Design and Testing of BACRA,a Web-Based Tool for Middle Managers at Health Care Facilities to Lead the Search for Solutions to Patient Safety Incidents

BackgroundLack of time, lack of familiarity with root cause analysis, or suspicion that the reporting may result in negative consequences hinder involvement in the analysis of safety incidents and the search for preventive actions that can improve patient safety.ObjectiveThe aim was develop a tool that enables hospitals and primary care professionals to immediately analyze the causes of incidents and to propose and implement measures intended to prevent their recurrence.MethodsThe design of the Web-based tool (BACRA) considered research on the barriers for reporting, review of incident analysis tools, and the experience of eight managers from the field of patient safety. BACRA’s design was improved in successive versions (BACRA v1.1 and BACRA v1.2) based on feedback from 86 middle managers. BACRA v1.1 was used by 13 frontline professionals to analyze incidents of safety; 59 professionals used BACRA v1.2 and assessed the respective usefulness and ease of use of both versions.ResultsBACRA contains seven tabs that guide the user through the process of analyzing a safety incident and proposing preventive actions for similar future incidents. BACRA does not identify the person completing each analysis since the password introduced to hide said analysis only is linked to the information concerning the incident and not to any personal data. The tool was used by 72 professionals from hospitals and primary care centers. BACRA v1.2 was assessed more favorably than BACRA v1.1, both in terms of its usefulness (z=2.2, P=.03) and its ease of use (z=3.0, P=.003).ConclusionsBACRA helps to analyze incidents of safety and to propose preventive actions. BACRA guarantees anonymity of the analysis and reduces the reluctance of professionals to carry out this task. BACRA is useful and easy to use.     

精神科护理学教学对护理本科生就精神疾病患者歧视态度影响的研究

目的了解护理本科生在接受精神科护理学课程教学前后对精神疾病患者歧视态度的状况,为精神科护理学教学方式的改进与完善提供依据。方法 2012年3月-6月运用歧视精神疾病患者评估量表对某高校接受精神科护理学课程学习的护理本科生进行问卷调查,比较课程学习前后学生对精神疾病患者歧视态度的变化及原因。结果教学前后,学生在隔离因子及能力因子方面对精神疾病患者的歧视态度改变不大,前后相比差异无统计学意义（P〉0.05）,在危险因子方面的则有所改观,对精神疾病患者的危险趋向评价降低,前后比较差异有统计学意义（P〈0.05）。结论精神科护理教学应当打破常规模式,增加学生与患者的接触,以减轻其对精神疾病患者的歧视。     

对慢性肾脏病患者实施健康教育效果分析

目的 观察对慢性肾脏病(chronic kidney disease,CKD)患者实施健康教育的效果.方法 将100例CKD患者随机分为研究组和对照组,对研究组实施详细的健康宣教,对照组实施常规治疗与护理.结果 研究组患者住院时间、并发症发生率明显低于对照组,而健康教育达标例数、患者满意率明显高于对照组,差异有统计学意义(P＜0.01).结论 有效的健康教育能节约大量医疗资源,提高患者就医满意度,延缓并发症的发生.     

The devil is in the details: The seven deadly sins of organizing and continuing interprofessional education in the US

In spite of increased calls for expanding interprofessional practice (IPP) in the US health care system to address concerns about patient safety and quality of care, there has not been a corresponding dramatic growth in interprofessional education (IPE) programs. Indeed, the history of IPE in the US has been a roller-coaster ride of gains and losses, successes and failures. Understanding why this has been so requires the development of a personal and political economy framework, based on an understanding of the structural, ideological, and economic factors and forces that characterize IPE in American higher education. Using a metaphor of the seven deadly sins (lust, pride, greed, gluttony, envy, sloth, and wrath), this discussion focuses on both things that should not be done (sins of commission) and those that should be done but are not (sins of omission) to create successful and sustainable IPE programs. Taken together, these factors help to frame a perspective on IPE that highlights the essential knowledge, attitudes, and skills needed by faculty and administrators to create, implement, and – most importantly – sustain successful programs. Implications of this framework for promoting increased IPE are discussed, particularly with respect to insuring its successful continuation into the future.     

Language,Income, Education,and Alcohol-Related Fatal Motor Vehicle Crashes

Abstract

This paper investigates the role of race/ethnicity, language skills (a proxy for acculturation among Hispanics in Arizona, California, New Mexico, and Texas), income, and education level on alcohol-related fatal motor vehicle crashes. Using the Fatality Analysis Reporting System (FARS), we confirmed previous state-based studies showing that high income and education levels have a protective influence on alcohol-related fatal motor vehicle crashes. We also confirmed that language proficiency/acculturation tends to increase the vulnerability of Hispanic women to alcohol-related fatalities. Differences in alcohol-related fatality rates across Hispanic subgroups are observed. Future reductions in alcohol-related traffic fatalities may require prevention policies that take into account existent variations in acculturation, income, and education among racial/ethnic groups and subgroups.     

The utilization of Arabic online drug information among adults in Saudi Arabia

In Saudi Arabia, the utilization of the world wide web has become increasingly popular. However, the exact figure of such use is unknown. This study aimed to determine the percentage of, and experience with, online Arabic drug information by Arabic-speaking adults in Saudi Arabia. A web based questionnaire was used. The questionnaire language was Arabic. Public were invited to participate in the survey through e-mails, Twitter, WhatsApp and Facebook in March 2012. The survey included 17 items examining the types of accessed Arabic drug information, the respondent’s demographics, their ability to easily find and understand Arabic drug-related information, and their trustfulness and dependency on such information websites. Of the 422 Arabic speaking adults who answered the questionnaire, 88% stated that they used Arabic websites to answer drug-related questions. Of the respondents, 50% had a bachelor’s degree, 44% were young adults, over half were female (60%), and 72% of them have a chronic disease. The ease of retrieving online information was the most common reason (69%) for consulting such websites. Google as a search engine was the most frequently (86%) accessible website. Although respondents reported different drug-related topics in their online searching, the search for adverse effects was the most common (68%). Respondents claimed that they could easily find (65%) and understand (49%) the drug-related information. Although a good number of respondents qualified this type of information as good, double-checking of information on other websites was highly recommended. Trustfulness was one of the important parameters to measure and 205 respondents (55%) claimed that they only trusted half of the information cited. Moreover, around 48% of respondents considered that finding the same information on more than one website increased its trustfulness. Surprisingly, 54% of respondents did not depend on Arabic information websites when making decisions on drug use. There are a high proportion of Arabic speaking people in Saudi Arabia using and consulting Arabic drug information websites. This information is easily found and understood. However, the quality and trustfulness of such websites are not high enough to depend on them. A qualified Arabic drug information website is important to meet this need.     

A brief intervention to improve food allergy knowledge among US pediatricians: lessons learned

Objective: To evaluate a brief educational tool for pediatricians developed to address known gaps in food allergy knowledge. Study Design: Pre‐ and post‐assessments were administered to a convenience sample of 61 US pediatricians completing the Food Allergy Comprehension Tool between February and March of 2010. McNemar’s and Wilcoxon signed rank tests were used to determine whether clinical knowledge of food allergy and level of comfort in caring for food‐allergic children increased significantly after reviewing the tool. Logistic regression models were used to measure the association of participant characteristics with increased knowledge and comfort. Results: Sixty‐one percent of surveyed physicians answered more knowledge questions correctly after reviewing the tool. Significantly more participants correctly indicated that anaphylaxis poses the greatest threat to teenagers rather than young children, and correctly rejected chronic nasal problems as a symptom of food allergy (p < 0.05). Comfort in caring for food‐allergic children increased significantly on all items post‐intervention (p < 0.05). Odds of increased knowledge and comfort were significantly higher among pediatricians without previous training in food allergy. Conclusion: The Food Allergy Comprehension Tool is a rapid way to address known knowledge gaps among pediatricians and to identify areas in need of further intervention. We recommend integration of the tool with current food allergy guidelines.