ASSESSMENT OF PATIENT SAFETY IN VACCINATION ROOMS

ABSTRACT Objective: identify adherence to patient safety recommendations in the vaccination room. Method: this is a cross-sectional study that analyzed 463 vaccination procedures in six vaccination rooms in Minas Gerais from June to July 2018. Data were obtained with the application of the Patient Safety Checklist for Vaccination Rooms through systematic observation of the vaccination procedure. Descriptive statistics were used for data analysis. Results: 463 vaccination procedures were observed, and the mean overall adherence score was 58.5%, min. 43.3% and max. 74.1%. The items of higher adherence were related to the records of vaccine data (name, date, and batch) on the vaccination card; vaccine application with dose, route of administration, location and correct materials; and records in an information system. The items of lower adherence were related to health guidance; investigation of adverse events following immunization and the health status of the vaccinated person; records of vaccine laboratory and vaccination center on the vaccination card; vaccine workforce handwashing; and proper vaccine preparation. Conclusion: the mean overall score found in this study was 58.5% for the adherence to recommendations for vaccination procedures. This result highlights the need for educational interventions that promote patient safety in the vaccination room and studies analyzing the factors that prevent such adherence.

Download Full-text

Assessment of Knowledge and Compliance to Evidence-Based Guidelines for VAP Prevention among ICU Nurses in Tanzania

10.21203/rs.3.rs-117804/v1 ◽

2020 ◽

Author(s):

Vicent Bankanie ◽

Anne Outwater ◽

Li Wang ◽

Li Yinglan

Keyword(s):

Nursing Education ◽

Knowledge Score ◽

Educational Interventions ◽

Cross Sectional Study ◽

Local Context ◽

Evidence Based ◽

Cross Sectional ◽

Effective Measure ◽

The Mean ◽

Evidence Based Guidelines

Abstract Background: Implementation of evidence-based guidelines (EBGs) related to VAP is an effective measure for the prevention of ventilator-associated pneumonia (VAP). While low knowledge regarding the EBGs related to VAP prevention among ICU nurses is still a major concern among nurses in ICUs globally, the situation in Tanzania is scarcely known. This study aimed to assess the ICU nurses’ knowledge, compliance, and barriers toward evidence-based guidelines for the prevention of VAP in Tanzania.Methods: A cross-sectional study, involving ICU nurses of major hospitals in Tanzania, was conducted. A structured questionnaire was administered among 116 ICU. Data analysis included descriptive statistics and independent t-test.Results: The mean knowledge score was 38.6% which is lower than the lowest ever reported knowledge score for EBGs for VAP prevention. Nurses with a degree or higher level of nursing education performed significantly better than the nurses with a diploma or lower level of nursing education(p=0.004). The mean self-reported adherence score for EBGs for the prevention of VAP was 60.8%. The main barriers to the implementation of EBGs for VAP prevention were lack of skills (96.6%), lack of adequate staff (95.5%), and lack of knowledge (79.3%).Conclusion: Considering the severity and impact of VAP, and the higher risks of HAIs in resource-limited countries like Tanzania, the lower level of knowledge and compliance implies the need for on-going educational interventions and evaluation of the implementation of the EBGs for VAP prevention by considering the local context.

Download Full-text

Fatigue as a primary and secondary factor in relation to shift-rotating and patient safety in nurses

Journal of Hospital Administration ◽

10.5430/jha.v9n1p1 ◽

2019 ◽

Vol 9 (1) ◽

pp. 1

Author(s):

Deldar Morad Abdulah ◽

Karwan Ali Perot ◽

Eleanor Holroyd

Keyword(s):

Patient Safety ◽

Well Being ◽

Cross Sectional Study ◽

Adverse Outcomes ◽

Cross Sectional ◽

Mean Values ◽

Secondary Factor ◽

Significant Impairment ◽

The Mean ◽

The Impact

Objective: The role of nurses’ shift-rotations in predicting adverse patient events has received little attention. The effect of fatigue on patient safety as a primary factor and the impact of shift-working on fatigue as a secondary factor in hospital-based nurses was investigated in the present study.Methods: In this cross-sectional study set in Iraqi Kurdistan in 2018, 71 nurses (Range: 20-44 years) were recruited purposively who worked in rotating shifts, in four multi-specialty hospitals.Results: The mean age of the nurses was 30.24 years (SD: 4.81; range: 20-44 years). The majority of nurses worked in the public sector (63.4%). The nurses worked in morning shift (26.8%) and shift-rotations (39.4%) for between 7.75 and 9.13 hours. In addition, 59.4% and 18.3% of nurses reported that they injured “sometimes” and “frequently” (respectively) patients in their care either directly or indirectly. Similarly, 19.7% of them reported that these were medication errors “sometimes” and “frequently.” Patient information was recorded incompletely or incorrectly sometimes by 18.3% and frequently by 35.2%. Also, 36.6% and 31.0% of them reported that they delayed care to patients frequently and sometimes, respectively. The mean values of physical and psychological fatigue were 8.77 of 21 and 3.42 of 12, respectively. The physical and psychological fatigue were escalated in case of lower total psychological well-being (p = .009 and p = .018, respectively). The study showed that single-shift working is a predictor of delayed patients care; 95.3% vs. 60.7%; p < .001).Conclusions: Hospital administrators must be aware that nurses are not able to work effectively on short roosters or extended shifts. Protocols for better nurse health surveillance and social support in respect to 24 hours shift work must be prioritized in order to avoid mental and physical significant impairment on nurses and adverse outcomes for their clients.

Download Full-text

Prevalence of shisha smoking and risk factors among female adolescents in Iran

10.21203/rs.2.19626/v1 ◽

2019 ◽

Author(s):

Saeed Bashirian ◽

Majid Barati ◽

Manoochehr Karami ◽

Behrooz Hamzeh ◽

elahe ezati

Keyword(s):

Risk Factors ◽

Age Groups ◽

Educational Interventions ◽

Cross Sectional Study ◽

Female Adolescents ◽

Limited Data ◽

Cross Sectional ◽

Western City ◽

The Mean ◽

Study Participants

Abstract Background: shisha smoking is on the increase in Iarn, but there are limited data on its use among adolescents. This research purpose is to the survey prevalence of shisha smoking and risk factors among female in Iran. Methods: This was a cross-sectional study . The study participants was 1302. The sampling was multistage random. 12 schools from three sectors of Kermanshah in the western city in Iran( 4 schools from each sector), were selected. Students were in grades 7 to 12. data were collected using questionnaire and analyzed by descriptive statistical methods and Logistic regression test by using SPSS 22 software. Results: The mean (SD) ages of the students and the ages when the participants started SS were 15.22 ± 1.85 and 13.64 (1.64) respectively. 32.4% of the participants ever having used a shisha and 20.4% mentioned they used shisha the last 30 days. Most of the subjects smoked shishas in friends’ houses (45.8%) and with their friends (47.4%). The significantly important factors that affect SS in these age groups were the father's and mother's occupation, family size, living with others, father's education, having a friend who smokes shishas, friends’ encouragement to smoke shisha, and being in a family that smoke shishas. Conclusions: shisha smoking has become a major concern in female . shisha prevention needs extensive studies. Investigation of shisha behavioral factors is essential in designing of educational interventions. Key words: Female, adolescents, student, shisha smoking .

Download Full-text

Validation of the Attitudes to Patient Safety Questionnaire for Nursing Students in the Spanish Context

10.21203/rs.3.rs-127643/v1 ◽

2020 ◽

Author(s):

Águeda Cervera-Gasch ◽

Víctor M González-Chordá ◽

Fred Gustavo Manrique-Abril ◽

Laura Andreu-Pejo ◽

María Jesús Valero-Chillerón ◽

...

Keyword(s):

Patient Safety ◽

Nursing Students ◽

Psychometric Properties ◽

Student Attitudes ◽

Nursing Student ◽

Educational Interventions ◽

Cross Sectional Study ◽

Nominal Group ◽

Cross Sectional ◽

Undergraduate Nursing

Abstract Background: There are different instruments to assess the attitudes of nursing students towards patient safety. However, no questionnaire validated in Spanish with this objective was identified. The objective of this study was to validate the Attitudes to Patient Safety (APS) questionnaire for nursing students in Spain and to study the attitudes towards patient safety of nursing students at the Universitat Jaume I (Spain). Design: Cross-sectional psychometric study developed in a sample of 177 undergraduate nursing students. The study was carried out in the second semester of 2016Methods: First, a nominal group was created to perform cross-cultural adaptation and determine content validity of the Attitude to Patient Safety Questionnaire (APQS-III). Second, a cross-sectional study was conducted to determine the psychometric properties of the questionnaire and to study nursing student attitudes towards patient safety. Results: Exploratory factorial analysis explained 53.82% of the variance, with good internal consistency (α=0.808), and confirmatory factor analysis indicate an adequate fit between the model and the data (χ2=366; p<0.001; χ2/df=1.886; RMSEA=0.07; IC95%=0.059–0.081; CFI=0.885. Intra-observer reliability was good (ICC=0.792, p <0.001). The mean overall score of the questionnaire was 3.92 (95% CI=3.88-4.03). Significant differences were observed regarding whether the students had completed a clinical practicum (p=0.012) and the academic year (p=0.25). Conclusion: The psychometric properties of the APS questionnaire adapted for Spanish nursing students are adequate. Students show an adequate attitude towards patient safety; however, it is necessary to develop a strategy to guarantee the acquisition of competency for patient safety as well as to design and evaluate specific educational interventions.

Download Full-text

Validation of the attitudes to patient safety questionnaire for nursing students in the Spanish context

BMC Nursing ◽

10.1186/s12912-021-00634-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Águeda Cervera-Gasch ◽

Víctor M González-Chordá ◽

Fred Gustavo Manrique-Abril ◽

Laura Andreu-Pejo ◽

María Jesús Valero-Chillerón ◽

...

Keyword(s):

Patient Safety ◽

Nursing Students ◽

Psychometric Properties ◽

Student Attitudes ◽

Nursing Student ◽

Educational Interventions ◽

Cross Sectional Study ◽

Nominal Group ◽

Cross Sectional ◽

Undergraduate Nursing

Abstract Background There are different instruments to assess the attitudes of nursing students towards patient safety. However, no questionnaire validated in Spanish with this objective was identified. The objective of this study was to validate the Attitudes to Patient Safety (APS) questionnaire for nursing students in Spain and to study the attitudes towards patient safety of nursing students at the Universitat Jaume I (Spain). Design Cross-sectional psychometric study developed in a sample of 177 undergraduate nursing students. The study was carried out in the second semester of 2016. Methods First, a nominal group was created to perform cross-cultural adaptation and determine content validity of the Attitude to Patient Safety Questionnaire (APQS-III). Second, a cross-sectional study was conducted to determine the psychometric properties of the questionnaire and to study nursing student attitudes towards patient safety. Results Exploratory factorial analysis explained 53.82 % of the variance, with good internal consistency (α = 0.808), and confirmatory factor analysis indicate an adequate fit between the model and the data (χ2 = 366; p < 0.001; χ2/df = 1.886; RMSEA = 0.07; IC95 %=0.059–0.081; CFI = 0.885). Intra-observer reliability was good (ICC = 0.792, p < 0.001). The mean overall score of the questionnaire was 3.92 (95 % CI = 3.88–4.03). Significant differences were observed regarding whether the students had completed a clinical practicum (p = 0.012) and the academic year (p = 0.25). Conclusions The psychometric properties of the APS questionnaire adapted for Spanish nursing students are adequate. Students show an adequate attitude towards patient safety; however, it is necessary to develop a strategy to guarantee the acquisition of competency for patient safety as well as to design and evaluate specific educational interventions.

Download Full-text

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v6i2.50744 ◽

2020 ◽

Vol 6 (2) ◽

pp. 74-77

Author(s):

Mohammad Enayet Hussain ◽

Bithi Debnath ◽

AFM Al Masum Khan ◽

Md Ferdous Mian ◽

Md Nahidul Islam ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Clinical Diagnosis ◽

Optic Neuropathy ◽

Cross Sectional Study ◽

P Value ◽

Pattern Reversal ◽

Cross Sectional ◽

The Mean ◽

Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

Download Full-text

Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

10.33798/ajmas2019/00265. ◽

2019 ◽

Vol 2 (1) ◽

pp. 1-18

Author(s):

Chijioke Okeudo ◽

B.U. Ezem

Keyword(s):

Amniotic Fluid ◽

Gestational Age ◽

Cross Sectional Study ◽

Fluid Volume ◽

Singleton Pregnancy ◽

Cross Sectional ◽

South Eastern ◽

Amniotic Fluid Volume ◽

The Mean ◽

Singleton Pregnancies

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

Download Full-text

Advantages and limitations of the endoscopic tympanoscopy a prospective study

10.30574/ijsra.2020.1.1.0016 ◽

2020 ◽

Vol 1 (1) ◽

pp. 012-017

Author(s):

Najib Zouhair ◽

Anass Chaouki ◽

Amine M’khatri ◽

Youssef Oukessou ◽

Sami Rouadi ◽

...

Keyword(s):

Middle Ear ◽

Operating Time ◽

Cross Sectional Study ◽

Cross Sectional ◽

Invasive Approach ◽

Intraoperative Bleeding ◽

Advantages And Disadvantages ◽

Early Return ◽

The Mean ◽

Endoscopic Tympanoplasty

Tympanoplasty is one of the most performed procedures in ENT. The aggressiveness of its microscopic approach has led otologists to adopt the endoscopic approach as a less invasive alternative. The purpose of this work is to appreciate the advantages and disadvantages of this surgical technique. We conducted a prospective descriptive cross-sectional study on 20 interventions within the ENT department of August the 20th 1953 Hospital of Casablanca from April 2019 to June 2019. The average age of operated patients was 36.3 years. Perforations were unilateral in (71%) of the cases with a predominance of the anterior (29%) and subtotal (36%) locations. The tympanoplasties were performed by 3 different senior otologic surgeons, and were left in (57%). The mean operating time was (59.5 min) and the mean anesthesia duration was 75.1 min. Intraoperative vision allowed us to fully visualize the margins of all perforations (100%) and anatomical structures of the middle ear in almost all interventions. The first procedures carried out were filled with difficulties whose management of intraoperative bleeding was the main one in (42.8%) of the cases. (57%) procedures were described as easy. No complication was detected intraoperatively or immediately postoperatively. Endoscopic tympanoplasty has several advantages, including: Minimally invasive approach to the middle ear; panoramic perioperative vision; Gain of operating time; decrease in the duration of anesthesia; Valuable educational tool; postoperative comfort; Decrease in hospital stay and early return to daily activities; Better aesthetic rendering; cost and transportability. However, we also note a number of disadvantages of endoscopic tympanoplasty, particularly: performing the procedure with one hand; difficulty passing through the EAC; 2D vision that alters the perception of depth; management of intraoperative bleeding; fogging; learning curve.

Download Full-text

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

Nepal Medical College Journal ◽

10.3126/nmcj.v22i3.32638 ◽

2020 ◽

Vol 22 (3) ◽

pp. 141-145

Author(s):

Krishna Chandra Devkota ◽

S Hamal ◽

PP Panta

Keyword(s):

Pleural Effusion ◽

Cross Sectional Study ◽

Pleural Space ◽

Sectional Study ◽

Inclusion Criteria ◽

Cross Sectional ◽

Medical College ◽

The Common ◽

The Mean ◽

Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

Download Full-text

Attitudes of pharmacy students towards patient safety: a cross-sectional study from six developing countries

BMJ Open ◽

10.1136/bmjopen-2020-039459 ◽

2020 ◽

Vol 10 (12) ◽

pp. e039459

Author(s):

Abdallah Y Naser ◽

Zahra Khalil Alsairafi ◽

Ahmed Awaisu ◽

Hassan Alwafi ◽

Oriana Awwad ◽

...

Keyword(s):

Developing Countries ◽

Saudi Arabia ◽

Patient Safety ◽

Quality Improvement ◽

Core Competencies ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Pharmacy Students ◽

Sectional Study ◽

Cross Sectional

ObjectiveTo evaluate the attitudes of undergraduate pharmacy students towards patient safety in six developing countries.DesignA cross-sectional study.SettingParticipants were enrolled from the participating universities in six countries.ParticipantsUndergraduate pharmacy students from the participating universities in six developing countries (Jordan, Saudi Arabia, Kuwait, Qatar, India and Indonesia) were invited to participate in the study between October 2018 and September 2019.Primary outcomeAttitudes towards patient safety was measured using 14-item questionnaire that contained five subscales: being quality-improvement focused, internalising errors regardless of harm, value of contextual learning, acceptability of questioning more senior healthcare professionals’ behaviour and attitude towards open disclosure. Multiple-linear regression analysis was used to identify predictors of positive attitudes towards patient safety.ResultsA total of 2595 students participated in this study (1044 from Jordan, 514 from Saudi Arabia, 134 from Kuwait, 61 from Qatar, 416 from India and 429 from Indonesia). Overall, the pharmacy students reported a positive attitude towards patient safety with a mean score of 37.4 (SD=7.0) out of 56 (66.8%). The ‘being quality-improvement focused’ subscale had the highest score, 75.6%. The subscale with the lowest score was ‘internalising errors regardless of harm’, 49.2%. Female students had significantly better attitudes towards patient safety scores compared with male students (p=0.001). Being at a higher level of study and involvement in or witnessing harm to patients while practising were important predictors of negative attitudes towards patient safety (p<0.001).ConclusionPatient safety content should be covered comprehensively in pharmacy curricula and reinforced in each year of study. This should be more focused on students in their final year of study and who have started their training. This will ensure that the next generation of pharmacists are equipped with the requisite knowledge, core competencies and attitudes to ensure optimal patient safety when they practice.

Download Full-text