Patient Safety Awareness Among Dental Students In Lahore, Pakistan: A Multi-Centre Studye.

BACKGROUND: Awareness of key issues associated with patient safety is vital for improving patient care in all fields of medical sciences including dentistry. This study was done to assess awareness among dental undergraduates towards patient safety in different dental institutions of Lahore, Pakistan. METHODS: It was a cross-sectional analytical study conducted at Combined Military Hospital Lahore Medical College & Institute of Dentistry from 1st May to 30th November, 2020. Two hundred third and fourth year BDS students (149 females and 51males; mean age 21.91±1.08) of 4 dental institutions of Lahore, mostly from private institutions (79.5%) completed Awareness of Patient Safety Questionnaire (APSQIII) to assess awareness of patient safety in dental undergraduates. Data was analyzed through SPSS 21. RESULTS: Teaching and learning about patient safety got the highest item scores while "Team functioning" got the highest 6.1 mean domain score. "Professional incompetence as an error cause" got the lowest 3.1 mean score followed by "Disclosure responsibility" (4.3). No significant difference was seen with respect to gender. Fourth year students were found to be more aware about error disclosure and error reporting confidence with statistically significant difference. All reverse coded items were scored in disagreed range by participants. CONCLUSIONS: Despite positive attitudes towards patient safety, lack of awareness was seen in key issues. Incorporation of patient safety in undergraduate curriculum may help in improving patient care and health services.

The blame game- experiences of female residents in obstetrics & gynecology regarding lapses in patient safety.

Objectives: Primary objective was to explore experiences of female residents of Obstetrics and Gynecology (OB/GYN) regarding lapses in patient safety (PS) while secondary objective was to explore factors hampering or favouring improvement of PS in OB/GYN. Methods: In this qualitative narrative study carried out in OB/GYN department of Combined Military Hospital (CMH) Lahore for six months from 1st April to 30th September 2021, six fourth-year residents were asked to write narratives of their personal experiences of medical error (witnessed or committed) in detail and reflect on those experiences, which were then transcribed. Code labels and themes were assigned manually. Interpretation of these themes was done after thematic content analysis. Results: Six, fourth-year female residents with a mean age of 28.6±1.8 participated in the study. Two main themes with sub-themes were identified: 1) Challenges in patient safety (Personal challenges, Workplace challenges, Barriers to PS), 2) Lessons learnt from experiences (Self-improvement and; Promotion of patient safety culture). Heavy workload with long working hours, lack of communication and teamwork, lack of experience and inadequate supervision were major factors involved in PS lapses experienced by residents. Conclusion: Incidents of Patient Safety (PS) lapses had a strong impact on the emotional and professional life of residents. Formal PS training with improvement of working conditions may help promote PS culture.

Perspective of health professionals on hand hygiene in a tertiary care center in Pakistan.

OBJECTIVE: To determine the awareness of postgraduate residents and nurses working in a tertiary care hospital about hand hygiene. METHODS: The cross-sectional study was conducted in October 2018 at The Children's Hospital and the Institute of Child Health, Lahore, Pakistan, and comprised postgraduate residents and nurses. Data was collected using a 31-item self-administered inventory. Data analysis was done using SPSS 21. RESULTS: Of the 360 subject, 152(42.2%) were postgraduate residents and 208(57.8%) were nurses. Overall score of knowledge 202(56%) was low compared to attitude 260(72%) and practice 283(78.6%). The combined score of all three domains was 245(68%), indicating moderate awareness. Postgraduate residents had significantly better knowledge 98(64%) compared to nurses 104 (50%) (p=0.01), while nurses had better attitude score 159(76.4%) compared to the residents 103(68%) (p<0.05). The practice subscale score was not significantly different between the groups (p>0.05). CONCLUSIONS: Both postgraduate residents and nurses showed moderately satisfactory knowledge, attitude and practice towards hand hygiene.

Prevalence of Self-medication for Acid Peptic Disease amongst People of Manawa, Lahore.

Introduction Acid peptic disease is a common disorder, affecting millions of people worldwide. Its pharmacological management includes proton pump inhibitors, H2 blockers, antacids and mucosal protective agents. Multiple studies in Pakistan have shown increased tendency of population for self-medication. This has serious implications regarding false diagnoses, misuse of drugs and occurrence of adverse effects. The objective of this study was to estimate the prevalence of self-medication among the people of Manawa, Lahore. Methods A cross-sectional study was conducted between January 2019 and June 2019 amongst the general population of Manawa, Lahore. Patients with the typical presentation of acid peptic disease were included in the study. A total of 500 people, fulfilling the inclusion criteria, were chosen. A questionnaire form was adapted from similar studies performed on self-medication. It was divided into two parts. First part included the social and demographic data while the second part consisted of details about the prevalence and factors related to the practice of self-medication amongst acid peptic disease (APD) patients. The data collected was transcribed into SPSS 22.0 (IBM Corp., Armonk, NY) for statistical analysis. All the categorical variables were analyzed as frequencies and percentages. No statistical comparisons were done as it was a descriptive, exploratory study. Results Out of 500 participants, 404 were females and 96 were males. Most of them were middle-aged (53%) and illiterate (68.4%). Number of participants who practiced self-medication was found to be 313 (62.6%). The highest prevalence of self-medication was found for proton pump inhibitors (43.1%), followed by antacids (23.6%), unknown homeopathic and Hakeem medicine (20.4%) and H2 blockers (12.8%). The most common reasons stated for self-medication included inability to afford medical consultation (44.2%), lack of knowledge about drug side effects (35.8%), easy access to Hakeem and homeopathic medicines (27.6% and 4.8%, respectively) and inaccessibility to doctors (19.2%). Conclusion A large majority of people in Manawa practise self-medication for acid peptic disease, owing to multiple reasons.

Possible Mode of Spread of Hepatitis B and Hepatitis C in Chronic Liver Disease Patients Presenting at CMH Lahore Medical College and Institute of Dentistry.

Introduction Chronic hepatitis B and C are the leading causes of chronic liver disease and a significant cause of mortality and morbidity worldwide. Hepatitis B is a preventable disease with vaccination, which is available worldwide. About 257 million people are affected worldwide with hepatitis B and around 71 million people with hepatitis C, and Pakistan is the second most prevalent country with hepatitis C. The possible mode of spread of hepatitis B and C in chronic liver disease patients presenting at CMH medical wards and dental clinics was evaluated. Among various types of hepatitis, A, B, and C are the most common. The course of disease followed by hepatitis A is short term, but when we talk about the common types, which are B and C, the disease is chronic and, moreover, the complications associated with these types are more severe too. Materials and methods The study was carried out at the medical wards and dental clinics of CMH Lahore Medical College. A total of 240 patients were evaluated for the possible mode of spread of hepatitis B and C. A detailed history regarding the use of needles, surgical procedures, including dental treatment, unsterilized razors for shaving (barbers'), blood transfusions, tattooing, and mode of delivery in females, was evaluated and data were interpreted. Aims and objectives To observe the mode of spread of hepatitis B and C among patients of CMH Lahore Medical College and Institute of Dentistry. Results The results of our study revealed that the most common mode of spread of disease in males was exposure to infected blades and instruments at barbers' shops. In females, blood transfusion and caesarian section, especially in rural areas, remained the most common possible cause of spread. A small number of patients was not aware of the possible mode of transmission, whereas a few others did not seek treatment for the disease. Conclusion From our study, we can conclude that a substantial number of patients with chronic liver disease have exposure to various risk factors. Exposure to the unsterilized equipment of barbers and improperly screened blood remains the main cause of the spread of hepatitis B and C in males whereas surgical procedures related to gynecological procedures and blood transfusions remain the second most common cause. Dental procedures in the hands of trained dental professionals/dentists carry less danger of transmitting the disease but carry an equally high incidence if quacks do the dental procedures.

Patient safety awareness among Undergraduate Medical Students in Pakistani Medical School.

OBJECTIVE: To measure the level of awareness of patient safety among undergraduate medical students in Pakistani Medical School and to find the difference with respect to gender and prior experience with medical error. METHODS: This cross-sectional study was conducted at the University of Lahore (UOL), Pakistan from January to March 2017, and comprised final year medical students. Data was collected using a questionnaire 'APSQ- III' on 7 point Likert scale. Eight questions were reverse coded. Survey was anonymous. SPSS package 20 was used for statistical analysis. RESULTS: Questionnaire was filled by 122 students, with 81% response rate. The best score 6.17 was given for the 'team functioning', followed by 6.04 for 'long working hours as a cause of medical error'. The domains regarding involvement of patient, confidence to report medical errors and role of training and learning on patient safety scored high in the agreed range of >5. Reverse coded questions about 'professional incompetence as an error cause' and 'disclosure of errors' showed negative perception. No significant differences of perceptions were found with respect to gender and prior experience with medical error (p= >0.05). CONCLUSION: Undergraduate medical students at UOL had a positive attitude towards patient safety. However, there were misconceptions about causes of medical errors and error disclosure among students and patient safety education needs to be incorporated in medical curriculum of Pakistan.