ABSTRACT
<p><b>BACKGROUND</b>Amiodarone is a useful antiarrhythmic drug. Phlebitis, caused by intravenous amiodarone, is common in patients in coronary care units (CCUs).</p><p><b>OBJECTIVE</b>The aim of this study was to evaluate the effect of topical chamomile on the incidence of phlebitis due to the administration of an amiodarone infusion into the peripheral vein.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>This was a randomized, double-blind clinical trial, conducted on 40 patients (n = 20 per group) in two groups-an intervention group (chamomile ointment) and a control group (lanoline, as a placebo), hospitalized in the CCUs and undergoing an amiodarone infusion into the peripheral vein over 24 h. Following the cannulation and commencement of the infusion, placebo or chamomile ointment was rubbed in, up to 10 cm superior to the catheter and repeated every eight hours for three days. The cannula site was then assessed based on the phlebitis checklist.</p><p><b>MAIN OUTCOME MEASURES</b>The incidence and time of occurrence of phlebitis, relative risk, severity of phlebitis were the main outcome measures.</p><p><b>RESULTS</b>Nineteen patients (19/20) in the control group had phlebitis on the first day of the study and one patient (20/20) on the second day. In the intervention group, phlebitis occurred in 13 cases (13/20) on the first day and another two (2/7) was found on the second day. The incidence of phlebitis was significantly different between two groups (P = 0.023). The cumulative incidence of phlebitis in the intervention group (15/20) is significantly later and lower than that in the control group (20/20) during two days (P = 0.008). Two patients in the intervention group did not develop phlebitis at all during the 3-day study. Also, the relative risk of phlebitis in the two groups was 0.68 (P = 0.008 5). A significant difference was not observed with regard to phlebitis severity in both groups.</p><p><b>CONCLUSION</b>It seems that phlebitis occurred to a lesser extent and at a later time frame in the intervention group compared to control group. Topical chamomile may be effective in decreasing the incidence of phlebitis due to an amiodarone infusion.</p><p><b>TRIAL REGISTRATION</b>This protocol was registered in the Iranian Registry of Clinical Trials (IRCT2014042017361N1).</p>
ABSTRACT
Hospital Emergency preparedness in dealing with crises and disasters is essential for success in providing quality services. The aim of this study was to evaluate emergency preparedness in hospitals of Qazvin University of Medical Sciences in responding to crisis. In this cross - sectional research, six hospital emergencies of Qazvin University of medical sciences were studied in 2013. Data was collected by hospital emergency response checklists with 90 questions in different areas [such as command and control, communication, safety and security, triage, surge capacity, continuity of essential services, human resources, management of materials and inventory area, post-disaster recovery] which has been developed by WHO through observation and interview. Data analysis was performed using central indexes; also, tables and graphs were used to describe the results. According to the findings, the maximum and minimum level of preparedness against disasters were in command and control area [80/83%] and management of materials and inventory area [57%] respectively. Generally, the level of emergency preparedness of hospitals to deal with disasters evaluated about 70/72%. Regarding the history of disasters in the studied province and appropriate preparedness of the hospitals, it will be effective to estimate essential sources and medicines, equipment maintenance, rapid preparation of materials and strengthening the hospital buildings in order to enhance the preparation of the hospitals
Subject(s)
Civil Defense , Disasters , Emergencies , World Health Organization , Cross-Sectional StudiesABSTRACT
Clinical risk management focuses on improving the quality and safety of health care services by identifying the circumstances and opportunities that put patients at risk of harm and acting to prevent or control those risks. The goal of this study is to identify and assess the failure modes in the ICU of Qazvin's Social Security Hospital [Razi Hospital] through Failure Mode and Effect Analysis [FMEA]. This was a qualitative-quantitative research by Focus Discussion Group [FDG] performed in Qazvin Province, Iran during 2011. The study population included all individuals and owners who are familiar with the process in ICU. Sampling method was purposeful and the FDG group members were selected by the researcher. The research instrument was standard worksheet that has been used by several researchers. Data was analyzed by FMEA technique. Forty eight clinical errors and failure modes identified, results showed that the highest risk probability number [RPN] was in respiratory care "Ventilator's alarm malfunction [no alarm]" with the score 288, and the lowest was in gastrointestinal "not washing the NG-Tube" with the score 8. Many of the identified errors can be prevented by group members. Clinical risk assessment and management is the key to delivery of effective health care
Subject(s)
Humans , Risk Management , Intensive Care Units , Delivery of Health Care , Data Interpretation, StatisticalABSTRACT
Objective[s]: To analyze the current position of HDI in Iran and regional countries considered in the scope of the 20 year vision program document
Methods: The considered survey countries are Kuwait, United Arab Emirates, Armenia, Turkey, Lebanon, Islamic Republic of Iran, Azerbaijan, Syria and Pakistan. Based on HDI reports Iranian indicators of 0.571 in 1975 has grown to 0.782 in 2009, and based on the most recent United Nations human Development report [Oct 6, 2009]
Results: Islamic republic of Iran is ranked 88th amongst the 182 world countries and is ranked 12th amongst the 25 regional countries of the 20 year vision plan document
Conclusion: Management and personnel of health sector have a key role to improving the index and as a result take a leading role in human development and improvement of our country's ranking amongst the regional and world countries
ABSTRACT
To compare the effects of intratracheal and intravenous lidocaine on bucking, cough and emergence time at the end of anesthesia. Sixty patients were randomly allocated in to 2 groups to receive lidocaine 1.5mg/kg either intravenous or intratracheal in a double-blind study. The number of bucking and coughs for each patient was continuously monitored for thirty minutes after extubation. Heart rate, systolic, and diastolic blood pressures were measured before the injection of test solution and one minute after the tracheal extubation. The emergence time was also recorded. There was no significant difference in the number of bucking [P=0.192] before extubation and coughs during the 30-min monitoring after extubation [P=0.97] between two groups. The difference in emergence time between two groups was not significant [P=0.715]. The effect of intravenous or intratracheal lidocaine was similar on bucking, cough, and emergence time at the end of general anaesthesia
ABSTRACT
The scientific, technological and economic development of a society is closely related to its public health. Therefore; improvement of health service quality along with increasing the number of health facilities is one of the main concerns of health care authorities in developed countries. This study was designed to compare accreditation models of health care organizations in Europe and the United States. This was a comparative-review study in which a wide range of paper and electronic data sources related to different accreditation models in all European countries and the US were collected. The origins, underlying principles and the application of various accreditation models in health care were compared. Our findings showed that four models of health care accreditation were applied in European countries. The ISO and EFQM models had industrial origins, and were more frequently used in technical fields such as laboratories and administrative department of hospitals. Other accreditation models, however, had health care origins and were used for the accreditation of all sections of hospitals as well as for specialized clinical groups. One of the main challenges facing countries whishing to establish an accreditation system is to reach an agreement on the concept and characteristics of the accreditation model