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Factors Associated with Use of Traditional Birth Attendants for Child Delivery: A Cross-Sectional Study 使用传统助产士接生的相关因素:横断面研究
Pub Date : 2024-02-13 DOI: 10.36401/jqsh-23-27
Genevieve Agboyo, Andrews Asamoah, J. Ganle, Augustine Kumah
Even though the use of skilled birth attendants at birth reduces the risk of maternal mortality and associated complications, some pregnant women prefer to use either traditional birth attendants (TBAs) or deliver at home. Although the use of assisted delivery was reduced between 2014 and 2016 in North Tongu, the rate of TBA use among pregnant women in the district was increasing. There is, therefore, the need to establish the reason for this increase in TBA use. We conducted a study to assess factors that influence the use of TBAs in the North Tongu district. A retrospective cross-sectional facility-based survey was conducted among 449 women who delivered within the past 12 months and were accessing postnatal care services in the North Tongu district. A simple random sampling method was used to select women who attend child welfare clinics. Bivariate and multivariate analyses were conducted to determine the factors that were significantly associated with use of TBAs. All statistical analyses were done at a 95% confidence level with statistical significance at p ≤ 0.05. The mean age of the respondents was 27.0 years ± 6.2 SD. The prevalence of use of TBA during childbirth among women was 26.5%. Factors that significantly influenced use of TBAs during childbirth were age, religion, educational status, and parity. Other significant factors included several antenatal care visits and the attitude of health workers toward pregnant women. Use of TBA services at birth in the study district remains relatively high. Women who use antenatal and postnatal care services should be educated on the importance of skilled delivery. There is also a need to equip TBAs and reposition them as link agents to facilitate referrals of pregnant women to health facilities where there is a need for additional birth attendants.
尽管在分娩时使用熟练的助产士可降低孕产妇死亡和相关并发症的风险,但一些孕妇更愿意使用传统助产士(TBAs)或在家分娩。虽然在 2014 年至 2016 年期间,北通古地区使用助产士接生的情况有所减少,但该地区孕妇使用传统助产士接生的比例却在上升。因此,有必要确定使用 TBA 增加的原因。我们开展了一项研究,以评估影响北汤古地区使用传统助产士的因素。 我们对北通古地区在过去 12 个月内分娩并接受产后护理服务的 449 名产妇进行了一项基于设施的回顾性横断面调查。调查采用简单随机抽样法,选取了在儿童福利诊所就诊的妇女。我们进行了二元和多元分析,以确定与使用传统助产士显著相关的因素。所有统计分析均在 95% 的置信水平下进行,统计显著性为 p≤ 0.05。 受访者的平均年龄为 27.0 岁 ± 6.2 SD。妇女在分娩时使用传统助产士的比例为 26.5%。对分娩时使用传统助产士有重大影响的因素包括年龄、宗教信仰、教育状况和胎次。其他重要因素包括多次产前检查和卫生工作者对孕妇的态度。 在研究地区,分娩时使用传统助产士服务的比例仍然较高。应向使用产前和产后护理服务的妇女宣传熟练接生的重要性。此外,还需要为传统助产士配备设备,并将她们重新定位为联系代理,以便于将孕妇转诊到需要额外助产士的医疗机构。
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引用次数: 0
Improving Patient Safety: Learning from Reported Hospital-Acquired Pressure Ulcers 改善患者安全:从报告的医院获得性压疮中学习
Pub Date : 2024-02-01 DOI: 10.36401/jqsh-23-25
Anthony Octo Forkuo-Minka, Augustine Kumah, Afua Yeboaa Asomaning
A hospital-acquired pressure ulcer (HAPU) is a localized lesion or injury to the underlying tissue (wound) while the patient is on admission. It occurs when standardized nursing care is not correctly followed in the presence of friction and shear, leading to skin or underlying tissue breakdown. Unfortunately, inadequate knowledge of nurses to assess and provide standardized care for pressure ulcers or manage HAPUs results in patient harm. We aim to share lessons from a reported HAPU incident and address the knowledge gap in patient safety risk assessment, identification, and wound management at Nyaho Medical Centre (Accra, Ghana). A review of HAPU incidents was conducted using quality improvement tools such as cause-and-effect analyses to identify contributing factors and root causes. Subsequently, plan-do-study-act (PDSA) cycles were used to test interventions to improve pressure ulcer assessments and wound management. A run chart was used to analyze and evaluate the interventions over 12 weeks (Aug–Oct 2021). Development of policies and a standard operating procedure for pressure ulcers and wounds improved accuracy in identifying pressure ulcer risks and management of wounds. Eighty-three patients were assessed with the pressure ulcer assessment tool. Complete (100%) adherence to the pressure ulcer and wound policy and standard operating procedure (SOP) was achieved, and the number of HAPUs decreased from five to one during the study period. This study demonstrated that the combined use of quality methods and tools can be suitable for improving processes and outcomes for patients at risk for HAPUs.
医院获得性压疮(HAPU)是指病人在入院时出现的局部病变或下层组织(伤口)损伤。当存在摩擦力和剪切力时,如果没有正确遵循标准化护理,就会导致皮肤或下层组织破损。遗憾的是,护士对压疮的评估和标准化护理或 HAPU 的管理知识不足,导致了对患者的伤害。我们旨在分享 Nyaho 医疗中心(加纳阿克拉)发生的一起压疮事件的教训,并解决患者安全风险评估、识别和伤口管理方面的知识缺口。 我们使用质量改进工具(如因果分析)对 HAPU 事件进行了审查,以确定促成因素和根本原因。随后,利用计划-执行-研究-行动(PDSA)循环测试干预措施,以改进压疮评估和伤口管理。使用运行图对 12 周内(2021 年 8 月至 10 月)的干预措施进行分析和评估。 压疮和伤口政策及标准操作程序的制定提高了压疮风险识别和伤口管理的准确性。使用压疮评估工具对 83 名患者进行了评估。在研究期间,压疮和伤口政策及标准操作程序(SOP)得到了完全(100%)的遵守,HAPU 数量从 5 例减少到 1 例。 这项研究表明,结合使用质量方法和工具,可以有效改善高危 HAPU 患者的治疗流程和效果。
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引用次数: 0
Practices Used to Improve Patient Safety Culture Among Healthcare Professionals in a Tertiary Care Hospital 一家三甲医院医护人员改善患者安全文化的做法
Pub Date : 2024-02-01 DOI: 10.36401/jqsh-23-10
Haroon Bashir, M. Barkatullah, Arslan Raza, Muddasar Mushtaq, Khanzada Sheraz Khan, Awais Saber, Shahid Ahmad
A patient safety culture primarily refers to the values, beliefs, attitudes, and behaviors within a healthcare setup in a community that assists in prioritizing patient safety and encouraging the reporting of errors and near-misses in that facility. There is a direct impact of patient safety culture on how well patient safety and quality improvement programs work. The aim of this cross-sectional descriptive study was to investigate the practices to improve patient safety culture and adverse event reporting practices among healthcare professionals in a tertiary care hospital located in Mirpur Azad Jammu and Kashmir. In the non-probability convenience sampling of this cross-sectional study, Divisional Headquarters Teaching Hospital in Mirpur, Azad Kashmir used the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture Hospital Survey to collect data about the perceptions of healthcare professionals regarding patient safety culture within their hospital to assess the trends of patient safety culture by obtaining longitudinal data. A pre-validated questionnaire that has undergone a rigorous trial of testing to maximize the reliability and accuracy of the outcomes was distributed among clinical staff (healthcare professionals who interact with patients on a daily basis, such as nurses, doctors, pharmacists, and laboratory technicians) and administrative staff (medical superintendent, deputy medical superintendent, assistant medical superintendent, heads of departments). A total of 312 questionnaires were returned (response rate, 76%). The study found that the dimension “supervisor/manager expectation and action promoting safety” had the highest positive response rate (65.16%), and “nonpunitive response” had the lowest (27.4%). Higher scores in “nonpunitive response to error” were associated with lower rates of medication errors, pressure ulcers, and surgical site infections, and higher scores in “frequency of event reporting” were associated with lower rates of medication errors, pressure ulcers, falls, hospital-acquired infections, and urinary tract infections. We suggest that in order for hospital staff to continue providing excellent, clinically safe treatment, a well-structured hospital culture promoting patient safety is necessary. Moreover, further study is needed to determine strategies to improve patient safety expertise and awareness, and lower the frequency of adverse occurrences.
患者安全文化主要是指一个社区医疗机构内的价值观、信念、态度和行为,这些价值观、信念、态度和行为有助于将患者安全放在首位,并鼓励该机构报告错误和险情。患者安全文化对患者安全和质量改进计划的效果有直接影响。这项横断面描述性研究旨在调查位于查谟和克什米尔米尔普尔-阿扎德的一家三级医院的医护人员在改善患者安全文化和不良事件报告方面的做法。 在这项横断面研究的非概率方便抽样中,阿扎德-克什米尔米尔布尔的分区总部教学医院采用了医疗保健研究与质量机构的患者安全文化医院调查来收集医护人员对其医院内患者安全文化的看法,以便通过获取纵向数据来评估患者安全文化的趋势。为了最大限度地提高结果的可靠性和准确性,我们向临床医护人员(每天与患者打交道的医护人员,如护士、医生、药剂师和实验室技术人员)和行政人员(医务总监、副医务总监、助理医务总监、各部门主管)发放了一份经过严格测试的预验证问卷。 共收回 312 份问卷(回收率为 76%)。研究发现,"主管/管理者对促进安全的期望和行动 "这一维度的正面回答率最高(65.16%),而 "非惩罚性回应 "的正面回答率最低(27.4%)。对错误的非惩罚性反应 "得分越高,用药错误、压疮和手术部位感染的发生率就越低,而 "事件报告频率 "得分越高,用药错误、压疮、跌倒、医院感染和尿路感染的发生率就越低。 我们认为,为了让医院员工继续提供优质、临床安全的治疗,有必要建立一个促进患者安全的结构良好的医院文化。此外,还需要进一步研究,以确定提高患者安全专业知识和意识、降低不良事件发生频率的策略。
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引用次数: 0
Guest Editor and Reviewer Acknowledgments: 2023 特邀编辑和审稿人致谢:2023
Pub Date : 2024-02-01 DOI: 10.36401/jqsh-23-x0
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引用次数: 0
Improving Venous Thromboembolism Prophylaxis Through Service Integration, Policy Enhancement, and Health Informatics 通过服务整合、政策强化和健康信息学改进静脉血栓栓塞预防措施
Pub Date : 2024-02-01 DOI: 10.36401/jqsh-23-16
Yacoub Abuzied, Ahmad Deeb, Layla Alanizy, Rasmieh M. Al-amer, M. Alsheef
Venous thromboembolism (VTE) prevention and management are susceptible issues that require specific rules to sustain and oversee their functioning, as preventing VTE is a vital patient safety priority. This paper aims to investigate and provide recommendations for VTE assessment and reassessment through policy enhancement and development. We reviewed different papers and policies to propose recommendations and theme analysis for policy modifications and enhancements to improve VTE prophylaxis and management. Recommendations were set to enhance the overall work of VTE prophylaxis, where the current VTE protocols and policies must ensure high levels of patient safety and satisfaction. The recommendations included working through a well-organized multidisciplinary team and staff engagement to support and enhance VTE’s work. Nurses’, pharmacists’, and physical therapists’ involvement in setting up the plan and prevention is the way to share the knowledge and paradigm of experience to standardize the management. Promoting policies regarding VTE prophylaxis assessment and reassessment using electronic modules as a part of the digital health process was proposed. A deep understanding of the underlying issues and the incorporation of generic policy recommendations were set. This article presents recommendations for stakeholders, social media platforms, and healthcare practitioners to enhance VTE prophylaxis and management.
静脉血栓栓塞症(VTE)的预防和管理是一个易受影响的问题,需要特定的规则来维持和监督其运作,因为预防 VTE 是患者安全的重中之重。本文旨在通过加强和制定政策,对 VTE 评估和重新评估进行调查并提出建议。 我们审查了不同的论文和政策,为政策的修改和改进提出建议和主题分析,以改善 VTE 的预防和管理。 我们提出的建议旨在加强 VTE 预防的整体工作,目前的 VTE 协议和政策必须确保高度的患者安全和满意度。这些建议包括通过组织良好的多学科团队和员工参与来支持和加强 VTE 工作。护士、药剂师和理疗师参与制定计划和预防,是分享知识和经验范例以实现标准化管理的途径。作为数字健康流程的一部分,建议使用电子模块推广有关 VTE 预防评估和再评估的政策。对根本问题的深刻理解和通用政策建议的纳入是既定的。 本文为利益相关者、社交媒体平台和医疗从业人员提出了加强 VTE 预防和管理的建议。
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引用次数: 0
Improving Venous Thromboembolism Prophylaxis Through Service Integration, Policy Enhancement, and Health Informatics 通过服务整合、政策强化和健康信息学改进静脉血栓栓塞预防措施
Pub Date : 2024-02-01 DOI: 10.36401/jqsh-23-16
Yacoub Abuzied, Ahmad Deeb, Layla Alanizy, Rasmieh M. Al-amer, M. Alsheef
Venous thromboembolism (VTE) prevention and management are susceptible issues that require specific rules to sustain and oversee their functioning, as preventing VTE is a vital patient safety priority. This paper aims to investigate and provide recommendations for VTE assessment and reassessment through policy enhancement and development. We reviewed different papers and policies to propose recommendations and theme analysis for policy modifications and enhancements to improve VTE prophylaxis and management. Recommendations were set to enhance the overall work of VTE prophylaxis, where the current VTE protocols and policies must ensure high levels of patient safety and satisfaction. The recommendations included working through a well-organized multidisciplinary team and staff engagement to support and enhance VTE’s work. Nurses’, pharmacists’, and physical therapists’ involvement in setting up the plan and prevention is the way to share the knowledge and paradigm of experience to standardize the management. Promoting policies regarding VTE prophylaxis assessment and reassessment using electronic modules as a part of the digital health process was proposed. A deep understanding of the underlying issues and the incorporation of generic policy recommendations were set. This article presents recommendations for stakeholders, social media platforms, and healthcare practitioners to enhance VTE prophylaxis and management.
静脉血栓栓塞症(VTE)的预防和管理是一个易受影响的问题,需要特定的规则来维持和监督其运作,因为预防 VTE 是患者安全的重中之重。本文旨在通过加强和制定政策,对 VTE 评估和重新评估进行调查并提出建议。 我们审查了不同的论文和政策,为政策的修改和改进提出建议和主题分析,以改善 VTE 的预防和管理。 我们提出的建议旨在加强 VTE 预防的整体工作,目前的 VTE 协议和政策必须确保高度的患者安全和满意度。这些建议包括通过组织良好的多学科团队和员工参与来支持和加强 VTE 工作。护士、药剂师和理疗师参与制定计划和预防,是分享知识和经验范例以实现标准化管理的途径。作为数字健康流程的一部分,建议使用电子模块推广有关 VTE 预防评估和再评估的政策。对根本问题的深刻理解和通用政策建议的纳入是既定的。 本文为利益相关者、社交媒体平台和医疗从业人员提出了加强 VTE 预防和管理的建议。
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引用次数: 0
Practices Used to Improve Patient Safety Culture Among Healthcare Professionals in a Tertiary Care Hospital 一家三甲医院医护人员改善患者安全文化的做法
Pub Date : 2024-02-01 DOI: 10.36401/jqsh-23-10
Haroon Bashir, M. Barkatullah, Arslan Raza, Muddasar Mushtaq, Khanzada Sheraz Khan, Awais Saber, Shahid Ahmad
A patient safety culture primarily refers to the values, beliefs, attitudes, and behaviors within a healthcare setup in a community that assists in prioritizing patient safety and encouraging the reporting of errors and near-misses in that facility. There is a direct impact of patient safety culture on how well patient safety and quality improvement programs work. The aim of this cross-sectional descriptive study was to investigate the practices to improve patient safety culture and adverse event reporting practices among healthcare professionals in a tertiary care hospital located in Mirpur Azad Jammu and Kashmir. In the non-probability convenience sampling of this cross-sectional study, Divisional Headquarters Teaching Hospital in Mirpur, Azad Kashmir used the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture Hospital Survey to collect data about the perceptions of healthcare professionals regarding patient safety culture within their hospital to assess the trends of patient safety culture by obtaining longitudinal data. A pre-validated questionnaire that has undergone a rigorous trial of testing to maximize the reliability and accuracy of the outcomes was distributed among clinical staff (healthcare professionals who interact with patients on a daily basis, such as nurses, doctors, pharmacists, and laboratory technicians) and administrative staff (medical superintendent, deputy medical superintendent, assistant medical superintendent, heads of departments). A total of 312 questionnaires were returned (response rate, 76%). The study found that the dimension “supervisor/manager expectation and action promoting safety” had the highest positive response rate (65.16%), and “nonpunitive response” had the lowest (27.4%). Higher scores in “nonpunitive response to error” were associated with lower rates of medication errors, pressure ulcers, and surgical site infections, and higher scores in “frequency of event reporting” were associated with lower rates of medication errors, pressure ulcers, falls, hospital-acquired infections, and urinary tract infections. We suggest that in order for hospital staff to continue providing excellent, clinically safe treatment, a well-structured hospital culture promoting patient safety is necessary. Moreover, further study is needed to determine strategies to improve patient safety expertise and awareness, and lower the frequency of adverse occurrences.
患者安全文化主要是指一个社区医疗机构内的价值观、信念、态度和行为,这些价值观、信念、态度和行为有助于将患者安全放在首位,并鼓励该机构报告错误和险情。患者安全文化对患者安全和质量改进计划的效果有直接影响。这项横断面描述性研究旨在调查位于查谟和克什米尔米尔普尔-阿扎德的一家三级医院的医护人员在改善患者安全文化和不良事件报告方面的做法。 在这项横断面研究的非概率方便抽样中,阿扎德-克什米尔米尔布尔的分区总部教学医院采用了医疗保健研究与质量机构的患者安全文化医院调查来收集医护人员对其医院内患者安全文化的看法,以便通过获取纵向数据来评估患者安全文化的趋势。为了最大限度地提高结果的可靠性和准确性,我们向临床医护人员(每天与患者打交道的医护人员,如护士、医生、药剂师和实验室技术人员)和行政人员(医务总监、副医务总监、助理医务总监、各部门主管)发放了一份经过严格测试的预验证问卷。 共收回 312 份问卷(回收率为 76%)。研究发现,"主管/管理者对促进安全的期望和行动 "这一维度的正面回答率最高(65.16%),而 "非惩罚性回应 "的正面回答率最低(27.4%)。对错误的非惩罚性反应 "得分越高,用药错误、压疮和手术部位感染的发生率就越低,而 "事件报告频率 "得分越高,用药错误、压疮、跌倒、医院感染和尿路感染的发生率就越低。 我们认为,为了让医院员工继续提供优质、临床安全的治疗,有必要建立一个促进患者安全的结构良好的医院文化。此外,还需要进一步研究,以确定提高患者安全专业知识和意识、降低不良事件发生频率的策略。
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引用次数: 0
Improving Patient Safety: Learning from Reported Hospital-Acquired Pressure Ulcers 改善患者安全:从报告的医院获得性压疮中学习
Pub Date : 2024-02-01 DOI: 10.36401/jqsh-23-25
Anthony Octo Forkuo-Minka, Augustine Kumah, Afua Yeboaa Asomaning
A hospital-acquired pressure ulcer (HAPU) is a localized lesion or injury to the underlying tissue (wound) while the patient is on admission. It occurs when standardized nursing care is not correctly followed in the presence of friction and shear, leading to skin or underlying tissue breakdown. Unfortunately, inadequate knowledge of nurses to assess and provide standardized care for pressure ulcers or manage HAPUs results in patient harm. We aim to share lessons from a reported HAPU incident and address the knowledge gap in patient safety risk assessment, identification, and wound management at Nyaho Medical Centre (Accra, Ghana). A review of HAPU incidents was conducted using quality improvement tools such as cause-and-effect analyses to identify contributing factors and root causes. Subsequently, plan-do-study-act (PDSA) cycles were used to test interventions to improve pressure ulcer assessments and wound management. A run chart was used to analyze and evaluate the interventions over 12 weeks (Aug–Oct 2021). Development of policies and a standard operating procedure for pressure ulcers and wounds improved accuracy in identifying pressure ulcer risks and management of wounds. Eighty-three patients were assessed with the pressure ulcer assessment tool. Complete (100%) adherence to the pressure ulcer and wound policy and standard operating procedure (SOP) was achieved, and the number of HAPUs decreased from five to one during the study period. This study demonstrated that the combined use of quality methods and tools can be suitable for improving processes and outcomes for patients at risk for HAPUs.
医院获得性压疮(HAPU)是指病人在入院时出现的局部病变或下层组织(伤口)损伤。当存在摩擦力和剪切力时,如果没有正确遵循标准化护理,就会导致皮肤或下层组织破损。遗憾的是,护士对压疮的评估和标准化护理或 HAPU 的管理知识不足,导致了对患者的伤害。我们旨在分享 Nyaho 医疗中心(加纳阿克拉)发生的一起压疮事件的教训,并解决患者安全风险评估、识别和伤口管理方面的知识缺口。 我们使用质量改进工具(如因果分析)对 HAPU 事件进行了审查,以确定促成因素和根本原因。随后,利用计划-执行-研究-行动(PDSA)循环测试干预措施,以改进压疮评估和伤口管理。使用运行图对 12 周内(2021 年 8 月至 10 月)的干预措施进行分析和评估。 压疮和伤口政策及标准操作程序的制定提高了压疮风险识别和伤口管理的准确性。使用压疮评估工具对 83 名患者进行了评估。在研究期间,压疮和伤口政策及标准操作程序(SOP)得到了完全(100%)的遵守,HAPU 数量从 5 例减少到 1 例。 这项研究表明,结合使用质量方法和工具,可以有效改善高危 HAPU 患者的治疗流程和效果。
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引用次数: 0
Guest Editor and Reviewer Acknowledgments: 2023 特邀编辑和审稿人致谢:2023
Pub Date : 2024-02-01 DOI: 10.36401/jqsh-23-x0
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引用次数: 0
Adopting the Klein Triple Path Model of Insight for Clinical Quality Improvement 采用克莱因三重路径洞察模型改进临床质量
Pub Date : 2024-02-01 DOI: 10.36401/jqsh-23-44
Isaac K. S. Ng
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引用次数: 0
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Global journal on quality and safety in healthcare
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