Awareness and Compliance to International Patient Safety Goals among Healthcare Personnel of a Tertiary Care Hospital in Northern India

Introduction: Advances and commitment to patient safety worldwide have grown since the late 1990s which have led to a remarkable transformation in the way patient safety is viewed. Having begun as a subject of minor academic interest, it is now embedded in most healthcare systems worldwide. The International Patient Safety Goals (IPSG) are important guidelines developed by Joint Commission International to promote safe and high-quality patient care. Patient safety is the responsibility of every healthcare personnel who is directly or indirectly involved in patient care. Aim: To determine the level of awareness amongst doctors, nurses and technicians and their compliance to IPSG in a tertiary care hospital. Materials and Methods: This observational cross-sectional study was conducted from March to May 2021, in a tertiary care teaching hospital of North India. Stratified sampling technique was used in determining the number of doctors, nurses and technicians required for this study. A validated questionnaire was used to assess the awareness level of healthcare personnel to IPSG. ‘1’ mark was assigned to each correct answer and ‘0’ were awarded to wrong answers. The data was collected and coded in a Microsoft excel database. Descriptive data analysis was done. Results: A total of 394 patient records/documents were audited for patient safety compliance. It was observed that 339 (86%) documents revealed compliance to all six IPSG. Out of the six goals of IPSG, the best compliance was observed for the fourth goal of IPSG (ensure safe surgery) for which the compliance was 100%. The lowest compliance was observed for 2nd, 5th and 6th goal (improve effective communication, reduce the risk of healthcare associated infection and reduce the patient harm resulting from fall) which was 81%, 80% and 78%, respectively. The awareness questionnaire was given to doctors (n=60), nurses (n=86) and technicians (n=76). The findings revealed that awareness was highest in nurses (84.8%) followed by doctors (81.7%) and technicians (80.2%). Conclusion: The study has found out that the awareness level of doctors, nurses and technicians towards patient safety goals is good. Further quality improvement in this field can be achieved by conducting on the job training, workshops, lectures and seminar

Are Health Caregivers safe from workplace violence? A cross sectional study on workplace safety from Tertiary Care Hospital of Uttarakhand

Background: The prevalence of workplace violence in the healthcare sector is a problem that is frequently ignored and underreported. The performance of healthcare workers who have been the target of violence may suffer, which may have a negative effect on patient satisfaction and health. Aims & Objectives: The purpose of the current study was to determine the prevalence of workplace violence (WPV), risk factors for violence against healthcare workers, and their experiences regarding the same. Methodology: It was a cross-sectional study conducted on 157 hospital staff at Tertiary Care Medical College of Uttarakhand. Data was gathered using a semi-structured, self-administered questionnaire that was modified from the ILO, ICN, WHO, and PSI. Data were analyzed using SPSS software (version 20). Results: Factors like age, gender, job profile, lesser work experience, night shifts, and fewer staff on duty were found to have a positive association with workplace violence. It was observed that the majority of incidents took place in the ward, and the patient’s relatives were the attacker in most of the cases. It was also seen that the majority of Hospital staff did not get bothered by the incident except by staying super alert while dealing with other patients or their relatives. Conclusion: The study concludes that while caring for patients, Hospital staff are at risk of being victims of aggressive and violent situations. To reduce this problem, strategies like training staff in order to handle such incidents in the future should be brought into practice. Laws should be made stricter & assaulting staff on duty should be made a cognizable offense with serious consequences & heavy penalties. Also, the young budding MBBS students should be trained by incorporating these strategies, laws & policies in the CBME curriculu

Analysis of serum metal ion levels in dental implant patients

Background: Dental implants have been widely used for the replacement of missing teeth in fully and partially edentulous patients. Titanium (Ti) has been the material of choice for dental implants due to its superior corrosion resistance behaviour and desirable mechanical properties. Hence; the present study was undertaken for assessing the serum metal ion levels in Dental Implant Patients. Materials & methods: A total of 20 subjects with missing mandibular first molar and scheduled for prosthetic rehabilitation for same using dental implant therapy were enrolled. Blood samples were obtained at baseline and sent to laboratory where auto-analyser was used for evaluation of metal ions levels. All the dental implant procedures were carried out under the hands of skilled implantologists. After placement of dental implants, blood samples were obtained at 8 weeks and 6 months follow-up. Metal ions were assessed at subsequent follow-ups. All the results were analysed by SPSS software. Results: Mean serum titanium concentration at baseline, 8 weeks and 6 months was fond to be 2.39 mg/dL, 2.35 mg/dL and 2.38 mg/dL respectively. Mean serum aluminium concentration at baseline, 8 weeks and 6 months was fond to be 4.19 mg/dL, 4.16 mg/dL and 4.18 mg/dL respectively

Homocysteine levels in implant failure patients: an observational study

Background: Dental implants have been a part of our lives since 1965 when studies of Branemark commenced. Today, ever increasing number of dental implants in total or partial edentulous patients provides an outstanding treatment alternative to conventional prosthetic rehabilitation all around the world. However, widespread use of dental implants has brought alone a gradually increasing condition called “disease of peri-implant tissues”. The present study was conducted for assessing the Homocysteine levels in implant failure patients. Materials & methods: A total of 25 subjects with clinical and radiographic evidence of peri-implantitis and 25 healthy controls were enrolled. Complete demographic and clinical details of all the subjects were obtained. Fasting (minimum of 12hrs) venous blood samples were collected. The venous blood was collected in plain vials which will sent to the laboratory for biochemical analysis and evaluation of systemic parameters of both peri-implantitis group and control group. Serum homocysteine was assessed by means of Elisa Immunoassay. Results: Mean serum homocysteine levels among subjects of the control group and peri-implantitis group was 13.27 µmol/L and 25.2 µmol/L respectively. Significant results were obtained while comparing the mean serum homocysteine levels among subjects of the peri-implantitis group and control group

Analysis of impact of complete dentures on respiratory performance: An observational study

Background: The present study was conducted for analysing the impact of Complete Dentures on Respiratory Performance. Materials & methods: 20 subjects with presence complete edentulous arch and who had history of complete denture usage for atleast five years were enrolled. Spirometric testing was carried out at following steps: Phase 1: Testing in absence of denture, Phase 2: Testing in presence of both dentures, Phase 3: Testing in presence of maxillary denture only; and Phase 4: Testing in presence of mandibular dentures only. FVC value, PEF value, FEV1 value and FEF25–75 value was recorded with the spirometric test. Analysis of all the results was done by SPSS software, followed by assessment of level of significant with chi-square test and student test. Results: While analysing statistically, it was seen that there was significant decrease in value of Spirometric variables in the presence of dentures. Conclusion: Denture wearer edentulous patients are subjected to risk of development of Spirometric alterations. Hence; these patients should be given timely instructions about various respiratory exercise protocols

Assessment of interoperator variability in shade selection using two shade guides: An observational study

Background: Shade determination for direct and indirect restorations has always been a challenging aspect of esthetic dentistry. Hence; the present study was conducted for assessing Interoperator Variability in Shade Selection using Two Shade Guides. Materials & methods: Two different shade guides used were: Shade Guide 1- Vitapan classical shade guide and Shade Guide 2-VITA toothguide 3D-Master shade guide. A total of 40 subjects were enrolled. Only those subjects were enrolled which had healthy maxillary right permanent central incisor. Two independent operators participated in the study.  Each subject was seated upright in the dental chair and the middle third portion of the maxillary right central incisor teeth to be matched was slightly moistened. The percentage of variability in shade selection between the operators was calculated. All the results were subjected to statistical analysis. Results: For shade guide 1, kappa value and interpersonal variability was 0.89 and 16% respectively. For shade guide 2, kappa value and interpersonal variability was 0.71 and 29% respectively. Hence; interpersonal variability was higher for shade guide 2 in comparison to shade guide 1. Conclusion: From the above results, the authors concluded that VITA Toothguide 3D-Master showed higher variability in comparison with Vita lumen shade guide

Comparison of flexural strength in two types of denture base resins

Background: The present study was conducted for assessing and comparing flexural strength in two types of denture base resins. Materials & methods: A total of 20 acrylic specimens were made. Stainless steel dies were made. Twenty acrylic specimens were fabricated using these stainless steel dies. The metal dies were flasked using dental plaster to complete the flasking procedure. The stainless steel dies were retrieved to create the mold space for the acrylic specimen. All the specimens were randomly divided into to study groups as follows: Group A: Conventional denture base resins and Group B: Glass reinforced denture base resins. Flexural strength of the samples was accessed using the universal testing machine. Results: Mean flexural strength of group A specimens was 109.5 MPa. Mean flexural strength of group B specimens was 139.7 MPa. While comparing the mean flexural strength between group A and group B, significant results were obtained. Conclusion: Glass reinforced denture base resins demonstrated higher flexural strength in comparison to conventional denture base resin

Evaluation of flexural strength of glass carbomer cement and conventional glass ionomer cement: A comparative study

Background: The conventional glass ionomer cement (GIC) has been advocated as a restorative material because of its ability to chemically bond to tooth structures and release fluoride.Recently, glass carbomer cement, a GIC-based restorative material, has been introduced with claims of improved physical characteristics. Hence; the present study was conducted for comparing the Flexural Strength of Glass Carbomer Cement and Conventional Glass Ionomer Cement.Materials & methods: The present study was conducted for comparing the Flexural Strength of Glass Carbomer Cement and Conventional Glass Ionomer Cement. Study moulds were made out of silicone putty material. Stainless steel scaffolding was used for creating a mould of desired dimensions.  Total 40 specimens were prepared and divided into two study groups with 20 specimens in each group. One group was of conventional GIC while the other group was GCC.After preparation of the specimen, testing of flexural strength was done using universal force testing machine. All the results were recorded, analysed and compared. Results: Mean flexural strength of GIC and GCC was 28.3 MPa and 26.9 MPa respectively. Non-significant results were obtained while comparing the mean flexural strength of GIC and GCC. Conclusion: Flexural strength of glass carbomer cement was similar to conventional glass ionomer cement.&nbsp

Assessment of implant failure rate in smokers and non-smokers

Background: One of the most imperative developments in modern dentistry is the ability to replace missing teeth using titanium implants placed directly into the jaw. Smoking has been associated with countless diseases, including cancer and neurological, cardiovascular, and respiratory diseases. Hence; the present study was conducted for assessing the implant failure rate in smokers and non-smokers. Materials & methods: A total of 100 subjects were enrolled in the present study. All the 100 subjects were divided into four study groups according to their cigarette smoking habits as follows: Group A: 25 non-smokers, Group B: 25 smokers with habit of smoking less than 5 cigarettes per day from past 5 years, Group C: 25 smokers with habit of smoking 5 to 10 cigarettes per day from past 5 years, and Group D: 25 smokers with habit of smoking more than 10 cigarettes per day from past 5 years. Radiographic and assessment of all the patients was done at six months follow-up. Results: Success rate of dental implant therapy among subjects of group A, group B, group C and group D was 100 percent, 92 percent, 84 percent and 76 percent respectively

Diabetes and dental implant prognosis

Background: The present study was conducted for assessing prognosis of dental implants in diabetic patients. Materials & methods: A total of 30 subjects with controlled diabetes and 30 healthy controls were enrolled. A Performa was made and detailed clinical profile of all the subjects was enrolled. Thorough oral examination of all the subjects was carried out. Baseline hemodynamic profile and biochemical profile of all the subjects was assessed. Only those subjects were enrolled which required prosthetic rehabilitation for missing mandibular first molar. Dental implant therapy was carried out in all the subjects. After 6 months follow-up radiographic and clinical evaluation of all the subjects was done for assessing the prognosis. Results: Among the controlled diabetic group, success of dental implant therapy was seen in 93.33 percent of the patients while among the control group, success of dental implant therapy was seen in 96.67 percent of the patients. Non-significant results were obtained while comparing the prognosis of dental implant therapy among the two study groups. Conclusion: Under controlled glycaemic conditions, dental implant therapy among diabetic patients had excellent prognosis