99 research outputs found
A national study of patient safety culture in hospitals in Bulgaria
No full textDept, of Health management and health economic, Medical University Plovdiv, Bulgaria. Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction
Patient safety culture (PSC) is an essential component of
the care quality. An important contribution to the
evaluation of hospital culture and the enhancement of
PSC is the HSOPSC questionnaire elaborated by the
Agency for Healthcare Research and Quality (AHRQ) [1].
The questionnaire displays reliable psychometric
characteristics and has been validated in more than 20
countries.
Objective
This study aimed to assess the patient safety culture
among hospital staff using the Bulgarian version of
Hospital Survey on Patient Safety Culture (B-HSOPSC) and
explore the areas of deficiencies and opportunities for
improvement regarding this issue.
Methods
A national cross-sectional survey was conducted using a
special developed Internet-based software platform. The
questionnaire for assessment of Hospital Survey on
Patient Safety Culture (HSOPSC) includes 42 questions,
organized in 12 domains. To the Bulgarian version of BHSOPSC
two new items were added [2]. In total, 545
healthcare professionals from hospitals in different
regions of Bulgaria were enrolled. The data were
exported to SPSS 17.0 statistical software and analyzed
with descriptive statistics.
Results
In general, results show positive assessments
of patient safety culture, regardless of few of
exceptions. The dimensions "Handoffs and
transitions" and „Supervisor/manager
expectations and actions promoting safety "
showed the highest mean values, respectively
3.76+0.79 and 3.64+0.79, whereas the
"Staffing" and "Non-punitive response to
error" have received the lowest mean values,
respectively 2.79+0.60 and 2.99+0.89.
Conclusion
For the first time in Bulgaria, with the aid of a
web-based platform to report adverse events
and errors in medical practice, the level of
hospital patient safety was measured. Special
attention should be paid to the staff turnover
in hospital, as well as the introduction of a
patient safety reporting system in our country.
References
1. Sorra JS, Nieva VF. Hospital Survey on Patient Safety
Culture. Rockville, MD: Agency for Healthcare Research
and Quality; 2004. [Accessed January 23,2020].
2. Stoyanova, R., Dimova, R., Tarnovska, M., & Boeva, T.
(2018). Linguistic validation and cultural adaptation of
Bulgarian version of hospital survey on patient safety
culture (HSOPSC). Open access Macedonian journal of
medical sciences, 6(5):925-930
Corrosion of concrete structures due to climate change
No full textConcrete is clearly one of the most predominant-used material in both residential and non-residential structures across Europe (Peled and Fishman, 2021). A reinforced concrete (RC) structure is expected to satisfy criteria for serviceability, structural integrity, and stability over its designed operational lifespan, without significant loss of utility or excessive unforeseen maintenance (for general requirements see also EN 1990). Comprehending the degradation mechanisms that impact these structures is essential for accurately estimating their service life and formulating cost-effective maintenance strategies. The main mechanisms responsible for concrete degradation include corrosion caused by carbonation and the presence of chloride ions, freeze-thaw cycles, sulphate attack and erosion due to high-velocity water flow, ice, or wind-blown sand.Integral Design & Managemen
Application of the D-Fullness Technique for Breakdown Point Study of the Trimmed Likelihood Estimator to a Generalized Logistic Model
No full text2000 Mathematics Subject Classification: 62J12, 62F35A new definition for a d-fullness of a set of functions is proposed and its equivalence to the original one given by Vandev [11] is proved. The breakdown point of the WTLk estimator of Vandev and Neykov [13] for a grouped binary linear regression model with generalized logistic link is studied.Research partially supported by contracts: PRO-ENBIS: GTC1-2001-4303
The EUROPEP questionnaire for patient’s evaluation of general practice care: Bulgarian experience
No full textAim To validate the Bulgarian EUROPEP-questionnaire and its implementation to measure patient evaluation of general practice care in Bulgarian population.
Methods A multicenter cross-sectional study was conducted at twenty five primary care practices from South-Central Region of Bulgaria. A total of 1000 adult patients aged over 18 years and visiting the practice for more than a year were approached consecutively to take part in the study. The internal consistency and test-retest reliability of the EUROPEP questionnaire were evaluated. To confirm the construct validity of the questionniare, еxplanatory factor analysis was performed.
Results Cronbach’alpha for “clinical behaviour” is 0.95 and for “organisation of care” 0.81. Factor analysis identifed two factors, which accounted for 77.0% of the total variation in these items. On average, 58.7% of respondents rated the level of care received as excellent. The waiting time in the waiting room was the item most poorly rated (33.8%). The item “keeping patients’ records and data confidential” was the most highly rated (88.8%). Patients were less satisfied with “providing quick services for urgent health problems” (78.5% excellent or good) and “getting an appropriate for them appointment” (76.2% excellent or good).
Conclusion Two scales with satisfactory psychometric properties were established in the Bulgarian version of the EUROPEP-questionnaire. The study identified areas requiring improvement in general practice, such as reduction in waiting times and obtaining patient’s convenience appointment
Evaluation of psychosocial work environment among healthcare professionals in cardiac care units
No full textIntroduction: Modern healthcare organizations and medical institutions depend on several factors, including the psychological environment as part of organizational culture. The psychological climate is multifaceted and difficult to quantify. The majority of scientific researchers agree that a good psychological climate supports teamwork, good communication, and a willingness to disclose errors and adverse events. Aim: The objective of the study is to test a comprehensive and theory-based psychosocial work environment questionnaire and analyze the psychosocial climate among healthcare professionals in cardiac care units. Material and methods: A survey-based cross-sectional study was done from November 2022 to March 2023 to analyze the psychological climate of cardiac ward professionals in South-Central Bulgarian hospitals. The study used the Bulgarian version of Koys and DeCotiis’ Inductive Measures of Psychological Climate (IMPC) questionnaire. Results: The survey included 273 participants, 75.1% of whom were women (n=205). The respondents’ median age was 46, ranging from 35 to 54. They included 35.2% (n=96) with over 21 years of hospital experience. The highest proportion of in-hospital experience in a present hospital facility / present hospital unit was in the category 1 to 5 years – 27.5% (n=74) / 27.5% (n=74). The respondents were mostly registered nurses (40.3%, n=110). Specialist doctors were second at 23.8% (n=65), followed by paramedics at 14.7% (n=40), fellow doctors at 11.7% (n=32), and technical/medical personnel at 7.3% (n=20). Our study defines the psychological climate in cardiac units as having low pressure, moderate autonomy, recognition, and innovation, and high levels of trust, cohesion, support, and fairness. Conclusion: The study focused on cardiac units, necessitating tailored approaches to address concerns across other wards. Establishing transparent and secure healthcare cultures, valuing employee input, and improving the psychological environment requires stakeholder collaboration
Application of the bow-tie analysis to improve patient safety – a lesson learned from clinical practice
No full textAbstract Aim: This study aimed to assess the risk management of drug safety in an operating theater setting within a hospital-based treatment facility. Materials and methods: This is a case study detailing a single patient. The bow-tie model was modified for analyzing medication errors in anesthesiology practice and implemented in the operating room of the university hospital. The diagram was created using well-established methods. The data was gathered using an online portal (www.rsps.bg) designed to evaluate hospital safety culture and report incidents. Results: The Striped Bow Tie® methodology-built model illustrated the primary reasons for the medication error. The risk score was estimated to be 12 based on the specified parameters. The severity is rated on a 4-point scale ranging from catastrophic (4), critical (3), marginal (2), to negligible (1). The likelihood is assessed on a 5-point scale from frequent (5), probable (4), occasional (3), moderate (2), to unlikely (1). Preventive methods were suggested to minimize the risk, avert the incident, and manage the process. Conclusion: The bow-tie approach is suitable and simple to apply in hospital anesthesia practice and serves as an essential instrument for analyzing medication safety risks. The analysis demonstrated systemic errors that led to the incident, including unrealized potential for continuing medical education and transforming the hospital into a place where clinicians can constantly learn by reporting adverse events and medical errors
Reply to letter to the editor titled “Methodological issue on mixed‐methods study of reported clinical cases of undesirable events, medical errors, and near misses in health care”
No full textThe Survey of Health Care Managers’ Attitude towards the Implementation of Information and Communication System for the Registration of Medical Errors
No full textThe aim of the study has been to examine attitudeand motivation of managers of Health Care Establishments forthe implementation of information and communication systemfor the registration and reporting of medical errors.A sociological method: anonymous inquiry sent by e-mail or bypost has been used to register the initial information. More thanhalf of the health care managers (59.6% (62)) are willing toimplement an information system for the registration of medicalerrors in their respective health care establishment
ANALYSIS AND ESTIMATION OF THE VARIANCE OF CROSS-VALIDATION ESTIMATORS OF THE GENERALIZATION ERROR: A SHORT REVIEW
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