated very low or low awareness. No significant differences were found based on work experience, gender, age, educational level, or hospital affiliation (P > 0.05).

    Conclusions

    The study reveals a critical knowledge deficit among nursing staff in Zahedan regarding fungal infections. Over 70% of nurses demonstrate low or very low overall awareness, a trend consistent across all evaluated domains. This systemic issue underscores the urgent need for comprehensive, targeted educational interventions, ongoing professional development, and institutional policy changes to enhance nurses' competency in managing fungal infections. Such measures are crucial for improving patient safety, reducing infection rates, and ultimately saving lives.

    Keywords: Fungal Infections, Nursing Staff, Knowledge Assessment, Hospital-Acquired Infections, Patient Safety, Infection Control, Continuing Education
  • روح انگیز نوروزی نیا، کریم شیاسی، مهسا خدمتی زارع، پردیس رحمت پور*
    مقدمه

    ایمنی بیمار، یکی از عناصر حیاتی برای ارائه موثر خدمات مراقبت سلامت است. اتاق های عمل بیمارستانها، به عنوان یکی از پرخطرترین محل های بیمارستانی است که نیازمند شناسایی عوامل موثر بر بروز خطا و نیز موانع گزارش دهی آن است. این مطالعه با هدف طراحی و ارزیابی ویژگی های روانسنجی ابزارهای عوامل موثر بر بروز خطا و موانع گزارش دهی آن در اتاق عمل از دیدگاه دانشجویان اتاق عمل و هوشبری در سال 1401 انجام شد.

    روش کار

    این مطالعه مقطعی تحلیلی در سال 1401 بر روی 270 نفر از دانشجویان اتاق عمل و هوشبری دانشگاه علوم پزشکی البرز انجام شد. در گام اول با استفاده از مرور متون و نظرات پانل خبرگان دو ابزار عوامل موثر بر بروز خطا، و موانع گزارش دهی خطا طراحی و درگام بعد روایی صوری، محتوا، سازه، و پایایی ابزارها ارزیابی گردید.

    یافته ها

    پس از انجام اصلاحات درخواستی در روایی صوری، نسبت روایی محتوا و شاخص روایی محتوا در کلیه گویه ها ارزیابی و بالاتر از 062 و0.7 بود. در روایی سازه، ابزار عوامل موثر بر بروز خطا در اتاق عمل با 22 گویه و چهار عامل شامل عوامل فردی (8گویه)، عوامل آموزشی-مهارتی (6گویه)، عوامل محیطی (4گویه) و عوامل مدیریتی(4گویه) استخراج شد. ضریب آلفای کرونباخ عوامل مذکور از 0.79 تا 0.90 و امگا مک دونالد از 0.7 تا 0.87 محاسبه شد. ابزار عوامل موثر بر گزارش دهی خطا در اتاق عمل با 19 گویه در سه عامل شامل پیامدهای قانونی (11گویه)، عوامل مدیریتی (4گویه) و فرآیند گزارش دهی (4گویه) استخراج شد. ضریب آلفای کرونباخ برای عوامل از 0.86 تا 0.95 و امگا مک دونالد از 0.7 تا 0.89 محاسبه شد.

    نتیجه گیری

    براساس نتایج این مطالعه، دو ابزار عوامل موثر بر بروز خطا، و موانع گزارش دهی خطا از شاخص های روایی و پایایی قابل قبولی برخوردار است و می تواند جهت سنجش مفاهیم مذکور در  در اتاق عمل از دیدگاه دانشجویان اتاق عمل و هوشبری استفاده گردد. مدیران آموزشی و درمانی می توانند با شناسایی عوامل موثر بروز خطا و رفع موانع گزارش دهی آن، تصمیمات موثری در جهت کاهش موارد بروز خطا و نیز تسهیل فرآیند گزارش دهی آن در اتاق عمل های بیمارستانی اتخاذ و اجرایی نموده و بدین ترتیب موجب ارتقای ایمنی بیمار شوند.

    کلید واژگان: ایمنی بیمار, اتاق های عمل, خطاهای پزشکی, ارزیابی آموزشی, روان سنجی
    Roohangiz Norouzinia, Karim Shyasi, Mahsa Khedmatizare, Pardis Rahmatpour*
    Introduction

    Patient safety is crucial for effective healthcare delivery, and operating rooms (ORs) are among the most hazardous environments in hospitals. Identifying factors that contribute to errors and barriers to reporting them is essential. This study aimed to design and evaluate the psychometric properties of scales measuring factors influencing error occurrence and barriers to error reporting in the OR, as perceived by operating room and anesthesia students in 2022.

    Methods

    This cross-sectional analytical study was conducted in 2022 with 270 operating room and anesthesia students from Alborz University of Medical Sciences. Two scales were developed: one for “factors affecting the occurrence of errors” and another for “barriers to error reporting,” informed by literature review and expert panel insights. The scales underwent evaluation for face, content, and construct validity, as well as reliability assessment.

    Results

    Following revisions for face validity, the content validity ratio (CVR) and content validity index (CVI) for all items exceeded 0.62 and 0.7, respectively. Exploratory factor analysis revealed four factors for the error occurrence scale: individual factors (8 items), educational-skill factors (6 items), environmental factors (4 items), and managerial factors (4 items). Cronbach's alpha values ranged from 0.79 to 0.90, and McDonald's omega values from 0.7 to 0.87. For the error reporting scale, three factors emerged: legal consequences (11 items), management factors (4 items), and reporting process (4 items). Cronbach's alpha for these factors ranged from 0.86 to 0.95, and McDonald's omega from 0.7 to 0.89.

    Conclusion

    The developed scales demonstrated acceptable validity and reliability, making them suitable for assessing the factors influencing errors and reporting barriers in ORs from the perspective of operating room and anesthesia students. Addressing these factors can enable educational and medical managers to implement effective strategies to enhance patient safety by reducing errors and improving the reporting process in hospital ORs.

    Keywords: Patient Safety, Operating Rooms, Medical Errors, Educational Measurement, Psychometrics
  • Roohangiz Norouzinia, Maryam Aghabarary, Alan H Rosenstein, Pardis Rahmatpour*
    Background and Objective

    Disruptive behaviors (DBs) can have a negative impact on patient safety and employee satisfaction. Therefore, this study aimed to investigate the prevalence and clinical and psychological outcomes of DBs among physicians and nurses in the emergency departments of teaching hospitals in Iran.

    Materials & Methods

    In this cross-sectional study, 105 participants, including 33 physicians and 72 nurses working in the emergency departments of two teaching hospitals affiliated to Alborz University of Medical Sciences, who were selected using a convenience sampling method during May-June 2020. They filled out a demographic form and Rosenstein and O’Daniel’s DB scale. The data were analyzed in SPSS software version 20 using descriptive statistics and independent t-test. 

    Results

    The DBs were prevalent in the emergency departments. All respondents reported that they had witnessed DBs in their hospitals. The primary barrier to reporting was the feeling that nothing ever changes (47.6%). The majority of physicians and nurses (81%) indicated that DBs had a significant impact on patient outcomes. There was a significant difference between nurses’ and physicians’ responses to the seriousness of nurse DBs (t=-13.05, P<0.001) and the seriousness of the impact of DBs on patient outcomes (t=-5.75, P<0.001).

    Conclusion

    Addressing DBs in the emergency departments requires practical and effective educational interventions for the personnel, increasing awareness of hospital managers, developing policies and guidelines, and monitoring their implementation.

    Keywords: Disruptive Behavior (DB) Disorder, Emergency Treatment, Nursing Care, Patient Safety
  • Dominika Kohanová*, Andrea Solgajová, Daniela Bartoníčková
    Background

    The phenomenon of rationed nursing care represents a global problem that jeopardizes the provision of quality and safe care. To date, there are a limited number of studies that focus on the occurrence of this phenomenon in the private care setting.

    Objectives

    To explore the frequency and patterns of rationed nursing care and the factors that contribute to its frequency in selected private hospitals in Slovakia.

    Methods

    This descriptive cross-sectional study was conducted between November 2022 and January 2023. Data collection was carried out using the Basel Extent Rationing of Nursing Care – Revised. The study sample consisted of 174 nurses working in three selected Slovak private hospitals. In data analysis, we used descriptive statistics for the evaluation of the instrument and the sample characteristics. Additionally, differences in the frequency of rationed nursing care based on selected variables were analyzed using nonparametric tests (Mann-Whitney U test; Kruskal-Wallis test). For numerical variables the Spearman correlation coefficient (r) was used. The results were tested at a significance level of p <0.05.

    Results

    The frequency of rationed nursing care was 49.3%. The most frequently withheld nursing care activity was increased supervision of confused patients and the need for their restraint (69.8%; 2.26 ± 1.09). Differences in the evaluation of rationed nursing care were identified based on the type of unit and the position of the job. The occurrence of rationed nursing care was influenced by nurse experience in the current position, evaluation of quality care, overall patient safety degree, number of patients/shifts, number of admitted ad discharged patients/shifts, job satisfaction, satisfaction with the current position, and satisfaction with teamwork in our study (p <0.05).

    Conclusion

    This study serves as a catalyst for nurse managers to take proactive steps in addressing rationed nursing care, fostering a culture of safety, and promoting excellence in patient-centered care delivery within private hospital settings in Slovakia. By embracing innovation, collaboration, and a commitment to continuous improvement, we can overcome the challenges posed by rationed care and uphold the principles of quality, safety, and compassion in nursing practice.

    Keywords: Health Care Rationing, Nursing Care, Patient Safety, Private Hospitals, Surveys, Questionnaires
  • SOMAYEH ALIREZAEI, MALIHEH SADEGHNEZHAD *, MONIR RAMEZANI
    Introduction
    Patient safety is the most important priority in the healthcare system. Medical universities always attempt to find innovative and more effective educational methods to improvethe students’ abilities for clinical decision-making and quality and safe care. Thus, this study was designed to evaluate the effect of scenario-based learning on the knowledge, attitude, andperception of nursing students about patient safety.
    Methods
    This quasi-experimental study was conducted between September 2023 and January 2024. The study sample comprised 78 nursing and midwifery students from the fourth and fifth semesters of their bachelor’s degrees, each of whom was systematically reviewed. The participants were allocated to the intervention (n=43) and control groups (n=35) randomly, using simple randomization. The educational content was presented via scenario-based learning for participants in the intervention group, while it was presented through lecture and discussion in the control group. The questionnaire was standardized and structured, and its validity and reliability were assessed. Data gathering was performed one month after the intervention using a knowledge, attitude, and practice questionnaire. Data were analyzed in SPSS software version 16 using descriptive statistical methods and inferential tests, including the chi-square test, independent T-test, paired T-test, and ANCOVA.
    Results
    The study findings indicated that there were no significant differences in attitude (P=0.152) and perception (P=0.264) scores between the intervention and control groups before the intervention. However, after the intervention, a significant difference was observed (P<0.001). [Knowledge 14.97±3.70 vs. 19.37±3.31), attitude (31.74±5.38 vs. 34.62±9.59), perception(35.60±7.51 vs.38.95±8.21)].
    Conclusion
    Scenario-based learning can be a more effective way to teach nursing and midwifery students about patient safety. Thus, researchers recommend that this educational method should be used by nursing and midwifery instructors to improve the students’ ability to provide safer care for patients.
    Keywords: Education, Learning, Patient Safety, Students
  • فاطمه مهدیان*، فریبا جوکار، نرگس صادقی
    مقدمه

    ایمنی بیمار، حالتی از عدم وجود آسیب های قابل پیشگیری و همچنین کاهش خطر آسیب های ناشی از مراقبت های سلامت، به کمترین حد قابل قبول است. آموزش این مفهوم، امروزه در سراسر جهان یک نیاز شناخته شده است و تلاش هایی برای گنجاندن آن در کوریکولوم پرستاری انجام شده است، چرا که سبب بهبود کیفیت و ارتقای ایمنی بیمار می شود؛ اما چالش هایی از قبیل فقدان هیئت علمی آماده و ابهاماتی در زمینه کم و کیف آموزش رسمی آن وجود دارد؛ لذا مطالعه حاضر با هدف تبیین کیفیت آموزش مفهوم ایمنی بیمار در کوریکولوم آموزش کارشناسی پرستاری در ایران انجام شده است.

    روش کار

    مطالعه حاضر یک مطالعه چند روشی است. روش نخست یک مطالعه تطبیقی با روش جرج بردی شامل چهار مرحله توصیف، تفسیر، همجواری و مقایسه است که 5 برنامه  برتر کارشناسی پرستاری دنیا بر اساس معیار رتبه بندی شانگهای سال 2021 و کوریکولوم کارشناسی پرستاری ایران مورد بررسی قرار گرفت. گام دوم یک مطالعه با رویکرد کیفی است و جمع آوری داده ها با روش مصاحبه نیمه ساختار یافته با 12 نفر از اعضای هیات علمی پرستاری انجام شد و تا رسیدن به اشباع ادامه یافت سپس با روش تحلیل محتوای قراردادی مورد تجزیه و تحلیل قرار گرفت.

    یافته ها

    با بررسی تطبیقی برنامه های آموزشی بر اساس سرفصل های مفاهیم اساسی ایمنی بیمار، بهبود ایمنی در تجویز دارو، خطاها، عوامل سازمانی، درک و مدیریت ریسک بالینی، تعامل بیماران و مراقبین، کار تیمی، روش های بهبود کیفیت، مراقبت از بیمار، پیشگیری و کنترل عفونت، ایمنی بیمار و روش های تهاجمی؛ مشخص شد میزان پرداختن به این مفاهیم در برنامه آموزش پرستاری دانشگاه جان هاپکینز با بیشترین امتیاز (20)، دانشگاه کارولینسکا با کمترین امتیاز (4) و  ایران امتیاز (7) را کسب نمود. در مطالعه کیفی با تجزیه و تحلیل مصاحبه ها 7 طبقه اصلی استخراج شد که عبارتند از: مرزهای مفهوم ایمنی، محدوده ایمنی در برنامه آموزشی، رویکرد ادغام برای مفهوم ایمنی، آموزش ایمنی، ادغام ابعاد انسان، ایمنی ، درس رسمی، محتوی درس ایمنی، ساختار و ایمنی.

    نتیجه گیری

    یافته ها نشان داد که آموزش مفهوم ایمنی بیمار، در کوریکولوم آموزشی ایران در مقایسه با دانشگاه های برتر دنیا در پاره ای از مفاهیم جایگاه مناسبی دارد اما توجه چندانی به آموزش کار تیمی در مفهوم ایمنی بیمار نشده است. نتایج تجزیه و تحلیل  مصاحبه با اساتیدهیئت علمی پرستاری چنین نشان داد که کوریکولوم اجرا شده می تواند منجر به پیامدهای یادگیری برای دانشجویان شود هرچند بهتر است آموزش مفهوم ایمنی بیمار در برنامه درسی دوره کارشناسی پرستاری به صورت درس مستقل به شیوه تم طولی و تاکید بر  همه ابعاد چهارگانه سلامت باشد.

    کلید واژگان: ایمنی بیمار, آموزش پرستاری, کوریکولوم پرستاری
    Fatemeh Mahdian*, Fariba Jokar, Narges Sadeghi
    Introduction

    Patient safety, a state of absence of serious injuries and also reduction of risks caused by health care, is the minimum acceptable level. Teaching this concept is a worldwide requirement for its inclusion in the nursing curriculum, as it improves quality and increases patient safety. But there are challenges such as the lack of a ready faculty and uncertainties regarding the quality of its formal education. The present study was conducted with the aim of explaining the quality of teaching the concept of patient safety in the curriculum of undergraduate nursing education in Iran.

    Methods

    The present study is a multi-method study. The first method is a comparative study with George Brady's method, which includes four stages of description, interpretation, comparison, and the top 5 nursing bachelor's programs in the world were examined based on the 2021 Shanghai ranking criteria and Iran's nursing bachelor's curriculum. The second step is a study with a qualitative approach, and data collection was done by semi-structured interview method with 12 nursing faculty members and continued until saturation was reached, then it was analyzed by conventional content analysis method.

    Conclusion

    The findings showed that teaching the concept of patient safety in Iran's educational curriculum has a good place in some concepts compared to the top universities in the world, but not much attention has been paid to teaching teamwork in the concept of patient safety. The results of the analysis of the interview with the nursing professors showed that the implemented curriculum can lead to learning outcomes for the students, although it is better to teach the concept of patient safety in the nursing bachelor's curriculum as an independent lesson in a longitudinal theme manner and emphasize all dimensions. be the fourfold health.

    Keywords: Patient Safety, Nursing Education, Nursing Curriculum
  • مهناز هادی پور، مریم یوسفی مبینا ریاحی، سید فرشاد علامه، علی گنجعلی خان، آرش سیفی، مهرداد احمدی، زینب صیامی، عزیز رسولی *
    سابقه و هدف

    استریلیزاسیون از فرآیندهای پراهمیت در بیمارستان است و ایمنی بیمار وابسته به کیفیت عملکرد بخش استریل مرکزی است. در این مطالعه، تاثیر دوره آموزش به پرسنل بخش استریل مرکزی در بهبود عملکرد آنان بررسی شد.

    روش کار

    این مطالعه ی مداخله ای آموزشی در - 11 بیمارستان آموزشی وابسته به دانشگاه علوم پزشکی تهران در سال 1401 انجام شد. مداخله مورد نظر برگزاری دوره ی آموزشی شامل 100 ساعت نظری و 40 ساعت عملی بود. در انتهای مطالعه، آزمون کتبی از شرکت کنندگان و بازدید حضوری از مراکز در دو نوبت توسط مجریان طرح انجام شد. ابزار مورد استفاده در بازدیدها چک لیستی شامل بررسی حوزه ی ساختاری و عملکردی بیمارستان بود. حداکثر نمره کسب شده در این پرسشنامه 80 و حداقل کسب نمره 60 به عنوان نمره ی قبولی در نظر گرفته شد.

    یافته ها

    در مجموع، 156 نفر مورد آموزش و آزمون قرار گرفتند و همه ی افراد موفق به کسب حداقل نمره در آزمون شدند. نمره کسب شده در تمام مراکز درمانی پس از آموزش به صورت معنی داری افزایش پیدا کرد و هیچکدام از مراکز نمرهای کمتر از 54 را کسب نکردند. بیشترین نمره کسب شده مربوط به مرکز درمانی شماره 7 با نمره 1 / 73 بود. در تمام مراکز درمانی شاخص های موارد ساختاری و عملکردی مستقیم و غیرمستقیم افزایش پیدا کرد.

    نتیجه گیری

    آموزش پرسنل بخش استریلیزاسیون مرکزی در توانمندسازی آنها، و کیفیت خدمات موثر است؛ بنابراین با توجه به اهمیت فعالیت این بخش در مراکز درمانی برای ایمنی بیمار، افزایش کیفیت خدمات و کاهش هزینه ها، ضرورت دارد آموزش این کارکنان از اولویت های هر مرکز درمانی است.

    کلید واژگان: استریلیزاسیون, بیمارستان, ایمنی بیمار, آموزش, عفونت
    Mahnaz Hadipour, Maryam Yousefi, Mobina Riahi, Seyyed Farshad Allameh, Ali Ganjalikhan, Arash Seyfi, Mehrdad Ahmadi, Zainab Siami, Aziz Rasouli *
    Background and Objective

    Sterilization is one of the most important processes in the hospitals، where the safety of the patients depends on the quality of the central sterile department staff performance. In this study، the effect of the training course for the staff of the central sterile department in improving their performance was investigated.

    Materials and Methods

    This interventional study was conducted in 11 hospitals affiliated with the Tehran University of Medical Sciences. The central sterile department staff were trained for 100 theoretical hours and 40 practical hours. The maximum score obtained in this questionnaire was 80، and the minimum score of 60 was considered as an acceptable score. The project managers visited the trained centers on two occasions. The tool used in the visits was a checklist assess the structural and functional area of the hospital، with the maximum score of 80.

    Results

    In total، 156 people were trained and all of them passed the test. The score obtained in all hospitals increased after training and none of the centers obtained a score lower than 54، and the highest score was 73.1. Also، the indicators of structural and direct and indirect functional areas increased in all centers.

    Conclusion

    The training of central sterilization department staff is effective in empowering them. Therefore، considering the importance of the central sterilization activity in patient safety and hospital costs، training these employees needs to be as one of the priorities of every medical center.

    Keywords: Central Sterilization Department, Hospital, Patient Safety, Education, Infection
  • Abbas Abdolvand, Seyed Ali Mahdiyoun, Elahe Mousavi *
    BACKGROUND

    Nowadays, attention to patient safety is important in providing hospital services and any failure to do so can have adverse consequences. Safety is one of the most salient rights of patients when receiving health services. The purpose of this study was to evaluate personnel perspective about patient safety culture in Shahid Beheshti Hospital in Hamadan, Iran.

    METHODS

    This descriptive cross-sectional study was carried out on 101 medical personnel of Shahid Beheshti Hospital in Hamadan in operating rooms, intensive care, endocrine surgery, pulmonary, and emergency surgery in December 2019. Patient Safety Culture Survey Standard Questionnaire was used to assess patient safety culture. The first part of the questionnaire contained demographic information and the second part contained 42 questions. The results were analyzed by SPSS software.

    RESULTS

    27.7% of study participants were operating room personnel. 36.6% (n = 37) of personnel were men and 63.4% (n = 64) were women. In terms of attitude toward patient safety in different parts of the hospital, the operating room received the highest score (143) and the emergency room the lowest score (124).

    CONCLUSION

    Increasing attention to the patient safety culture will lead to the development and advancement of the country's hospitals and will lead them to a patient-friendly hospital. Moreover, the lower average dimensions in this study should be considered in order to enhance these dimensions.

    Keywords: Patient Safety, Safety Culture, Hospital, Hospital Personnel
  • محمد رنجبر، زهرا آزموده*، طاهره شفقت، عارفه دهقانی تفتی
    زمینه و هدف

    هوش اخلاقی در پرستاران، به واسطه ماهیت انسانی و اخلاقی شغل و حرفه آن ها از اهمیت خاصی برخوردار است و می تواند قاعده ای را برای عملکرد صحیح انسان ها فراهم آورد و به عنوان یک عامل پیش بینی کننده رفتار محسوب می شود. هوش اخلاقی پرستاران به توانایی آن ها در تشخیص درست از نادرست و پایبندی به اصول اخلاقی اشاره دارد. پرستارانی که هوش اخلاقی بالاتری دارند، تعهد بیشتری به ایمنی بیمار و رعایت پروتکل های حرفه ای نشان می دهند و نگرش مثبت تری نسبت  به ایمنی بیمار خواهند داشت. هدف پژوهش حاضر بررسی ارتباط بین هوش اخلاقی و نگرش نسبت به ایمنی بیمار در پرستاران شاغل در بیمارستان آموزشی شهید صدوقی یزد در سال 1402 بود.

    روش پژوهش: 

    پژوهش حاضر، یک مطالعه توصیفی-تحلیلی بود که به صورت مقطعی در سال 1402 انجام شد. نمونه مطالعه شامل 237 نفر از پرستاران شاغل در بیمارستان آموزشی شهید صدوقی بود که به روش نمونه گیری طبقه ای تصادفی، انتخاب شدند. برای جمع آوری داده ها از دو پرسشنامه استاندارد با مقیاس 5 گزینه ای لیکرت استفاده شد. داده ها پس از جمع آوری توسط نرم افزار SPSS 24 و با استفاده از آمار توصیفی، آنالیز واریانس یک طرفه و ضریب همبستگی پیرسون، تحلیل شدند.

    یافته ها

    میانگین هوش اخلاقی پرستاران مورد پژوهش22/30 ± 135/22 و میانگین نگرش پرستاران نسبت به ایمنی بیمار 17/32 ± 72/65 بوده ااست که نشان دهنده ی هوش اخلاقی بالا و نگرش متوسط نسبت به ایمنی بیماران در پرستاران شاغل در بیمارستان شهید صدوقی است. نتایج ضریب همبستگی پیرسون نشان داد بین هوش اخلاقی و نگرش پرستاران نسبت به ایمنی بیمار، همبستگی مثبت و معنی داری وجود دارد (0/19 =r  ،0/003 =p).

    نتیجه گیری

    هوش اخلاقی، در پیش بینی نگرش پرستاران، نسبت به ایمنی بیماران نقش دارد؛ بنابراین، به نظر می رسد با تقویت هوش اخلاقی پرستاران می توان نگرش آن ها نسبت به ایمنی بیمار را تحت تاثیر قرار داد؛ لذا می توان از آموزش اخلاق حرفه ای، توسعه مهارت های تفکر انتقادی و ایجاد فرهنگ سازمانی اخلاق محور استفاده کرد. همچنین برگزاری کارگاه های بحث درباره موارد اخلاقی و حمایت از سوی مدیریت اخلاق مدار، می تواند پرستاران را در تصمیم گیری های اخلاقی و رفتار مسئولانه تر در زمینه ایمنی بیمار تقویت کند.

    کلید واژگان: هوش اخلاقی, نگرش, پرستار, ایمنی بیمار, بیمارستان
    Mohammad Ranjbar, Zahra Azmoudeh*, Tahereh Shafghat, Arefeh Dehghani Tafti
    Background

    Moral intelligence in nurses is of particular importance due to the human and moral nature of their job and profession. Moral intelligence can provide a rule for the correct functioning of humans and is considered a predictive factor of behavior. The moral intelligence of nurses refers to their ability to distinguish right from wrong and adhere to ethical principles. Nurses with higher moral intelligence show more commitment to patient safety and adherence to professional protocols and have a more positive attitude toward patient safety. The purpose of this study was to investigate the relationship between moral intelligence and attitude towards patient safety in nurses working at Shahid Sadoughi Teaching Hospital in Yazd in 2023.

    Methods

    The present study was a descriptive-analytical one conducted cross-sectionally in 2023. The statistical population included 237 nurses working in Shahid Sadoughi Teaching Hospital, Yazd, who were selected by stratified random sampling. Two standard questionnaires with a 5-point Likert scale were used to collect data. Data were analyzed by SPSS24 using descriptive statistics, one-way analysis of variance and Pearson's correlation coefficient.

    Results

    The average moral intelligence of the studied nurses was 135.22 ± 22.30, and the average attitude of the nurses towards patient safety was 72.65 ± 17.32, indicating high moral intelligence and an average attitude towards patients safety in nurses in Shahid Sadoughi University. The results of Pearson's correlation coefficient showed that there is a positive and significant correlation between moral intelligence and nurses' attitude towards patient safety (r = 0.19, p = 0.003).

    Conclusion

    Moral intelligence plays a role in predicting nurses' attitude towards patient safety; therefore, it seems that by strengthening the moral intelligence of nurses, their attitude towards patient safety can be influenced. To strengthen the moral intelligence of nurses and improve their attitude towards patient safety, professional ethics training, development of critical thinking skills and creation of ethical organizational culture can be used. Also, holding workshops to discuss ethical issues and support from ethical management can strengthen nurses in making ethical decisions and more responsible behavior in the field of patient safety.

    Keywords: Moral Intelligence, Attitude, Nurse, Patient Safety, Hospital
  • Ali Raee-Ezzabadi, Adel Eftekhari, Naeimeh Baghshahi, Mohammadhossein Dehghani, Najmeh Baghian
    Background

    Accreditation means systematic evaluation of health service centers with specific standards. One of the most important goals of the accreditation process is to improve patient safety. Patient safety visits are one of the most important standards for improving safety. One of the ways to increase the effectiveness of visits is holding feedback sessions.

    Objectives

    The present study was conducted with the aim of assessing the effect of feedback provision on improving patient safety indices based on the hospital accreditation model in Shahid Rahnemoon Hospital, Yazd.

    Methods

    The present study is a semi-experimental study with a before-and-after design that was conducted in Shahid Rahnemoon Hospital, Yazd, from September to December 2021 and January to August 2022. After each visit, formal feedback sessions were held with the attendance of patient safety team members and officials of the visited wards/units. Evaluation indicators included patient safety indicators in accreditation standards, such as error reporting, rate of unwanted events, and patient safety culture score. These were measured before and after feedback. The tools used were the patient safety standards evaluation checklist based on the accreditation model, the patient safety culture questionnaire, and other indicators extracted using documentation. The Patient Safety Culture Evaluation Questionnaire was completed by 360 nurses working in the hospital in the form of a census. Analysis was done using descriptive statistical tests and paired t-tests with STATA 14.2 software.

    Results

    Based on the results of the study, safety feedback was provided to increase patient safety indicators in different departments and units of hospitals [t = - 4.8652, w/df = 10, P = 0.0007, (P = 0.05)]. A significant difference was observed in the amount of error reporting (P = 0.031) and patient safety (P < 0.001) before and after the intervention. The degree of compliance with the dimensions of the patient safety culture had a statistically significant difference before and after the intervention (P < 0.001).

    Conclusions

    Providing a safety feedback program had a significant positive effect on the cons umption and consequences of the patient’s safety culture. Therefore, conducting regular safety visits and setting up a direct feedback program to each department/unit after the visit, and the follow-up of corrective measures, will lead to an increase in patient safety standards.

    Keywords: Feedback, Patient Safety, Indices, Accreditation, Hospital
نکته
  • نتایج بر اساس تاریخ انتشار مرتب شده‌اند.
  • کلیدواژه مورد نظر شما تنها در فیلد کلیدواژگان مقالات جستجو شده‌است. به منظور حذف نتایج غیر مرتبط، جستجو تنها در مقالات مجلاتی انجام شده که با مجله ماخذ هم موضوع هستند.
  • در صورتی که می‌خواهید جستجو را در همه موضوعات و با شرایط دیگر تکرار کنید به صفحه جستجوی پیشرفته مجلات مراجعه کنید.
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