فهرست مطالب

Journal Of Patient safety and quality improvement
Volume:2 Issue: 4, Automn 2014

  • تاریخ انتشار: 1393/08/11
  • تعداد عناوین: 8
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  • Seyed Mansour Rayegani, Elham Kargozar, Darioush Eliaspour, Seyed Ahmad Raeissadat, Ehsan Sanati, Masoumeh Bayat Pages 142-147
    Introduction
    Carpal Tunnel Syndrome (CTS) is one of the main causes of disability. The diagnosis of CTS confirm by electrodiagnostic tests. Sonography is an alternative method for diagnosis of CTS that can investigate anatomy and probable pathology. The aim of this study is to investigate the multiple sonographic diagnostic criteria and compare its diagnostic value with electrodiagnosis.
    Materials And Methods
    In this descriptive-cross sectional study, 84 wrists (42 patients with CTS and 42 individuals without any clinical signs in upper limb) were investigated. Symptomatic patients underwent clinical examination, standard electrodiagnostic evaluation of upper limb and sonographic investigation of median nerve in forearm and wrist. The control group underwent sonographic investigation.
    Results
    Cross Sectional Area (CSA) of Median nerve at distal wrist crease, at the level of Hamate hook and Trapezium, the amount of flexor retinaculum bowing, ratio of CSA at the forearm to distal wrist crease and ratio of CSA at the Pisiform level to distal wrist crease had significant difference in the case group compared to the control group (P-value<0.05). Among these criterion, the most sensitivity, NPV and accuracy was for CSA at distal wrist crease (73.8%, 72.5%, 71.4% respectively), the most specificity, PPV was at the level of Hamate hook and Trapezium (85.3%, 80% respectively).
    Conclusion
    Our study reveals that sonography is a somehow sensitive and specific method in diagnosis of CTS and can be used as an adjuvant method in diagnosis of CTS but cannot substitute electrodiagnosis.
    Keywords: Carpal tunnel syndrome Electrodiagnosis Median nerve Sonography
  • Shabbu Ahmadi Bonakdar, Mahdieh Pouryazdanpanah, Zahra Ganie Far, Saba Ghazanfari, Abdolreza Norouzy Pages 148-150
    Introduction
    Malnutrition is common in intensive care unit, occurring in (30% to 50%) of hospitalized patients. To prevent malnutrition, nutritionists recommend industrials formula for patients who cannot eat but with functional gastrointestinal track, But due to verbal nurse`s reports standard enteral formula is inducing diarrhea. In this study our purpose is to evaluate the incidence of diarrhea in hospitalized patients with standard Enteral Nutrition (EN) formula intake.
    Materials And Methods
    13 patients participated in our study. We used Milatech brand as entral formula. Formula administration was depended 200 or 250 cc every two or three hours a day in dependent to patients needs and tolerance. Gastro Intestinal (GI) complications were recorded by nursing stuff in patients medical records. Complication frequencies were considered during three days for each person.
    Results
    No patients have diarrhea, only residue was seen in four patients.
    Conclusion
    Evaluation of patients receiving Milatech standard formula showed that diarrhea wasn’t seen in hospitalized patients. Diarrhea was reported by the nurses may refer to other diarrhea genic causes including of long length of stay, entral duration or medical side effects or infections.
    Keywords: Diarrhea Enteral nutrition Formula
  • Fatemehsadat Seyed Nematollah Roshan, Hasan Navipor, Fatemeh Alhani Pages 151-155
    Introduction

    Iron deficiency is one of the most common nutritional disorders worldwide. Regarding that fact, the aim of this study was to study the effectiveness of education-based intervention using small group discussions in empowering adolescent girls to prevent Iron deficiency anemia.

    Materials And Methods

    The present semi-experimental practical research was performed by choosing 60 female high-schoolers through random cluster sampling (n=30 test group and n=30 control group). The research tools included one questionnaire of demographic information & an assessment questionnaire for subjects’ empowerment in preventing iron deficiency anemia. After collecting pre-test data, the educational intervention was implemented for adolescent girls in the test group & the post-test was carried out one week after the intervention ended. The data were analyzed using SPSS software and applying appropriate statistical tests.

    Results

    At baseline, independent T-test showed no significant difference between the two groups in the perceived susceptibility, perceived severity, and self efficacy, all of which could be regarded as empowerment process components (P>0.05). However, significant differences were observed after intervention. Also, the paired T-test showed a significant difference before and after the intervention in the test group in means of the perceived susceptibility, perceived severity, self efficacy and, in the grand scheme, adolescent girls'' empowerment (P<0.05). No significant differences were evident in the control group.

    Conclusion

    Our findings showed that the education-based intervention using small groupdiscussions was effective in empowering adolescent girls to prevent Iron deficiency anemia.

    Keywords: Adolescent girls, Empowerment, Group discussion, Iron deficiency anemia
  • Hossein Ebrahimipour, Arash Shirdel, Mohammad Esmaeil Rahimi, Marzieh Meraji, Elaheh Hooshmand, Arefe Pourtaleb, Ebrahim Mohammad Pour, Ali Dehghani, Ali Vafaee Najar Pages 156-159
    Introduction
    Operations cancellation at the last minute is one of the main reasons of inefficiency and waste of resources in Hospitals. This study aims to investigate the reasons and the frequency of operations cancellations in Khatam-al-Anbia Eye Hospital (Mashhad-Iran) in 2013.
    Materials And Methods
    In this descriptive and cross-sectional study, all canceled scheduled operations in 2013 in Khatam-al-Anbiya Eye Hospital were investigated and the data were recorded in a checklist. Study variables included: 1) the number of planned operations, 2) the number of canceled operations, 3) age, 4) gender and 5) the reason of operation cancellation. Data were analyzed using descriptive statistics and SPSS16.
    Results
    Of 16512 operations scheduled during 2013, 329 cases (1.99 percent) were canceled. The reason of cancellation was not mentioned in (28.6 percent) of cases. Other reasons of operations cancellation included, in the order of importance, high-risk underlying disease (22.5%), medical advice ignorance from the patient''s behalf (10.6%), change in clinical status (7.9%), prolongation of previous operations (7%), patient’s dissatisfaction (5.8%), Patients'' incomplete Nil Per Os (NPO) time (5.5%), inadequate equipment (4.6%), lack of lab tests and consultations (2.7%), diagnosis change (2.4%), surgeon''s absence (1.8%), and incomplete admission documents (0.6%).
    Conclusion
    In a high percentage of canceled cases, the reasons of operation cancellations had not been mentioned in the patient’s file. A significant portion of theses cancellations can be attributed to the patients'' incomplete cooperation. Cancellations can be significantly reduced through providing the patient with enough instructions and explanations.
    Keywords: Hospital Operation Surgery cancellation
  • Rozita Davoodi, Saeed Eslami Hasan Abadi, Golnaz Sabouri, Maryam Salehi, Haleh Ghooshkhanei, Shaghayegh Rahmani, Azadeh Soltanifar, Maryam Zare Hoseini, Mahbobeh Asadi, Malek Gharaeian Morshed Pages 160-164
    Introduction
    One of the first and important steps to improve medical waste management is awareness and monitoring of the quality and quantity of medical waste. The aim of this study was to determine the present status of waste generation and the process of waste management in hospitals.
    Materials And Methods
    This cross sectional study was performed in ten university hospitals in Mashhad. A standard questionnaire was prepared according to the National Health instructions and completed by the project team members who were environmental health experts.
    Results
    The total waste which was generated in the studied hospitals was 7683 kg/day. The study showed total waste generation in selected hospitals as (61.85%) general medical waste, (34.90%) infectious waste and (3.25%) sharp waste. The average generation rate for total, general, infectious and sharp waste was (2.6, 1.5, 1.01) and (0.08) kg/bed/day, respectively. Mean scores of the different steps of waste management process with respect to National Health instructions were as follows: waste segregation (64%), waste storage (67%), waste transportation (76 %) and waste treatment 63%. There was no significant difference between the average rate of waste generation per bed in public and specialized hospitals (P=0.34).
    Conclusion
    High rate of infectious waste shows the need for establishing executive rules and standards for medical waste management. Medical managers should update their knowledge and further educating their staff; implying careful and constant monitoring of waste management.
    Keywords: Hospital Medical waste Waste management
  • Mahdi Foroutan Pages 165-167
    Introduction
    It is estimated that 2800000 to 4800000 individuals in Iran suffer from some kind of mental or physical handicap. According to Iranian social welfare university, about 24000 mental retard children would be added to this population. The aim of this study was to evaluate demographic factors which were associated with mental retardation in Khorasan Razavi population.
    Materials And Methods
    In this cross sectional study, the records of all mentally retarded children who had been referred for further evaluation to Mashhad social welfare was evaluated between 2004 and 2013. To evaluate mental retardation severity, Vineland social maturity scale was used for children younger than (5.5) years old, or the older children who did not respond to other tests. In cases of children older than (5.5) years who could communicate, Wechsler Intelligence Scale for Children (WISC) and Raven''s Progressive Matrices were performed. Tests final confirmation hanged on psychiatric interview and clinical assessment. Data was analyzed by SPSS version 16 and parametric and non parametric tests were used.
    Results
    A population of 200 children with a mean age of 7.5±6.6 years were evaluated. Smoking, drug abuse and consanguineous marriage were the main factors associated with mental retardation severity. (57%) of children had a relative with mental retardation.
    Conclusion
    Considering Mental Retardation (MR) financial burden, planning to reduce and control preventable factors such as parents’ drug abuse could be possible through education and cultural changes.
    Keywords: Children Mental retard Social welfare
  • Arash Beiraghi Toosi, Hamed Shariat Razavi Pages 168-170
    Skin cancer is a late complication of ionizing radiation. Two skin neoplasms prominent Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) are the most famous complications of radiotherapy. Basal Cell Carcinoma (BCC) is the most common human malignant neoplasm. Many genetic and environmental factors are involved in its onset. BCC is observed in sun-exposed areas of skin. Some patients with scalp BCC have had a history of scalp radiation for the treatment of tinea capitis in childhood. Evidence that ionizing radiation is carcinogenic first came from past reports of nonmelanoma skin cancers on the hands of workers using radiation devices. The total dose of radiation and irradiated site exposed to sunlight can lead to a short incubation period. It is not clear whether BCC in these cases has a more aggressive nature and requires a more aggressive resection of the lesion. The aim of this review was to evaluate the differences between BCC specification and treatment results between irradiated and nonirradiated patients.
    Keywords: BCC specification Childhood radiation Scalp BCC
  • Shima Sheybani, Nahid Zirak, Razieh Poorandi, Elnaz Hosseini Pages 171-174
    Introduction
    Spontaneous uterine rupture, a life-threatening condition for both parturient and their fetus, often tends to occur during labour, particularly in those with a scarred uterus (rare in unscarred ones). The diagnosis must be born in mind in case of a pregnant woman presenting with shock, abdominal pain and diminished fetal heart rate. Any additional preoperative evaluation seems redundant as it only wastes golden surgical time. Case:The case we intend to present is a multigravid woman (G3L2) in 28th week of gestation with an unscarred uterus. She had cardiac surgery six months earlier Atrial Septal Defect (ASD) device closure with Percutaneous Coronary Intervention (PCI). She presented with severe dyspnea, diminished lung sounds in the right lower zone, chest pain at rest, and radiating pain to her right shoulder from 12 hours earlier. No FHR was detected by auscultation with Doppler. She had generalized abdominal tenderness and rebound tenderness.
    Keywords: Preterm uterine rupture Pregnant woman Spontaneous uterine rupture