RESUMO
Background: "Patient Safety" in everyday practices is a target of healthcare leaders, and adverse events reported by healthcare providers directly reflect patient safety in the health system. Recognising how residents and practising physicians rate adverse events concerning their work conditions and burnout must be explored. Objective: This study aims to explore the mediation effect of burnout dimensions (emotional exhaustion and burnout-interpersonal disengagement) between the effects of work conditions on perceived patient safety by exploring the adverse events that residents and practising physicians reported. Methods: A quantitative and cross-sectional study collected data from 249 residents and practising physicians in a huge teaching hospital and primary health care centre (PHC) in the Eastern Province of Saudi Arabia. Hayes Macro regression analysis was employed to evaluate the multiple mediation effect of burnout dimensions, with 5000 bootstrapping and a confidence interval (CI) of 95% for statistical inference and p≤0.05 for the significance level. Results: Leadership support (B= 0.39, t= 6.24, p<0.001) and physician engagement (B=0.43, t=6.50, p<0.001) were associated with a decreased rate of adverse events to patient safety, whereas workload (B=-0.23, t=-3.73, p<0.001) was negatively associated with an increased rate of adverse events. Burnout was shown to mediate the relationship between the effects of physician's leadership support (R2=0.26, F=27.50, p<0.001), work engagement (R2=0.25, F=27.07, p<0.001) and workload (R2=0.23, F=24.23, p<0.001) on the rate of adverse events. Conclusion: This study provides insights into burnout dimensions and their consequences on patient safety indicators (ie, adverse events). Work conditions (ie, leadership support, physician engagement, and workload) directly affect the rate of adverse events and indirectly through mediators like burnout-emotional exhaustion and burnout-interpersonal disengagement.
RESUMO
Methods: This was an observational cross-sectional study conducted among physicians working at the College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), and its affiliated academic tertiary hospital, King Fahad Hospital of the University (KFHU), Eastern province-KSA. Data were collected between August 2019 and March 2020 via a structured, pretested, self-administered questionnaire distributed to 220 eligible physicians at KFHU. A final sample of 101 physicians completed our survey. Collected data was coded and analysed using SPSS, and the results presented as frequencies, percentages, and summary statistics. Results: Among our respondents, 62 (61.4%) were males, 46 (45.5%) were in the age group of 35 to 44 years, and 62 (61.3%) were Saudi. Two-thirds of physicians (58 (57.4%)) use smart devices in healthcare delivery, and 51 (50.5%) are satisfied with this use. A minority (21 (20.8%)) knew about telemedicine guidelines, 8 (7.9%) had encountered legal issues related to telemedicine use, and 52 (51.5%) were doubtful about patients' readiness for virtual care. Regarding physicians' awareness of the ethical aspects regulating the use of social media and medical apps in patient care, only 44 (45.3%) were aware of the proper reporting system if they found accounts sharing unreliable information. Nevertheless, the majority (91 (92.9%)) agreed it is essential for healthcare providers to report such accounts. Concerning physicians' awareness of the rules and regulations of online self-promotion, the majority of our respondents were unsure or unaware of such regulations (46 (45.6%) and 18 (17.8%)), respectively. Nonetheless, 67 (66.3%) of the physicians would not pay SM influencers to advertise for them. Conclusion: Two-thirds of our physicians use smart devices in healthcare delivery, with 1 in 13 having encountered related legal issues. Nonetheless, only a minority was aware of telemedicine use regulating guidelines, including physicians' online self-promotion regulations. These results highlight the necessity of targeted physicians' training on telemedicine use related guidelines, thereby ensuring the safety of both patients and healthcare professionals and the optimum utilization of online health-related interactions.
RESUMO
Foreign body (FB) injury to the head is not uncommon in medical practice. Various objects have been reported in penetrating head injuries. Depth and location of penetration determine the expected complications and management approach. Here, we describe a case of FB injury to the head by the metal badge of a uniform hat and discuss the medical implications of such injuries among a large population of workers at risk. A 23-year-old male presented to the emergency room with the metal badge of his uniform hat embedded in the left side of his forehead after a physical altercation at work. Imaging revealed FB penetrating the soft tissue and minimally embedded in the outer table of the left frontal bone. The FB was removed in the emergency room with no complications. The wound was then cleaned and sutured, and the patient was discharged home with oral antibiotics for one week. Penetrating FB to the head can present significant morbidity to military personnel, and thus a safer design of work uniforms is warranted.
