Journal of Healthcare Quality Research最新文献

Objective

To validate an educational material on diabetes through an expert consensus for its implementation into a web site.

Material and methods

An observational study was carried out in a group of health professionals, for which an educational material was developed for patients with diabetes. Topics included nutrition, physical exercise, control indicators, complications, pharmacological treatment, among others. The language, text and figures were focused on easy comprehension, additionally, a section of didactic activities to be answered by the patient with diabetes at the end of each module was included. To evaluate the educational material by health professionals, an instrument was designed and validated. Once all the educational material was available, each of the modules was sent by e-mail to at least three clinical experts in the assigned topic, as well as the instrument for the evaluation of the module.

Results

Thirty-seven experts were included in the study, 76% rated the educational modules evaluated as highly adequate, while only 24% rated them as adequate. The instrument used obtained a good level of internal consistency, with a Cronbach's alpha coefficient of 0.92. In the dimensions of the instrument, the lowest Cronbach's alpha score was that of “call-to-action”, with a value of 0.71.

Conclusion

The diabetes educational material was rated as highly appropriate by the clinical experts. The developed instrument has an adequate content validity, as well as a good level of internal consistency.

Objective

In Spain, the Quality Units advise health centres, services and professionals on the methodology of continuous improvement of the quality of care. A system based on good practice standards could provide these units with a tool to improve their results and value their work. The objective was to develop, agree on and validate standards, to properly guide and orient the functions, results and continuous improvement of the Quality Units in health centers.

Material and methods

A qualitative–quantitative, prospective and cross-sectional study was carried out, applying the Metaplan method, the e-Delphi technique and a simulation study. The participants were coordinators of these units, belonging to 14 Spanish Autonomous Communities and distributed in four experts’ panels. They agreed on the standards to be used and evaluated the different types of validity.

Results

The 204 standards proposed by the scientific committee were reduced to 157 with Metaplan, to 110 with e-Delphi, and to 96 with the committee's final review (87.3% consensus, content validity). The construct validity showed a Cronbach's alpha > 0.7 (P < .001); the validity of content was reaffirmed in the simulation workshop (80% “understood” each other, P < .001; and there was “documentary evidence” in 84%, P < .001); face validity was accepted (75% “related to quality dimensions”, P < .001); and the validity of the criteria was verified with a sensitivity of 84.2%, a specificity of 98.3%, and a kappa index of 0.84.

Conclusions

Valid standards have been developed for Quality Units in health centers.

Introduction

The objective of the project was to identify new strategies, agreed upon by experts, that help reduce the prevalence of Health Care Related Infections (HAIs) given the increase in their prevalence as a result of the pandemic and improve patient safety.

Material and methods

The project was developed in three phases. The first two are framed in a sequential explanatory mixed model. Phase 1 consisted of a quantitative study (anonymous survey) to find out the perception of healthcare professionals about HAIs, risk factors, preventive measures, protocols, disinfection products and approaches. Phase 2 consisted of a qualitative exploratory study in which a panel of 15 experts analyzed the results, using focus group techniques, integrating both phases through the elaboration of metainferences. Phase 3 consisted of a qualitative descriptive study where, through nominal group techniques, agreed proposals for strategies to prevent HAIs were prepared.

Results

The panel of experts defined a total of 51 proposals for new strategies: 15 in hand hygiene, 13 in surface cleaning, 13 in the use of devices, and 10 in HAI prevention training. Of all of them, 13 were agreed upon as preferable (medium-high viability and high impact) and 7 as recommendable (low viability and high impact).

Conclusions

In the prevention of HAIs, experts recommend applying different strategies simultaneously, which include innovative, technological and humanization aspects, both in data collection, intervention and training, prioritizing those with the greatest impact. and feasibility.

Introduction

Patient and healthcare workers’ satisfaction is an important issue in the healthcare sector today. This study aims to evaluate the relationship between healthcare workers and patient satisfaction levels among Turkish individuals, with particular emphasis on the contribution of the former to the latter.

Materials and methods

The current study was conducted in a state hospital in İstanbul, Türkiye. Face-to-face surveys were conducted from January to April 2022 to administer two diverse questionnaires for inpatients and attending healthcare workers in the same clinic. Path analysis was used to examine the relationships.

Results

The path analysis demonstrated that 25.2% of patient satisfaction was constituted by the satisfaction of healthcare workers. The final model had an excellent fit with the data x² (112.89), x²/df (2.130); SRMR = 0.0679, CFI = 0.956, RMSEA = 0.0798. According to the results of this analysis, healthcare worker satisfaction positively influences patient satisfaction and causes it to increase.

Conclusion

Healthcare satisfaction plays a central role in providing patient satisfaction, which in turn helps with the challenges that healthcare faces today.

Objective

To analyze the occupational and psychological consequences suffered by healthcare workers who are considered second victims (SV).

Material and methods

Observational, descriptive and cross-sectional study among the healthcare workers of a university hospital. The answers collected in a specifically designed questionnaire about psychological consequences at work and the result of a post-traumatic stress scale, “Impact of Event Scale-Revised (IES-R, spanish version)” were evaluated. The variables between the groups were compared using the Chi square test (or Fisher's exact test) when both were qualitative and with the Student's T (or the Mann–Whitney U test for independent data), when one of them was quantitative. The level of statistical significance was P<.05.

Results

75.5% (148/207) of the participants in the study suffered some adverse event (AE) and, of these, 88.5% (131/148) were considered SV.

Physicians had a 2.2 times higher risk of feeling SV than nurses (95% CI: 1.88-2.52). The impact on the patient related to the AE explained why the professionals involved in it felt SV (P=.037).

80.6% (N = 104) of the SVs presented post-traumatic stress. Women were 2.4 times more likely to suffer from it (OR: 2.4; 95% CI: 1.5-4.0).

Intrusive thoughts in the SV were almost three times more frequent when the damage suffered by the patient was permanent or death (OR: 2.5; 95% CI: 0.2-3.6).

Conclusions

Many healthcare workers, especially physicians, considered themselves to be SV, and many of them suffered from post-traumatic stress. The impact on the patient related to the AE was a risk factor for being SV and for suffering psychological consequences.