scholarly journals A Proactive Risk Assessment Through Healthcare Failure Mode and Effect Analysis in Pediatric Surgery Department

2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Yasamin Molavi-Taleghani ◽  
Hossein Ebrahimpour ◽  
Hojjat Sheikhbardsiri

Background: Patient safety is the first step to improve the quality of care. Objectives: Therefore, the present study aimed to examine the risk assessment of processes in a pediatric surgery department using the Health Failure Mode and Effect Analysis (HFMEA) in 2017 - 2018. Methods: In this research, a mixed-method design (qualitative action and quantitative descriptive cross-sectional study) was used to analyze failure mode and their effects. The nursing errors in the clinical management model were used to classify failure modes, and the theory of inventive problem solving was used to determine a solution for improvement. Results: According to the five procedures selected by the voting method and their rating, 25 processes, 48 sub-processes, and 218 failure modes were identified with HEMEA. Eight risk modes (3.6%) were found as non-acceptable risks and were transferred to the decision tree. The main root causes (hazard score ≥ 4) were as follows: Technical-related factors (14.34%), organizational-related factors (31.9%), human-related factors (45.3%), and other factors (7.6%). Conclusions: The HFMEA method is very effective in identifying the possible failure of treatment procedures, determining the cause of each failure mode, and proposing improvement strategies.

2020 ◽  
Vol 12 (2) ◽  
pp. 106-111
Author(s):  
Juan Sebastián Ordoñez Peña ◽  
Priscila Estefanía Orellana Proaño ◽  
Fernando Córdova Neira

BACKGROUND: Congenital urinary tract abnormalities are diverse, and can affect different structures of this system. The importance of early diagnosis is avoiding kidney damage in the children. The aim of this study was to identify the frequency of urinary tract abnormalities in pediatric patients, in Hospital José Carrasco Arteaga Pediatric Surgery Department, from January 2014 to December 2018. METHODS: Descriptive cross-sectional study. The universe were 230 pediatric patients with confirmed diagnosis of congenital urinary tract abnormalities, from Hospital José Carrasco Arteaga Pediatric Surgery Department, from January 2014 to December 2018. Incomplete medical charts were excluded (n=47 children). 183 children were part of the this study. . La malformación más frecuente fue la hidronefrosis transitoria 70%, seguida de reflujo Vesico-Ureteral (RVU) 16.39% (n=30), estenosis pieloureteral 5.46% (n=10), megauréter 6.55% (n=12) y displasia renal 1.63% (n=3). RESULTS: The frequency of urological abnormalities was 2.73% (n = 183), predominately infants with 56%, and 57% male. 26.78% presented with symptoms related to urinary tract infection. Ultrasound was performed in 95% of the children, urethrocistography in 55% and renal scintigraphy in 31%. Prenatal findings were found in 34.97%. The most frequent abnormality was transient hydronephrosis (70%), followed up by vesico-ureteral reflux (VUR) 16.39% (n = 30), pyeloureteral stenosis 5.46% (n = 10), megaureter 6.55% (n = 12) and renal dysplasia 1.63% (n = 3). CONCLUSION: Urological malformations are common between genetic abnormalities, most of them are asymptomatic; locally due to the low rate of prenatal diagnosis, they are diagnosed in between 24 months of age. Transient hydronephrosis is the most frequent abnormality. Urinary tract infections are commonly the starting line in this groups of patients; when malformations are suspected, ultrasound is always suitable.


2017 ◽  
Vol 39 (1) ◽  
pp. 71
Author(s):  
Kamari Ana Reffatti ◽  
Tatiane Baratieri ◽  
Maicon Henrique Lentsck ◽  
Carine Teles Sangaleti

This study aimed to evaluate the risk of developing pressure ulcers (PU) and related factors in elderly residents in LTI of a medium-sized municipality in southern Brazil. The method applied was a cross-sectional study with elderly residents in a long-term institution (LTI) in Brazil, using sociodemographic questionnaire, health conditions questionnaire and Braden Scale. The data was analyzed using descriptive and inferential statistics. The results showed that most seniors had some degree of risk (57.2%) to develop PU, but no elderly presented the condition. Among the elderly at risk for PU, 54.5% of them rate their health as good, 46.7% participate in activities and 52.6% are satisfied with the institution. Conclusions: The absence of PU and positive evaluations of the elderly may be a result of the care offered by the LTI. The Braden Scale is an instrument that enables the planning and implementation of actions to improve the health of institutionalized elderly. 


2020 ◽  
Vol 1 (1) ◽  
pp. 162-173
Author(s):  
Dinesh Kumar Kushwaha ◽  
◽  
Dilbagh Panchal ◽  
Anish Sachdeva ◽  
◽  
...  

Failure Mode Effect Analysis (FMEA) is popular and versatile approach applicable to risk assessment and safety improvement of a repairable engineering system. This method encompasses various fields such as manufacturing, healthcare, paper mill, thermal power industry, software industry, services, security etc. in terms of its application. In general, FMEA is based on Risk Priority Number (RPN) score which is found by product of probability of Occurrence (O), Severity of failure (S) and Failure Detection (D). As human judgement is approximate in nature, the accuracy of data obtained from FMEA members depend on degree of subjectivity. The subjective knowledge of members not only contains uncertainty but hesitation too which in turn, affect the results. Fuzzy FMEA considers uncertainty and vagueness of the data/ information obtained from experts. In order to take into account, the hesitation of experts and vague concept, in the present work we propose integrated framework based on Intuitionistic Fuzzy- Failure Mode Effect Analysis (IF-FMEA) and IF-Technique for Order Preference by Similarity to Ideal Solution (IF-TOPSIS) techniques to rank the listed failure causes. Failure cause Fibrizer (FR) was found to be the most critical failure cause with RPN score 0.500. IF-TOPSIS has been implemented within IF-FMEA to compare and verify ranking results obtained by both the IF based approaches. The proposed method was presented with its application for examining the risk assessment of cutting system in sugar mill industry situated in western Uttar Pradesh province of India. The result would be useful for the plant maintenance manager to fix the best maintenance schedule for improving availability of cutting system.


2015 ◽  
pp. 153-161
Author(s):  
Thi Bach Yen Hoang ◽  
Thi Hai Pham ◽  
Dinh Tuyen Hoang ◽  
Thi Huong Le ◽  
Van Thang Vo

Food consumption survey is an essential parts of nutrition surveys. It helps to determine the type and quantity of food consumed, assessing the balance of the diet, the relationship between nutrient intake and health, diseases, and economic status, culture society... There are many methods to investigate food consumption. 24-hour food record is a method that record all food consumed by the subject during previous 24 hours. Using this method in chidren helps to assess the their diet to see if it responses the demand in order to have proper nutrition. Objectives: 1. Calculating the number of each food groups consumed within 24 hours of children 1 to 5 years in Phuoc Vinh ward, Hue City; 2. Assessing the quality of their diet and some related factors. Methodology: A cross-sectional study was implemented on 200 pairs of children aged 1 to 5 and parents or caregivers living in Phuoc Vinh ward, Hue city and some related factors. Results: 82% of the children’s diets covered 4 food groups. Prevalence of glucide, protein, lipide out of the total energy intake were 44.1%, 19.5%, 36.3% respectively within group of 12-<48 months and 50%, 19.5%, 30.6% respectively within group of 48-<72 months. Total energy and protein intake were higher than demanded (p <0.05) while glucide and lipide were lower than demanded (p <0.05). Economical status of family was significant associated with variety of food (all 4 food groups) in the diet of children (p <0.05) and total energy consumed (p <0.05). Conclusion: The children did not have proper nutrition so further research need to be implemented to have suitable interventions. Key words: 24 hours food records, children aged 1 to 5, Hue city.


2012 ◽  
pp. 129-134
Author(s):  
Thi Lan Tran ◽  
Thi Huong Le ◽  
Xuan Ninh Nguyen

Objectives: Assess the nutritional status, worm infection status and some related factors among children aged 12-36 months of Dakrong district, Quang Tri province. Subject and method: A cross sectional study was carried out in 2010, in 680 children aged 12-36 months in 4 communes of Dakrong district, Quang Tri province. Results: The malnutrition rate was 55.0% for underweight, 66.5% for stunting and 16.2% for wasting. The prevalence of malnutrition increases by age group. The prevalence of worm infection was 31.6%, the highest prevalence was belong to Ascaris infection (24.6%), followed by Hookworm and Trichuris (6.5% and 6.2%, respectively). The prevalence of worm infection among children under two is very high (27.0%). The prevalence of worm infection was distributed quite equally between the malnutrition children group and normal children group. Recommendation: Early deworming forchildren from 12 months should be considered as important strategy against the malnutrition of children in Dakrong district, Quang Tri province


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e029931 ◽  
Author(s):  
Akihiko Narisada ◽  
Kohta Suzuki

ObjectiveTo investigate the associations among procrastination (time inconsistency), work environment and obesity-related factors in Japanese male workers.DesignCross-sectional study.SettingData were collected at two work sites of Japanese electronics manufacturing company in 2015.Participants795 full-time male workers in a Japanese electric company, aged 35–64 years, who underwent health checkups in 2015.Main outcome measuresBody mass index (BMI), adult weight change, obesity (BMI ≥25 kg/m2), adult weight gain over 10 kg (AWG10) and metabolic syndrome (MetS). Multivariable linear and logistic regression analyses were performed to assess the associations of procrastination assessed by using a one-item questionnaire and white-collar and blue-collar work with obesity-related factors.ResultsWhite-collar workers with high procrastination levels showed positive associations with BMI (B: 0.75, 95% CI 0.06 to 1.44) and adult weight change (B: 1.77, 95% CI 0.26 to 3.29), and had increased odds of AWG10 (OR: 1.85, 95% CI 1.04 to 3.29) and MetS (OR: 2.29 95% CI 1.18 to 4.44) after adjustment for age, education, work-related factors and lifestyle factors. However, such positive associations were not observed among blue-collar workers.ConclusionsProcrastination and white-collar work might have a joint effect on weight gain during adulthood and consequential obesity.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyan Wang ◽  
Xiaoling Dai ◽  
Zichuan Yao ◽  
Xianqing Zhu ◽  
Yunzhong Jiang ◽  
...  

Abstract Introduction To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic. Methods This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression. Results Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384–1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805–0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286–0.920). Conclusions This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.


Author(s):  
Elena Bartolomé ◽  
Paula Benítez

Failure Mode and Effect Analysis (FMEA) is a powerful quality tool, widely used in industry, for the identification of failure modes, their effects and causes. In this work, we investigated the utility of FMEA in the education field to improve active learning processes. In our case study, the FMEA principles were adapted to assess the risk of failures in a Mechanical Engineering course on “Theory of Machines and Mechanisms” conducted through a project-based, collaborative “Study and Research Path (SRP)” methodology. The SRP is an active learning instruction format which is initiated by a generating question that leads to a sequence of derived questions and answers, and combines moments of study and inquiry. By applying the FMEA, the teaching team was able to identify the most critical failures of the process, and implement corrective actions to improve the SRP in the subsequent year. Thus, our work shows that FMEA represents a simple tool of risk assesment which can serve to identify criticality in educational process, and improve the quality of active learning.


2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110346
Author(s):  
Techane Sisay Tuji ◽  
Addisu Dabi Wake ◽  
Gezahegn Badeg Adere ◽  
Aselefu Beka Wedajo ◽  
Batu Dekeba Obole ◽  
...  

Objective To assess the prevalence of spontaneous preterm births and to identify the associated risk factors. Methods This single-centre cross-sectional study enrolled women that experienced a preterm birth as registered on the neonatal log-book between 30 December 2019 and 30 December 2020. A pre-tested structured checklist was used to collect data (sociodemographic characteristics; obstetric-related factors; medical history; and pregnancy-related factors). Bivariate logistic regression analyses were applied to identify factors associated with spontaneous preterm birth. A multivariate model identified significant independent risk factors. Results A total of 310 patients participated in the study. The prevalence of spontaneous preterm birth in this population was 67.1% (208 of 310; 95% confidence interval [CI] 61.5, 71.9). Patients without a partner (adjusted odds ratio [AOR] = 1.470, 95% CI 1.23, 4.42), patients residing in a rural area (AOR = 2.51, 95% CI 1.123, 5.513) and those with a history of PIH during their current pregnancy (AOR = 0.104, 95% CI 0.053, 0.014) were significantly more likely to have a spontaneous preterm birth. Conclusion The prevalence of spontaneous preterm birth in in this study was high. Healthcare providers and all stakeholders should focus on screening pregnant women at the risk of spontaneous preterm birth.


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