Journal of Healthcare Quality Research最新文献_第4页

Conformance to the National List of Essential Medicines 2022 in a government tertiary care hospital 政府三级医院符合《2022年国家基本药物目录》

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-11-01 Epub Date: 2025-05-30 DOI: 10.1016/j.jhqr.2025.101141

A. Jain , N.D. Bhardwaj , M. Suhaib , P. Srivastava , S. Khan , S. Rawat

Background

Access to essential medicines is vital for healthcare. The National List of Essential Medicines (NLEM) 2022 serves a guide for Indian healthcare facilities in procuring and providing essential medicines at different levels of healthcare. This study aimed at assessing the compliance of essential medicines availability at a tertiary care government hospital.

Methods

This cross-sectional study was conducted over a period of 24 weeks to assess the availability of essential medicines via reviewing of documents and content analysis. One-Sample Proportion Z-Test (two-tailed) was used to statistically test the result. Z-score was calculated and statistical significance of result was checked. The compliance for various categories as per NLEM 2022 was analyzed and an overall compliance was calculated.

Results

The hospital procured 85.4% (328/384) of NLEM 2022 drugs. Based on the One-Sample Proportion Z-Test, calculated Z-score was 2.65 with 95% confidence interval which indicates the hospital's procurement rate of 85.4% is significantly higher than the expected WHO benchmark of 80%. A total of 18 NLEM sections had ≥80% compliance, with eight sections reached full compliance. However, gaps existed in sections like antidotes, diagnostic agents and dermatological medicines.

Conclusion

In comparison with earlier studies from India, the tertiary care hospital under study has shown better adherence to NLEM 2022 guidelines but there are still some gaps. By addressing the gaps, hospital can continuously improve healthcare delivery, ensure patient safety, and adapt to evolving health challenges, ultimately ensuring high-quality patient care.

获得基本药物对卫生保健至关重要。《2022年国家基本药物清单》为印度卫生保健机构在不同级别的卫生保健中采购和提供基本药物提供了指南。本研究旨在评估三级政府医院基本药物供应的合规性。方法采用横断面研究方法，通过文献查阅和内容分析，对基本药物的可获得性进行评估，研究时间为24周。采用单样本比例z检验（双尾）对结果进行统计学检验。计算Z-score并检验结果的统计学显著性。分析了NLEM 2022中不同类别的合规性，并计算了总体合规性。结果该院采购NLEM 2022药品的比例为85.4%（328/384）。根据单样本比例z检验，计算出的z分数为2.65，置信区间为95%，表明该院采购率为85.4%，显著高于WHO预期基准80%。共有18个NLEM切片符合≥80%，其中8个达到完全符合。然而，在解毒剂、诊断剂和皮肤病药物等方面存在差距。与印度早期的研究相比，所研究的三级保健医院更好地遵守了NLEM 2022指南，但仍有一些差距。通过解决这些差距，医院可以不断改进医疗保健服务，确保患者安全，并适应不断变化的健康挑战，最终确保高质量的患者护理。

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引用次数: 0

Criterios y norma de acreditación en calidad para servicios de hospitalización a domicilio: documento de la Sociedad Española de Hospitalización a Domicilio y la Sociedad Española de Calidad Asistencial 家庭住院服务质量认证标准和标准：西班牙家庭住院协会和西班牙护理质量协会的文件

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-11-01 Epub Date: 2025-05-16 DOI: 10.1016/j.jhqr.2025.101144

M. Miron Rubio , J. Regalado de los Cobos , L. Villegas Bruguera , A. Basterretxea Ozamiz , I. Carrillo Murcia , M. Guilabert Mora , J.J. Mira Solves , M. Santiñà Vila

Introduction and objectives

Home hospitalization has emerged as an effective alternative to traditional hospitalization, especially relevant during the COVID-19 pandemic. However, home hospitalization lacks uniformity in its implementation. This study, conducted by the Spanish Society of Home Hospitalization and the Spanish Society of Healthcare Quality, aims to develop specific quality criteria and an accreditation standard for home hospitalization units.

Materials and methods

The qualitative study, carried out between May 2021 and June 2022, was conducted in 3 phases: literature review, consensus conference, and Delphi technique. The literature review identified existing quality criteria, and the consensus conference defined the areas and dimensions of quality. Using the Delphi technique, 67 national experts refined and reached a consensus on these criteria through 2 rounds of online surveys.

Results

The review identified 240 ideas grouped into 17 categories, and after the consensus conference, 120 initial criteria were proposed, reduced to 54 for the Delphi technique. Finally, 23 quality criteria were agreed upon, 14 considered essential and 9 recommended, covering areas such as accessibility, efficacy, patient safety, integrated care, patient experience, and unit efficiency.

Conclusions

The study provides a consensual quality standard for home hospitalization units in Spain, facilitating self-assessment, accreditation, and continuous improvement. The implementation of these criteria will help standardize home hospitalization, ensure service quality, and promote the expansion of this care model, with the Spanish Society of Home Hospitalization responsible for its dissemination and updating.

导语和目标家庭住院已成为传统住院的有效替代方案，在2019冠状病毒病大流行期间尤为重要。然而，家庭住院在实施上缺乏统一性。这项研究由西班牙家庭住院协会和西班牙保健质量协会进行，目的是为家庭住院单位制定具体的质量标准和认证标准。材料和方法定性研究于2021年5月至2022年6月进行，分为三个阶段：文献综述、共识会议和德尔菲技术。文献综述确定了现有的质量标准，共识会议定义了质量的领域和维度。67位国家专家利用德尔菲法，通过两轮在线调查，对这些标准进行了提炼并达成了共识。结果本综述确定了240个观点，分为17类，经过共识会议，提出了120个初步标准，减少到54个德尔菲技术。最后，达成了23项质量标准，14项被认为是基本标准，9项被推荐，涵盖了可及性、疗效、患者安全、综合护理、患者体验和单位效率等领域。结论本研究为西班牙家庭住院单位提供了一个共识性的质量标准，便于自我评估、认证和持续改进。这些标准的实施将有助于使家庭住院标准化，确保服务质量，并促进这种护理模式的推广，西班牙家庭住院协会负责传播和更新这种模式。

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引用次数: 0

¿Son los nanorrobots una alternativa de mejora en la calidad del tratamiento de la insuficiencia respiratoria? 纳米机器人是提高呼吸衰竭治疗质量的替代方法吗？

IF 1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-11-01 Epub Date: 2025-08-18 DOI: 10.1016/j.jhqr.2025.101157

Alejandro González-Castro , Camilo González Fernández , Arturo Ávila

引用次数: 0

Comparison and analysis of biological drug consumption in two Italian hospital settings: Governance actions and prescribing appropriateness 比较和分析两家意大利医院的生物药物消费：治理行动和处方适当性

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-11-01 Epub Date: 2025-06-09 DOI: 10.1016/j.jhqr.2025.101148

M. Vaccaro , G. Polito , G. Bagaglini , M. Capuozzo , R. Langella , E. Nava , A. Zovi , F. Ferrara

Background

Biosimilar drugs represent a valuable opportunity for healthcare systems worldwide, offering substantial cost savings while ensuring equivalent efficacy and safety in treating chronic conditions. These savings can be reinvested in ongoing medical innovation.

Methods

An investigation was carried out to evaluate the utilization of key biologic therapies across various clinical indications within two Italian healthcare institutions: Asl Napoli 3 Sud and Policlinico Umberto I in Rome. Information regarding consumption and expenditure was extracted from institutional databases. A comparison with figures from 2021 was conducted to detect any growth in biosimilar adoption throughout 2022.

Results

The 2022 review demonstrated that most of the examined compounds were administered predominantly as biosimilars, with proportions nearing complete substitution, aside from some notable outliers. In particular, reluctance persisted in prescribing biosimilar adalimumab (73.8%) and etanercept (73.3%) at Asl Napoli 3 Sud, as well as erythropoietin (69.5%) and rituximab (72.8%) at Policlinico Umberto I.

Conclusion

The year-on-year comparison between 2021 and 2022 underscored a growing shift toward biosimilar prescriptions. This favorable direction indicates the likelihood of reaching full implementation soon, with meaningful advantages for the National Healthcare Service and citizens, promoting an efficient and economically viable model of care.

生物仿制药为全球医疗保健系统提供了一个宝贵的机会，在确保治疗慢性疾病的同等功效和安全性的同时，提供了大量的成本节约。这些节省下来的资金可以再投资于正在进行的医疗创新。方法开展一项调查，评估两家意大利医疗机构（那不勒斯3 Sud医院和罗马Umberto I医院）在各种临床适应症中关键生物疗法的使用情况。有关消费和支出的资料摘自机构数据库。与2021年的数据进行比较，以检测整个2022年生物仿制药采用的增长情况。结果2022年的审查表明，除了一些显著的异常值外，大多数被检查的化合物主要作为生物类似药给药，比例接近完全替代。特别是，在Asl Napoli 3 Sud，不愿开生物仿制药阿达木单抗（73.8%）和依那西普（73.3%），以及在Policlinico Umberto i，不愿开促红细胞生成素（69.5%）和利妥昔单抗（72.8%）。结论2021年和2022年的同比比较表明，越来越多的人转向开生物仿制药。这一有利的方向表明，很快就有可能全面实施，对国家医疗保健服务和公民有意义的好处，促进一种高效和经济上可行的护理模式。

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引用次数: 0

Cross-cultural adaptation and validation of the Arabic version of self-care of coronary heart disease inventory 阿拉伯语冠心病自我护理量表的跨文化适应与验证

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-11-01 Epub Date: 2025-05-20 DOI: 10.1016/j.jhqr.2025.101145

A.M. Al Jaber , A.A.M. Shaheen , A. Albarrati , A.S. Alqahtani , R.F.M. Gwada , H. Alay

Aim

This study aimed to translate and cross-culturally adapt the Self Care of Coronary Heart Disease (CHD) Inventory into Arabic and measure its psychometric properties among Arabic-speaking patients with CHD.

Method

Using Sousa's guidelines on translation, the study assesses the content validity, construct validity, internal consistency, and test–retest reliability of the Arabic version of the Self-Care of Coronary Heart Inventory (SC-CHDI-Ar). A total of 181 patients with CHD were involved in the validity and reliability testing, and a test re-test was conducted with 61 patients at cardiology clinics in Riyadh, Saudi Arabia.

Results

The content validity index of the three subscales of SC-CHDI-Ar was acceptable. Additionally, the SC-CHDI-Ar did not have any floor or ceiling effects. Positive significant correlations were found among the subscales of SC-CHDI-Ar with the Arabic Cardiac Self Efficacy Questionnaire (CSEQ-A) scores. The internal consistency of SC-CHDI-Ar were ranged from (α = 0.70 to 0.95), and the test–retest of the maintenance, management, and confidence subscales were ICC_2,1 = 0.86 (95%CI; .70–0.91), 0.76 (95%CI; 0.59–0.85), and 0.76 (95%CI; 0.56– 0.85), respectively.

Conclusion

The SC-CHDII-Ar is an understandable, valid, and reliable instrument for determining the self-care needs of patients with CHD in Saudi Arabia.

目的将《冠心病自我护理量表》翻译成阿拉伯文并进行跨文化改编，并测量阿拉伯文冠心病患者的心理测量特征。方法采用Sousa翻译指南，对阿拉伯文版《冠心病自我护理量表》（SC-CHDI-Ar）的内容效度、结构效度、内部一致性和重测信度进行评估。共有181例冠心病患者参与了效度和信度测试，并对沙特阿拉伯利雅得心脏病科诊所的61例患者进行了测试再测试。结果SC-CHDI-Ar三个分量表的内容效度指标均可接受。此外，SC-CHDI-Ar没有任何下限或上限效应。SC-CHDI-Ar各分量表与阿拉伯心脏自我效能问卷（CSEQ-A）得分呈显著正相关。SC-CHDI-Ar的内部一致性范围为（α = 0.70 ~ 0.95），维持、管理和信心分量表的重测为ICC2,1 = 0.86 (95%CI；0.70 - 0.91), 0.76 (95%ci；0.59-0.85), 0.76 (95%CI；0.56 - 0.85)。结论sc - chdi - ar是一种可理解、有效、可靠的测定沙特阿拉伯冠心病患者自我保健需求的工具。

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引用次数: 0

Cataract care process: Systematic review of clinical guidelines and synthesis of recommendations 白内障护理过程：临床指南的系统回顾和建议的综合。

IF 1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-11-01 Epub Date: 2025-09-29 DOI: 10.1016/j.jhqr.2025.101161

M. García Anguas , A.M. Seva-Llor , R. Cabrera Beyrouti

Introduction

In 2020, 94 million people worldwide had moderate to severe visual impairment or blindness due to cataracts, particularly among older adults. The allocation of resources and appropriate strategies are essential for effective healthcare management that can control costs and improve patients’ quality of life. Clinical Practice Guidelines (CPGs) help reduce variability in care.

Objective

To analyze, compare, and synthesize recommendations from multiple guidelines on the same topic in order to identify consistencies, discrepancies, and opportunities for improvement.

Methods

Websites of international organizations, scientific societies, and various databases such as PubMed, WoS, and Cinahl were reviewed. A systematic review identified five high-quality CPGs for cataract management, with recommendations covering diagnosis, treatment, and postoperative follow-up.

Results

Although some variability was found, common recommendations were identified. Two widely agreed upon recommendations stood out: avoiding routine preoperative medical tests for local anesthesia, as they do not reduce complications, and using intracameral antibiotics (cefuroxime/moxifloxacin) for infection prevention, supported by high-level evidence, among others. The guideline developed by the American Academy of Ophthalmology – Cataract in the Adult Eye Preferred Practice Pattern – was found to be the most valid and useful.

Conclusion

Standardizing high-evidence recommendations can improve clinical decision-making, reduce variability, and enhance patient outcomes. This study highlights the need for better implementation strategies and patient-centered education to improve adherence to care.

2020年，全世界有9400万人因白内障出现中度至重度视力障碍或失明，尤其是老年人。资源分配和适当的策略对于有效的医疗保健管理至关重要，可以控制成本并改善患者的生活质量。临床实践指南（CPGs）有助于减少护理的可变性。目的：分析、比较和综合来自同一主题的多个指南的建议，以确定一致性、差异和改进机会。方法：查阅国际组织网站、科学学会网站以及PubMed、WoS、china等数据库。一项系统综述确定了5种用于白内障治疗的高质量cpg，并提供了包括诊断、治疗和术后随访的建议。结果：虽然发现了一些差异，但确定了共同的建议。其中有两项得到广泛同意的建议：避免术前常规的局部麻醉医学检查，因为它们不能减少并发症；以及使用内源性抗生素（头孢呋辛/莫西沙星）预防感染，这得到了高水平证据的支持。由美国眼科学会制定的指南——成人眼科首选实践模式中的白内障——被认为是最有效和有用的。结论：标准化高证据推荐可以改善临床决策，减少可变性，提高患者预后。本研究强调需要更好的实施策略和以患者为中心的教育，以提高对护理的依从性。

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引用次数: 0

Salutogénesis en vez de patogénesis, ¿estamos realizando la necesaria transformación del modelo de sistema de salud? 健康发生而不是发病发生，我们是否正在对卫生系统模式进行必要的转变？

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-11-01 Epub Date: 2025-06-09 DOI: 10.1016/j.jhqr.2025.101149

M. Santiñà Vila , D. Juvinyà Canal

引用次数: 0

Results of a survey to evaluate awareness and practices of critical incident reported by anaesthesiologists 一项评估由麻醉师报告的危急事件的意识和实践的调查结果

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-11-01 Epub Date: 2025-06-13 DOI: 10.1016/j.jhqr.2025.101147

S. Kaniyil , P. Pavithran , A.K. Arun Krishna , M.C. Rajesh

Background and objectives

Enhancing patient safety in Anaesthesia relies significantly on critical incident reporting and analysis. We did an online web-based survey aiming to evaluate the awareness and practices of our anaesthesiologists on critical incident reporting in India.

Materials and methods

A validated questionnaire was disseminated via online social media platforms to evaluate the awareness and current practices of anaesthesiologists on incident reporting and analysis. Timely reminders were issued to enhance response rates, and data analyzed upon receipt of sufficient responses.

Results

Among the 506 responses received, 60% reported having a workplace incident reporting system. Despite high awareness, a significant majority expressed reluctance to report incidents, citing the fear of blame and shame as a deterrent. The most frequently reported incidents included cardiac arrest and drug errors. Identified contributing factors included inadequate staffing, communication gaps, prolonged work hours, a stressful work environment, and the absence of institutional protocols.

Conclusions

Despite a notable level of awareness regarding critical incident reporting among our anaesthesiologists, apprehensions related to blame and finger-pointing hinder the reporting process. As a uniform reporting system is lacking, formulating a national guideline, and establishing a standard reporting system is the need of the hour.

背景和目的增强麻醉患者安全在很大程度上依赖于关键事件的报告和分析。我们做了一个基于网络的在线调查，旨在评估我们的麻醉师对印度重大事件报告的认识和实践。材料和方法通过在线社交媒体平台分发一份经过验证的问卷，以评估麻醉师对事件报告和分析的认识和当前做法。及时发出提醒以提高回应率，并在收到足够回应后分析数据。结果在收到的506份回复中，60%的受访者表示拥有工作场所事件报告系统。尽管有很高的意识，但绝大多数人表示不愿报告这些事件，理由是害怕受到指责和羞辱。最常见的报告事件包括心脏骤停和药物错误。确定的促成因素包括人员配备不足、沟通差距、工作时间延长、工作环境紧张以及缺乏机构协议。尽管我们的麻醉师对危急事件报告的认识程度很高，但与指责和指责有关的担忧阻碍了报告过程。由于缺乏统一的报告制度，制定全国性的指导方针，建立规范的报告制度是当务之急。

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引用次数: 0

Float nurses and patient safety: A checklist to prevent ‘second victims’ 浮动护士和患者安全：防止“第二受害者”的清单

IF 1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-11-01 Epub Date: 2025-08-18 DOI: 10.1016/j.jhqr.2025.101159

M. Bennasar-Veny , E. Castro-Sánchez

引用次数: 0

[Impact of clinical simulation on improving compliance with the surgical safety checklist]. [临床模拟对提高手术安全检查表依从性的影响]。

IF 1 Q4 HEALTH CARE SCIENCES & SERVICES

Journal of Healthcare Quality Research

Pub Date : 2025-10-01 DOI: 10.1016/j.jhqr.2025.101166

M Corominas Iglesias, M Blasco Afonso, J Piqué-Buisan

Introduction: Surgery is a fundamental component of healthcare, with over 300 million procedures performed annually. At least half of adverse events are considered preventable through tools such as the Surgical Safety Checklist (SSC). However, adherence to the SSC is often incomplete. Simulation-based training offers a meaningful learning methodology that can effectively improve compliance. This study aims to evaluate the use of simulation as a strategy to increase SSC adherence at our hospital.

Methods: We conducted a retrospective, quasi-experimental quantitative intervention study, analyzing pre- and post-simulation data collected between the second half of 2021 and the second half of 2023. The target population included operating room healthcare professionals, and the SSC endorsed by the WHO was used. Clinical simulations were carried out that had been previously designed to imitate real situations in operating rooms with natural equipment and their respective post-debriefings as guided reflection for learning.

Results: Simulation participation rates by department were as follows: 40% for Anesthesiology, 55.5% for Surgery, 75% for Orthopedics, and 76.5% for surgical nurses. The impact of the intervention was assessed by retrospectively reviewing SSC compliance before and after the simulation training. The results showed a significant increase in SSC compliance at the entry phase and during the surgical pause (P=.000), while no significant change was observed at the surgical exit phase.

Conclusion: The findings suggest that implementing simulation-based interventions in the operating room can enhance compliance with the Surgical Safety Checklist, thereby contributing to improved patient safety.

手术是医疗保健的基本组成部分，每年有超过3亿例手术。通过手术安全检查表（SSC）等工具，至少有一半的不良事件被认为是可以预防的。然而，对SSC的遵守往往是不完整的。基于模拟的培训提供了一种有意义的学习方法，可以有效地提高依从性。本研究旨在评估在我院使用模拟作为一种策略来提高SSC的依从性。方法：我们进行了一项回顾性、准实验性的定量干预研究，分析了2021年下半年至2023年下半年收集的模拟前后数据。目标人群包括手术室医护专业人员，使用世界卫生组织认可的SSC。临床模拟进行了之前的设计，以模仿手术室的真实情况，使用自然设备和各自的事后汇报，作为指导学习的反思。结果：科室模拟参与率分别为麻醉科40%、外科55.5%、骨科75%、外科护士76.5%。通过回顾模拟训练前后的SSC依从性来评估干预的影响。结果显示，进入期和手术暂停期间SSC依从性显著增加（P= 0.000），而在手术结束期未观察到显著变化。结论：研究结果表明，在手术室实施基于模拟的干预措施可以提高对《手术安全检查表》的依从性，从而有助于提高患者的安全性。

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引用次数: 0