How to Improve Patient Safety Culture in Croatian Hospitals?

Patient safety culture (PCS) has a crucial impact on the safety practices of healthcare delivery systems. The purpose of this study was to assess the state of PSC in Croatian hospitals and compare it with hospitals in the United States. The study was conducted in three public general hospitals in Croatia using the Croatian translation of the Hospital Survey of Patient Safety Culture (HSOPSC). A comparison of the results from Croatian and American hospitals was performed using a T-square test. We found statistically significant differences in all 12 PSC dimensions. Croatian responses were more positive in the two dimensions of Handoff s and Transitions and Overall Perceptions of Patient Safety. In the remaining ten dimensions, Croatian responses were less positive than in US hospitals, with the most prominent areas being Nonpunitive Response to Error, Frequency of Events Reported, Communication Openness, Teamwork within Units, Feedback & Communication about Error, Management Support for Patient Safety, and Staffing. Our findings show that PSC is significantly lower in Croatian than in American hospitals, particularly in the areas of Nonpunitive Response to Error, Leadership, Teamwork, Communication Openness and Staffing. This suggests that a more comprehensive system for the improvement of patient safety within the framework of the Croatian healthcare system needs to be developed. Our findings also help confirm that HSOPSC is a useful and appropriate tool for the assessment of PSC. HSOPSC highlights the PSC components in need of improvement and should be considered for use in national and international benchmarking.

Value of ß2-microglobulin in the serum of healthy subjects older than 40 years.

The aim of this research was to determine if the age of healthy subjects older than 40 years of age has an influence on the concentration of ß(2) -microglobulin in the serum of subjects of different populations. We examined the values of ß(2) -microglobulin in the serum of 51 healthy subjects aged 40-86 years using the microparticle enzyme immunoassay AxSYM ß(2) -microglobulin test. The reference values of ß(2) -microglobulin according to the nonparametric statistical method is 0.95-2.73 mg/L. A correlation was found between ß(2) -microglobulin and age: 40-50 years (0.94-1.54 mg/L), 51-65 years (0.96-2.62 mg/L), and >65 years (1.13-2.84 mg/L). There was no significant statistical difference of ß(2) -microglobulin between genders (P > 0.05); however, there was a statistically significant difference between the concentration of ß(2) -microglobulin and the subjects' age. (Spearman's rank correlation coefficient ρ = 0.66; P < 0.01). A direct correlation between age and the concentration of ß(2) -microglobulin was observed. This research is a contribution to determining reference values of ß(2) -microglobulin in subjects of different populations.

A case report of spontaneous concurrent bilateral rupture of the quadriceps tendons in a patient with chronic renal failure.

In patients with chronic renal failure, many complications may develop that involve all organ systems, especially the locomotor system. Spontaneous concurrent bilateral rupture of the quadriceps tendons is a very rare complication in patients with chronic renal failure, usually occurring in patients under 50 years of age. Although there are numerous causes that lead to tendon weakness and rupture, most authors agree that secondary hyperparathyroidism plays a major role in the pathogenesis of tendon rupture. Soft tissue and perivascular calcifications, diminished local circulation, reduced tendon elasticity, impaired collagen metabolism, nerve lesions, repeated trauma, and articular swelling contribute to tendon weakness and rupture. A patient is presented in whom spontaneous concurrent bilateral quadriceps tendon rupture occurred at the age of 34, after seven years of hemodialysis therapy. Timely diagnosis and operative management with primary tendon suturing followed by physiotherapy produced a good anatomical and functional result.