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Wijaya L, Alfarizi M. Teaching Hospital Governance Model for Service Quality Performance: Case Study of Indonesian Central General Hospital. Hosp Top 2024:1-19. [PMID: 39276330 DOI: 10.1080/00185868.2024.2403667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2024]
Abstract
This study aims to investigate the effect of teaching hospital management practices on the quality performance of health services by involving elements such as hospital accreditation standards, quality management, and JCI Academic Hospital-specific standards that are indirectly connected. This study chose a survey-based quantitative approach to clinical professional students in vertical teaching hospitals under the direct management of the Ministry of Health of the Republic of Indonesia. Six proposed hypotheses were tested by Partial Least Square-Structural Equation Modeling (PLS-SEM) analysis. The test results showed a positive influence between hospital teaching governance and hospital accreditation compliance, quality assurance and JCI Academic Hospital standards. Third, compliance with teaching hospital standards was also found to have a significant positive effect on the performance of teaching hospital service quality. Understanding the role of governance in encouraging the performance of teaching hospital service quality can help develop effective managerial strategies in achieving complete service quality for patients and clinical profession participants. This research resulted in contributions to existing practices and literature as governance modeling in dual quality standards charged to teaching hospitals.
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Affiliation(s)
- Lianna Wijaya
- Management Department, BINUS Online Learning, Bina Nusantara University, Jakarta, Indonesia
| | - Muhammad Alfarizi
- Management Department, BINUS Online Learning, Bina Nusantara University, Jakarta, Indonesia
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Gao Y, Guo Y, Zheng M, He L, Guo M, Jin Z, Fan P. A refined management system focusing on medication dispensing errors: A 14-year retrospective study of a hospital outpatient pharmacy. Saudi Pharm J 2023; 31:101845. [PMID: 38028216 PMCID: PMC10651669 DOI: 10.1016/j.jsps.2023.101845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This study aimed to evaluate the efficiency of a 14-year refined management system for the reduction of dispensing errors in a large-scale hospital outpatient pharmacy and to determine the effects of person-related and environment-related factors on the occurrence of dispensing errors. Methods A retrospective study was performed. Data on dispensing errors, inventory and account management from 2008 to 2021 were collected from the electronic system and evaluated using the direct observation method and the Plan-Do-Check-Act (PDCA) cycle. Results The consistency of the inventory and accounts increased substantially (from 86.93 % to 99.75 %) with the implementation of the refined management program. From 2008 to 2021, the total number of dispensing errors was reduced by approximately 96.1 %. The number of dispensing errors in quantity and name was reduced by approximately 98.2 % and 95.07 %, respectively. A remarkable reduction in the error rate was achieved (from 0.014 % to 0.00002 %), and the rate of dispensing errors was significantly reduced (0.019 % vs. 0.0003 %, p < 0.001). Across all medication dispensing errors, human-related errors decreased substantially (208 vs. 7, p < 0.05), as did non-human-related errors also (202 vs. 9, p < 0.05). There was a correlation between the occurrence of errors and pharmacists' sex (females generally made fewer errors than males), age (more errors were made by those aged 31-40 years), and working years (more errors were made by those with more than 11 years of work experience) from 2016 to 2021. The technicians improved during this procedure. Conclusions Refined management using the PDCA cycle was helpful in preventing dispensing errors and improving medication safety for patients.
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Affiliation(s)
- Yangyang Gao
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yi Guo
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Minglin Zheng
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Lulu He
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Mengran Guo
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zhaohui Jin
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ping Fan
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu 610041, China
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Fathelrahman AI, Almalki HA, Bajunaid HR, Al-Harthi GK, Aljuaid MO, Majrashi RY, Alsuwat MA. Assessing the Presence of the Joint Commission International Accreditation Requirements in Western Saudi Arabia Hospital Pharmacies: A Cross-sectional Study. J Res Pharm Pract 2023; 12:1-8. [PMID: 38213607 PMCID: PMC10779688 DOI: 10.4103/jrpp.jrpp_5_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2024] Open
Abstract
Objective The Central Board of Accreditation for Healthcare Institutions (CBAHI) the national Saudi accreditation body accredited most hospitals in Saudi Arabia whereas, the Joint Commission International (JCI) a well-known international accreditation body accredited some hospitals. We assessed Western Saudi Arabia hospital pharmacists' knowledge, opinions, and observations about pharmacy-related JCI accreditation criteria needed for hospitals. Methods This was a cross-sectional survey-based study conducted among pharmacy personnel working in the Ministry of Health (MOH), Military, and private hospitals in the Makkah region in western Saudi Arabia. The present report represents the findings of descriptive and comparative analyses. Comparative analyses were tested by Student's t-test, analysis of variance, and Chi-square when applicable and a P ≤ 0.05 was considered statistically significant. Findings One hundred and one pharmacists completed the survey; most of them were from Taif (53.5%) and Jeddah (37.6%) and fewer from Makkah (8.9%). The highest proportions were from MOH (55.4%), private (29.7%), and some from military (14.9%) hospitals. They worked mostly in hospitals accredited with CBAHI (93.1%) than JCI (58.4%) and only (41.6%) worked with quality units. Correct answers on knowledge items ranged from 14.9% to 65.3%. On five-point Likert Scale, they showed supportive ratings on how they perceived the importance of JCI statement provided (overall average score: 3.78) and on how statement criteria are implemented in their hospitals (overall average score: 3.76). Higher proportions of those working in quality units compared to their counterparts were aware that accreditation cycles for JCI and CBAHI are identical (66.7% vs. 55.9%, P = 0.009) and that JCI criteria are more concise than CBAHI (59.5% vs. 52.5%, P = 0.007). Higher proportions of those working in JCI-accredited hospitals compared to their counterparts were aware that JCI criteria are clearer than CBAHI (55.9% vs. 33.3%, P = 0.021) and that JCI criteria are more concise than CBAHI (61% vs. 47.6%, P = 0.012). Conclusion To a high extent, pharmacists were supportive of JCI criteria and considered the criteria to be implemented in their hospitals. There is a room for improvement to enhance awareness and support of JCI quality criteria among pharmacists.
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Hussein M, Pavlova M, Ghalwash M, Groot W. The impact of hospital accreditation on the quality of healthcare: a systematic literature review. BMC Health Serv Res 2021; 21:1057. [PMID: 34610823 PMCID: PMC8493726 DOI: 10.1186/s12913-021-07097-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Accreditation is viewed as a reputable tool to evaluate and enhance the quality of health care. However, its effect on performance and outcomes remains unclear. This review aimed to identify and analyze the evidence on the impact of hospital accreditation. METHODS We systematically searched electronic databases (PubMed, CINAHL, PsycINFO, EMBASE, MEDLINE (OvidSP), CDSR, CENTRAL, ScienceDirect, SSCI, RSCI, SciELO, and KCI) and other sources using relevant subject headings. We included peer-reviewed quantitative studies published over the last two decades, irrespective of its design or language. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers independently screened initially identified articles, reviewed the full-text of potentially relevant studies, extracted necessary data, and assessed the methodological quality of the included studies using a validated tool. The accreditation effects were synthesized and categorized thematically into six impact themes. RESULTS We screened a total of 17,830 studies, of which 76 empirical studies that examined the impact of accreditation met our inclusion criteria. These studies were methodologically heterogeneous. Apart from the effect of accreditation on healthcare workers and particularly on job stress, our results indicate a consistent positive effect of hospital accreditation on safety culture, process-related performance measures, efficiency, and the patient length of stay, whereas employee satisfaction, patient satisfaction and experience, and 30-day hospital readmission rate were found to be unrelated to accreditation. Paradoxical results regarding the impact of accreditation on mortality rate and healthcare-associated infections hampered drawing firm conclusions on these outcome measures. CONCLUSION There is reasonable evidence to support the notion that compliance with accreditation standards has multiple plausible benefits in improving the performance in the hospital setting. Despite inconclusive evidence on causality, introducing hospital accreditation schemes stimulates performance improvement and patient safety. Efforts to incentivize and modernize accreditation are recommended to move towards institutionalization and sustaining the performance gains. PROSPERO registration number CRD42020167863.
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Affiliation(s)
- Mohammed Hussein
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
- Department of Hospitals Accreditation, Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI), Riyadh, Saudi Arabia.
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Mostafa Ghalwash
- Department of Hospitals Accreditation, Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI), Riyadh, Saudi Arabia
| | - Wim Groot
- Department of Health Services Research, CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Top Institute Evidence-Based Education Research (TIER), Maastricht University, Maastricht, The Netherlands
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Jemal M, Kure MA, Gobena T, Geda B. Nurse-Physician Communication in Patient Care and Associated Factors in Public Hospitals of Harari Regional State and Dire-Dawa City Administration, Eastern Ethiopia: A Multicenter-Mixed Methods Study. J Multidiscip Healthc 2021; 14:2315-2331. [PMID: 34475760 PMCID: PMC8407677 DOI: 10.2147/jmdh.s320721] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background Nurse–physician communication remains a public health challenge in the health care setting of developing countries. Clear and respectful nurse–physician communication is very crucial for the health of the patients. Numerous studies have shown that inter-professional communication gaps are the leading cause of adverse medical events that compromise the quality of patient care in the clinical setting. Although it has negative consequences and wider effects on patient care, nurse–physician communication in patient care is rarely studied in Africa. In eastern Ethiopia, predictors of nurse–physician communication in patient care have not been studied. Therefore, this study was aimed to assess nurse–physician communication in patient care in public hospitals of Harari Regional State and Dire-Dawa city administration, Eastern Ethiopia. Methods The multicenter-mixed methods (a quantitative cross-sectional and phenomenological qualitative) were conducted from March 07 to April 07, 2019 in public Hospitals of Eastern Ethiopia. A total of 440 nurses and physicians working in public hospitals in the Harari Regional State and Dire-Dawa administration were enrolled in the study. Participants were approached through a simple random sampling technique. Data were collected using a pretested, self-administered questionnaire and entered into Epi-Data version 3.1, and exported to STATA software (version SE 14) for further analysis. Descriptive statistics were carried out using frequency tables, proportions, and summary measures. Multivariable logistic regression analysis was carried out to identify the true effects of the selected predictor variables on the outcome variable after controlling for possible confounders. Statistical significance was declared at p-value <0.05. Qualitative data were collected from 10 key informants using a semi-structured questionnaire and analyzed using statistical software, Open Code (version 4.2) by thematic analysis method. Results Overall, the magnitude of the level of nurse–physician communication in patient care was found to be 53.2% [95% CI (48.9–58.0)]. In the final model of multivariable analysis, being in the age group of 31–40 [(AOR=0.42, 95% CI (0.25–0.72)], ever married nurse or physician [(AOR=2.28, 95% CI(1.41–3.69)], being a nurse professional [AOR=2.36, 95% CI (1.23–4.54)], a salary class of 2250–3562ETB [(AOR=0.25, 95% CI (0.08–0.84)], higher score for organizational related factors [(AOR=0.58, 95% CI (0.36–0.92)], and higher score for work-related attitude behaviors [(AOR=0.62, 95% CI(0.39–0.984)] were factors independently associated with the poor level of nurse–physician communication in patient care. In the qualitative findings, unattractive working environments and negative attitudes of professionals were found to be barriers to nurse–physician communication in patient care. Conclusion In this study, the nurse–physician communication in patient care was relatively low because more than half of the level of nurse–physician communication was found to be poor. Increasing in age, getting a lower monthly salary, higher report for work-related attitude, and organizational related factors were the potential predictors that would decrease the good level of nurse–physician communication in patient care. This result provides cue due attention to improving nurse–physician communication in patient care through various techniques.
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Affiliation(s)
- Mehammedamin Jemal
- Department of Nursing, Hiwot Fana Specialized University Hospital, Haramaya University, Harar, Ethiopia
| | - Mohammed Abdurke Kure
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tesfaye Gobena
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Witczak I, Uchmanowicz I, Tartaglia R, Rypicz Ł. Safety Assessment of the Pharmacotherapy Process at the Nurse and Midwife Level - An Observational Study. Ther Clin Risk Manag 2020; 16:1057-1065. [PMID: 33177830 PMCID: PMC7649244 DOI: 10.2147/tcrm.s276901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/26/2020] [Indexed: 01/10/2023] Open
Abstract
Purpose Pharmacological errors are among the most common in the healthcare system. This study aimed to determine the level of safety of the pharmacotherapy process at the stage performed by nurses and midwives by indicating the key risk factors affecting patients’ safety. Methods A group of 1276 nurses and 136 midwives in Poland participated in the study. The survey was conducted in the period from May 2019 to August 2019. The original Nursing Risk in Pharmacotherapy (NURIPH) tool was used. Results The Cronbach alpha coefficient was 0.832. The low legibility of the medical orders (item 1) was indicated as the highest risk. A mean of 4.50 means that this factor’s significance is assessed between “very significant” and “significant.” The communication between physician, nurse and midwife, time pressure, and work organization were also rated high (Items 2, 3, and 4). The averages for these factors are higher than 4, so their evaluation is more than “significant.”. Conclusion Nurses and midwives involved in the pharmacotherapy process are exposed to many ergonomic factors triggering risk. A huge problem is the lack of readability of medical orders, which may be a factor triggering a medical error.
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Affiliation(s)
- Izabela Witczak
- Department of Health Care Economics and Quality, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Riccardo Tartaglia
- President of the Italian Network for Safety in Health Care, Florence, Italy
| | - Łukasz Rypicz
- Department of Health Care Economics and Quality, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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Cancino KD, Arias M, Caballero E, Escudero E. Development of a safe drug administration assessment instrument for nursing students. Rev Lat Am Enfermagem 2020; 28:e3246. [PMID: 32022156 PMCID: PMC7000185 DOI: 10.1590/1518-8345.2989.3246] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/05/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to determine the content and face validity of a safe drug administration assessment instrument for nursing students. METHOD quantitative, descriptive study. The literature on medication errors made by students was analyzed, and an instrument was developed using the Architecture of Integrated Information Systems and the Work Breakdown Structure. Face validity was analyzed using the nominal technique, with experts in education, management, research and/or clinical practice. RESULTS nine experts participated in the validation process, which resulted in an instrument containing 8 sub-processes and 58 items, adjusted to the simulation environment and to clinical practice. CONCLUSION the instrument may be used for the evaluation of safe drug administration by nursing students, especially in a simulation environment.
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Affiliation(s)
- Karen Domínguez Cancino
- Universidad Finis Terrae, Escuela de Enfermería, Santiago,
Chile
- Universidad María Auxiliadora, Facultad de Salud, Peru
| | - Marisol Arias
- Universidad Finis Terrae, Escuela de Enfermería, Santiago,
Chile
| | | | - Eliana Escudero
- Universidad Finis Terrae, Escuela de Enfermería, Santiago,
Chile
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Okumura Y, Inomata T, Iwagami M, Eguchi A, Mizuno J, Shiang T, Kawasaki S, Shimada A, Inada E, Amano A, Murakami A. Shortened cataract surgery by standardisation of the perioperative protocol according to the Joint Commission International accreditation: a retrospective observational study. BMJ Open 2019; 9:e028656. [PMID: 31203249 PMCID: PMC6588965 DOI: 10.1136/bmjopen-2018-028656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES To investigate the impact of standardisation of the perioperative protocol based on the Joint Commission International (JCI) accreditation guidelines for operating time in cataract surgery. DESIGN Retrospective observational study. SETTING Single centre in Japan. PARTICIPANTS Between March 2014 and June 2016, 3127 patients underwent cataract surgery under topical anaesthesia including 2581 and 546 patients before and after JCI accreditation, respectively. PRIMARY AND SECONDARY OUTCOMES We compared three time periods, comprising the preprocedure/surgery time (pre-PT), PT and post-PT, and total PT (TPT) of cataract surgery between patients before and after JCI accreditation, by regression analysis adjusted for age, sex and cataract surgery-associated confounders. RESULTS The main outcomes were pre-PT, PT, post-PT and TPT. Pre-PT (19.8±10.5 vs 13.9±8.5 min, p<0.001) and post-PT (3.5±4.6 vs 2.6±2.1 min, p<0.001) significantly decreased after JCI accreditation, while PT did not significantly change (16.8±6.7 vs 16.2±6.3 min, p=0.065). Consequently, TPT decreased on average by 7.3 min per person after JCI accreditation (40.1±13.4 vs 32.8±10.9 min, p<0.001). After adjusting for confounders, pre-PT (β=-5.82 min, 95% CI -6.75 to -4.88), PT (β=-0.76 min, 95% CI -1.34 to -1.71), post-PT (β=-0.85 min, 95% CI -1.24 to -0.45) and TPT (β=-7.43 min, 95% CI -8.61 to -6.24) were significantly shortened after JCI accreditation. CONCLUSION Perioperative protocol standardisation, based on JCI accreditation, shortened TPT in cataract surgery under local anaesthesia.
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Affiliation(s)
- Yuichi Okumura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Takenori Inomata
- Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Masao Iwagami
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Department of Health Services Research, Faculty of Medicine, Univeristy of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Atsuko Eguchi
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Ju Mizuno
- Department of Anesthesia and Pain Medicine, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Tina Shiang
- Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Shiori Kawasaki
- Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Akie Shimada
- Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Eiichi Inada
- Department of Anesthesia and Pain Medicine, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Atsushi Amano
- Department of Strategic Operating Room Management and Improvement, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
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Zyoud SH, Khaled SM, Kawasmi BM, Habeba AM, Hamadneh AT, Anabosi HH, Fadel AB, Sweileh WM, Awang R, Al-Jabi SW. Knowledge about the administration and regulation of high alert medications among nurses in Palestine: a cross-sectional study. BMC Nurs 2019; 18:11. [PMID: 30936779 PMCID: PMC6425670 DOI: 10.1186/s12912-019-0336-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/13/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Medication errors (MEs) are unintended failures in the drug treatment process that can occur during prescription, dispensing, storing, preparation or administration of medications. High alert medications (HAMs) are defined as those medications that bear the highest risk of causing significant patient harm when used incorrectly, either due to their serious adverse events or to a narrow therapeutic window. Nurses are responsible for administration of HAMs; incorrect administration can have a significant clinical outcome. This study aimed to assess the level of knowledge of HAMs among nurses in government hospitals in West Bank, Palestine. METHODS A cross-sectional study was conducted in 2015, in West Bank, Palestine. Data were collected via a face to face interview questionnaire, which was taken from a previous study. Data were collected by convenient sampling. The questionnaire consisted of four parts: demographic characteristics of the nurses, drug administration knowledge (10 true-false questions), drug regulation knowledge (10 true-false questions), and self-evaluation. RESULTS A total of 280 nurses participated in the study; these nurses were working in the emergency room (ER), intensive care unit (ICU), paediatric or medical ward. The response rate was 93%. Nurses were found to have insufficient knowledge about HAMs; 67.1% of participants had a score of less than 70%, with a mean total score of 59.9 ± 15.1. Factors associated with sufficient knowledge among nurses were HAMs training and ICU training, both with p-values of 0.002. Nurses with a master degree, those working in the ICU ward, head nurses, and male nurses were the most knowledgeable groups, with a p-values < 0.001. 81.8% of respondents hoped to obtain additional training. The leading obstacles reported were inconsistent opinions between doctors and nurses (37.9%), and no established standard operating procedure for HAMs (37.1%). CONCLUSIONS Lack of knowledge was one of the obstacles that nurses encountered during administration of HAMs which might result in MEs. Nurses reported that they would like to have additional training to update their pharmacology knowledge. Nurses could benefit from additional continuing education and training programs.
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Affiliation(s)
- Sa’ed H. Zyoud
- 0000 0004 0631 5695grid.11942.3fPoison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samar M. Khaled
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Baraa M. Kawasmi
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ahed M. Habeba
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Ayat T. Hamadneh
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Hanan H. Anabosi
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Asma’a Bani Fadel
- 0000 0004 0631 5695grid.11942.3fPharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Waleed M. Sweileh
- 0000 0004 0631 5695grid.11942.3fDepartment of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Rahmat Awang
- 0000 0001 2294 3534grid.11875.3aWHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), 11800 Penang, Malaysia
| | - Samah W. Al-Jabi
- 0000 0004 0631 5695grid.11942.3fDivision of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Feldman SS, Buchalter S, Hayes LW. Health Information Technology in Healthcare Quality and Patient Safety: Literature Review. JMIR Med Inform 2018; 6:e10264. [PMID: 29866642 PMCID: PMC6006013 DOI: 10.2196/10264] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/01/2018] [Accepted: 05/19/2018] [Indexed: 01/08/2023] Open
Abstract
Background The area of healthcare quality and patient safety is starting to use health information technology to prevent reportable events, identify them before they become issues, and act on events that are thought to be unavoidable. As healthcare organizations begin to explore the use of health information technology in this realm, it is often unclear where fiscal and human efforts should be focused. Objective The purpose of this study was to provide a foundation for understanding where to focus health information technology fiscal and human resources as well as expectations for the use of health information technology in healthcare quality and patient safety. Methods A literature review was conducted to identify peer-reviewed publications reporting on the actual use of health information technology in healthcare quality and patient safety. Inductive thematic analysis with open coding was used to categorize a total of 41 studies. Three pre-set categories were used: prevention, identification, and action. Three additional categories were formed through coding: challenges, outcomes, and location. Results This study identifies five main categories across seven study settings. A majority of the studies used health IT for identification and prevention of healthcare quality and patient safety issues. In this realm, alerts, clinical decision support, and customized health IT solutions were most often implemented. Implementation, interface design, and culture were most often noted as challenges. Conclusions This study provides valuable information as organizations determine where they stand to get the most “bang for their buck” relative to health IT for quality and patient safety. Knowing what implementations are being effectivity used by other organizations helps with fiscal and human resource planning as well as managing expectations relative to cost, scope, and outcomes. The findings from this scan of the literature suggest that having organizational champion leaders that can shepherd implementation, impact culture, and bridge knowledge with developers would be a valuable resource allocation to consider.
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Affiliation(s)
- Sue S Feldman
- Department of Health Services Adminstration, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Scott Buchalter
- Pulmonary and Critical Care, The University of Alabama at Birmingham Medical Center, Birmingham, AL, United States
| | - Leslie W Hayes
- Department of Pediatrics, The University of Alabama at Birmingham Medical Center, Birmingham, AL, United States
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Fang X, Zhu LL, Pan SD, Xia P, Chen M, Zhou Q. Safe medication management and use of narcotics in a Joint Commission International-accredited academic medical center hospital in the People's Republic of China. Ther Clin Risk Manag 2016; 12:535-44. [PMID: 27103812 PMCID: PMC4827882 DOI: 10.2147/tcrm.s103853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People’s Republic of China during 2011–2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011. A 100% implementation rate of standard storage of narcotics has been achieved in the hospital since December 2012. A “Plan, Do, Check, Act” cycle was efficient because the ratio of number of inappropriate narcotics prescriptions to total number of narcotics prescriptions for inpatients decreased from August 2014 to December 2014 (28.22% versus 2.96%, P=0.0000), and it was controlled below 6% from then on. During the journey to good pain management ward accreditation by the Ministry of Health, People’s Republic of China, (April 2012–October 2012), the medical oncology ward successfully demonstrated an increase in the pain screening rate at admission from 43.5% to 100%, cancer pain control rate from 85% to 96%, and degree of satisfaction toward pain nursing from 95.4% to 100% (all P-values <0.05). Oral morphine equivalent dosage in the good pain management ward increased from 2.3 mg/patient before June 2012 to 54.74 mg/patient in 2014. From 2011 to 2015, the oral morphine equivalent dose per discharged patient increased from 8.52 mg/person to 20.36 mg/person. A 100% implementation rate of independent double-check prior to narcotics dosing has been achieved since January 2013. From 2014 to 2015, the ratio of number of narcotics-related medication errors to number of discharged patients significantly decreased (6.95% versus 0.99%, P=0.0000). Taken together, continuous quality improvements have been achieved in safe medication management and use of narcotics by an integrated multidisciplinary collaboration during the journey to JCI accreditation and in the post-JCI accreditation era.
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Affiliation(s)
- Xu Fang
- Office of Hospital Administration, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China; Office of Party and Administration Council, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Ling-Ling Zhu
- Geriatric VIP Care Ward, Division of Nursing, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Sheng-Dong Pan
- Division of Medical Administration, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Ping Xia
- Division of Medical Administration, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Meng Chen
- Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Quan Zhou
- Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
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