Background:Today, the rate of surgeries is increasing, but surgeries are canceled due to various reasons. Unexpected cancellation of surgeries not only results in disorder in the operating room schedule, but also causes stress for patients and their family and increases costs. We determined the number and causes of surgery cancellations and areas for improvement.Materials and Methods:This outcome evaluation of Six Sigma program was conducted on 850 cases after the implementation of the program and compared to that of 850 cases which received routine care before the program. Cases were selected through easy sampling during the study. Before the implementation, the number of cancellations was recorded daily and their reasons were investigated. Then, Six Sigma program was implemented in accordance with the reasons for each category and necessary steps were taken to prevent the cancellation of surgeries. Data were collected for 3 months using a three-section data collection form. For data analysis, distribution and relative frequency and chi-square test were used.Results:The three categories of patient, physician, and hospital system were identified as the main causes. The highest rate of cancellation was related to ENT surgeries (74.19%). No cancellations were made in orology surgeries. The implementation of the Six Sigma program caused a significant difference in surgery cancellation (P = 0.003); 31 (3.6%) cases of cancellation were reduced to 12 (1.4%) cases.Conclusions:The results showed that Six Sigma program is a pre-surgery care quality improvement program. Patient education and the implementation of the 6 sigma program can be effective in reducing the rate of cancellation of operations.
Introduction: Worldwide specific diseases are jeopardizing people's health in the world as well as in Iran. Chronic renal failure as a developed and irreversible failure is usually progressive. End Stage Renal Disease (ESRD) is a situation when renal function is not sufficient to preserve one's life leading to acute uremia resulting in dialysis and/or kidney transplantation for the patients. Although dialysis methods bring about complications for the patients, peritoneal dialysis is relatively cost-effective and more convenient to survive. The present study aimed to investigate (the) Etiologic factor of renal failure and imposed complications of peritoneal dialysis in the patients of Isfahan Alzahra hospital. Materials and Methods: It was a cross-sectional descriptive study conducted on 67 patients in Isfahan Peritoneal Dialysis Center. The data from the patients were collected through a two-section questionnaire whose first section was allocated to demographic information and the second part was related to the disease and complications of peritoneal dialysis. The collected data were analyzed by SPSS version 18. Results: The findings showed that there were 39 (58%) males and 28 (42%) females. Mean age of the subjects was 48 (18.8) years old. Regarding marital status, 65% were married and 35% were single. Considering complications, 28 subjects (53.5%) had infectious complications while 24 subjects (46.2%) had non-infectious complications. The highest frequency in etiologic factor of renal failure was diabetes mellitus in 29 subjects (43.9%) and the lowest for polycystic kidney in 2 subjects (3%); in addition, hypertension was observed in 51 subjects (77.3%). Discussion: The most frequent and important complication of peritoneal dialysis catheters is infection, which may result in catheter loss and discontinuation of peritoneal dialysis (PD). Diabetes and hypertension were found as the most important etiologic factors for renal failure. They should also be considered as two major risk factors in prevention of renal diseases.
Introduction The incidence of gastric ulcers in patients with abdominal stoma is high and affects the quality of patients’ life. Aim To evaluate the effect of Adib herbal ointment containing chamomile rose, black nightshade origin versus Comfeel and Conveen ointments on the skin of abdominal stoma. Material and methods This is a clinical study in which the volunteers were stoma patients. Study group consisted of 52 qualified subjects, 26 were included in the experimental group and 26 in the control group. A 2-part questionnaire was used for the data collection. The 1st part was demographic information. The 2nd part of the data collection was evaluated according to the pressure ulcer scale for healing (PUSH) tool, which used for examining skin ulcers around the stoma. P ≤ 0.05 was considered as a significant. Results and discussion The results of the Mann–Whitney test showed that between the mean score of the total score of the wound before intervention (P = 0.92) and on the 3rd day (P = 0.476), 6th (P = 0.222), 9th (P = 0.11) and 12th (P = 0.418), there was no significant difference between the control and test groups. Also, the Friedman test (intra-group) also showed that between the mean score of the total score of the wound before the intervention and the 3rd, 6th, 9th and 12th days in the control group (P = 0.0001) and in the experimental group (P = 0.0001) There was a significant statistical difference. Conclusions Based on the study, Adib herbal ointment could be recommended for the treatment of stoma to the skin as an herbal product as other common treatments.
Introduction: The ring system is one of the devices that are necessary for patients in hospital. Patients can use it in emergencies and call nurses for help. Patients who have a tracheal tube cannot make the simplest requests, and they do not have verbal communication due to tracheal tube or tracheostomy tube. According to surveys, patients' survival is 55.5% in intensive care unit (ICU). They experience severe stressful conditions. This project is designed to solve communicational problems for ICU patients. We have developed and successfully tested a new moveable "nurse call system" for ICU patient. Material Methods: this is an interventional study. Regarding the main goal of this project, it seems that the best design for "nurse call system" is horizontal panels. The Panel of device contains a touchable board, which consists of symbols that allow patients to select them despite of their physical limitation. When patient touches any symbol, the message will be sent and heard by the nurse and the patient as well, so the patient will be sure that the massages is received properly. A notepad device will be used on which patients are able to write too. It is finger touch, and has virtual keywords in both Persian and English alphabets. The voice messages and other data will be transmitted to the computer in central nurse station by a wireless accesses point. In this study, we evaluated the viewpoint of nurses and patients who have used this device. Results: 40 questionnaires were distributed, but 30 cases were collected. Results showed that 26.7% (8 cases) were men, 73.3% (22 cases) women. 26.7% (23 cases) were nurses, 6.7% (2 cases) doctor, 6.7% (2 cases) nurse assistant. 33.3% (9 cases) were in the morning shift, 66.7% (21 cases) worked in other shifts. About patient 60% (6 cases) were men, 40% (4 cases) women and in 98% comments were completely compliant and device was full consent. Conclusion: The Nurse Call system caused patients' satisfaction. In addition, this device resolved many problems of patients and made it possible to have active communication with them.
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