marzieh noorbakhsh

This research aimed at analyzing the adverse events reported related to blood transfusion in one of the large vice-chancellorships of Iran University of Medical Sciences in spring 2018.

This descriptive study was performed based on the eight stages of the root cause analysis (RCA) of healthcare events by the National Authority for Health. For classification of the considered concerns, the “classifying nursing errors in clinical management (NECM)” model, failure classification, approved by the UK National Health System, and also a creative problem-solving technique were used for determining the improvement solutions.

Based on the results, 70% of states of blood transfusion error and blood products were placed in the category of care errors, 10% in the communication category, 20% in the category of implementation errors, and 0% in the category of knowledge and skill errors. A total of 38 influencing factors were identified for adverse events of blood transfusion, the most cause of the error was associated with organizational factors (18.4%), and the least reasons for failure were equipment and resource factors (5.3%).

The establishment of advanced systems for the automatic transmission of blood and blood products, due to the lack of proper infrastructure in Iran, is not economically feasible. Therefore, at the level of this deputy, the guideline for managing blood transfusion and blood products in the two areas of "measures required before, during, and after blood transfusion and blood products" and "hemovigilance for physicians" were developed.

From an administrational point of view, patient satisfaction with healthcare, diagnosis, and rehabilitation services is highly important. The present study was done to evaluate the satisfaction of patients referring to the emergency departments of hospitals in Arak. This study was a descriptive-analytic, cross-sectional one which was carried out using a questionnaire. The collected data were analyzed by SPSS software and the related tests. Overall, over the first period, 72.9% of the patients were satisfied with the services, whereas this level of satisfaction reached 73.3% in the second period. By comparison, levels of satisfaction with the physical environment (86.2%), health condition (85.9%), speed and accuracy of care provider (69.6%), the quality of information provision (23.1%), behavior of guards and staff (60.2%), facilities (60.1%), drug availability (66.4%), discharge and costs (51.6%), and consideration of religious issues (86.6%) in the emergency departments over the first period reached 87.4%, 84.1%, 69.7%, 25.6%, 61.7%,67.9%, 50.9%, and 88.1%, respectively over the second period. The findings of this study showed that patients’ satisfaction with emergency departments’ services was reasonable. The greatest dissatisfaction was related to costs, drugs, procedural problems, method of treatment, facilities, wait time, and insufficient information provision.

Myopia is the most common refractive defect and degenerative myopia is one of the five causes of blindness in the world. The aim of this study is to examine degenerative myopia and its related risk factors. In this cross-sectional study, the data was collected through a questionnaire along with the auto-refraction apparatus, which was utilized for determining the myopic degree. The inclusion criteria for this study were the age above the 10, myopia or astigmatic myopia, apparent media (in fonduscopic examination), and the absence of age related retinal defect. A total 65 patients participated in this study 51% of whom had degenerative myopia. Choroid neovascularization was observed in 17.65% of the subjects. There was a significant difference in the relationship between hypertension(r=28%), diabetes mellitus (r =22%) and glaucoma, and degenerative myopia; however, this difference was not observed between cataract and myopia. The correlation coefficients between hypertension and diabetes mellitus, and degenerative myopia were 28% and 22%, respectively. This correlation was very low in the case of glaucoma. The greatest correlation existed between the myopic crescent and hypertension (r=0.295%). In all of the cases, the correlation coefficient between diabetes mellitus and all the myopic complications was positive but below 40%. The majority of the patients had degenerative myopia. Hypertension and diabetes mellitus were the most common co-existing diseases. Noticing the correlation coefficient existing between hypertension and myopia, the need for controlling hypertension and diabetes mellitus for preventing retinal complications is emphasized. Also, for preventing the adverse effects of degenerative myopia in retinal defects, controlling glaucoma is suggested.