Volume 34, Issue 129 (April 2021)                   IJN 2021, 34(129): 50-66 | Back to browse issues page


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Farahani M, Esmaeili M, Ashrafizadeh H, Hajibabaee F, Haghani S, Ariyamloo P. Evaluation of Imam Khomeini Hospital of Tehran Compliance with the Standards of Patient Safety Friendly Hospital about the COVID-19 Pandemic: A Case Report 19 pandemic: case report study. IJN 2021; 34 (129) :50-66
URL: http://ijn.iums.ac.ir/article-1-3390-en.html
1- Management and Intensive Care Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
2- Management and Intensive Care and Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
3- Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4- Intensive Care and Management Department School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran (Corresponding author) Tel: 09188141451 Email: f-hajibabaee@sina.tums.ac.ir
5- Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
6- Nursing Managemant, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abstract:   (3223 Views)
Background & Aims: Ensuring patient safety is the first vital step in improving the quality of healthcare services. Patient safety is defined as an event that prevents unwanted injuries to a patient due to functional and unintentional actions. Safety standards are a set of requirements that are critical to implementing patient safety programs at hospitals. These standards provide an operational framework to help the hospitals fully match with the dimensions of patient safety in order to provide quality and patient-centered services. Therefore, 100% compliance with the required standards of patient safety-friendly hospital should be the priority of every hospital. The COVID-19 pandemic is one of the emerging infectious diseases that has affected the whole world in recent months. As its outbreak is an unexpected event or sequence of events of enormous scale and overwhelming speed, it has led to a high degree of uncertainty and has posed a variety of challenges to healthcare systems. Therefore, the realization of this important issue is felt more than ever in the structures and processes of each hospital of the healthcare system, in order to successfully control and efficiently manage this disease and preserve national assets. Therefore, this study aimed to determine the compliance of Imam Khomeini Hospital of Tehran with the patient safety-friendly hospital standards with respect to COVID-19 pandemic in 2020.
Materials & Methods: This descriptive-analytical cross-sectional study was conducted from September- December 2020 in Imam Khomeini Hospital Complex of Tehran during COVID-19 pandemic. 266 nurses with inclusion criteria were selected via stratified random sampling. For this purpose, the required list of 1,200 nurses was received from the nursing office of the complex. 866 nurses from 50 different wards were selected from the list based on the inclusion criteria. Then, the nurses who were in the same wards were placed in one stratum, so that the existing 50 wards including emergency department, operating room, ICU, CCU, NICU, dialysis, internal ward, surgical ward, infectious disease wards, oncology, pediatric ward, VIP and diagnostic wards were finally placed in 13 strata. Therefore, 292 samples were selected based on the quota of nurses from 13 existing strata via simple random sampling to provide a specified sample size of 266 nurses with an additional 10% to manage their attrition. Online sampling was performed by sending the link of the questionnaires through the virtual network of the study. The questionnaires included nurses' demographic information and patient safety-friendly hospital standards (Parvizi et al), including 27 items and five dimensions. The minimum score was 27 and the maximum score was 135. A higher score from the point of view of the research unit meant that the hospital was more in line with the standards of a patient safety-friendly hospital. Item 21 was scored in reverse. Scores 108-135 showed high compliance, scores 80-107 indicated moderate compliance, and scores 27-79 indicated the poor compliance of the hospital with the standards of patient safety friendly hospital. The internal consistency of the instrument was determined to be 0.934 using Cronbach's alpha. After introducing the researcher and explaining the research objectives to the research units, data were collected. Data were analyzed using descriptive statistics including absolute and relative frequency distribution, mean and standard deviation in SPSS software version 16.
Results: The mean and standard deviation of the age of nurses was 38.6 ± 7.94 years and most of them (90.2%) were female. The mean and standard deviation of the total length of service as a nurse and the length of service in the current ward was 13.87 ± 7.41 and 6.87 ± 5.80 years, respectively. ICU nurses had the highest frequency, 25.6%, compared to other hospital wards, and also rotating shifts with 42.4% had the highest frequency. The level of compliance with the standards of patient safety friendly hospitals was 97.35 ± 16.59 from the perspective of most nurses (61.7%) (80-107), and 3.58 ± 0.62 based on a Likert scale, which indicates moderate compliance. Continuing education dimension with the average compliance equal to 3.87 ± 0.69 had the highest mean and governance and leadership with the average compliance equal to 3.41 ± 0.71 had the lowest mean scores. Mean scores of dimensions of a safe environment, participation, and interaction with patients and the community, safe clinical services were 3.45 ± 0.67, 3.44 ± 0.85, and 3.71 ± 0.7, respectively.
Conclusion: Based on the findings of the present study, the level of compliance with the standards of a patient safety-friendly hospital was moderate in the Imam Khomeini Hospital complex during the coronavirus pandemic. The highest and lowest levels of compliance were related to the dimension of continuing education and the dimension of governance and leadership included in the standards of patient safety-friendly hospital. To improve the current situation, purposeful and evidence-based management of organizational resources, attention to "barriers to achievement" dimensions of patient safety, institutionalizing patient safety culture and promoting safety, attention and focus on patient safety indicators, continuous and effective training of educational staff needs are needed to improve the safety of beneficiaries, especially during the COVID-19 pandemic. Relying on the results of the present study, managers can take appropriate corrective measures to achieve 100% compliance with patient safety-friendly hospital standards and national accreditation standards, and achieve patient safety goals and provide quality and patient-centered services in the healthcare system. The results of the present study can provide a basis for examining the patient safety status and monitoring it in future researches. It is recommended that future researchers, in order to ensure patient safety and monitor the quality of healthcare and patient-centered services, analyze non-compliance in mandatory, basic, and advanced standards of patient safety-friendly hospitals using PSFHI checklist of the World Health Organization through the process of observation, interview, and review of documents in the Imam Khomeini Hospital complex.
 
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Type of Study: Research | Subject: nursing
Received: 2021/01/11 | Accepted: 2021/04/12 | Published: 2021/04/12

References
1. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, Newhouse JP, Weiler PC, Hiatt HH. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. New Eng J Medic. 1991;324(6):370-6. [DOI:10.1056/NEJM199102073240604] [PMID]
2. World Health Organization. Patient Safety: World Health Organization. 2015. 2018.
3. Psaty BM, Burke SP. Protecting the health of the public-Institute of Medicine recommendations on drug safety. New Eng J Medic. 2006;355(17):1753-5. [DOI:10.1056/NEJMp068228] [PMID]
4. Nasiripour AA, Raeissi P, Ghaffari F, Maleki M, Jafari M. Ashkan NA, Pouran R, Farhad G, Mohhamadreza M, Mehrnush J. Designing A Medical Errors Control Model For Tehran University Of Medical Science Hospitals. Payavard Salamat. 2014;8(1):44-56.
5. World Health Organisation. patient safety. 2019 Available from: https://www.who.int/teams/integrated-health-services/patient-safety
6. Morshedizadeh M. Principles of hospital maintenance and safety. Tehran. 2010. p:15-30.
7. Pourtaghi GH, Hekmat M, Rafati Shaldehi H, Salem M. Hospital incidents' prevalence rate and its effective agents in the staff of a military hospital. Journal of Military Medicine. 2011;13(1):53-7.
8. World Health Organization. Patient safety assessment manual, 2nd ed.: EMRO Publications; 2016.
9. Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, Zinner MJ, Dierks MM. A prospective study of patient safety in the operating room. Surgery. 2006;139(2):159-73. [DOI:10.1016/j.surg.2005.07.037] [PMID]
10. Adl J, Shokoohi Y, Kakooei H. Safety climate as an indicator to evaluate the performance of occupational health and safety management system. Journal of health. 2012;3(1):32-40. [DOI:10.18869/acadpub.aums.1.3.166]
11. Mazhari Z, Adel A. Patient safety status in hospitals of Tehran-patient safety friendly hospitals standards: 2013. Journal of Payavard Salamat. 2015;8(5):379-89.
12. World Health Organization. Home care for patients with suspected novel coronavirus (‎‎‎‎‎‎‎‎‎‎ nCoV)‎‎‎‎‎‎‎‎‎‎ infection presenting with mild symptoms and management of contacts: interim guidance, 20 January 2020.
13. Postel-Vinay S, Massard C, Soria JC. Coronavirus disease (COVID-19) outbreak and phase 1 trials: should we consider a specific patient management?. Europ J Cancer. 2020;137:235-9. [DOI:10.1016/j.ejca.2020.07.009] [PMID] [PMCID]
14. Al Thobaity A, Alshammari F. Nurses on the frontline against the COVID-19 pandemic: an integrative review. Dubai Medical Journal. 2020;3(3):87-92. [DOI:10.1159/000509361] [PMCID]
15. Sabet A, Jabari O, Alipour S, Sabet MR. Investigating the relationship between stress management and organizational commitment among nurses during Covid-19 pandemic, with the mediating role of communication skills training. Journal of Modern Medical Information Sciences. 2020;6(2):1-10. [DOI:10.29252/jmis.6.2.1]
16. Mosalanezhad l, Abiri S, Zeini jahromi M, Hatami N, Kalani N. Study of work-family conflict in nurses and physicians caring for patients with Covid 19: A cross-sectional descriptive study in 2020: An ethical challenge in the medical staff. Education and Ethics in Nursing. 2020;9(1):93-101.
17. Nathwani S, Rahman N. The 3 P's model enhancing patient safety during the COVID‐19 pandemic. Oral Surgery. 2021 Feb 17. [DOI:10.1111/ors.12607] [PMID] [PMCID]
18. Staines A, Amalberti R, Berwick DM, Braithwaite J, Lachman P, Vincent CA. COVID-19: patient safety and quality improvement skills to deploy during the surge. Int J Qual Health Care. 2021;33(1):mzaa050. [DOI:10.1093/intqhc/mzaa050] [PMID] [PMCID]
19. Parvizi M. The impact of safety standards implementation on patient safety function at Shahid Faghihi Hospital in Shiraz. Shiraz: Islamic Azad University; 2018.
20. Smits M, Christiaans-Dingelhoff I, Wagner C, van der Wal G, Groenewegen PP. The psychometric properties of the'Hospital Survey on Patient Safety Culture'in Dutch hospitals. BMC health services research. 2008;8(1):1-9. [DOI:10.1186/1472-6963-8-230] [PMID] [PMCID]
21. Sabouri G, Ghafghazi M, Zare M, Asadi M. Patient Safety Status in Selected Training Hospitals Affiliated to Mashhad University of Medical Sciences, Mashhad, Iran. J Patient Safety Quality Improvement. 2020;8(3):161-5.
22. Habibzadeh H, Akbari F, Ghavami H, Moradi K. A Survey on the Establishment of Patient-Friendly Safety Standards in Urmia University of Medical Sciences. Journal of Urmia Nursing and Midwifery Faculty. 2019;17(7):525-34.
23. Jabbari A, Raisi A, Rostami V. Patient safety status in selected training hospitals affiliated with Isfahan university of medical sciences. Health Information Management. 2015;12(1(41)):99-108.
24. Asefzade S, Mehrabian F, Nikpey A, Kianmehr SH. Assessment of patient safety based on standards of patient safety friendly hospitals in education and treatment centers of Rasht City in 2013. [DOI:10.18869/acadpub.rme.5.1.36]
25. Mohammad AR, Sari AA, Kor EM, Hosseini M, Rakhshan ST, Ezati M. Patient safety in Tehran university of medical sciences' general hospitals, Iran. Iranian journal of public health. 2013;42(3):306.
26. Shahri S, Kebriaee A, Seyedi HR, Sarafraz Z. Patient safety climate in medical centers of Kashan. Journal of Health Promotion Management. 2012;1(1):62-72.
27. Kuriakose R, Aggarwal A, Sohi RK, Goel R, Rashmi NC, Gambhir RS. Patient safety in primary and outpatient health care. J Fam Medic Prim Care. 2020;9(1):7. [DOI:10.4103/jfmpc.jfmpc_837_19] [PMID] [PMCID]
28. Zh N, Goudarzi Z, Keshmiri F, Pourreza A. Comparison of the education and research indicators of patient safety status between selected hospitals of Tehran University of Medical Sciences based on the WHO standards. Education Strategies in Medical Sciences. 2014;7(4):241-8.
29. Gordon M, Findley R. Educational interventions to improve handover in health care: a systematic review. Med Educ. 2011;45(11):1081-9. [DOI:10.1111/j.1365-2923.2011.04049.x] [PMID]
30. Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiologica Scandinavica. 2009;53(2):143-51. [DOI:10.1111/j.1399-6576.2008.01717.x] [PMID]
31. Berenholtz S, Pronovost PJ. Barriers to translating evidence into practice. Current opinion in critical care. 2003;9(4):321-5. [DOI:10.1097/00075198-200308000-00012] [PMID]
32. Chopra V, Gesink BJ, DE JONG J, Bovill JG, Spierdijk J, Brand R. Does training on an anaesthesia simulator lead to improvement in performance?. Br J Anaesth. 1994;73(3):293-7. [DOI:10.1093/bja/73.3.293] [PMID]
33. Straight M. One strategy to reduce medication errors: the effect of an online continuing education module on nurses' use of the Lexi-Comp feature of the Pyxis MedStation 2000. CIN: Computers, Informatics, Nursing. 2008;26(1):23-30. [DOI:10.1097/01.NCN.0000304761.56671.ad] [PMID]
34. Dimassi H, El-Jardali F, Jaafar M, Jamal D, Hamdan R. The current state of patient safety culture in Lebanese hospitals. 2010. [DOI:10.1186/1472-6963-11-45] [PMID] [PMCID]
35. Janati A, Dadgar E, Sadegh Tabrizi J, Asghari Jafarabadi M, GHolamzade Nikjoo R. Health system professionals, attitude towards necessary criteria for hospitals managers, performance assessment. Yafteh. 2012;14(3):91-101.
36. Pourreza AG, Akbari HF, Khoda BV. Maintenance and Safety Management at Diagnostic Units of Gilan University of Medical Sciences'hospitals. Health Information Management Journal. 2006;3(2):93-102.
37. Jahangiri M, Sorkhi F, Rasooli EZ, Izadi F. Compliance Study of Safe Environment Standards in Selected Hospitals of Shiraz University of Medical Sciences, Iran. Health System Reserch. 2016;12(1):27-31.
38. Fathi M. Survey of status of security in the hospitals & treatment health services of Kurdistan University of Medical Sciences in 2003. Scientific Journal of Kurdistan University of Medical Sciences. 2003;7(2):37-42.
39. Kamali Dehkordi F, Maghsoudi S, Emami Sigaroudi A, Kazemnejad Leili E. Study of Predictive factors of public health based on job satisfaction in employees of Rasht city Health Service Centers. Journal of Holistic Nursing And Midwifery. 2015;25(4):110-7.
40. Safa M, Esmailee S, GHasembroojerdi F, Hagizadeh F, myrabzadehardekani B. Incidence of post-traumatic stress disorder after COVID-19 among medical staff of masih Daneshvari hospital. Journal of Medical Council of Iran. 2020;38(1):27-33.
41. Sheykh TA, Farzandipour M. Quality of informed consent process in inpatients undergoing surgery. Scientific Journal of Forensic Medicine. 2008;14(3):151-8.
42. Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, Zinner MJ, Dierks MM. A prospective study of patient safety in the operating room. Surgery. 2006;139(2):159-73. [DOI:10.1016/j.surg.2005.07.037] [PMID]
43. Asemani O. A review of the models of physician-patient relationship and its challenges. Iranian Journal of Medical Ethics and History of Medicine. 2012;5(4):36-50.
44. Gibbs VC. Patient safety practices in the operating room: correct-site surgery and nothing left behind. Surgical Clinics. 2005;85(6):1307-19. [DOI:10.1016/j.suc.2005.09.007] [PMID]

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