The role of demographic, job-related and psychological characteristics on the prevalence of repetitive patient safety incidents among Iranian nurses.

BACKGROUND: Job-related psychosocial factors have a substantial effect on the occurrence of adverse events among healthcare professionals. OBJECTIVE: An analytical and descriptive survey was conducted to evaluate the relationship between the occurrence of patient safety incidents and psychological factors. METHODS: The study sample consisted of 177 nurses who were asked about patient safety events over six months. Repetitive patient safety incidents were selected by examining medical records and interviewing specialists. Also, psychological factors were assessed using job content questionnaire (JCQ). RESULTS: Repetitive patient safety incidents were involved medication administration error, pressure ulcer and skin-muscular injuries, patient falls, inability to CPR patients, blood transfusion reactions, and death due to human error. The findings showed that 92 participants (52%) had at least one case of patient safety incident. Among patient safety incidents, medication administration error and death due to human error had the highest and lowest repletion, respectively. Nurses training, job insecurity and peer support were significant predictors of different aspects of patient safety (p < 0.05). CONCLUSION: Proper collaboration between new and experienced nurses can have a significant impact to reduce patient safety incidents. In addition, nursing training can be a good way to understand risk points in medical errors.

Clinical Presentation and Microbial Analyses of Contact Lens Keratitis; an Epidemiologic Study.

INTRODUCTION: Microbial keratitis is an infective process of the cornea with a potentially and serious visual impairments. Contact lenses are a major cause of microbial keratitis in the developed countries especially among young people. Therefore, the purpose of the present study was to evaluate the frequency and microbiological characteristic of CLK in patients referred to the emergency department (ED) of teaching hospitals, Babol, Iran. METHODS: This is a cross-sectional study of all patients with contact lens induced corneal ulcers admitted to the teaching hospitals of Babol, Iran, from 2011- 2013. An ophthalmologist examined patients with the slit-lamp and clinical features of them were noted (including pain, redness, foreign body sensation, chemosis, epiphora, blurred vision, discomfort, photophobia, discharge, ocular redness and swelling). All suspected infectious corneal ulcers were scraped for microbial culture and two slides were prepared. Data were analyzed using SPSS software, version 18.0. RESULTS: A total of 14 patients (17 eyes) were recruited into the study (100% female). The patients' age ranged from 16-37 years old (mean age 21.58±7.23 years). The most prevalent observed clinical signs were pain and redness. Three samples reported as sterile. The most common isolated causative organism was pseudomonas aeroginosa (78.6%), Staphylococcus aureus 14.3%, and enterobacter 7.1%, respectively. Treatment outcome was excellent in 23.5%, good in 47.1%, and poor in 29.4% of cases. CONCLUSION: Improper lens wear and care as well as the lack of awareness about the importance of aftercare visits have been identified as potential risk factors for the corneal ulcer among contact lens wearers. Training and increasing the awareness of adequate lens care and disinfection practices, consulting with an ophthalmologist, and frequent replacement of contact lens storage cases would greatly help reducing the risk of microbial keratitis.