ABSTRACT
Laboratory errors may occur in every stage of laboratory management process and lead to a considerable harm to inpatients. This study was aim to investigate the Proactive risk assessment of the laboratory management process in Ghaem Hospital, Mashhad [2013]. This was a descriptive research that quantitatively and qualitatively analyzed some failure modes and effects. In order to classify the modes of failure and effective causes of them and also determining the improvement strategies, we have used "nursing error management association", "Eindhoven" and "theory of inventive problem solving" models respectively. In 5 steps of laboratory management process which is conducted on17 listed sub-processes, on average 59 error modes in each ward was identified. 18.7% of error modes were identified as high risk errors [hazard score >/= 8]. Most of error causes were related to human factors [42.7%].In addition, 31.6% of preventive measures were assigned in human resources management strategy group and 16.9% in team work group. The Healthcare Failure Mode and Effect Analysis method was very efficient in identifying failure modes, determining causes which impact each failure mode, and proposing improvement strategies for laboratory management processes of Ghaem Department
ABSTRACT
The increase in substance abuse among youths and its complications form one of the most pressing health problems among students as an important and vulnerable group in society. The purpose of this study is to assess the knowledge and attitude of dormitory students of Shahid Beheshti University of medical sciences regarding substance abuse in 2013. This is a descriptive-analytic cross sectional study carried out on dormitory students of Shahid Beheshti University of medical sciences regarding substance abuse in 2013. 604 male and female students living in the dormitories were selected via random sampling. Data were collected using a questionnaire developed by the researcher based on the questionnaire used by Dehghan, and on a review of relevant literature and expert opinion obtained from professors of the field. Data were analyzed by SPSS16 using descriptive and analytical tests [Pearson correlation, T-test and chi-square]. The mean score of knowledge of dormitory students at Shahid Beheshti University of Medical Sciences was 9.86+/-2.13. Most students [65.6%] had moderate knowledge about drugs. The subjects' mean score on attitude was 61.99+/-10.10. Most students [58.3%] had moderate positive attitudes towards drugs. Students are considered as major assets of a country. Therefore, planning and developing intervention strategies to prevent and reduce substance abuse among university students is essential and plays a major role in improving their health
ABSTRACT
Knee pain Is one of the most common reasons patients visit their physician. In this regard Magnetic Resonance Imaging [MRI] is the tool of preference for diagnosis. The aim of this study was to determine appropriate guidelines for knee MRI administration using the RAND Appropriateness Method [RAM]-2013. This qualitative study was done in the Mashhad University of Medical Sciences in 2013. The most appropriate approved knee MRI administration clinical guidelines were evaluated using Guidelines Evaluation and Research Appraisal [AGREE]. Panel members consisting of six orthopedic and three rheumatologic doctors gave scores ranging from 1 to 9 for each scenario. The indications were grouped as appropriate, equivocal and inappropriate. Data were analyzed by descriptive statistics and SPSS ver. 18 software. Sixty-three scenarios were extracted from the guidelines and then the scenarios were evaluated in 26 indications. Thirty-two [50.79%] cases were considered appropriate, 12 [19.04%] cases uncertain and 19 [30.1%] cases inappropriate. The RAND appropriateness method is helpful in identifying the opinion of stakeholders in health care systems. Moreover, making practical use of clinical guidelines can improve patients' quality of care and prevent un-necessary costs
ABSTRACT
Good medical nutrition therapy [MNT] is crucial to inpatients' health and treatment, and is part of routine hospital cares. Surgery ward is a highly danger-prone section in any hospital. The present study was conducted for a proactive risk analysis of nutrition and food distribution in Mashhad Qaem Hospital' Women's Surgery Ward in 2013 through health care failure mode and effect analysis [HFMEA]. A qualitative-quantitative research identified and analyzed the failure modes and effects through HFMEA. To rank error modes, we drew upon nursing errors in the clinical management model; to rank the effective causes of failure, we approved the model by the UK National Health System; and to rank the performance improvement approaches, we used the theory of inventive problem solving, TRIZ [theory of inventive problem solving]. A total of 42 failure modes were identified for 15 sub-processes listed in 7 processes of nutrition and food distribution. In sum, 11.9% of the failures modes were classified as high risk [hazard scores >=8]. Of 15 effective failure modes, the highest number of cause failure modes was associated with team factors, and the lowest number was associated with facilities. Using proactive HFMEA is highly effective in detecting potential failures in medication, effective factors in failure modes, and performance improvement approaches in hospital food distribution. [Monitoring proper patient-wards relationship], [committee establishment on diet, nutrition and medications], [performance assessment checklist making] and [supervising by nutrition authority over food distribution in wards] were identified as effective performance approaches in the Women's Surgery Ward in Qaem Hospital