Safety Profile and Patient Satisfaction in an Egyptian Cardiac Critical Care Unit

Background: Patient safety was one of the most important issues that arisen in health care management many studies were done at different cities to evaluate healthcare safety goals, the development of a checklist might help in improving the safety culture Purpose: Our work aimed to Measure the patient satisfaction at CCU, and assess the patient safety culture at CCU and finally develop Patient safety Checklist to improve performance Method: Our study was carried out in an adult Cardiac Critical care unit (CCU) at Tanta University hospital using the following Tools Safety Culture Survey Assessment toolDesigned safety checklistPatient Satisfaction Questionnaire (PSQ) It included the following phases Assessment of the safety cultureDevelopment of the checklistEvaluation of the checklist Results Study results claim that safety culture are poor in CCU especially for involvement of staff in decision making, and the absent of Safety rules and procedure which not supported from top management. But the new established safety checklist arise the safety awareness among the CCU staff. Most of patients complaining of waiting time, insurance coverage, care services, availability resources and perfection. Furthermore many physicians skills need more training to “be careful with patient’s complain, Explaining the diagnosis and treatment strategies with patients, be good listener’s, and Explain the medical terms”. Finally, patients feel insecure for all medical problems. Keywords: Safety goals- cardiac critical care- patient satisfaction-checklist DOI: 10.7176/JHMN/62-07 Publication date:May 31st 201

Workplace Empowerment as Perceived by Staff Nurses in Acute Health Care Hospitals

Empowerment is culture-bound expression that may vary in meaning across the different cultures. It is the expansion of freedom of choice, ability to act, autonomously, control of resources and ability to make decisions. Efforts to improve nursing working conditions are critical to retaining nurses currently in the system and attracting newcomers to the profession. The aim of the present study is to evaluate the workplace empowerment as perceived by staff nurses in acute health care hospitals, through a cross-section survey in three hospitals. The study sample was selected randomly. The condition of work effectiveness questioner_II (CWEQII) was used to measure the structure of workplace empowerment. The results indicate that the staff nurses reported moderate level of empowerment and some factors affecting positively the workplace empowerment like high education level and experience of staff

Bioactive injectable mucoadhesive thermosensitive natural polymeric hydrogels for oral bone and periodontal regeneration

Periodontitis is an inflammation-related condition, caused by an infectious microbiome and host defense that causes damage to periodontium. The natural processes of the mouth, like saliva production and eating, significantly diminish therapeutic medication residency in the region of periodontal disease. Furthermore, the complexity and diversity of pathological mechanisms make successful periodontitis treatment challenging. As a result, developing enhanced local drug delivery technologies and logical therapy procedures provides the foundation for effective periodontitis treatment. Being biocompatible, biodegradable, and easily administered to the periodontal tissues, hydrogels have sparked substantial an intense curiosity in the discipline of periodontal therapy. The primary objective of hydrogel research has changed in recent years to intelligent thermosensitive hydrogels, that involve local adjustable sol-gel transformations and regulate medication release in reaction to temperature, we present a thorough introduction to the creation and efficient construction of new intelligent thermosensitive hydrogels for periodontal regeneration. We also address cutting-edge smart hydrogel treatment options based on periodontitis pathophysiology. Furthermore, the problems and prospective study objectives are reviewed, with a focus on establishing effective hydrogel delivery methods and prospective clinical applications

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Analysis the patients’ careflows using process mining

Recently, The Egyptian health sector whether it is public or private; utilizes emerging technologies such as data mining, business intelligence, Internet of Things (IoT), among many others to enhance the service and to deal with increasing costs and growing pressures. However, process mining has not yet been used in the Egyptian organizations, whereas the process mining can enable the domain experts in many fields to achieve a realistic view of the problems that are currently happening in the undertaken field, and thus solve it. This paper presents application of the process mining techniques in the healthcare field to obtain meaningful insights about its careflows, e.g., to discover typical paths followed by certain patient groups. Also, to analyze careflows that have a high degree of dynamic and complexity. The proposed methodology starts by the preprocess step on the event logs to eliminate outliers and clean the event log. And then apply a set of the popular discovery miner algorithms to discover the process model. Then careflows processes are analyzed from three main perspectives: the control-flow perspective, the performance perspective and, the organizational perspective. That contributes with many insights for the domain experts to improve the existing careflows. Through evaluating the simplicity metric of extracted models; the paper suggested a method to quantify the simplicity metric. The paper used a dataset from a cardiac surgery unit in an Egyptian hospital. The results of the applied process mining techniques provide the hospital managers a real analysis and insights to make the patient journey easier

Analysis the patients' careflows using process mining.

Recently, The Egyptian health sector whether it is public or private; utilizes emerging technologies such as data mining, business intelligence, Internet of Things (IoT), among many others to enhance the service and to deal with increasing costs and growing pressures. However, process mining has not yet been used in the Egyptian organizations, whereas the process mining can enable the domain experts in many fields to achieve a realistic view of the problems that are currently happening in the undertaken field, and thus solve it. This paper presents application of the process mining techniques in the healthcare field to obtain meaningful insights about its careflows, e.g., to discover typical paths followed by certain patient groups. Also, to analyze careflows that have a high degree of dynamic and complexity. The proposed methodology starts by the preprocess step on the event logs to eliminate outliers and clean the event log. And then apply a set of the popular discovery miner algorithms to discover the process model. Then careflows processes are analyzed from three main perspectives: the control-flow perspective, the performance perspective and, the organizational perspective. That contributes with many insights for the domain experts to improve the existing careflows. Through evaluating the simplicity metric of extracted models; the paper suggested a method to quantify the simplicity metric. The paper used a dataset from a cardiac surgery unit in an Egyptian hospital. The results of the applied process mining techniques provide the hospital managers a real analysis and insights to make the patient journey easier

Dental pulp stem cells ameliorate D-galactose-induced cardiac ageing in rats

Background Ageing is a key risk factor for cardiovascular disease and is linked to several alterations in cardiac structure and function, including left ventricular hypertrophy and increased cardiomyocyte volume, as well as a decline in the number of cardiomyocytes and ventricular dysfunction, emphasizing the pathological impacts of cardiomyocyte ageing. Dental pulp stem cells (DPSCs) are promising as a cellular therapeutic source due to their minimally invasive surgical approach and remarkable proliferative ability. Aim This study is the first to investigate the outcomes of the systemic transplantation of DPSCs in a D-galactose (D-gal)-induced rat model of cardiac ageing. Methods. Thirty 9-week-old Sprague-Dawley male rats were randomly assigned into three groups: control, ageing (D-gal), and transplanted groups (D-gal + DPSCs). D-gal (300 mg/kg/day) was administered intraperitoneally daily for 8 weeks. The rats in the transplantation group were intravenously injected with DPSCs at a dose of 1 × 106 once every 2 weeks. Results The transplanted cells migrated to the heart, differentiated into cardiomyocytes, improved cardiac function, upregulated Sirt1 expression, exerted antioxidative effects, modulated connexin-43 expression, attenuated cardiac histopathological alterations, and had anti-senescent and anti-apoptotic effects. Conclusion Our results reveal the beneficial effects of DPSC transplantation in a cardiac ageing rat model, suggesting their potential as a viable cell therapy for ageing hearts

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe