Displaying publications 1 - 20 of 35 in total

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  1. Saeed BQ, Jairoun AA, Ashraf Khamis A, Hatim Abdelrahim L, Abobakr Aljomhi A, Adrees AO, et al.
    Risk Manag Healthc Policy, 2021;14:2733-2741.
    PMID: 34234589 DOI: 10.2147/RMHP.S308754
    Background: Vitamin D deficiency (VDD) and insufficiency (VDI) is a public health problem worldwide. Low blood levels of vitamin D have been associated with many illnesses, including respiratory tract infections (RTIs). This study aims to evaluate the prevalence of VDD and VDI among university students, assess the correlation with demographic and anthropometric factors, and determine the effect of VDD on the respiratory tract infection (RTI) incidence.

    Methods: A cross-sectional and prospective design was used. Our sample consisted of 287 students aged 18-24 years from the University of Sharjah-UAE. Participants were tested for serum 25(hydroxyvitamin)D levels, Body mass index (BMI) was calculated, and the survey was completed. The association between VDD, VDI with the participant's characteristics, and the incidents of RTIs were examined.

    Results: VDD and VDI were highly prevalent among 85% of the students. The median serum 25(OH) D level was 15.8 ng/dl (19.5±11.6). The mean BMI was (24.32±6.3) kg/m. The results showed a significant positive correlation between VDI and VDD with gender and students who were previously diagnosed with VDD (P 

  2. Mahmoud MA, Islam MA, Ahmed M, Bashir R, Ibrahim R, Al-Nemiri S, et al.
    Risk Manag Healthc Policy, 2021;14:4235-4241.
    PMID: 34675717 DOI: 10.2147/RMHP.S325184
    Objective: The aim of this study was to validate the Arabic version of General Medication Adherence Scale (GMAS) in Sudanese patients with type 2 diabetes mellitus (T2DM).

    Methods: A 3-month cross-sectional study was conducted among patients with T2DM at Al-Daraja Health Center, located in Wad Medani, Sudan. A convenient sample of patients was selected, and the study sample size was calculated using the item response ratio. Factorial, known group, and construct validities were determined. Internal consistency and reliability were also determined.

    Results: Responses were provided by 500 patients. The average medication adherence score was 30 (median 31). The normed fit index (NFI) was 0.950, the comparative fit index (CFI) was 0.963, the incremental fit index (IFI) was 0.963, and the root-mean-square error of approximation (RMSEA) was 0.071. The results from these fit indices indicated a good model. Factorial, known group and construct validities were all established. A significant association was found between adherence score and age (P = 0.03) since a larger proportion of older patients were found to have high adherence compared to patients in other age groups. The reliability (α) of the questionnaire was 0.834.

    Conclusion: The Arabic version of GMAS was validated in Sudanese patients with T2DM making it a suitable scale to be used in this population.

  3. Diao Y, Li M, Huang Z, Sun J, Chee YL, Liu Y
    Risk Manag Healthc Policy, 2019;12:357-367.
    PMID: 31908552 DOI: 10.2147/RMHP.S226379
    China's healthcare reform aims to provide affordable and equitable basic healthcare for all by 2020. Access to medicines is an essential part of the healthcare. The efforts of promoting access to medicines have been moving from meeting the needs of the basic healthcare, towards increasingly dedicated resources to offer breakthrough therapies. Looking at access to novel medicines from a health system perspective, and placing the changes China has made into that system context, this paper makes a comprehensive review of the progress of access to novel medicines in China. The review drew on two sources of information, which included desk review of published and grey literature, and key informant interview. Five hurdles were identified which create barriers of access to novel medicines, ranging from regulation and financing of medicines, intellectually property rights protection, and development of innovation capacity, to other health system components. Multiple policies have been implementing in China to remove the multiple access barriers gradually. Universal access to medicines has been moving from towards the basic common conditions to the world breakthrough technologies. We see cause for optimism, but recognize that there is a long way to go. Achieving broader and better access to modern medicines for Chinese patients will require multiple and coordinated government efforts, which would need to target the whole lifecycle regulation of novel medicines with a health system perspective, from balancing IP protection, strengthening R&D and public health, to appropriate regulatory approach and financing mechanism, and to supply chain management, as well as smart use.
  4. Alzoubi MM, Hayati KS, Rosliza AM, Ahmad AA, Al-Hamdan ZM
    Risk Manag Healthc Policy, 2019;12:167-177.
    PMID: 31576185 DOI: 10.2147/RMHP.S197038
    Background: Synergistic integration of predictors and elements that determine the success of total quality management (TQM) implementations in hospitals has been the bane of theoretical development in the TQM research area. Thus, this paper aims to offer a systematic literature review to provide a foundation on which research on TQM can be built and to identify the predictors of successful TQM in the health-care context.

    Materials and methods: A systematic literature survey was adopted in this paper, involving the review of 25 relevant researched articles found in the databases Science Direct, EBSCO, MEDLINE, CINAHL and PubMed.

    Result: The systematic literature survey reveals five variables to be core predictors of TQM, signifying how important these variables are in the successful implementation of TQM in the health-care context. Also, it is revealed that the identified core predictors have positive effects on an improved health-care system. However, the systematic survey of the literature reveals a dearth of studies on TQM in the health-care context.

    Conclusion: As TQM has become an important management approach for advancing effectiveness in the health-care sector, this kind of research is of value to researchers and managers. Stakeholders in the health sectors should introduce and implement TQM in hospitals and clinics. Nevertheless, this study has limitations, including that the databases and search engines adopted for the literature search are not exhaustive.

  5. Lin Y, Hu Z, Danaee M, Alias H, Wong LP
    Risk Manag Healthc Policy, 2021;14:3605-3615.
    PMID: 34475792 DOI: 10.2147/RMHP.S322764
    Introduction: A shortage of nurses has been a major global concern, particularly during pandemics. Nursing students turning away from the nursing profession upon graduation may exacerbate nursing workforce shortfalls. The main objective of this study was to assess perceived occupational turnover intention among nursing students and associated factors (fear of COVID-19 and life satisfaction). Students were also asked to provide suggestions that could enhance their intention to join the nursing profession.

    Methods: An online survey was sent to all registered undergraduate nursing students at Fujian Medical University, China. The partial least squares structural equation model (PLS-SEM) was used to investigate key factors influencing turnover intention.

    Results: A total of 1020 complete responses were received (response rate: 86.2%). Nearly half (49.1%) reported that they would choose not to be on a nursing course if given a choice, 45.4% often think of not going into the nursing profession in the future, and 23.7% would consider entering a healthcare industry that has zero contact with patients. The total turnover intention score range was 3 to 15, and the mean ± standard deviation (SD) was 9.2 (SD ± 2.5). PLS-SEM path analysis revealed that fear of COVID-19 (β = 0.226, p < 0.001) had a positive effect on turnover intention. Satisfaction with life (β = -0.212, p < 0.001) had a negative effect on turnover intention. Analysis of open-ended survey data on students' perspectives on how to encourage nursing students to enter the nursing workforce revealed five central themes: 1) professional role, respect, and recognition; 2) higher wages; 3) reduce workload; 4) enhance occupational health and safety; and 5) career advancement opportunities.

    Conclusion: Factors influencing turnover intention and suggestions to reduce students' apprehension towards joining the nursing profession found in this study should be seriously taken into consideration in initiatives to address the nurse shortages.

  6. Haque M, Islam T, Rahman NAA, McKimm J, Abdullah A, Dhingra S
    Risk Manag Healthc Policy, 2020;13:409-426.
    PMID: 32547272 DOI: 10.2147/RMHP.S239074
    The prevalence of long-term (chronic) non-communicable diseases (NCDs) is increasing globally due to an ageing global population, urbanization, changes in lifestyles, and inequitable access to healthcare. Although previously more common in high- and upper-middle-income countries, lower-middle-income countries (LMICs) are more affected, with NCDs in LMICs currently accounting for 85-90% of premature deaths among 30-69 years old. NCDs have both high morbidity and mortality and high treatment costs, not only for the diseases themselves but also for their complications. Primary health care (PHC) services are a vital component in the prevention and control of long-term NCDs, particularly in LMICs, where the health infrastructure and hospital services may be under strain. Drawing from published studies, this review analyses how PHC services can be utilized and strengthened to help prevent and control long-term NCDs in LMICs. The review finds that a PHC service approach, which deals with health in a comprehensive way, including the promotion, prevention, and control of diseases, can be useful in both high and low resource settings. Further, a PHC based approach also provides opportunities for communities to better access appropriate healthcare, which ensures more significant equity, efficiency, effectiveness, safety, and timeliness, empowers service users, and helps healthcare providers to achieve better health outcomes at lower costs.
  7. Haque M, McKimm J, Sartelli M, Dhingra S, Labricciosa FM, Islam S, et al.
    Risk Manag Healthc Policy, 2020;13:1765-1780.
    PMID: 33061710 DOI: 10.2147/RMHP.S269315
    Healthcare-associated infections (HCAIs) are a major source of morbidity and mortality and are the second most prevalent cause of death. Furthermore, it has been reported that for every one-hundred patients admitted to hospital, seven patients in high-income economies and ten in emerging and low-income economies acquire at least one type of HCAI. Currently, almost all pathogenic microorganisms have developed antimicrobial resistance, and few new antimicrobials are being developed and brought to market. The literature search for this narrative review was performed by searching bibliographic databases (including Google Scholar and PubMed) using the search terms: "Strategies," "Prevention," and "Healthcare-Associated Infections," followed by snowballing references cited by critical articles. We found that although hand hygiene is a centuries-old concept, it is still the primary strategy used around the world to prevent HCAIs. It forms one of a bundle of approaches used to clean and maintain a safe hospital environment and to stop the transmission of contagious and infectious microorganisms, including multidrug-resistant microbes. Finally, antibiotic stewardship also has a crucial role in reducing the impact of HCAIs through conserving currently available antimicrobials.
  8. Lugova H, Samad N, Haque M
    Risk Manag Healthc Policy, 2020;13:2937-2948.
    PMID: 33328772 DOI: 10.2147/RMHP.S283698
    The ongoing humanitarian crisis in the Democratic Republic of the Congo has triggered sexual and gender-based violence, including rape, sexual slavery, trafficking, intimate partner violence, and sexual exploitation. Gender inequalities and abuse of power experienced by women and young girls at refugee settings further exacerbate their vulnerability to different forms of violence. This study aimed to offer an evidence-based approach to developing strategies in tackling the complex problem of sexual and gender-based violence among refugees and internally displaced persons in the Congo. We conducted a narrative review of all the relevant papers known to the authors to explore the origins of the problem, its implications on public health, and its impact on equity. The study revealed that sexual assault survivors face physical and psychological sufferings, excruciating emotions, and profound disruption of their social well-being since they are often stigmatized and ostracized by society. The analysis of current government policies revealed a lack of programs to address survivors' specific concerns and policy enforcement problems. This study suggested strategic objectives and policy implementation steps. The proposed strategies address women empowerment and gender stigma, provision of effective health services, and adequate response action.
  9. Alshahrani SM, Alavudeen SS, Alakhali KM, Al-Worafi YM, Bahamdan AK, Vigneshwaran E
    Risk Manag Healthc Policy, 2019;12:243-249.
    PMID: 31814786 DOI: 10.2147/RMHP.S230257
    Purpose: This study objective was to explore the pattern of self-medications among King Khalid University students, Saudi Arabia.

    Patients and methods: A cross-sectional study was conducted over five months among King Khalid University students, Abha, Saudi Arabia.

    Results: Among all the study participants, nearly 98.7% were practicing self-medication. Headache (75.9%), cough and cold (52.5%), and fever (35.6%) and body pain (24.6%) were the most reported symptoms. Use of painkillers (91.6%) was significantly predominant among the medical students, whereas non-medical students used antibiotics (35.4%).Time saving (64.2%), mild symptom (51.7%) and quick relief (36.9%) were the reasons behind seeking self-medication in this study.

    Conclusion: Self-medications was common in King Khalid University. Educational programs are highly recommended.

  10. Paudel S, Palaian S, Shankar PR, Subedi N
    Risk Manag Healthc Policy, 2021;14:2253-2261.
    PMID: 34104016 DOI: 10.2147/RMHP.S310289
    PURPOSE: The study was conducted to explore the perception of healthcare workers and staff towards the risk of COVID-19 vaccination and to study vaccine hesitancy amongst them.

    METHODS: A total of 266 healthcare workers working in a medical college in Nepal were studied using a questionnaire consisting of three sections: demographics, experiences and perception of COVID-19, and COVID-19 vaccine safety. Data were analyzed using IBM SPSS version 26. The total perception score was calculated by noting respondent's agreement with a set of eleven statements using a Likert-type scale. Non-parametric tests (Mann-Whitney U and Kruskal-Wallis) were used for analysis (p<0.05).

    RESULTS: Altogether, 13.9% of respondents had been diagnosed COVID-19 positive prior to the survey. Many considered themselves to be at increased risk of contracting COVID-19. Only over one third (38.3%) were willing to be vaccinated. The most common reason for refusal/hesitancy was concern about vaccine safety. The median (interquartile range) total perception score was 36 (4) (maximum possible score=55). The score was significantly higher among those who had been diagnosed COVID positive, those who perceived the pandemic as being moderate or severe and among those willing to be vaccinated.

    CONCLUSION: Addressing doubts related to vaccine safety and providing more data on the safety of vaccine may be helpful in overcoming hesitancy.

  11. Jairoun AA, Al-Hemyari SS, Shahwan M, Jairoun O, Zyoud SH
    Risk Manag Healthc Policy, 2024;17:663-675.
    PMID: 38528943 DOI: 10.2147/RMHP.S440482
    BACKGROUND: p-Phenylenediamine (PPD) has been used over the past five decades as a primary precursor in the production of oxidative hair dyes. Numerous health dangers are associated with the short- and long-term use of PPD, raising concerns about its safety. For instance, mounting data suggests that PPD is linked to dermatitis and allergy cases.

    OBJECTIVE: To quantify the PPD content in hair dyes by measuring the PPD concentration after mixing the ingredients of commercial hair dyes.

    METHODS: A total of 290 permanent hair dyes were tested. RP-HPLC-DAD analysis was performed to determine and quantify the PPD content.

    RESULTS: The estimated mean of the PPD limit was 0.89 (95% CI [0.81-0.96]). Of the 290 tested hair dyes, 7.2% (n = 21) exceeded the recommended PPD concentration after mixing. Significantly more hair dyes manufactured in India and China had a PPD content exceeding 2% after mixing compared to dyes from other regions (P = 0.001). Moreover, hair dyes manufactured in India and the UAE were more likely to have incomplete descriptions of the conditions of use and warnings on the label (P = 0.002).

    CONCLUSION: The effectiveness of the current regulations relevant to these products should be reevaluated. Moreover, through the use of good manufacturing procedures (GMPs), research, and the reporting of adverse reactions, hair dyes should be subjected to better control and monitoring in terms of their safety and quality.

  12. Ng DL, Bin Jamalludin MA, Gan XY, Ng SY, Bin Mohamad Rasidin MZ, Felix BA, et al.
    Risk Manag Healthc Policy, 2023;16:2505-2519.
    PMID: 38024502 DOI: 10.2147/RMHP.S439530
    INTRODUCTION: Malaysia entered the transition to the endemic phase of Coronavirus 2019 (COVID-19) on 1st April 2022. This study aims to determine the public's willingness to perform COVID-19 self-testing. Factors that influenced their willingness were also assessed.

    METHODS: A nationwide, cross-sectional, and population-based study was conducted online in Malaysia from 28th April 2023 to 4th June 2023. Individuals aged 18 years and above were enrolled through the snowball sampling method. Data were analyzed by using the Chi-Square test, independent t-test, and binary logistic regression.

    RESULTS: One thousand four hundred fifty-three responses were included in the analysis. Of these respondents, 89.3% were willing, 4.1% were reluctant, and 6.6% remained hesitant to perform COVID-19 self-testing, The common reasons given by those willing to perform COVID-19 self-testing included being able to self-isolate (99.0%) and seek treatment (96.3%) earlier if tested positive. The common reasons against COVID-19 self-testing included the belief that COVID-19 is equivalent to the common flu (91.7%) and having received the COVID-19 vaccine (78.3%). The isolation policy for COVID-19 was the most significant consideration for those who were still hesitant (85.4%). Women [adjusted odds ratios (OR): 2.1, 95% confidence intervals (95% CI): 1.44-3.00, p < 0.001], individuals with tertiary education (OR: 2.1, 95% CI: 1.32-3.26, p = 0.002), those vaccinated against COVID-19 (OR: 8.1, 95% CI: 2.63-24.82, p < 0.001), and individuals with prior experience of COVID-19 self-testing (OR: 4.2, 95% CI: 2.84-6.12, p < 0.001) showed a significantly higher willingness to engage in COVID-19 self-testing.

    CONCLUSION: The public exhibited a high willingness to perform COVID-19 self-testing during the transition to the endemic phase in Malaysia. Future strategies to promote COVID-19 self-testing uptake in Malaysia should focus on vulnerable groups, address the common concerns among those hesitant and reluctant, and highlight the advantages of COVID-19 self-testing.

  13. Awai NS, Ganasegeran K, Abdul Manaf MR
    PMID: 33447111 DOI: 10.2147/RMHP.S280954
    Background and Purpose: Workplace bullying has been regarded as a serious phenomenon, particularly in health-care settings, due to its tendency to predispose health workers to serious psychological repercussions, job dissatisfaction, and turnover. Such consequences are costly to health systems and disruptive to the continuity of patient care. While global bullying literature in health settings grows, evidence on the magnitude of the problem from a Malaysian perspective is scarce. This study aimed to determine the prevalence of workplace bullying and its associated factors among health workers in a Malaysian public university hospital.

    Methods: This cross-sectional study was conducted from October to December 2019 among 178 hospital workers at the Hospital Canselor Tuanku Muhriz in Kuala Lumpur, Malaysia. The study utilized a self-administered questionnaire that consisted of items on sociodemographics, work characteristics, sources of bullying, and the validated Malay version of the 23-item Negative Acts Questionnaire - revised to determine the prevalence of bullying. Descriptive and inferential statistics were analyzed using SPSS 22.0. Statistical significance was set at P<0.05.

    Results: The prevalence of workplace bullying in this sample was 11.2%. Superiors or supervisors from other departments and colleagues were the main perpetrators. In the multivariate model, working for 10 years or less (aOR 4, 95% CI 1.3-12.3; P=0.014) and not being involved in patient care (aOR 5, 95% CI 2.5-10; P<0.001) were statistically significant attributes associated with workplace bullying.

    Conclusion: Workplace bullying in the current study was strongly associated with occupational characteristics, particularly length of service and service orientation of the workers. Hospital directors and managers could undertake preventive measures to identify groups vulnerable to bullying and subsequently craft appropriate coping strategies and mentoring programs to curb bullying.

  14. Leelavanich D, Adjimatera N, Broese Van Groenou L, Anantachoti P
    Risk Manag Healthc Policy, 2020;13:2753-2768.
    PMID: 33273873 DOI: 10.2147/RMHP.S281629
    Purpose: The drug classification system, as prescription or non-prescription drug category, has been utilized as a regulatory strategy to ensure patient safety. In Thailand, the same system has been used for decades, though the drug classification criteria were updated to accommodate drug re-classification in 2016. These new criteria, however, have not been applied retroactively. Inconsistency in drug classification has been observed leading to concerns regarding the drug classification system. This has prompted the need for a review of the drug classification system in Thailand. This study aims to explore Thailand and other selected countries' regulatory management regarding the drug classification system, drug classification criteria, and drug classification itself.

    Methods: The drug classification systems of the United States, the United Kingdom, Japan, Singapore, Malaysia, the Philippines, and Canada were selected to study alongside Thailand's system. The regulatory review was conducted through each country's drug regulatory agency website and available published research. Complementary interviews with drug regulatory authorities were conducted when written documentation was unclear and had limited access. Fifty-two common drugs were selected to compare their actual classifications across the different countries.

    Results: All selected countries classified drugs into two major groups: prescription drugs and non-prescription drugs. The studied countries further sub-classified non-prescription drugs into 1-4 categories. Principles of drug classification criteria among countries are similar; they comprised of three themes: disease characteristics, drug safety profile, and other drug characteristics. Actual drug classification of antibiotics, dyslipidemia treatments, and hypertension treatments in Thailand are notedly different from other countries. Furthermore, 77.4% of drugs studied in Thailand fall into the behind-the-counter (dangerous) drug category, which varied from antihistamines to antibiotics, dyslipidemia treatments, and vaccines.

    Conclusion: Thailand's drug classification criteria are comparable with other nations; however, there is a need to review drug classification statuses as many drugs have been classified into improper drug categories.

  15. Jakovljevic M, Sugahara T, Timofeyev Y, Rancic N
    Risk Manag Healthc Policy, 2020;13:2261-2280.
    PMID: 33117004 DOI: 10.2147/RMHP.S266386
    Purpose: The goal of this study was to assess the effectiveness of healthcare spending among the leading Asian economies.

    Methods: We have selected a total of nine Asian nations, based on the strength of their economic output and long-term real GDP growth rates. The OECD members included Japan and the Republic of Korea, while the seven non-OECD nations were China, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand. Healthcare systems efficiency was analyzed over the period 1996-2017. To assess the effectiveness of healthcare expenditure of each group of countries, the two-way fixed effects model (country- and year effects) was used.

    Results: Quality of governance and current health expenditure determine healthcare system performance. Population density and urbanization are positively associated with a healthy life expectancy in the non-OECD Asian countries. In this group, unsafe water drinking has a statistically negative effect on healthy life expectancy. Interestingly, only per capita consumption of carbohydrates is significantly linked with healthy life expectancy. In these non-OECD Asian countries, unsafe water drinking and per capita carbon dioxide emissions increase infant mortality. There is a strong negative association between GDP per capita and infant mortality in both sub-samples, although its impact is far larger in the OECD group. In Japan and South Korea, unemployment is negatively associated with infant mortality.

    Conclusion: Japan outperforms other countries from the sample in major healthcare performance indicators, while South Korea is ranked second. The only exception is per capita carbon dioxide emissions, which have maximal values in the Republic of Korea and Japan. Non-OECD nations' outcomes were led by China, as the largest economy. This group was characterized with substantial improvement in efficiency of health spending since the middle of the 1990s. Yet, progress was noted with remarkable heterogeneity within the group.

  16. Lin X, Lin Y, Hu Z, Alias H, Wong LP
    Risk Manag Healthc Policy, 2021;14:3383-3393.
    PMID: 34429670 DOI: 10.2147/RMHP.S320448
    Purpose: This study aimed to investigate the impact of the COVID-19 pandemic on the practice of 'new normal' lifestyles, economic and social distribution, and individuals' well-being of people in China after the country ease the lockdown restriction.

    Methods: A cross-sectional, self-administered online survey was carried out between 3 September and 15 October 2020.

    Results: A total of 8393 complete responses were received from a nationwide sample. Poor sustainability in the practice of "new norm" was reported. Noteworthy disparities were observed in willingness to carry out "new normal" practices by gender, urban-rural locality, non-Han and Han Chinese and educational attainment. There was evidence of economic and social disruption associated with COVID-19 or "new normal" practices. The current mean (±standard deviation [SD]) happiness score (110.45 ± 17.55) was slightly lower than the mean happiness score before (111.12 ± 17.83) the COVID-19 pandemic (t= -9.01, p<0.001). Lower socioeconomic status and greater economic and social disruptions were associated with lower current happiness scores. Moreover, greater willingness to adapt to "new normal" practices was associated with higher levels of happiness.

    Conclusion: There is a need to encourage sustainable practice of new norm post-pandemic. Segments of the public continue to experience significant economic and social effects and the post-pandemic 'new norms' remain at risk of leading to psychological consequences.

  17. Juliasih NN, Dhamanti I, Semita IN, Wartiningsih M, Mahmudah M, Yakub F
    Risk Manag Healthc Policy, 2023;16:1731-1738.
    PMID: 37692768 DOI: 10.2147/RMHP.S425760
    INTRODUCTION: A hospital's patient safety culture affects surgical outcomes. Operating room safety culture has been overlooked despite the importance of patient safety. The AHRQ's Hospital Survey on Patient Safety Culture (HSOPSC) has been used worldwide to assess and enhance patient safety culture. This study examined how patient safety culture and infection prevention effect patient safety in the Operating Room (OR).

    METHODS: This observational study used an online survey and included 143 OR workers. Descriptive statistics and multilinear regression were used to examine how patient safety culture and infection prevention affects level of patient safety.

    RESULTS: Most responders worked in excellent-accredited general hospitals. Most responders were male, aged between 26 to 40 years old, and had bachelor's degrees. Most were hospital-experienced nurses. Less than half had worked in units for over ten years. Organizational Learning - Continuous Improvement; Teamwork and Handoffs; and Information Exchange had the most positive responses in the OR. However, Staffing, Work Pace, and Patient Safety ranked lowest. Organizational Learning - Continuous Improvement and Hospital Management Support for Infection Prevention Efforts were found to affect OR patient safety level perceptions.

    CONCLUSION: According to the findings of our study, the overall patient safety culture in the operating room remains weak which highlights the importance of continuing efforts to improve patient safety in the OR. Further study could be directed to identify organizational learning in infection prevention to enhance the patient safety in the OR.

  18. Pang KL, Ekeuku SO, Chin KY
    Risk Manag Healthc Policy, 2021;14:2715-2732.
    PMID: 34194253 DOI: 10.2147/RMHP.S316429
    Air pollution is associated with inflammation and oxidative stress, which predispose to several chronic diseases in human. Emerging evidence suggests that the severity and progression of osteoporosis are directly associated with inflammation induced by air pollutants like particulate matter (PM). This systematic review examined the relationship between PM and bone health or fractures. A comprehensive literature search was conducted from January until February 2021 using the PubMed, Scopus, Web of Science, Google Scholar and Cochrane Library databases. Human cross-sectional, cohort and case-control studies were considered. Of the 1500 papers identified, 14 articles were included based on the inclusion and exclusion criteria. The air pollution index investigated by most studies were PM2.5 and PM10. Current studies demonstrated inconsistent associations between PM and osteoporosis risk or fractures, which may partly due to the heterogeneity in subjects' characteristics, study design and analysis. In conclusion, there is an inconclusive relationship between osteoporosis risk and fracture and PM exposures which require further validation.
  19. Vaismoradi M, Jamshed S, Lorenzl S, Paal P
    Risk Manag Healthc Policy, 2021;14:2841-2849.
    PMID: 34262371 DOI: 10.2147/RMHP.S316744
    Older people with long-term mental health conditions who receive care in their own home are vulnerable to the inappropriate use of medications and polypharmacy given their underlying health conditions and comorbidities. Inappropriate use of pro re nata (PRN) medications in these older people can enhance their suffering and have negative consequences for their quality of life and well-being, leading to readmission to healthcare settings and the increased cost of health care. This narrative review on published international literature aims at improving our understanding of medicines management in home care and how to improve PRN medication use among older people with long-term health conditions in their own home. Accordingly, the improvement of PRN medicines management for these older people requires the development of an individualised care plan considering 'reduction of older people's dependence on PRN medications', 'empowerment of family caregivers', and 'support by healthcare professionals.' PRN medication use should be reduced through deprescription and discontinuation strategies. Also, older people and their family caregivers should be encouraged to prioritize the use of non-pharmacologic methods to relieve physical and psychological problems. Besides the empowerment of family caregivers through role development, education and training about PRN medications, and involvement in decision-making, they need support by the multidisciplinary network in terms of supervision, monitoring, and home visits.
  20. Castillo-Carandang NT, Buenaventura RD, Chia YC, Do Van D, Lee C, Duong NL, et al.
    Risk Manag Healthc Policy, 2020;13:803-819.
    PMID: 32765135 DOI: 10.2147/RMHP.S256165
    Introduction: Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality in the Association of Southeast Asian Nations (ASEAN) member states. Progress has been slow despite the World Health Organization action plan for the prevention and control of NCDs in the region. This paper presents recommendations focused on practical strategies for optimizing NCD management in the ASEAN region.

    Methods: A multidisciplinary group of experts from six ASEAN member states convened for two face-to-face meetings to discuss barriers and possible recommendations for optimizing NCD management, focused on cardiovascular diseases and mental disorders, in the region. Multiple approaches, ie, analysis of insights from the meetings and a review of existing literature on NCD programs in the ASEAN region were followed. The proposed recommendations were also based on selected successful interventions in ASEAN member states, thus providing actionable strategies.

    Results: The gaps identified in NCD management for cardiovascular diseases and mental disorders in the ASEAN region were classified into gaps relating to policies and to clinical and public health practice. The proposed solutions addressing policy gaps include fostering multisectoral public-private partnerships, employing "whole-of-government" and "whole-of-society" approaches and promoting "health-in-all policies approach" to manage issues with financing, accessibility, efficiency and quality of health services. Whereas proposed solutions to bridge clinical and public health practice gaps entail strengthening primary care services, building the capacity of trained healthcare workers and employing collaborative care for holistic management of patients.

    Conclusion: The scale of premature and preventable deaths from NCDs in the ASEAN region remains a serious public health concern and requires a "whole-of-system approach". The interventions proposed in this paper build on regional collaborations and knowledge sharing to help develop a concerted and targeted response to NCDs.

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