Effects of Patient Safety Culture on Patient Satisfaction With Radiological Services in Nigerian Radiodiagnostic Practice.

INTRODUCTION: Patient safety culture is believed to be the first step toward improvement in quality of health-care delivery which will impact patient satisfaction. OBJECTIVE: To assess the effect of patient safety culture on patient satisfaction in radiodiagnostic practice. METHOD: Two validated questionnaires via Hospital Survey on Patient Safety Culture by Agency of Health Research and Quality and patient satisfaction questionnaire by Hays were administered to radiodiagnostic staff and patients who came for diagnostic care, respectively. These questionnaires were based on 5-point Likert scale. Questionnaires on patient safety culture and patient satisfaction were administered to 80 radiology health workers and 376 patients of radiology, respectively. Simple random sampling was used to enlist the participants for patient satisfaction while a population study was carried out to enlist patient safety culture participants. Data were analyzed using SPSS version 17. RESULTS: Response rate for patient safety culture questionnaires was 94.6%, while that of patient satisfaction was 62.8%. Among the survey items of patient safety, teamwork has the highest positive response of 76.5%, while staffing has the least, 30%. Overall patient safety culture was 53.7%. The survey item with highest positive response in patient satisfaction survey was patient-provider relationship (80%), while service cost-effectiveness has the least of 59%. Overall patient satisfaction with radiological services was 72.6%. There is no correlation between patient safety culture and patient satisfaction. CONCLUSION: Even though there is an excellent level of patient satisfaction in this study, it is not related to the practice of patient safety culture in radiodiagnostic unit.

Relationship of amniotic fluid index (AFI) in third trimester with fetal weight and gender in a southeast Nigerian population.

BACKGROUND: Amniotic fluid (AF) is one of the major determinants of fetal biophysical profile and can predict pregnancy outcome. Abnormal value of amniotic fluid index (AFI) may indicate fetal and maternal disorders. PURPOSE: To establish reference standards for AFI for this population after 28 weeks of pregnancy and evaluate the relationship between AFI, the estimated fetal weight (EFWT), and fetal gender. MATERIAL AND METHODS: A prospective cross-sectional estimation of AFI and FWT was done in 385 apparently healthy pregnant women in the gestational age range of 28-42 weeks. General scanning in longitudinal, transverse, and oblique directions of the abdomen was done to assess the fetal wellbeing and determine the fetal gender for each participant. AF was measured in each of the quadrants of the abdomen. The four values of the AF were summed to get the AFI. Measurement of the head circumference, biparietal diameter, abdominal circumference, and femoral length of the fetus were obtained. The EFWT was calculated using Hadlock's formula. The data were divided into five groups: 28-30 weeks 6 days; 31-33 weeks 6 days; 34-36 weeks 6 days; 37-39 weeks 6 days; and 40-42 weeks. AFI for the different gestational age group studied and their percentiles were obtained. RESULTS: AFI normogram for the local population was established. Positive and significant correlations of AF and EFWT were seen in all the gestational age groups of the women. No significant correlations between AF and EFWT was seen in male fetuses. Regression equations of EFWT and AFI were obtained for female fetuses. CONCLUSION: The normal range for AFI values for the third trimester was established and could be used to evaluate AFI in the studied population. Established fetal weight should be taken into account when interpreting AFI for female fetuses but this need not be applied for male fetuses.

Impact of demographic and psychosocial factors on hysterosalpingography pain and discomfort

Background: Hysterosalpingography (HSG) is an important diagnostic procedure in the investigation of infertility. It is the radiographic delineation of uterine and tubal cavities and is part of the diagnostic evaluation of conjugal infertility.1 This diagnostic procedure is associated with high levels of anxiety, pain and stress from various causes. This study was designed to investigate the impact of demographic and psychosocial factors on HSG pain and discomfort. Method: One hundred hysterosalpingography referrals were recruited for this study. Verbal detector scales were used to assess pain perception, Likert scales were used to assess the psychosocial variables, while visual analogue scales were used to assess discomfort. Pearson's correlations were conducted. Tests were two-tailed, with p < 0.05 indicating statistical significance. Results: Some of the patients (34%) indicated that the administration of analgesics prior to the procedure reduced the pain and discomfort associated with the procedure. Mean ± standard deviation of pain and discomfort were 2.82 ± 0.77 and 6.36 ± 2.19 respectively. Age correlated signifi cantly with pain perception (r = -0.22, P < 0.05), while pain correlated signifi cantly with perception of discomfort(r = -0.46, P < 0.05). Conclusion: Age signifi cantly correlated with pain. This is a factor that could be harnessed for clinical use

Patient satisfaction with obstetric ultrasonography.

BACKGROUND: Several investigators studying patient satisfaction have shown that the mode of medical care delivery appears to be more important to the patient than the care itself. OBJECTIVE: This study investigated patient satisfaction ratings with obstetric ultrasonography based on variables that the operator of the ultrasound equipment can influence. METHOD: A total of 100 self-completion questionnaires were delivered to 4 ultrasound centers in Ebonyi State, Nigeria (25 to each center). The questionnaire included questions on patient demographics as well as ordinal scales for patients to rate their satisfaction on various indices. Ninety-two questionnaires (92%) were returned. Both descriptive and inferential statistics were done. Tests were 2 tailed with P<.05 indicating statistical significance. RESULTS: The results were encouraging. Average satisfaction ratings above 50% were noted for all the indices except for patients' perception of the time between arrival and departure, which was slightly below 50%. CONCLUSION: Good staff-patient interaction and proper organizational behavior could improve satisfaction ratings.