Number Of Medical Institutions Research Articles

Финансирование национальной системы здравоохранения с учетом тенденций развития медицинской помощи и социально-экономических реалий

The effectiveness of the functioning of the health care system consists in achieving high indicators of the quality of life of the population, which is achieved through the use of various regulatory and self-regulation tools in the health care system, which are always based on the need for financial support, which is the cornerstone of solving problems related to the need to increase the effectiveness of the health protection system. The financing of the healthcare system is considered from the point of view of its compliance with modern socio-economic realities. The optimal model of financing the domestic healthcare system is being investigated in terms of the relationship between the life expectancy of the population, the amount of financing for the health protection system, the number of medical institutions and the availability of medical personnel. The priority directions of the development of the national health financing system are substantiated. It is concluded that the national model for financing the health protection system should be a model based on the allocation of funds from the federal budget, which are directed to ensuring the financing of programs for the development of the national health system, as well as based on the creation of institutional, legislative and mental conditions for attracting public funds to the insurance industry medicine. It is confirmed that there is a close relationship between the effective indicator of life expectancy and public spending on health, which corresponds to WHO statistics. Other factors do not have such a strong impact on the national health system. It is recommended to further develop the healthcare financing system based on foreign experience, on the development of insurance and paid medicine.

PROTECTION OF THE RIGHTS OF HEALTHCARE WORKERS IN THE LIGHT OF EUROPEAN INTEGRATION PROCESSES

The aim of the article is to thoroughly characterize the rights of all health care workers in accordance with the current legislation of Ukraine, as well as to identify problems that arise in the process of protecting the rights of health care workers and to propose ways to eliminate them.
 Materials and methods. In the course of the research 1,000 healthcare workers were interviewed and surveyed regarding the violation of their fundamental rights in the city of Kyiv and medical and preventive institutions of the Kyiv region. Evaluating the violation of the rights of health care workers, it was found that every fifth medical worker notes the violation of his rights by patients, which is 70%, and by health care institutions – 25%; from colleagues – 3%; the other 2% refrained from answering.
 The results. As of January 1, 2024, according to the statistical data of the National Health Service of Ukraine, it is stated that from January 1, 2022 to December 31, 2023 in Ukraine: the number of specialist doctors increased by 5.2% (+4667), by 4.9% (+1280) – primary care physicians (PHC), by 6.7% (+9961) – secondary medical personnel [1]. Thus, the number of medical workers (doctors, middle and junior staff (without pharmacists)) in the Electronic Health Care System as of January 1, 2022 was more than 288000, as of January 1, 2024 – 345000, and medical institutions – 7,393. In July 2023, the number of medical workers was already 396000, and the number of medical institutions was 6559. Whereas in December, the number of medical workers increased to almost 520000, and medical institutions – to 8444 [2].
 Conclusions. In order to improve the protection of the rights of healthcare workers, it is necessary to implement at the legislative level the concept of medical neutrality, which should apply in all democratic countries, regardless of the situations that arise in society. The authors formulated the main principles of medical neutrality, in particular: protection of medical workers, patients, health care institutions and other medical formations, medical vehicles from attacks or from illegal interference; free access to medical care, in particular treatment, as well as necessary medicines and medical devices; humane treatment of the entire civilian population; lack of discrimination in the treatment of the sick or injured; observance of the rights of patients, in particular, to keep a secret about the state of health, to refuse treatment.

Toward tuberculosis elimination by understanding epidemiologic characteristics and risk factors in Hainan Province, China

BackgroundThe disease burden of tuberculosis (TB) was heavy in Hainan Province, China, and the information on transmission patterns was limited with few studies. This atudy aims to further explore the epidemiological characteristics and influencing factors of TB in Hainan Province, and thereby contribute valuable scientific evidences for TB elimination in Hainan Province.MethodsThe TB notification data in Hainan Province from 2013 to 2022 were collected from the Chinese National Disease Control Information System Tuberculosis Surveillance System, along with socio-economic data. The spatial–temporal and population distributions were analyzed, and spatial autocorrelation analysis was conducted to explore TB notification rate clustering. In addition, the epidemiological characteristics of the cases among in-country migrants were described, and the delay pattern in seeking medical care was investigated. Finally, a geographically and temporally weighted regression (GTWR) model was adopted to analyze the relationship between TB notification rate and socio-economic indicators. The tailored control suggestions in different regions for TB elimination was provided by understanding epidemiological characteristics and risk factors obtained by GTWR.ResultsFrom 2013 to 2022, 64,042 cases of TB were notified in Hainan Province. The estimated annual percentage change of TB notification rate in Hainan Province from 2013 to 2020 was − 6.88% [95% confidence interval (CI): − 5.30%, − 3.69%], with higher rates in central and southern regions. The majority of patients were males (76.33%) and farmers (67.80%). Cases among in-country migrants primarily originated from Sichuan (369 cases), Heilongjiang (267 cases), Hunan (236 cases), Guangdong (174 cases), and Guangxi (139 cases), accounting for 53%. The majority (98.83%) of TB cases were notified through passive case finding approaches, with delay in seeking care. The GTWR analysis showed that gross domestic product per capita, the number of medical institutions and health personnel per 10,000 people were main factors affecting the high TB notification rates in some regions in Hainan Province. Different regional tailored measures such as more TB specialized hospitals were proposed based on the characteristics of each region.ConclusionsThe notification rate of TB in Hainan Province has been declining overall but still remained high in central and southern regions. Particular attention should be paid to the prevalence of TB among males, farmers, and out-of-province migrant populations. The notification rate was also influenced by economic development and medical conditions, indicating the need of more TB specialized hospitals, active surveillance and other tailored prevention and control measures to promote the progress of TB elimination in Hainan Province.

Balancing the Scales: Elevating the Standard of Medical Education in India

I recently came across the editorial titled "So Many Docs, What's the Prescription?" published in your esteemed journal. (1) I read the editorial with great interest and concern and appreciate your insightful analysis of the challenges facing India's medical education system. The editorial has aptly raised concerns about the rapid increase in the number of medical institutions and available MBBS seats in India. It eloquently captures the dual-sided impact of this growth, noting commendable progress towards the doctor-population ratio target while shedding light on the alarming compromise in the quality of medical education and, subsequently, the competence of our doctors.

Should Physicians Be Permitted to Refuse Follow-Up Care to Patients Who Have Received an Organ Transplant Through Organ Trafficking?

In 2018, the Istanbul Declaration stated that organ transplantation via organ trafficking is a crime. Since then, the number of medical institutions in Japan who refuse follow-up care to patients who have undergone unethical organ transplantation overseas has been gradually increasing. Deterring transplant tourism involving organ trafficking is an issue that must be addressed by the government, medical institutions, and individual physicians. The refusal of medical institutions and individual physicians to provide follow-up care after organ transplantation may challenge the idea of the incompatibility thesis; moreover, it may be ethically justified in the context of conscientious objection if it is based on the belief of deterring transplant tourism instead of punitive motives or a reluctance to support a criminal activity. However, conscientious objection based on a belief in fair transplantation care is conditional; according to the compromise approach, it is limited to particular conditions, such as that the patient's medical state does not require urgent care and that the patient is reasonably able to receive follow-up care at another institution.

ASSESSMENT OF THE FUNCTIONING OF HEALTH CARE IN THE REPUBLIC OF TATARSTAN IN 2005–2021

The Republic of Tatarstan is located in the Volga Federal District and occupies one of the last places in the ranking in terms of the number of hospital beds per 10,000 people. It should also be noted unfavorable data on the number of medical staff, the number of people per place in the hospital, the number of receptions per shift. At the same time, the region is characterized by good socio-economic indicators in the field of health. Among them, the main ones are not only stable data on morbidity and mortality, but also the conditions for financing health care. The above requires research to assess these trends. The purpose of the study is to assess the factors influencing the health indicators of the Republic of Tatarstan. Materials and methods. In the course of studying theoretical and practical provisions, general scientific methods of cognition were used: comparison, abstraction, synthesis, induction and deduction, as well as methods of statistical analysis. The information base of the study was the data of the Ministry of Finance of the Russian Federation on the use of the consolidated budgets of the Russian Federation and its subjects, as well as indicators of the development of healthcare, transport, etc. published on the Rosstat website. The results of the study. Despite a significant reduction in the number of hospitals, medical personnel, and beds in rural areas, the Republic of Tatarstan manages to maintain morbidity and mortality rates at the same level with a slight increase during the pandemic. This was facilitated by the involvement of the population in sports, as well as alternative ways of providing medical services to rural residents. New health care services are favored by good transport accessibility of district and regional centers, conditions created in them for the provision of medical care to rural residents. New methods of providing curative and preventive care are being actively used, for example, through the use of mobile teams, remote consultations, as well as redirecting patient flows to district and regional centers. Financing of health care has not always been at a sufficient level, but in recent years it has improved, which positively characterizes the state of health care in the republic. Conclusions. The Republic of Tatarstan is characterized by good socio-economic indicators in the field of healthcare. The reduction in the number of medical institutions did not adversely affect the morbidity and mortality rates of the population of the republic. To a certain extent, this is due to the developed transport network, which contributes to the provision of assistance by mobile teams, as well as the redirection of the flow of cases to district and regional centers. Financing of health care has improved in recent years, which has also contributed to the success of the functioning of medical institutions.

An analysis of the status of diagnostic radiology equipment in China

ObjectiveTo analyze the current situation of diagnostic radiology equipment in Chinese mainland and to understand changes in the past 20 years, including gaps with other countries, in order to provide a scientific basis for the government to formulate relevant policies and regulations, and supplement Chinese data for international organizations. MethodsThis survey adopted a uniformly designed questionnaire, which was completed by the investigators or the respondents. The survey was distributed to all medical institutions that provided diagnostic radiology services in 31 provinces, autonomous regions, and municipalities, excluding Hong Kong, Macao, Taiwan, and military, China. ResultsThe survey showed that in the past 20 years, the number of medical institutions and diagnostic radiology equipment per million population in China has increased substantially. Dental radiology equipment increased nine-fold, and mammography equipment and computed tomography scanners showed a nearly five-fold increase. The four types of diagnostic radiology equipment, general diagnostic, fluoroscopic, mammography, and computed tomography, were associated with the population. Dental radiology equipment and bone mineral densitometers were related only to the gross domestic product (GDP). A large gap remains in the diagnostic radiology equipment per million population between China and the equipment of health-care level (HCL) I countries. ConclusionsAn imbalance in the number of units of diagnostic radiology equipment per million population was observed in the different regions, China. Various types of diagnostic radiology equipment, especially mammography equipment and computed tomography scanners, need to be deployed to meet the medical needs of different populations.

Analysis of spatial characteristics and geographic weighted regression of tuberculosis prevalence in Kashgar, China

Number of cases of tuberculosis (TB) was higher than that of the national level in Kashgar, China. This study aimed to analyze the spatial and temporal distribution of TB and the relationship between TB and social factors, which can provide a reference for the prevention and control of TB. We applied spatial autocorrelation analysis to study the distribution of tuberculosis in Kashgar. We used a geographically weighted regression (GWR) model to analyze the relationship between TB and social factors. A total of 100,330 cases of TB in Kashgar from 2016 to 2021 were analyzed. The number of TB cases in Kashgar was higher in the east, lower in the west, and most elevated in the center. The highest cumulative number of cases was found in Shache county. Global Moran's I ranged from -0.212 to -0.549, and local spatial autocorrelation analysis identified four clusters. According to our analysis, the incidence of tuberculosis was negatively correlated among the regions of Kashgar, and the related causes need to be analyzed in depth in future studies. Per capita gross domestic product (GDP), number of medical institutions per capita, and total population influenced the incidence of tuberculosis in Kashgar. Based on our findings, we suggest some effective measures to reduce the risk of TB infection, such as improving the living standard, developing the regional economy, and distributing health resources rationally.

Paradigms of megapolis nephrology in a changing world: status, problems and prospects of development of the nephrological service of St. Petersburg

The course of the COVID-19 pandemic has led to a critical increase in the burden on virtually all major branches of the health care system in our country and abroad. The aim of this article is to analyse the activities of the different parts of the city nephrol­ogy service in Saint-Petersburg and to consider promising ways to improve it. The nephrology service for the adult population in St. Petersburg includes: outpatient service; inpatient service - 183 beds in 24-hour inpatient departments of the city; dialysis service - 10 dialysis units in municipal medical organizations, 5 in federal institutions, and 8 centers/departments operating in the framework of private-public partnership. The number of patients on dialysis programme decreased by 10.5 % to 1,839 in 2021. These changes are likely due to an increase in mortality among these patients in 2020 and 2021 which is a consequence not only of COVID-19 but also of the adverse impact of the pandemic on the health system. The proportion of patients treated as outpatients in private dialysis centres increased during the three-year period. The incidence of arteriovenous fistula formation in primary vascular access decreased from 33.2 % to 14.2 % in 2020 compared with 2019. At the same time, the use of temporary central venous catheters as primary vascular access for renal replacement therapy has increased significantly from 43.0 % to 61.9 %. The development of the nephrology service is largely determined by its funding. To compensate the costs of medical in­ stitutions in the city for conducting renal replacement therapy it is necessary to increase the tariffs of compulsory health insurance (CHI) by at least 50 %. In the medical organizations of Saint-Petersburg municipal and federal subordination the share of "artificial kidney" devices that have used up their resource is 32.2 %, and in a number of medical institutions it exceeds 50 %.

RURAL AREAS OF UKRAINE: CURRENT STATE, PROBLEMS, SOLUTIONS

Rural areas occupy a special place in the socio-economic life of Ukraine. They are home to a third of the population of our state and account for a larger share of its area. The importance of these territories is enhanced by their exceptional contribution to the formation of the foundations of food security and the expansion of the country’s export potential. These and other factors make the development of rural areas one of the main priorities of the state policy of Ukraine aimed at raising the living standards of the rural population, increasing the efficiency of the functioning of the agro-industrial complex, improving the state of the environment and improving the quality of human capital. However, more than 30 years of Ukraine’s independence have not brought the expected increase in well-being to ordinary peasants. According to the processed data of the State Statistics Service of Ukraine, it has been established that rural areas are in a catastrophic state: the ecological condition of natural resources is deteriorating, engineering and social infrastructure, and the system of social services have fallen into disrepair. From year to year there is a decrease in the number of medical institutions and enterprises of household services, communication offices, schools and especially preschool institutions. The construction of social facilities and housing for rural youth has practically stopped. The social infrastructure has been practically destroyed, and those institutions of social and cultural purpose, which are still functioning at least somehow, are in survival conditions. Migration processes and the depopulation of the rural population have increased sharply. The agro-ecological condition of soils, the quality of agricultural products grown in rural settlement areas, and the quality of drinking water are deteriorating. The destruction and decline of rural areas is the result of insufficient attention of state management bodies to their problems. Today, 30% of Ukraine’s population lives in rural areas and there are 28,369 villages, while in 1990, 32.6% of the population lived in rural areas and there were 28,845 villages. For the period 1990–2021, 476 rural settlements have disappeared. The demographic situation in Ukraine has received negative changes, it remains especially acute in rural areas, and during the Russian aggression against Ukraine, the demographic situation has generally become catastrophic.

Analysis of Health and Demographic Data of the Rural Population of the Aiyrtau District

The task of restructuring the network of medical organizations, taking into account regional characteristics, in order to ensure maximum accessibility of medical care, fell into the national project "Quality and affordable healthcare for every citizen "Healthy Nation". The purpose of the study: to assess the availability of medical care for the rural population based on the analysis of medical and demographic indicators of the Aiyrtau district. Methods. In this study, in order to analyze the medical and demographic situation of the rural population of the Aiyrtau district, as well as to determine the accessibility of the healthcare system for the rural population, statistical data, accounting and reporting documentation of medical organizations were studied. Demographic indicators, morbidity rates, the number of medical institutions in the region, the equipment ofmedical organizations, the provision of medical workers, etc. were analyzed. Results. Medical and demographic indicators do not reach republican values. The overall mortality rate (15.87 per 1000 people) is 1.6 times higher than in the republic (9.53 per 1000 population). The birth rate (12.27 per 1000 population) is 1.9 times lower than the republican level (23.41 per 1000 population). Over the past 5 years (from 2017 to 2021), the birth rate in the region has decreased by 6.4% from 13.11 to 12.27 per 1000 population (Kazakhstan - a decrease of 7.5%). When studying the mortality rates of the population, a similar situation is observed, when in 2021 there was an increase to 15.07, and in 2022 it decreased by 10.6% to 13.46 per 1000 population. The total number of diseases was 23710, the leading position, as well as throughout the country, is occupied by respiratory diseases - 9519 (40.1%), followed by diseases of the circulatory system - 5348 (22.5%), endocrine diseases - 1844 (8%), followed by diseases of the digestive system - 880 (5.1%), neoplasms - 522, infectious and parasitic diseases - 427, injuries, poisoning - 422 (2.7%) and congenital anomalies (malformations), deformities and chromosomal disorders - 188 (1.79%). The healthcare system of the region is represented by 19 hospitals, 63 outpatient organizations (58 outpatient clinics, 5 outpatient clinics, including AIDS center, regional dentistry, etc.), 41 feldsher-obstetric and 403 medical centers. The bed fund of state medical organizations is 3223 beds. The district hospital with a polyclinic and a hospital is equipped with 85 beds for a round-the clock stay and 31 beds for a day stay, it has 10 medical outpatient clinics, 3 feldsher-obstetric stations, 46 medical stations. Conclusions. The results of the study show that the incidence among the rural population remains high. The main problems of the rural healthcare system, which significantly affect the availability of medical care for the rural population, are undeveloped infrastructure, under equipped medical organizations, which in turn leads to low detection of pathology, late diagnosis and treatment. There is also a shortage of personnel, especially a shortage of narrow specialists, which leads to low availability of specialized medical care.

Environmental issues of children's health in the Kazakh SSR (1941–1943)

The article discusses issues related to children's health care in the Kazakh SSR during World War II. Based on archival data the authors of the article concluded that the increase in child mortality in the early years of the war was due to the high incidence of infectious diseases such as whooping cough, diphtheria, dysentery, pneumonia, scarlet fever, measles, and others. The reasons were the shortage of the necessary number of medical institutions, their insufficient equipment and absence of qualified medical staff, untimely detection of diseases and late hospitalization, lack of quarantine boxes and certain percentage of unvaccinated children. Among other reasons there are low living standards of the population, poor sanitary conditions in some children's institutions, and nutritional problems of children. All this led to increased morbidity and mortality of children in the early period of the war.

Effects of early essential newborn care versus routine birth care on physiological variables and sleep state among newborn infants: a quasi-experimental design

BackgroundEarly essential newborn care (EENC) was introduced to medical practice in China in 2016, but the number of medical institutions that have put EENC into practice remains low due to insufficient clinical evidence and the absence of awareness among health professionals. This study aimed to explore the effect of EENC on physiological variables and sleep state among newborn infants and to provide evidence to support the implementation of EENC.MethodsA quasi-experimental design was conducted among 182 newborn infants in a tertiary maternity hospital in China from May 2020 to January 2021. A total of 91 newborn infants were included in the intervention group, and 91 were included in the control group to receive EENC or routine birth care, respectively.ResultsThe newborn infants in the intervention group had a lower incidence of hypothermia than those in the control group at 75 min, 90 min, 105 min, and 120 min after birth (p < 0.05). The time of first breathing after birth in the intervention group was earlier than that in the control group (5 s vs. 7 s, p < 0.05), and the infants had a better sleep state at 30 min, 60 min, 90 min, and 120 min after birth (p < 0.05).ConclusionsEENC can decrease the incidence of hypothermia, promote the initiation of breathing, and improve the sleep state among newborn infants compared to routine birth care in China. More coaching should be provided to health professionals to promote the implementation of EENC in China.Trial registrationChinese Clinical Trial Registry, Retrospective Registration (27/7/2021), registration number: ChiCTR2100049231.

Становлення та розвиток неврології в Києві

Стаття присвячена історичним фактам на шляху становлення та розвитку неврології у Києві. Автором були опрацьовані фонди Київського міського архіву, Київського державного архіву вищих органів влади та архівів ряду медичних установ міста. Наведений аналіз історичних подій, фактів дозволяє дослідити в хронологічному порядку становлення та розвиток неврології в місті Києві.

ПРОБЛЕМА МЕДИЦИНСКОЙ АКТИВНОСТИ НАСЕЛЕНИЯ РОССИИ В ЭПОХУ COVID-19

Significance. Medical activity is a person's practice in the field of protecting one's own and public health, expressed in compliance with medical recommendations and hygiene rules, a complex of therapeutic and preventive measures for improving health, identifying and eliminating pathological changes, functional disorders, and preventing diseases. The basis of medical activity is awareness, which is formed through effective hygiene education and promotion of a healthy lifestyle. Therefore, the nature and intensity of the medical activity of an individual is influenced by the level of education and culture, and knowledge of health-related issues. The purpose of the study is to consider the main problems of medical activity, preservation and promotion of health in the context of the COVID-19 pandemic. Material and methods. The information base of the study was publications in periodicals and the Internet, statistical data of the Rosstat, WHO, “Yandex. Coronavirus. Statistics”, polls by the state-run VTsIOM (All-Russia Opinion Research Center). The study used general logical and analytical methods, methods of statistical analysis and empirical research. Results. Medical activity and lifestyle play a leading role in controlling the spread of COVID-19. Non-compliance with anti-epidemic measures and irresponsible hygienic behavior (ignoring the mask regimen, personal hygiene rules, social distancing, “anti-vaccination” attitude), irresponsible medical behavior (undertreatment and ignoring medical rehabilitation), unhealthy diet (unbalanced diet, insufficient intake of vitamins and microelements), inadequate physical activity (its insufficiency) and addictive behaviors (smoking, drinking alcoholic beverages) contribute to both rapid spread of the infection in the social environment, and prolongation of the complicated epidemiological situation over time, minimizing the entire complex mechanism of the anti-COVID actions of the health and administrative services, increasing the risk of severe course of the disease, post-COVID complications and deaths. Reasons of the reduced medical activity of the Russians include lack of confidence in a medical specialist, medical organizations, and the health care system in general; dsregard of one's health; low sanitary culture of the population due to insufficient education in health preservation; reduction in the number of medical institutions and personnel of the state medical institutions, etc. Among the objective reasons, the first and most acute problem is the economic one: low standard of living of the significant part of the population, which dramatically limits the ability to maintain their health. The main vector in improving the current situation is the growth of economic well-being of the citizens; a conscious choice of health improvement strategies, supported by the system of measures to encourage citizens to take care of their health; promotion of a healthy lifestyle and self-preserving behavior; and government measures to support the wellness industry.

Evaluation of Health Resource Allocation Efficiency Based on Data Envelopment Analysis 2014–2018 in Two Dimensions of Time-Region

Since the new health care reform, China’s health care system has become increasingly mature and perfect, and the health awareness and needs of residents have also increased, which has raised higher requirements for the scientific understanding of the current status of health care resource allocation and making it achieve the goal of efficient operation. This paper evaluates the allocation of health resources in China from 2014 to 2018 in two dimensions: time and space by reviewing the China Health and Health Statistical Yearbook from 2014 to 2020, collecting data on the number of medical institutions, number of beds, per capita medical budget expenditure, number of consultations, and bed utilization rate during the study time interval, and analyzing them using data envelopment analysis. The results show that there are regional differences in the supply level of medical and health resources in China. Although the supply level is mainly on the rise, there are differences in the supply level of medical and health resources among provinces. The polarization phenomenon exists between eastern, central, and western regions, the urban and rural areas, the urban hospitals, and grassroots-level health care organizations.

Теоретико-методологические основы компаративного анализа систем здравоохранения в мире

The article examines and examines the research of foreign specialists in the field of economics and healthcare organization, who used a comparative approach to analysis in their works. The article examines the features of the application of mechanisms and models of health management characteristic of different countries, studied the experience of the UK, USA, Sweden, Finland, Germany and Japan. The article systematizes the views of scientists on the problem of applying comparative research in the field of healthcare. The article defines generalizations that characterize almost all existing healthcare systems in the world today. Studies are shown that allow us to identify common principles of the organization of health systems in the world, but, at the same time, to identify specific regional and national conditions that become the basis of existing regional, subnational and national health systems. In Russia, at the same time, the healthcare system includes an insurance component and private medicine. The development of the modern healthcare system in Russia can be assessed as not very positive, since with a general reduction in the number of medical personnel and the number of medical institutions in the 90s, this trend is currently continuing, albeit in a more smoothed form. A common place in the development of the healthcare system remains the growth of paid medical services and the orientation of sectoral public authorities in the direction of the development of the health care market with the strengthening of the role of the private sector. The healthcare system is undergoing, on the one hand, an upswing due to the growth of investments caused by coronavirus infection (buildings and entire complexes are being built and repurposed to combat it), and, on the other hand, especially for "traditional" diseases, the trend outlined in previous years continues.

Root Cause Analysis of Medication Administration Error by Nursing Staff at a Number of Medical Institutes in Riyadh

Background: Medication errors genuinely influence patient safety, staying cost in hospital and integrity of nursing job, because the nurses play a specific part in managing the medication for the patients. The present study was done with the aim to investigate factors associated with nurses’ medication errors in a number of medical institutes (Ministry of Health) and the role of clinical pharmacist in these errors.&#x0D; Methodology: The present study was a cross-sectional study based on standardized questionnaire which was designed and distributed to the target nurses in a number of medical institutes (Ministry of Health). The target number was (171) which was achieved depending on the calculation of sample size after the questionnaires was gathered; data was subjected to descriptive and inferential statistics.&#x0D; Results: The highest mean score of error was obtained in the factor related to medication packaging reason, which includes that different medications look alike, and the names of at least 60 medications were similar by 82.7%. The second group of reasons was system associated, which included: abbreviations were used instead of writing the orders out completely, overall 60.5% of the times nurses were pulled between teams. Third reason, overall 45.3% of the times the errors were associated with pharmacy when they did not prepare\label the medication correctly, and clinical pharmacist did not give education workshops to the nurses. Documentation issues were the fourth reason, 39.5% of the times nurses were interrupted while administering medication to perform other duties and nurses on the same unit did not adhere to the approved medication administration procedure.&#x0D; Conclusion: The data of the current study suggested the ranking of five reasons or root causes of why medication errors happened. These are medication package, system related, pharmacy related, documentation-transcription reason and physician-nurse related respectively. Furthermore, clinical pharmacists must thrive to improve the nurses' knowledge of how these factors will lead to critical errors and help them discover strategies to prevent these errors from happening.

ПЕРСПЕКТИВЫ РАЗВИТИЯ СУДЕБНОЙ ЗАЩИТЫ И ПРАВОВОГО РЕГУЛИРОВАНИЯ В ОБЕСПЕЧЕНИИ РАДИОНУКЛИДНЫМИ ИССЛЕДОВАНИЯМИ И ТЕРАПИЕЙ СЛАБОЗАЩИЩЕННЫХ ГРУПП ГРАЖДАН (ЖЕРТВЫ ПРЕСТУПЛЕНИЙ, ИНВАЛИДЫ, ПЕНСИОНЕРЫ)

In Russia there is currently a great need for high-tech methods of radionuclide diagnostics and therapy. However, given the relatively small number of medical institutions that carry out radionuclide diagnostic and therapeutic methods, the provision of this type of medical care to vulnerable groups of citizens is of particular relevance. The absence of appropriate judicial and legal protection measures in case of failure to provide this type of high-tech assistance is a legislative gap.

Feedback of patient survey on medication improves the management of polypharmacy: a pilot trial

BackgroundPatient awareness surveys on polypharmacy have been reported previously, but no previous study has examined the effects of sending feedback to health professionals on reducing medication use. Our study aimed to conduct a patient survey to examine factors contributing to polypharmacy, feedback the results to health professionals, and analyze the resulting changes in the number of polypharmacy patients and prescribed medications.MethodsAfter conducting a questionnaire survey of patients in Study 1, we provided its results to the healthcare professionals, and then surveyed the number of polypharmacy patients and oral medications using a before-after comparative study design in Study 2. In Study 1, we examined polypharmacy and its contributing factors by performing logistic regression analysis. In Study 2, we performed a t-test and a chi-square test.ResultsIn the questionnaire survey, significant differences were found in the following 3 items: age (odds ratio (OR) = 3.14; 95% confidence interval (CI) = 2.01–4.91), number of medical institutions (OR = 2.34; 95%CI = 1.50–3.64), and patients’ difficulty with asking their doctors to deprescribe their medications (OR = 2.21; 95%CI = 1.25–3.90). After the feedback, the number of polypharmacy patients decreased from 175 to 159 individuals and the mean number of prescribed medications per patient decreased from 8.2 to 7.7 (p < 0.001, respectively).ConclusionsProviding feedback to health professionals on polypharmacy survey results may lead to a decrease in the number of polypharmacy patients. Factors contributing to polypharmacy included age (75 years or older), the number of medical institutions (2 or more institutions), and patients’ difficulty with asking their physicians to deprescribe their medications. Feedback to health professionals reduced the percentage of polypharmacy patients and the number of prescribed medications.Trial registrationUMIN. Registered 21 June 2020 - Retrospectively registered, https://www.umin.ac.jp/ctr/index-j.htm