Medical safety reporting system neccessity and analysis of Turkey 2016 data: A health policy report.

BACKGROUND: The National Safety Reporting System, which is developed for Turkey, aims to classify medical errors with a coding methodology that handles errors in subcategories. Error entries done via the system are added to the statistics immediately by advanced live data reporting capabilities of the software. OBJECTIVE: Our aim was to provide information about the Turkey local reporting system to ensure patient safety by detecting medical errors. METHODS: The data used for analyses were obtained from https://www.grs.saglik.gov.tr and the web service used by hospital information systems. The error reporting time, most commonly reported errors, errors by professions and errors by location were examined under the major error categories and percentages that have been used in relevant data. RESULTS: In total, 53,477 errors were submitted to the National Safety Reporting System in 2016. When these entries were split into relevant categories such as drug errors, laboratory errors, surgical errors and patient safety errors, the most common errors were wrong dosage order, hemolyzed sample, not marking the side to be operated on and patient fall (patient/caretaker related), respectively. CONCLUSION: In order to reduce medical errors and provide patient safety, every institution must first of all do its own self-assessment. New user-friendly systems can be developed in order to increase medical error notifications and thus institutions can improve their healthcare quality.

Determination of Aflatoxins and Ochratoxin A in Traditional Turkish Cereal-Based Fermented Food by Multi-Affinity Column Cleanup and LC Fluorescence Detection: Single-Laboratory Validation.

Background: Tarhana is a traditional fermented, sun-dried Turkish food containing yogurtand cereals. There are several potential sources of mycotoxins in tarhana, such as contamination of ingredients or formation during preparation, when water activity is suitable for fungal growth and may lead to mycotoxin production during fermentation or subsequent sun-drying. Objective: To optimize an immunoaffinity column method and carry out single-laboratory validation for the determination of aflatoxins B1, B2, G1, and G2 together with ochratoxin A (OTA) in tarhana. Method: A homogenized sample was extracted with methanol-acetonitrile-water (25 + 25 + 50) using a high-speed blender. The sample extract was filtered, diluted with phosphate buffered saline (PBS) solution, and applied to a multi-immunoaffinity column (AFLAOCHRA PREP®). Aflatoxins and OTA were removed with neat methanol and then directly analyzed by reverse-phase LC with fluorescence detection using post-column bromination (Kobra® Cell). Results: Test portions of blank tarhana were spiked with a mixture of total aflatoxins and OTA to give levels ranging from 2.5 to 10.0 and 1.5 to 6.0 µg/kg, respectively. Recoveries for total aflatoxins and OTA ranged from 82 to 93 and 78 to 94%, respectively, for spiked samples. Based on results for spiked tarhana (30 replicates, each at three levels), the relative standard deviation for repeatability ranged from 1.4 to 7.2 and 3.6 to 7.7% for total aflatoxins and OTA, respectively. Conclusions: The performance characteristics for recovery, repeatability, and sensitivity have demonstrated that the method meets method performance criteria for use for official purposes. The method was demonstrated as being applicable to naturally contaminated samples of tarhana of varied composition obtained from local markets in Turkey. Highlights: This is the first immunoaffinity column method for simultaneous analysis of aflatoxins and OTA in traditional Turkish food (tarhana). Suitability was demonstrated by single-laboratory validation for official purposes in Turkey. The method was demonstrated as suitable for naturally contaminated samples of tarhana of varied composition.