Journal Of Patient safety and quality improvement
Volume:12 Issue: 3, Summer 2024

Total knee arthroplasty (TKA) is an effective treatment method for end-stage knee osteoarthritis, and with the aging population, the demand for this surgery has significantly increased. However, bleeding during and after TKA remains a major complication. Blood transfusion, while necessary in some cases, is associated with various complications. Therefore, finding measures to reduce the need for transfusion is crucial in minimizing postoperative complications.

This study was conducted to review the world literature on The Hemostatic Effect of Tranexamic Acid during and after Total Knee Arthroplasty. In this review study, the terms total knee arthroplasty and tranexamic acid were searched in the title and abstract of articles published in internationally recognized scientific databases, and all English and related articles were listed.

Tranexamic acid, an antifibrinolytic agent, has shown promising results in reducing blood loss in major surgeries such as TKA. Different administration methods of tranexamic acid have been deemed effective, with the choice depending on the surgical team's preference and protocol.

Several studies have demonstrated the efficacy of tranexamic acid in reducing bleeding during and after TKA, leading to a decreased need for blood transfusion and its associated complications. Additionally, tranexamic acid has been found to improve joint function post-surgery in TKA patients. Overall, tranexamic acid represents a valuable option in managing bleeding in TKA procedures, offering potential benefits in reducing transfusion requirements and improving patient outcomes.

This study evaluates procedural adherence and donor management practices at a blood donation center, focusing on donor safety using Patient-Reported Experience Measures (PREMs). A cross-sectional survey was conducted from April to June 2024 using a structured questionnaire based on CAHO guidelines. Blood donors aged 18 and above were surveyed about identification processes, health screenings, counseling quality, and post-donation care. The center adhered well to health screening protocols, but gaps were identified in donor identification processes and standardized inquiries about tattoos and medications. Donor education on HIV/AIDS and post-donation care was insufficient, with many donors unclear about when to seek medical help. Improvements are needed in donor identification, standardized screenings, and education. Counselors play a crucial role in addressing these gaps by ensuring thorough screenings and providing better post-donation guidance.

Adenotonsillar hypertrophy (ATH) is the most common cause of chronic upper airway obstruction in children. It is highly prevalent in patients with allergic disorders. This study aimed to investigate the prevalence of respiratory allergies in children’s candidates for adenotonsillectomy in the ENT clinic.

This study was performed on 78 children aged 5 to 10 who were candidates for adenotonsillectomy in the ENT department of Fatemi Hospital, Ardabil City, a referral center in the Ardabil province of Iran. Patients were evaluated for respiratory allergies with a skin prick test after completing forms for recording data in the Allergy clinic of Ardabil University of Medical Sciences. The data were analyzed using SPSS software version 21.

It was detected that 44.9% of children were allergic to various respiratory allergens. The presence of a history of asthma in patients with a probability of 75% led to being positive for respiratory allergy (P˂0.001). In addition, familial history of allergy was a risk factor, in which 7.66% of these children were reported with positive respiratory allergy (P˂0.01). The presence of atopic dermatitis and eye allergy symptoms led to the positivity of respiratory allergy with a higher probability, but it was not statistically significant.

Results showed that the prevalence of respiratory allergies was high in patients who were candidates for surgery with a history of asthma, atopic dermatitis , eye allergy, and familial history of allergies . Therefore, it is recommended that further evaluations be performed on these patients prior to surgery.

Kidney stones represent a prevalent urological condition, impacting approximately 12% of the global population. While the quality of life has been examined in various urological disorders, research focusing specifically on patients with kidney stones has been limited. This study aims to assess the influence of socio-demographic factors on the quality of life among individuals suffering from kidney stones.
This cross-sectional analysis involved 142 patients diagnosed with kidney stones. The quality of life was measured using the 36-Item Short Form Health Survey. The data collected were analyzed using SPSS version 25, with results presented as means and standard deviations for quantitative data and frequencies and percentages for qualitative data. The U-Mann-Whitney test was employed to compare quantitative variables between two groups, while the Kruskal-Wallis test was used to compare three or more groups. A sign test evaluated patients' quality of life pre- and post-treatment changes.
Patients’ scores varied, with the lowest recorded in the physical role limitations subscale (39.1±37.4) and the highest in the mental health subscale (62.7±15.1). A significant association was found between patients' gender and the subscales of social functioning (P=0.038), bodily pain (P=0.004), and general health (P=0.001). Treatment for kidney stones was shown to impact a patient’s quality of life significantly.
Individuals with kidney stones experience a diminished quality of life. Factors such as female gender, age exceeding 50, and obesity were notably linked to a decline in quality of life, whereas no significant correlations were identified with other factors. The treatment of kidney stones significantly contributed to an improvement in the quality of life.

The World Health Organisation (WHO) has universally recognized breastfeeding as the best way to give newborns the nutrients they need for healthy growth and development, especially during the first six months of life. Even with this acknowledgment, the world's rates of the early start of breastfeeding (EIBF) are still below optimal levels, which has a substantial impact on the mortality rates of newborns. The objective of our study was to address the challenge of low EIBF rates among neonates delivered vaginally through a rigorous quality improvement process.  A quality improvement study was conducted over six months at Pt B.D. Sharma PGIMS, Rohtak. The study involved postnatal mothers vaginally delivering neonates above 34 weeks gestation. A multidisciplinary team employed the Plan-Do-Study-Act (PDSA) methodology to address barriers to EIBF systematically. Baseline EIBF rates were measured, obstacles were identified through process mapping and analysis, and change ideas were iteratively tested.  Initial assessments revealed a baseline EIBF rate of 0%. Through successive PDSA cycles, policy gaps, procedural inefficiencies, staffing constraints, and facility limitations were systematically identified and addressed. Interventions included immediate breastfeeding initiation in the delivery room and targeted staff education. Over the study period, EIBF rates significantly improved, reaching an average of 85%.  This study shows that EIBF rates among newborns delivered vaginally can be greatly increased with the use of a systematic quality improvement approach. Barriers to EIBF were successfully reduced through iterative PDSA cycles and the involvement of important stakeholders, resulting in long-lasting practice changes. The results highlight the benefits of early breastfeeding initiation for the health of both mothers and babies, as well as the possible influence of focused interventions on medical procedures.

Depression is one of the most common debilitating disorders. In the present study, we aimed to investigate the effects of depression on self-compassion, cognitive flexibility, and historical memory in comparison with normal people.
In a descriptive study, 43 depressed patients and 43 healthy subjects were enrolled. The scale of depression, self-compassion, cognitive flexibility, and historical memory were examined in these subjects. The data were analyzed using SPSS software version 22.
This study showed that self-compassion, cognitive flexibility, and historical memory have a statistically significant reduction in depressed patients compared to healthy subjects (p<0.05).
Our study demonstrates that depression can significantly impact historical memory, personality traits (like self-compassion), and cognitive capabilities (like cognitive flexibility). These findings have important implications for understanding and treating depression in real-world settings.