Journal Of Patient safety and quality improvement
Volume:8 Issue: 4, Autumn 2020

This study aimed to evaluate the effect of a patient fall prevention program on nurses’ knowledge and number of patients falls in one of the teaching hospitals in Mashhad, Iran. This quasi-experimental study was conducted on 600 nurses working in a hospital affiliated with Mashhad University of Medical Sciences, Mashhad, Iran. The participants were selected via a proportionate stratification sampling method. The fall prevention program included two educational posters and a booklet that introduced key points regarding the prevention of patient falls based on the standard guidelines. The participants were asked to respond to a researcher-made questionnaire that measured their knowledge of patient fall prevention at pretest and posttest. The number of patient falls was evaluated before and after the prevention program. Data were analyzed using SPSS software (version 25) through descriptive and inferential (Wilcoxon test). A p-value less than 0.05 was considered statistically significant. There was a significant difference between the scores of pretest and posttest regarding the nurses’ knowledge (p <0.001). Moreover, the examination of the number of falls in three months before and after the patient fall prevention program showed a significant decrease (63%) in the patient falls. The results demonstrated that the provision of prevention programs in this study had a significant impact on the improvement of patient safety level by reducing the number of patient falls through increasing the knowledge of nurses and awareness of patients.

Self-medication is a double-edged sword the proper application of which is appreciated by the World Health Organization (WHO) guidelines since it can reduce the unnecessary pressure on the health care system. However, self-medication can lead to severe consequences if utilized inappropriately. Furthermore, self-medication practice is an important social health issue in medical students as educated people and would-be physicians. This study aimed to determine the knowledge, attitude, and practice of self-medication in medical students of Mashhad University of Medical Sciences, Mashhad, Iran. This cross-sectional questionnaire-based study included 296 medical students at distinct levels of education. The data were analyzed in SPSS software (version 26). Based on the findings, more than 80% of the students were aware of the complications, drug interactions, and importance of accurate use; however, only 9.1% and 27% of the participants were aware of the side-effects of herbal medicine and dietary supplements, respectively. Out of the total 296 participants, 83.5% of the cases declared that they did care about the side effects of medicines, and 81.3% of the students believed that a medical degree was essential for medicine prescription. In a confrontation with minor ailments, 21.9% of the cases practiced self-medication, and the majority (57.4%) of the used medicines were painkillers. The main reasons for self-medication was the underestimation of the disease (57.8%). Moreover, positive attitudes toward the safety of self-medication (P=0.04) and knowledge about medicine (p <0.001) were the major reasons for the self-medication practice in senior students, compared to juniors. However, no significant difference was found between seniors and juniors in terms of self-medication practice (P=0.85). Regarding the adverse effects of self-medication, drug dependency, microbial resistance, and high prevalence of self-medication among participants, it is suggested to provide educational programs on the adverse effects of self-medication. In addition, appropriate measures should be taken to control and prevent an easy access to medications.

Regarding the high prevalence of asymptomatic infections, recognition of patients infected with Coronavirus Disease 2019 (COVID-19) has turned into a challenging issue. Therefore, this study aimed to evaluate the prognosis of asymptomatic patients with abnormal CXR indicative of COVID-19 for two weeks. This cross-sectional study included 40 patients who were referred to shahid hashemi nezhad hospital with trauma and underwent CXR. The patients were selected based on the purposive sampling method. The inclusion criteria were asymptomatic patients with trauma who were referred to our hospital and underwent chest CXR indicative of COVID-19. Demographic characteristics of the patients were recorded in a checklist. The real-time reverse transcription-polymerase chain reaction assay was carried out to diagnose the novel COVID-19. Out of 40 patients, 23 cases had positive test results; however, the others did not perform the test. The patients were followed up for 30 days in terms of the progress of their respiratory disease. Furthermore, those in the hospital were controlled daily, and the discharged cases were followed up via telephone. This study included 40 traumatic patients, and the majority of cases (n=29,72.5%,) were male. Upon admission, 37 (92.5%) cases had no signs of common cold, such as cough and fever. However, three (7.5%) patients had an occasional cough, and 10 (25%) cases remembered to have flu-like symptoms in the past two weeks. The mean hospital stay of the patients was estimated at 3.2±1.4 days. It should be noted that no death and respiratory distress syndromes occurred during the follow-up period. A favorable prognosis of asymptomatic patients with CXR indicative of COVID-19 was obtained in this study, and none of the cases developed critical forms of the disease.

Ileus or transient intestinal motility disorder is one of the problems after surgery, which poses challenges facing the medical team. Previous studies approved the preemptive effects of non-steroidal anti-inflammatory drugs (NSAIDs) on ileus; however, the majority of them have focused on animal models. This study aimed to investigate the effects of administration of rectal indomethacin in reducing ileus in patients who underwent cholecystectomy. This randomized controlled trial included 40 patients with cholelithiasis who were divided into two groups of indomethacin (n=20) and placebo (n=20). The indomethacin group received 100 mg rectal indomethacin before the operation. Cholecystectomy was performed using an open technique. The recovery of bowel functions (i.e. the time of the first flatus passage, return of appetite, and total dosage of opioid analgesic medications) was evaluated in this study. Time of the first ileus passage (P=0.004), return of appetite time (P=0.06), and reduction of opioid usage (65.62±5.5 mg/day versus 93.26±2.56) were significantly shorter in the indomethacin group, compared to the placebo group. Furthermore, none of the patients had any significant indomethacin-related complications. According to the outcomes of this study, it is concluded that preoperative administration of NSAIDS can be helpful in postoperative ileus reduction.

Regarding serious impact of chronic back pain in quality of life of people, patients looking for treatment to relieve back pain. The anti- inflammatory properties of nettle plant (Urtica dioica) as spray in reducing severity of low back pain was investigated. This study as a registered controlled clinical trial (IRCT: 20171217037930N1) recruited 40 patients with chronic back pain who referred to Orthopedic clinic of Sabzevar Shahid Beheshti Hospital, Sabzevar, Iran by available sampling method. Patients were divided randomly into two groups; group A: treatment with utricaria spray and usual medical treatment (20 persons), group B: patients under just usual medical treatment (20 persons). Pain measurement tool carried out under the visual analog scale (VAS) after intervention into both groups, and data were analyzed by SPSS software. Both studied groups had the similar VAS before the study (P=0.15). Analysis of VAS showed that the average pain severity after intervention was decreased significantly into both studied groups (P=0.01). However these decrements in VAS were not statistically significant between two studied groups (P=0.06). Multiple linear regression analysis determined that utricaria spray could be decreased pain severity to averagely till 0.79%. We concluded that adding utricaria spray to usual treatment has no effect into decreasing chronic low back pain.

Aluminum phosphide or rice tablet is one of the most common pesticides and insecticides used in agriculture to protect crops, cereals, and rice. Recently, this substance has been increasingly used as a method for committing suicide among people in society. This study aimed to evaluate the clinical symptoms and para-clinical findings of deceased patients due to Aluminum phosphide poisoning in Ardabil province, Iran. This descriptive cross-sectional study was conducted on 97 hospitalized patients who died due to Aluminum phosphide poisoning in Ardabil province, Iran, from 2009 to 2017. The data were collected using a checklist and then analyzed in SPSS software (version 19) through descriptive and analytical statistics The mean age of all patients was 34.3±15.8 years, and the majority of the cases (77.3%) were female. The most important symptoms were nausea and vomiting in males (92%) and females (100%). Moreover, the patients had a mean recovery time of 5.89 h. Of all the deceased patients, 22 and 75 cases took two and one tablets, respectively. Furthermore, 92.7% of the patients had taken the rice tablets orally. The amount of Glasgow Coma Scale (P=0.001), systolic blood pressure (P=0.001), PH (P=0.001), heart rate (P=0.001), respiratory rate (P=0.001), bicarbonate (P=0.001) and white blood cell (P=0.009) in died patients in more than 24 hour significantly difference with died patients in less than 24 hour. The females obtained a significantly lower systolic blood pressure (P=0.01) and lower pH (p=0.045), but the higher partial pressure of oxygen (P=0.01), compared to males. The results of this study showed that the frequency of deaths due to rice pill poisoning was much higher in males than females; moreover, this value was higher in middle-aged groups, compared to other age groups.

The safety of patients or clients remains a priority public health issue worldwide. Patient safety culture (PSC) is a core quality assurance strategy in healthcare delivery systems. Therefore, it is crucial for key stakeholders in the healthcare setting to perceive the concept. The present study determined the awareness,  level of knowledge, attitude, and practice of PSC among care providers and managers in a tertiary health facility in Nigeria. This descriptive survey was carried out within June to November in 2016. Data collection was conducted via a self-administered structured questionnaire survey (QS), focus group discussions (FGD), and key informant interviews (KII). Stratified and convenient sampling techniques were used for QS, FGD, and KII, respectively. The data were analyzed using SPSS software (version 22), and associations were determined through the Chi-square test and t-test. A p-value of < 0.05 was considered statistically significant. The awareness, attitude, and practice of PSC were slightly above average. The knowledge of the availability of PSC unit affected the scores of 3 of the 12 studied PSC composites, namely Feedback and communication about the error, Nonpunitive response to error, and Management support (p <0.05). The overall PSC level of the care providers and managers was reported as 62.3%. The rate of PSC was within the range of 28-72% based on FGD. According to KII, the awareness and practice of PSC were reported as 100% and 60%, respectively. Based on the obtained results of the current study, it was apparently demonstrated the low awareness, attitude, and practice of PSC resulting in the low functionality of PSC. Therefore, it is required to take comprehensive educational and institutional measures aiming at the improvement of positive PSC. Management commitment to safety is a key element in this regard.