Hospital Practices and Research

Abstract Background: Alcohol-based antiseptics are widely used in clinical settings for skin disinfection prior to procedures, with efficacy dependent on both concentration and adequate wet contact time. Despite recommendations to allow antiseptics to air dry naturally, practices such as fanning or blowing are commonly used to hasten drying. The impact of such practices on antiseptic efficacy and safety remains unclear.
Objectives: To systematically map the existing literature on the effects of accelerated drying, particularly through fanning, blowing, or forced evaporation, on the antimicrobial efficacy of alcohol-based antiseptics used for skin disinfection.
Methods: A scoping review was conducted following the Arksey and O’Malley framework and the PRISMA-ScR guidelines. Five databases (PubMed, Embase, Scopus, CINAHL, and Web of Science) and grey literature sources were searched from inception to July 2025. Eligible studies examined alcohol-based antiseptics and assessed drying methods or contact time in relation to antimicrobial efficacy. Data were synthesized thematically.
Results: Eighteen publications met inclusion criteria, comprising experimental studies, clinical guidelines, technical protocols, and reviews. Four key themes emerged: (1) Sufficient wet contact time is essential for antimicrobial efficacy; (2) Fanning or accelerated evaporation reduces microbial kill rates, particularly for Staphylococcus aureus; (3) Surgical and clinical guidelines emphasize complete natural drying due to infection and fire risk; and (4) There is a lack of clinical trials evaluating infection outcomes or real-world adherence to drying recommendations.
Conclusion: Accelerating the drying of alcohol-based antiseptics can compromise antimicrobial efficacy by shortening contact time and has no support in current guidelines. Despite its widespread use, fanning remains unvalidated and potentially harmful. There is a need for clinical research on the impact of drying practices and adherence to protocols in real-world settings.

Abstract Background: Device-Associated Infections (DAIs) pose significant challenges in healthcare settings, leading to increased morbidity, mortality, and healthcare costs. Understanding the impact of the COVID-19 pandemic on DAIs and device utilization rates is crucial for optimizing infection control practices and enhancing patient safety.
Objectives: This study aims to elucidate the shifts in infection rates, specifically CAUTI, VAP, and CLABSI in a tertiary care centre before and after the onset of the global pandemic.
Methods: In this retrospective study, we analysed trends in DAIs and device utilization rates before (October 2019 - March 2020) and after (August 2021 - January 2022) the COVID-19 pandemic. Data on urinary catheter days, central line days, ventilator days, and rates of Catheter-Associated Urinary Tract Infection (CAUTI), Central Line-Associated Bloodstream Infection (CLABSI), and Ventilator-Associated Pneumonia (VAP) were collected from medical records.
Results: According to the findings of the present study, fluctuations in CAUTI, CLABSI, and VAP rates pre- and post-pandemic, with no significant difference in infection rates between the two periods (P >0.05) were observed. There was a notable increase in urinary catheter days post-pandemic, accompanied by reductions in ventilator days and central line days. The urinary catheter utilization ratio substantially increased post-pandemic, while ventilator and central line utilization ratios showed slight declines.
Conclusion: This study highlights the dynamic nature of DAIs and device utilization rates in the wake of the COVID-19 pandemic. Implementing evidence-based protocols and continuing research in infection control practices are essential for optimizing healthcare delivery and enhancing patient safety in the post-pandemic era.

Abstract

Abstract Physicians working in hospitals face challenges when it comes to understanding and meeting the medical, legal, and ethical subjects outlined in the hospital bylaws. Hospital staff physicians and the hospital administration both aspire for high quality medical care and the assurance of patient safety. Unfortunately, when quality concerns surface, there can be reasonable differences of opinion as to whether a physician’s practice pattern met the accepted threshold of the standard of care. Such differences of opinion can lead to conflict that fuels a physician review. One complication for physicians is that many of the issues that surface at peer reviews are veiled in legal concepts and underpinnings for which physicians lack education, training, and familiarity. It would be prudent for all physicians working in hospitals to become familiar with the hospital bylaws and regulations. Physicians must take a leadership role in assuring fair and equitable peer review.

Abstract Background: The issues of patient safety and healthcare quality have become increasingly important around the world since the 1990s. Many hospitals manage to reduce the number of adverse events (AEs) that can threaten patient safety in healthcare organizations. Assessing the existing patient safety culture gives hospital management a clear vision of an organization’s strengths and weaknesses. The Safety Attitudes Questionnaire, with its good psychometric properties and great internal consistency, has been used extensively to assess the patient safety culture in healthcare organizations.
Objective: Physicians and nurses form the core staff of each organization. With different demographic variables, they might perceive patient safety culture differently. This study purposed to identify critical demographic variables from the viewpoints of physicians and nurses that significantly influence the patient safety culture in a regional teaching hospital in Taiwan.
Methods: Linear regression with forward selection was employed in this study to focus on all physicians and nurses using results of a 2015 internal survey in the case hospital. Ten demographic variables were the independent variables, and seven dimensions of the Chinese version of the Safety Attitudes Questionnaire were dependent variables.
Results: Four out of 10 demographic variables had significant impacts on 6 out of 7 dimensions (with the exception of emotional exhaustion) from the Safety Attitudes Questionnaire. “Supervisor/manager” and “experience in position” followed by “age” were viewed by physicians and nurses as the most critical variables affecting the patient safety culture in this regional teaching hospital in Taiwan.
Conclusion: Assessing an organization’s current patient safety culture provides a significant value to improving patient safety. This study revealed that “supervisor/manager” and “experience in position” are the 2 most important demographic variables influencing the patient safety culture. Hospital management should take heed of the suggestions of staff members regarding these characteristics to continuously enhance their patient safety culture.

Abstract Background: Today, patient safety is an important issue in providing hospital services. Any failure in this area can cause undesirable consequences.
Objective:  The present study evaluated the status of patient safety culture in Educational Hospitals of Tehran, Iran.
Methods: This cross-sectional study surveyed 205 therapeutic and diagnostic personnel of three Tehran hospitals selected using the clustered method; samples were collected in a randomized manner. To examine patient safety culture, the standard questionnaire of patient safety culture with 12 dimensions was used. Data was analyzed using SPSS software.
Results: In the 12 dimensions of patient safety culture, exchange of data, expectations, and organization management had the lowest means of 3.28 (±0.87), and 3.32 (±0.74) among the various aspects of patient safety culture. Additionally, the two dimensions of teamwork within the organization’s units and frequency of reporting events with means of 3.71 (±0.79) and 3.73 (±0.7) had the highest means among the studied 12 dimensions of patient safety culture. The total mean of patient safety culture in the studied hospitals was 3.5 (±0.5).
Conclusion: Increasing the attention paid to patient safety culture will lead to the development and progress of hospitals in the country and will guide them toward becoming patient-friendly hospitals. Those dimensions which had low mean values in this study should be paid more attention so as to promote and protect them.

Abstract Background: Patient safety is a serious global public health issue. Estimates show that every day many patients are harmed while receiving hospital care. Health care staff plays a key role in providing quality and safe patient care, especially physicians who are main members of the medical team and a critical element in patient safety efforts.
Objective: The current study used a Theory of Planned Behavior (TPB) framework to investigate predictors of patient safety intentions and behavior of physicians.
Methods: This descriptive analytical study was conducted in 8 hospitals with 52 physicians participating. A researcher-designed questionnaire was prepared to investigate patient safety behaviors and behavior constructs of physicians based on the guidelines of constructing a TPB Questionnaire: Conceptual and Methodological Considerations. The content validity and reliability of the questionnaire were confirmed. Binary logistic regression analysis was performed using SPSS₁₈.
Results: The total mean score of physician safety behavior indicated that 3.8±0.92. 42% of physicians reported their safety behavior at a good level. There was no significant difference between the patient safety function of physicians in public and private hospitals (P=0.8) and working in medical or surgical wards (P=0.4). Among TPB constructs, “normative beliefs” had the greatest influence on physician intention for safety behaviors (wald=3.828, P=0.05).
Conclusion: The results showed that “normative beliefs” had the greatest influence on physician intention for safety behaviors; therefore, it seems that patient safety must be the most important concern of all health care staff, specifically managers and executives throughout health care centers.