[Are patients concerned about medical errors in emergency department?]

Concern about medical errors in all patients has been elevated recently. Understanding of how patients conceptualize medical error would help health care providers to diminish safety concerns and increase patient satisfaction. This study was performed to evaluate patients worrisome form medical errors and relationship with patient concern, characteristic and satisfaction. This descriptive cross-sectional study was done in Tehran on October 2008. A questionnaire was performed to assess patients feeling about medical errors and their satisfactions according to Likert Scale. During 1 week period, all of the patients who came to the emergency department of Hazrat Rassol Akram hospital were included in the study. Patients who had altered level of consciousness or intoxication or were less than 18 years old were excluded. Telephone interview were conducted 7 days later. Patients were asked about medical safety, concerns about medical errors and satisfaction with care. Data were gathered and analyzed by chi 2 and T test via SPSS 14 software. Of 638 patients, 48.3% of patients reported experiencing at least one specific error related concern; that most commonly were consuming too much time in emergency ward and medical stadents faalts. Their concerns were associated with age, educational level, length of stay and disposition [P<0.001]. 62% of patients showed high satisfaction regarding medical care service. Patient satisfaction was highly related to their concern. Although many patients have a good sense of security medical care services, but due to stressful situation in emergency departments, understanding of patient concerns, education and good communication with patients could decrease their concerns and increase satisfaction

[Use of diagnostic tests in patients with non traumatic acute abdominal pain referred to the emergency department]

Non-traumatic acute abdominal pain is one of the most common complaints in patients referred to emergency department. To make diagnosis decision several diagnostic tests such as WBC count, urine analysis, and abdominal sonography are usually ordered which disturb emergency department, staff and force significant cost to patient and are time consuming. This study was done for determining the tests frequency for diagnosis of patients presenting in ED of Hazrate rasoul hospital with non traumatic acute abdominal pain that had been dismissed from hospital in comparison to previous studies to find whether we can omit some unnecessary tests. Study method was descriptive-cross sectional. By sequential sampling, the data of 400 dismissed patients with non-traumatic acute abdominal pain were gathered and interpreted by statistical descriptive methods. Participants were 29-22 years old, 40.8% male and 59.2% female. WBC had been ordered in 92% of cases. Urine analysis and abdominal sonography had been ordered 91.7% and 95.5% respectively. Frequency of CBC ordering was similar to previous studies while was 2 and 4 fold more for UA and abdominal sonography in comparison to previous studies. These results necessitate revising the diagnostic tests for non-traumatic acute abdominal pain to omit unnecessary tests

Assessment of emergency medical education on knowledge alterations of medical students in Rasoul Akram Hospital [2005-2006]

Education and management are considered two integrated and non-separable requirements of an emergency department [ED]. Despite the emphasis on teaching of essentials of approaching and management of critical patients, medical students do not acquire the necessary knowledge to handle these patients during their rotation in different specialties other than emergency medicine [EM]. This study aims to evaluate the changes in EM knowledge of interns during their one month rotation in ED of Rasoul Akram Hospital. In a 15-month period, 226 interns were entered into this study. A pretest was taken at the beginning of their one-month internship period. Then, the interns were provided with a handbook, which was prepared and revised according to the approved curriculum of Ministry of Health and Medical Education of Iran and latest emergency medicine textbooks. The interns were taught by several lecture and practical sessions. At the end of their EM internship period, a post-test was taken and the change of their emergency medical knowledge was assessed by comparison of pre-and post-test results. The results showed a significant increase of mean post-test scores compared with the pretest scores. Also, there was a significant difference between the scores obtained by males and those obtained by females [P < 0.001]. The one-month EM training significantly improved the level of interns' knowledge