Hospital Practices and Research

Abstract Background: Iatrogenic urethral injury is a well-known risk of urinary catheter insertion. Associated morbidities include stricture formation, catheter associated infection, risk for instrumentation, and extended length of stay. Yet, insufficient attention is paid to its prevention.
Objective: This study aimed to assess the effectiveness of a computerized ordering system in reducing iatrogenic urethral injuries in men at high risk for iatrogenic urethral injury from traumatic catheterization.
Methods: A pre-post study was performed to assess the impact of a computerized ordering system that recommended a 16 Fr Coudé-tip catheter be used instead of the standard 16 Fr Foley catheter for men at high risk for difficult catheter insertion. The intervention was implemented in October 2012. The rates of traumatic and non-traumatic insertion consults were compared between the pre-intervention (10/1/2010-09/30/2011) and post-intervention (10/1/2012-9/30/2013) time periods.
Results: The results showed that 78.5% of patients with iatrogenic urethral injury possessed at least one identified risk factor for difficult catheterization. There was no significant difference in frequency of traumatic or non-traumatic insertion consults between the pre- and post-intervention cohorts.
Conclusion: The current study highlights the possibility of preventing traumatic insertions by targeting men at high risk for iatrogenic injury. Without a simultaneous plan for improving catheter placement awareness and training, any change in the ordering process is unlikely to succeed on its own.

Abstract Background: Poor teaching and lack of proper relations between teacher and student and various other causes affect students’ academic burnout.
Objectives: Present study was conducted to determine the relationship between educational justice and academic burnout in medical interns of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Methods: This study was descriptive and analytical. The number of samples was equal to 300 medical interns identified and entered by the census sampling method. Data were completed by two questionnaires (researcher-made educational justice and burnout standard) whose reliability and validity were confirmed. Data were analyzed by SPSS Version 22.
Results: There was no significant relationship between educational justice and academic burnout (P>0.05). Also, educational justice was below average and academic burnout was above average. There was a significant relationship between educational justice score and gender (P < 0.05), and there was no critical relationship with other demographic variables (P>0.05). There was no significant relationship between academic burnout score and all demographic variables (P>0.05).
Conclusion: This study concluded that causes other than educational justice have been influential on students’ academic burnout. Hence, it suggested that studies be conducted on high academic burnout and identify influential variables. On the other hand, although the relationship between the two variables was not significant, due to the low level of educational justice, the university’s need for fair educational opportunities, especially professors, should be considered.

Abstract Background: Hand hygiene plays a key role in the prevention of healthcare-associated infection in critical patients.
Objective: The current study aimed to evaluate compliance with hand hygiene practices.
Methods: An observational and descriptive study was carried out in a 35-bed medical-surgical critical care unit in La Habana (Cuba) from January 2017 to December 2018. The observational method recommended by the World Health Organization (WHO) was used.
Results: Overall compliance was 34.2% (5516/16 125), with better compliance among physicians (39%) compared with nurses (31.4%) and ancillary staff (19.5%). Better compliance was observed after patient contact (65.7%) and after contact with patients’ surroundings (42.0%) in comparison with greater focus on patient safety as before patient contact (23.3%) and before an aseptic task (11.4%). Hand washing was performed more frequently than hand rubs.
Conclusion: Compliance with hand hygiene practices is low and no improvement in compliance was observed during the study period. This practice is related to the high risk of transmission of healthcare-related infections in critical patients and requires quality improvement interventions.

Abstract Background: Patient safety culture in healthcare organizations has become an important issue globally for improving medical services. In 2016, Taiwan’s National Health Insurance (NHI) system covered 99.6% of Taiwan’s population. With the enhancement of medical quality, patients expect medical service providers to care more about safety and medical service. Understanding physicians and registered nurses’ attitudes toward patient safety is a critical issue for healthcare organizations wanting to improve the quality of the medical care they provide.
Objective: The purpose of this study was to discern physicians and registered nurses’ attitudes toward patient safety using Sexton and colleagues’ Safety Attitudes Questionnaire (SAQ) in order to develop strategies for improving the quality of medical services.
Methods: Pearson correlation analyses were conducted to demonstrate the relationships among six patient safety culture dimensions. Physicians and registered nurses were asked to complete the questionnaire in a case hospital in Taiwan in 2016.
Results: The results of Pearson correlation analyses demonstrated a strong and positive relationship between perceptions of management and working conditions. Additionally, teamwork climate was highly correlated to safety climate. The results also illustrated that teamwork climate and job satisfaction were significantly related.
Conclusion: The assessment of patient safety culture can provide a basis for hospital managers to monitor the quality of the medical care provided at their organizations. Hospital managers should put more efforts into the essentially important elements of patient safety culture, such as teamwork climate, safety climate, perceptions of management, and working conditions, so as to continuously improve the quality of medical care.

Abstract Background: Drugs play a strategic role as a health commodity. Thus, the supply chain management of drugs is an important issue to reducing costs and thereby improving patient health.
Objective: This study evaluated the status of drug supply chain management and health reform in the pharmaceutical sector of teaching hospitals in Ahvaz, Iran.
Methods: This cross-sectional study was carried out in pharmacies of teaching hospitals in Ahwaz, Iran in 2015. Data was collected through a checklist extracted from the Evaluation Checklist of the Food and Drug Deputy and related articles. The study checklist examined six dimensions of the Evaluation Checklist, including drug storage, administrative regulations, preparation of medicines, drug distribution, taking medication, and implementation of health reforms in the pharmaceutical sector. The content validity of the checklist was confirmed by experts and pharmaceutical specialists. Data was analyzed for descriptive characteristics such as frequency and percentage using EXCEL version 2010 software.
Results: The findings show that hospitals met standards for administrative regulations with 78.5% and preparation of medicines with 77.25%. The dimensions of drug storage with 74.75%, taking medication with 74.25%, implementation of health reforms with 71.5%, and drug distribution with 62.5% were in a near-standard state.
Conclusion: Supply chain management systems of medicines in teaching hospitals are near-standard. To improve hospitals, offering proper training to employees, using the fixed-rate shopping system, and providing facilities to patients are recommended.

Abstract Background: Kidney calculi are the most common cause of kidney failure.
Objectives: This study aimed to investigate the prevalence of renal colic and its risk factors in the patients referred to two emergency departments during a year.
Methods: This was a descriptive cross-sectional study conducted in two hospitals in Kerman city, south-east of Iran, for one year from March 2019 to March 2020. All the archives of the two emergency departments were reviewed, and the required information was recorded in a checklist. The data was analyzed in SPSS 20 software.
Results: A total of 504 patients were included in the study. The prevalence of renal colic was 0.5%. Most of the patients (58.5%) had an age between 19 and 39 years, and the majority (60.1%) were males and had a body mass index (BMI) above 25. A family history of renal colic was reported in 68.7% of the patients, and 63.9% had either hypertension or diabetes. Most of the patients consumed less than 3 liters of water per day. The highest referrals were seen in autumn (31.5%) and summer (27.4%).
Conclusion: Considering the relationship between renal colic and age, sex, BMI, occupation, a family history of the disease, the presence of underlying diseases, the amount and type of drinking water, and the season of referral, it is recommended to control these risk factors to reduce the incidence of the disease.

Abstract Background: Coronavirus disease 2019 (COVID-19) pandemic has been associated with various risks, including the exposure of infectious agents.
Objectives: The study aims at describing the incidence of blood and body fluid (BBF) exposure in a COVID-19 facility so as viral transmission potential through blood.
Methods: A descriptive study of BBF exposure notified was carried out in a community hospital in Qatar.
Results: In 2020, 29 needlesticks injuries were reported, which is a significant increase compared to the year 2019 (6 incidents) and 2018 (5 incidents). No evidence of SARS-CoV-2 transmission was shown concerning the injury using symptoms monitoring and lab test.
Conclusion: The increased risk of BBF exposure during the pandemic provides insight into the need to review the prevention practices of occupational exposure during pandemics. Additional studies are required to define the risk of COVID-19 related to occupational exposure to BBF.