BackgroundPatient safety culture is one of the main components of the quality of health services and is one of the main priorities of health studies. Accordingly, this study aimed to determine and compare the views of healthcare staff on the patient safety culture and the impact of effective factors on patient safety culture in public and private hospitals in Tehran, Iran.MethodsThis cross-sectional study was carried out on a sample of 1203 health care workers employed in three public and three private hospitals in Tehran, Iran. Stratified random sampling was used in this study. Data were collected using the Maslach burnout inventory and patient safety culture questionnaire (HSOPSC). IBM SPSS v22 and Amos v23 were used to perform path analysis.ResultsEight hundred sixty-seven (72.57%) females and 747 (27.43%) males with a mean age of 33.88 ± 7.66 were included. The average percentage of positive responses to the safety culture questionnaire in public and private hospitals was 65.5 and 58.3%, respectively. The strengths of patient safety culture in public hospitals were in three dimensions including non-punitive response to errors (80%), organizational learning—continuous improvement (79.77%), and overall perceptions of patient safety (75.16%), and in private hospitals, were three dimensions including non-punitive responses to errors (71.41%), organizational learning & continuous improvement (69.24%), and teamwork within units (62.35%). The type of hospital and work-shift hours influenced the burnout and patient safety questionnaire scores (P-value < 0.05). The path analysis results indicate the fitness of the proposed model (RMSEA = 0.024). The results showed a negative impact of a work shift (β = − 0.791), occupational burnout (β = − 0.554) and hospital type (β = − 0.147) on the observance of patient safety culture.ConclusionProviding feedback on errors and requirements for the frequent incident reporting, and patient information exchange seem necessary to promote the patient safety culture. Also, considering the negative impact of the shift work and burnout on patient safety culture, by planning and managing these factors appropriately, correct actions could be designed to improve the safety culture.
Postpartum depression (PPD) is a major depressive disorder. Its symptoms begin 4 weeks after delivery. Several studies have evaluated the association of the type of delivery with PPD; however, there are controversies regarding this association. Therefore, the aim of this systematic review was to estimate the overall association between cesarean section (CS) and PPD. Methods: The international databases of Medline, Scopus, Web of Science, Science Direct, EMBASE and Ovid were searched until May 2017. Quality assessment was done using the Newcastle-Ottawa Scale. The pooled odds ratio in case-control and relative risk in cohort studies were used as the measures of association. A randomeffects model was applied for the report of the results with 95% confidence intervals. Results: Of 989 studies, 32 articles met the eligibility criteria and were included in the review. The adjusted OR of the association between CS and PPD was 1.15 (95% CI: 1.00, 1.34) and the crude odds ratio of this association was 1.36 (1.20, 1.55). The odds ratio of the association of elective and emergency CS and PPD was 1.29 (1.12, 1.49) and 1.36 (1.20, 1.55), respectively. In addition, the pooled relative risk of the association between CS and PPD was 1.22 (0.94, 1.58) in cohort studies. Conclusions: Based on the results of this meta-analysis, it seems CS, regardless of the type of cesarean, is a risk factor for PPD.
There are various solutions for noise control. One of the important issues is the choice of the most appropriate solution based on criteria. The aim of this study was to prioritize the noise control solutions using a fuzzy AHPâ–“TOPSIS method in the distillation unit of a refinery. At first, the sound pressure level was measured at the distillation unit and the main noise sources were identified. Then, ten control solutions and five prioritization criteria including efficiency, cost, safety, executive capability and non-interference in the process were selected according to the opinions of experts. In the next step, twenty experts were asked to compare criteria and solutions. Finally, criteria were weighted using the Fuzzy analytical hierarchy process and solutions were prioritized using technique for order preference by similarity to ideal solution method. Criteria based on the importance in the noise control included efficiency (normal weight of 0.265), cost (normal weight of 0.234), safety (normal weight of 0.226), executive capability (normal weight of 0.202), and non-interference in the process (normal weight of 0.070). The personal enclosure (coefficient closeness index of 0.1475) and modification or change of process (coefficient closeness index of 0.0595) had the highest and lowest priorities at the noise control, respectively. Regarding criteria and operational conditions in the refinery, the use of a personal enclosure was selected as the first solution at the noise control. Fuzzy AHPâ–“TOPSIS method can also be used to prioritize control solutions in other industries.
Background: Patient safety culture is one of the main components of the quality of health services and is one of the main priorities of health studies. Considering the importance of this issue, this study aimed to determine and compare the views of health care staff on the patients’ safety culture and impact of effective factors on patient safety culture in public and private hospitals in Tehran, Iran. Methods: This cross-sectional study was carried out on a sample of 1203 health care workers employed in three public and three private hospitals in Tehran, Iran. Stratified random sampling was used in this study. Data were collected using maslach burnout inventory and patient safety culture questionnaire (HSOPSC). IBM SPSS v22 and Amos v23 were used to perform path analysis. Results: 867 (72.57%) females and 747 (27.43%) males with a mean age of 33.88 ± 7.66 were included. The average percentage of positive responses to safety culture questionnaire in public and private hospitals was 65.5% and 58.3%, respectively. The strengths of patient safety culture in public hospitals were in three dimensions including non-punitive response to errors (80%), organizational learning—continuous improvement (79.77%), and overall perceptions of patient safety (79.77%), and in private hospitals, were three dimensions including non-punitive responses to errors (71.41%), organizational learning—continuous improvement (69.24%), and teamwork within units (62.35%). The type of hospital and work-shift hours had an effect on the burnout and patient safety questionnaire scores (P-value <0.05). The path analysis results indicate the fitness of the proposed model (RMSEA= 0.024). The results showed a negative impact of work shift (β= -0.791), occupational burnout (β= -0.554) and hospital type (β= -0.147) on the observance of patient safety culture. Conclusion: providing feedback on errors and requirements for the frequent incident reporting, and patient information exchange seem necessary to promote the patient's safety culture. Also, considering the negative impact of the shift work and burnout on patient safety culture, by planning and managing these factors appropriately, correct actions could be designed to improve the safety culture.
Background Job stress and safety climate have been recognized as two crucial factors that can increase the risk of occupational accidents. This study was performed to determine the relationship between job stress and safety climate factors in the occurrence of accidents using the Bayesian network model. Methods This cross-sectional study was performed on 1530 male workers of Asaluyeh petrochemical company in Iran. The participants were asked to complete the questionnaires, including demographical information and accident history questionnaire, NIOSH generic job stress questionnaire, and Nordic safety climate questionnaire. Also, work experience and the accident history data were inquired from the petrochemical health unit. Finally, the relationships between the variables were investigated using the Bayesian network model. Results A high job stress condition could decrease the high safety climate from 53 to 37% and increase the accident occurrence from 72 to 94%. Moreover, a low safety climate condition could increase the accident occurrence from 72 to 93%. Also, the concurrent high job stress and low safety climate could raise the accident occurrence from 72 to 93%. Among the associations between the job stress factor and safety climate dimensions, the job stress and worker’s safety priority and risk non-acceptance (0.19) had the highest mean influence value. Conclusion The adverse effect of high job stress conditions on accident occurrence is twofold. It can directly increase the accident occurrence probability and in another way, it can indirectly increase the accident occurrence probability by causing the safety climate to go to a lower level.
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