Patient Safety Culture: Effects on Errors, Incident Reporting, and Patient Safety Grade.

OBJECTIVES: This study mainly examines the effects of patient safety culture dimensions on 4 outcomes (self-reported errors, witnessing errors, incident reporting, and patient safety grade). METHODS: The data were collected using the Turkish version of the Safety Attitudes Questionnaire, which consists of 6 dimensions (teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions). Of 1679 personnel working in 6 hospitals in Ankara, 860 were randomly selected. The data were analyzed using descriptive statistics, the Spearman correlation coefficient, and binary logistic regression analyses. RESULTS: The response rate was 62.7%. When the overall patient safety culture score increased by 1 point; the probability of witnessing an error was 2 times lower (P < 0.001), the probability of incident reporting was 4.22 times higher (P < 0.001), and the probability of assessing the patient safety grade as excellent was 29.86 times higher (P < 0.001). The teamwork climate was negatively related to making errors and witnessing errors (P < 0.001). The safety climate and working conditions were positively related to incident reporting and patient safety grade (P < 0.001). Job satisfaction was negatively related to incident reporting (P < 0.001). Perceptions of management were positively related to making errors and patient safety grade (P < 0.001). CONCLUSIONS: The patient safety culture scores were positively correlated with incident reporting and patient safety grade but negatively correlated with the occurrence of errors. Each dimension of the patient safety culture, except stress recognition, affected different outcomes. Therefore, managers should focus on different dimensions of patient safety culture to improve different outcomes.

Does N ratio affect survival in D1 and D2 lymph node dissection for gastric cancer?

AIM: To identify whether there could have been changes in survival if lymph node ratio (N ratio) had been used. METHODS: We assessed 334 gastric adenocarcinoma cases retrospectively between 2001 and 2009. Two hundred and sixteen patients out of 334 were included in the study. Patients were grouped according to disection1 (D1) or dissection 2 (D2) dissection. We compared the estimated survival and actual survival determined by Pathologic nodes (pN) class and N ratio, and SPSS 15.0 software was used for statistical analysis. RESULTS: Ninety-six (44.4%) patients underwent D1 dissection and 120 (55.6%) had D2 dissection. When groups were evaluated, 23 (24.0%) patients in D1 and 21 (17.5%) in D2 had stage migration (P = 0.001). When both D1 and D2 groups were evaluated for number of pathological lymph nodes, despite the fact that there was no difference in N ratio between D1 and D2 groups, a statistically significant difference was found between them with regard to pN1 and pN2 groups (P = 0.047, P = 0.044 respectively). In D1, pN0 had the longest survival while pN3 had the shortest. In D2, pN0 had the longest survival whereas pN3 had the shortest survival. CONCLUSION: N ratio is an accurate staging system for defining prognosis and treatment plan, thus decreasing methodological errors in gastric cancer staging.

Acute pancreatitis, bacterial translocation, and different octreotide regimens: an experimental study.

PURPOSE: To determine the effect of octreotide, octreotide with zinc, levamisole, and misoprostol on the bacterial translocation that develops in rats with acute pancreatitis (AP). METHODS: A total of 36 rats were divided into six groups, each consisting of six rats. Only laparotomy was performed on the first group. Acute pancreatitis was performed on the second group. Octreotide was given to the third, fourth, fifth, and sixth groups. Octreotide, octreotide with zinc, levamisole, and misoprostol were given to groups III, IV, V, VI, respectively. Rats were euthanized 48 h after the occurrence of AP. Blood and mesenteric lymph node samples were collected for polymerase chain reaction (PCR). Pancreatic tissue and terminal ileum were obtained for histopathological examinations. RESULTS: The severity of pancreatitis and mucosal damage of the terminal ileum was higher in group II than groups I, III, IV, V, and VI, histopathologically (P < 0.05). There wasn't a significant difference with respect to OA with Zn or L or M and OA group (P > 0.05). A significant difference was found in PCR positivity in blood and mesenteric lymph node between groups I and II (P < 0.05). CONCLUSIONS: In AP, administering octreotide alone significantly prevented the bacterial translocation by preventing mucosal damage. The zinc, levamisole, or misoprostol with octreotide did not influence the results.

Frantz's tumor (solid pseudopapillary tumor) of the pancreas. A case report.

CONTEXT: A solid pseudopapillary tumor of the pancreas is a rare neoplasm which, for the most part, affects young women and has a relatively favorable prognosis with a low malignant potential. These tumors usually have unclear clinical features and may form very large masses before being diagnosed. CASE REPORT: We report the case of a 29-year-old woman who underwent complete resection of the tumor using a distal pancreatectomy and splenectomy procedure. The patient is being followed-up and in good condition. A review of the relevant literature is also presented. CONCLUSIONS: A solid pseudopapillary tumor of the pancreas is a rare condition with a low potential for malignancy and favorable prognosis; surgical resection is generally curative.