Risk assessment of drug management process in women surgery department of qaem educational hospital (QEH) using HFMEA method (2013)

Evaluation and improvement of drug management process are essential for patient safety. The present study was performed whit the aim of assessing risk of drug management process in Women Surgery Department of QEH using HFMEA method in 2013. A mixed method was used to analyze failure modes and their effects with HFMEA. To classify failure modes; nursing errors in clinical management model, for classifying factors affecting error; approved model by the UK National Health System, and for determining solutions for improvement; Theory of Inventive Problem Solving, were used. 48 failure modes were identified for 14 sub-process of five steps drug management process. The frequency of failure modes were as follow:35.3 in supplying step, 20.75 in prescription step, 10.4 in preparing step, 22.9 in distribution step and 10.35 in follow up and monitoring step. Seventeen failure modes (35.14) were considered as non-acceptable risk (hazard score� 8) and were transferred to decision tree. Among 51 Influencing factors, the most common reasons for error were related to environmental factors (21.5), and the less common reasons for error were related to patient factors (4.3). HFMEA is a useful tool to evaluating, prioritization and analyzing failure modes in drug management process. Revision drug management process based focus-PDCA, assessing adverse drug reactions (ADR), USE patient identification bracelet, holding periodical pharmaceutical conferences to improve personnel knowledge, patient contribution in drug therapy; are performance solutions which were placed in work order. © 2015 by School of Pharmac

Effect of educational intervention based on Self-Efficacy theory (SET) on behavior of prevention of HIV/ AIDS in high risk women

Introduction: Today, Epidemic of HIV / AIDS is one of the most important health, social, economic problems of human and one of the biggest problems and concerns in many countries of the world that its scope and size is still increasing. This study was performed with aim to determine the effect of educational intervention based on SET on behaviors of prevention of HIV/ AIDS in high risk and vulnerable women in the city of Neka. Methods: This Quasi- experimental (case-control) study was performed on 70 high risk and vulnerable women referred to Drop-In Centers (DIC) in Sari and Neka. Data was gathered using a researcher-made along with completing questionnaire. According to the results obtained from primary completing of the questionnaire, educational intervention was designed based on the SET and was performed in intervention group. After 3 months of intervention, data of both groups was collected and analyzed using SPSS software (version 16) and Chi-square, Mann-Whitney, Wilcoxon, independent t, and paired t tests. PResults: After educational intervention, use of condom was increased at intervention group (45,7) compared to control group (5,7). The difference between before and after of self- efficacy was significant in intervention group (9.83±0.05) and control group (1.50±2.67) and performance in the intervention group with median and interquartile range of 2.0 (3.0) and control group 0.0 (0.0). In intervention group, there was a significant relation between increase of self-efficacy and increase in performance (P<0,001). Conclusion: Behaviors of prevention of AIDS and self-efficacy is insufficient in the studied women and educational intervention based on the SET can be effective on promotion of self-efficacy and use of condom to prevent from AIDS in these women. © 2015, Iranian Journal of Obstetrics, Gynecology and Infertility. All rights reserved

Diagnostic and Therapeutic Costs of Patients With a Diagnosis of Or Suspected of Coronavirus Disease in Iran

Objectives: To understand the social and individual effects of the disease and make decisions on the allocation of health resources, it is necessary to understand the economic burden of coronavirus disease (COVID-19); however, there are limited data in this field. This study aimed to estimate diagnostic and therapeutic costs of patients with a diagnosis of or suspected of COVID-19 disease admitted to hospitals in northeast Iran. Methods: This descriptive and analytical research was conducted as a retrospective study using the data collected from 2980 patients admitted to 30 hospitals from February to April 2020 in Iran. For data collection, an appropriate data capture tool was designed to record detailed resource use. A multivariate regression analysis was performed to examine the association between the treatment costs and sociodemographic, disease severity, and underlying diseases. Data were analyzed using Excel 2017 (Microsoft, Redmond, WA) and SPSS version 21 software (SPSS Inc., Chicago, IL). Results: The inpatient costs per patient were Int$416, of which 74% were paid by social health insurance systems, 19% by the government, and 7% by the patients. The largest cost components were hoteling (37%) and medicine (36%). The 4 subscales of age, sex, underlying disease, and severity predicted 48.6% of the cost variance. Conclusion: Understanding the economic consequences of diseases can help policymakers to make plans to reduce out-of-pocket payments and make plans for funding. Since COVID-19 is a newly emerging disease and there is no definitive cure for the disease, the discovery of an effective medicine may alter medical costs and reduce the hospital length of stay, therefore significantly reducing treatment costs

Quality assessment of services provided by health centers in Mashhad, Iran: SERVQUAL versus HEALTHQUAL scales

Background: Primary health care is the entry point to the health-care system and regarded as an essential step to achieving universal health coverage. The present study aimed at evaluating the quality of health-care services provided in health centers in Mashhad, Iran. Methods: This was a cross-sectional study implemented among 200 health service users who were referring to four health centers in Mashhad during January to June 2019. The quality of services in health centers was evaluated with the SERVQUAL and HEALTHQUAL models. Data was analyzed by employing paired t-test and independent sample t-test using SPSS version 16 software. The Levene test was used for examining the equality of variance (homogeneity). Significance level of all the tests was considered when p � 0.05. Results: According to the results of SERVQUAL questionnaire, the average scores of health service users� expectations and perceptions were 4.97 and 3.26, respectively, and the quality gap in the provided services was equal to � 1.7. Based on HEALTHQUAL questionnaire, the average scores of health service users� perception and expectations were 4.72 and 3.25, respectively, and the quality gap in the provided services was equal to � 1.16. Empathy was the highest quality dimension (� 2.019) based on SERVQUAL model, and efficiency dimension was the highest based on HEALTHQUAL model (� 1.761). Conclusions: The findings of the current study showed a negative gap between the service users� expectations and perceptions in both models. Therefore, the results of this study helps the health managers and policymakers to plan effective interventions for improving the provided services emphasizing the dimensions with the wider gaps. © 2021, The Author(s)

Preparation and evaluation of carvacrol pellets based on PVP solid-dispersion by extrusion-spheronization technique

Background and objectives: Carvacrol is one of the main pharmacologically active components of Thymus vulgaris essential oil which has shown several therapeutic effects. There are few works regarding the formulation of essential oils as oral solid dosage forms due to their liquid nature, stability and technical problems. The aim of this study was to combine the solid-dispersion approach and extrusion-spheronization technique to produce pellets with desirable physico-mechanical and release properties. Methods: Solid dispersion matrix (30%) of carvacrol in polyvinylpyrrolidone K30 was prepared by solvent evaporation. The matrix was mixed with Avicel and lactose and granulated by water. The wet mass was transformed into pellets by extrusion-spheronization. In order to compare the solid dispersion method with the classic approaches, another pellet formulation was prepared by absorption of carvacrol on Aerosil. The pellets were characterized for size (sieve analysis), shape factors (image analysis), mechanical strength, carvacrol content, and release rate (dissolution test). Accelerated stability test of formulations was also carried out. Results: Using suitable composition of solid dispersion matrix and granulation fluid, the pellets with desirable size and shape and mechanical properties could be produced. PVP-based pellets had higher mechanical strength, slower release rate and improved content and stability. The PVP ratio showed considerable effect on release properties of the pellets. Conclusion: Overall, the results revealed the feasibility of preparing desirable pellets containing carvacrol with acceptable content, stability and release properties which can be administered as hard gelatin capsules