Reducing chronic medical complications due to failure of patient safety using Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) method

BACKGROUND: Human errors in the medical profession can lead to irreparable errors in people's lives, damage, and heavy costs. Among health care workers, nurses spend more time with patients compared to other personnel; hence, they are more prone to human error. Therefore, the purpose of this study was to identify and evaluate human errors using the Standardized Plant Analysis Risk-Human Reliability Analysis (SPAR-H) method in nursing staff of a general hospital in Qazvin Province, Iran.METHODS: This cross-sectional study was conducted in a general hospital in Qazvin during last 6 months of 2016 and first 6 months of 2017. The target population in the present study was nursing groups based on their highest work experience, from each section in hospital. The SPAR-H method was used to investigate human error in the population and the collected data were analyzed using SPSS software.RESULTS: The highest error related to inappropriate venipuncture with probability of 0.7, and the least probable error related to error in entering the numbers of vital signs with the probability of 0.0045.CONCLUSION: Due to the sensitivity of the role of nurses in hospitals, the need for increased workforce, the use of people with higher work experience in sensitive sectors, reducing overtime even for those who volunteered to work overtime, scientific scheduling of the personnel’s work shifts, and providing practical training such as stress control methods in case of emergencies can be effective in reducing the probability of an error

The effect of job-stress on patient-safety in hospitals affiliated to Alborz University of Medical Sciences, Iran

BACKGROUND: Patient-safety is one of the main pillars of healthcare. Given that nurses are the largest group associated with patients, so with safety harms, job-stress among then can reduce patient-safety in hospitals. The aim of this article was to investigate the effects of job-stress on patient-safety in hospitals affiliated to Alborz University of Medical Sciences, Karaj, Iran.METHODS: In this cross-sectional study, data gathering tools consisted of a reliable researcher-made job-stress questionnaire, and a patient-safety checklist. 320 nurses in hospitals affiliated to Alborz University of Medical Sciences, who were selected using simple randomized sampling method, completed the questionnaire, and the checklist was filled by the researcher. Data were analyzed at two levels of inferential and descriptive statistics.RESULTS: Job-stress and also patient-safety were at average levels in studied hospitals. Among the demographic factors, only the relationship between job-stress and marital status was statistically significant (P < 0.050). There were no significant relationships between different aspects of job-stress among nurses and patient-safety.CONCLUSION: According to average level of job-stress among studied nurses, the quality of offered services would decrease and patient-safety would become undermined, if no action take place to reduce the job-stress among them. Therefore, it is necessary to increase nurses’ physical, psychological, and social health to increase patient-safety

Epidemiological study of cholera in Qazvin city during summer of 2011

Cholera is an acute intestinal infection caused by consuming food or water contaminated with the bacterium Vibrio cholerae. Two main epidemiological characteristic of disease is tendency for create of sudden outbreaks and the ability to causing a pandemic. The objective of this study is to describe the epidemiology of the disease. This survey is a descriptive cross-sectional study based on reports from the health centers and hospitals covered by city health centers. Rectal swab is obtained from all suspected cases. After reporting each positive case, health team was sent to the location and it completed the epidemiological form. Data were analyzed by version 16 of SPSS software. All reported patients were 44 cases. Epidemic lasted from 4 August to 18 September 2011. Ogawa was the predominant pathogenic serosubtype. 47.7% of all patients admitted to the hospital and 52.3% were treated as outpatients. Most of the patients were in age group >60 years and there were no reports of disease in age group under 15 years.  2 of the 44 patients had mild symptoms of diarrhea, 13 patients had moderate and 29 cases had severe diarrhea. Not affection of age groups less than 15 years indicates epidemic patterns of disease in the city. Severity of symptoms is important in case finding; then, in disease surveillance system we should obtain rectal swab specimen from all cases of diarrhea with severe symptoms.

Integration of a Combined Cycle Power Plant with MED-RO Desalination Based on Conventional and Advanced Exergy, Exergoeconomic, and Exergoenvironmental Analyses

The ever-increasing world population, change in lifestyle, and limited natural water and energy resources have made industrial seawater desalination plants the leading contenders for cost-efficient freshwater production. In this study, the integration of a combined cycle power plant (CCPP) with multi-effect distillation (MED) and reverse osmosis (RO) desalination units is investigated through comprehensive conventional and advanced exergy, exergoeconomic, and exergoenvironmental analyses. Firstly, the thermodynamic modelling of the CCPP is performed by using a mathematical programming procedure. Then, a mathematical model is developed for the integration of the existing CCPP plant with MED and RO desalination units. Finally, conventional and advanced exergy, exergoeconomic, and exergoenvironmental analyses are carried out to assess the main performance parameters of the integrated CCPP and MED-RO desalination system, as well as to identify potential technical, economic, and environmental improvements. A case study is presented based on the Shahid Salimi Neka power plant located at the north of Iran along the Caspian Sea. The mathematical modelling approach for the integrated CCPP and MED-RO desalination system is solved in MATLAB, and the results are validated via Thermoflex software. The results reveal an increase of 3.79% in fuel consumption after the integration of the CCPP with the desalination units. The exergy efficiency of the integrated system is 42.7%, and the highest cost of exergy destruction of the combustion chamber is 1.09 US$per second. Economic and environmental analyses of the integrated system also show that gas turbines present the highest investment cost of 0.047 US$ per second. At the same time, MED exhibits the highest environmental impact rate of 0.025 points per second

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Integration of a Combined Cycle Power Plant with MED-RO Desalination Based on Conventional and Advanced Exergy, Exergoeconomic, and Exergoenvironmental Analyses

The ever-increasing world population, change in lifestyle, and limited natural water and energy resources have made industrial seawater desalination plants the leading contenders for cost-efficient freshwater production. In this study, the integration of a combined cycle power plant (CCPP) with multi-effect distillation (MED) and reverse osmosis (RO) desalination units is investigated through comprehensive conventional and advanced exergy, exergoeconomic, and exergoenvironmental analyses. Firstly, the thermodynamic modelling of the CCPP is performed by using a mathematical programming procedure. Then, a mathematical model is developed for the integration of the existing CCPP plant with MED and RO desalination units. Finally, conventional and advanced exergy, exergoeconomic, and exergoenvironmental analyses are carried out to assess the main performance parameters of the integrated CCPP and MED-RO desalination system, as well as to identify potential technical, economic, and environmental improvements. A case study is presented based on the Shahid Salimi Neka power plant located at the north of Iran along the Caspian Sea. The mathematical modelling approach for the integrated CCPP and MED-RO desalination system is solved in MATLAB, and the results are validated via Thermoflex software. The results reveal an increase of 3.79% in fuel consumption after the integration of the CCPP with the desalination units. The exergy efficiency of the integrated system is 42.7%, and the highest cost of exergy destruction of the combustion chamber is 1.09 US$per second. Economic and environmental analyses of the integrated system also show that gas turbines present the highest investment cost of 0.047 US$ per second. At the same time, MED exhibits the highest environmental impact rate of 0.025 points per second

Antibiotic susceptibility and genetic relatedness of Shigella species isolated from food and human stool samples in Qazvin, Iran

Objective: The aim of this study was to investigate the genetic relatedness and antimicrobial resistance among Shigella species isolated from food and stool samples. Using cross sectional study method, Shigella spp. were isolated from food and clinical samples using culture-based, biochemical and serological methods. Antimicrobial susceptibility and genetic relatedness among the isolates were evaluated using disk diffusion and RAPD-PCR methods respectively. Results: The prevalence of Shigella spp. were 4.84 and 7.7% in food and stool samples respectively. All food isolates were Sh. sonnei. 91.42% of the Shigella stool isolates were Sh. sonnei. 62.5% of food isolates were resistant to tetracycline. 46.8, 50 and 65.8% of clinical isolates were resistant to imipenem, amikacin and azithromycin respectively. 50 and 85.7% of the food and clinical isolates respectively were MDR. Dendrogram generated by RAPD-PCR showed that the isolates from food and stool samples were categorized in a same group. Close genetic relatedness between MDR Shigella isolates from food and clinical samples indicate that foods can be considered as one of the main vehicles for transmission of MDR Shigella to human causing acute diseases. Survey of MDR Shigella among food and clinical samples is strongly suggested to be implemented. © 2021, The Author(s). Author keywords Antimicrobial susceptibility; Food samples; Genetic relatedness; Shigella species; Stool specimen