The rate of maternal mortality due to complications of pregnancy and delivery is one of the most significant indicators showing the development state of countries. The purpose of the present study is to assess importa...The rate of maternal mortality due to complications of pregnancy and delivery is one of the most significant indicators showing the development state of countries. The purpose of the present study is to assess important indicators of maternal health and predisposing factors of maternal mortality in Tehran province from 2008 to 2011. The present study is a case-control one. All mothers who had lost their life (n = 113) were selected through census and survived mothers (n = 327) through randomized stratified sampling. Statistical analysis was performed using SPSS V.22, X2 test, Fishers exact test and Logistic regression. The rate of maternal mortality was the highest (29.2%) in 2009 and the lowest (20.4%) in 2011. Variables type of maternity hospital (P-value = 0.036), maternal education (P-value < 0.001), husband’s education (P-value < 0.001) had a significant relation to maternal mortality. Logistic regression analysis showed that there is a relationship between the education level of the husband and maternal mortality. Considering the factors affecting maternal mortality, promoting hospital services, improving skills and knowledge of doctors, midwives and nurses and strengthening educational programs for the illiterate are the most effective measures to reduce maternal mortality.展开更多
The electronic medical record is an essential technology tool to improve the quality of care. In present study we reported on the design and feasibility of electronic medical records in Female Pelvic Floor Dysfunction...The electronic medical record is an essential technology tool to improve the quality of care. In present study we reported on the design and feasibility of electronic medical records in Female Pelvic Floor Dysfunction Ward. Our main goal was documentation with the least possible missed data, evidence-based decision making, documented active patient follow up and increasing patient’s satisfaction. The Electronic Registry System of Female Pelvic Floor Dysfunction (Vali e Asr Hospital, Tehran, Iran) was designed in mid 2014 and tested till March 2015. The software description was designed based on previous paper questionnaire used in this ward. The electronic questionnaires were filled in upon hospitalization and thereafter including follow ups. The questionnaire included 10 demographic and 15 main questions. A digital analog scale (1 - 10) in each part quantified the effects of problem on patient’s quality of life and also the effects of interventions as well. Entered information in each step was available for those with defined access. Reporting design was dependent on the needed data. Our supervised data entry was a guarantee to the quality of information with the least errors. Access to all para clinical data made rapid and evidence-based decision making. Patient satisfaction was achieved because of unified approach. The most interesting part was access to evidence-based results and data to be used in research projects. This study showed that EMRs in Female Pelvic Floor Dysfunction Wards could provide valuable information, improve the quality of care and increase patient’s satisfaction.展开更多
Background: Risk management is improving quality of health care services and creating a safer system of care. We determined the main maternal and fetal risks in five Hospitals (Tehran-Iran) to offer some practical str...Background: Risk management is improving quality of health care services and creating a safer system of care. We determined the main maternal and fetal risks in five Hospitals (Tehran-Iran) to offer some practical strategies to decline obstetric adverse events and provide better pregnancy outcome. Methods: A descriptive, cross-sectional study was carried out in 5 Iranian hospitals (2011-2012).?Twelve Obstetricians/perinatalogists and midwives from 5 hospitalswho were in charge of Maternity Units, were our assistants in these hospitals. We organized a secretariat including Obstetricians/perinatalogists and midwives. The principles of Obstetrics Risk Management were introduced to them in a 2 days’ workshop. Then the delegates from each hospital were asked to report the most common obstetrical complications of their hospitals. The main results were 24 complications. Then for sorting these risks we asked them to do scoring of the 24 complication with 1 - 10 grading in 4 aspects of probability of occurrence, possibility of prevention, priority of interventions and short term response to interventions. Post partum haemorrhage, labor management problems, and neonatal hypothermia got the highest scores in these regards, and then these 24 items were categorized in 2 groups of risk assessment and hospital management. Finally based on Risk Management Rules in Clinical Governance, the complications analysis was done with use of failure mode, effects analysis and practical strategies to decline obstetrical adverse events were suggested. Results: We understood all reported complications had common infrastructural problems: defects in Risk Assessment and Hospital Management Policies. We focused on basic infrastructural management in these 2 main subjects and in these two: our main problems were related to staff management and hospital management issues. Conclusion: Since managerial and staff dependent problems were our main problems, these two should be considered as our main priorities in risk management program.展开更多
文摘The rate of maternal mortality due to complications of pregnancy and delivery is one of the most significant indicators showing the development state of countries. The purpose of the present study is to assess important indicators of maternal health and predisposing factors of maternal mortality in Tehran province from 2008 to 2011. The present study is a case-control one. All mothers who had lost their life (n = 113) were selected through census and survived mothers (n = 327) through randomized stratified sampling. Statistical analysis was performed using SPSS V.22, X2 test, Fishers exact test and Logistic regression. The rate of maternal mortality was the highest (29.2%) in 2009 and the lowest (20.4%) in 2011. Variables type of maternity hospital (P-value = 0.036), maternal education (P-value < 0.001), husband’s education (P-value < 0.001) had a significant relation to maternal mortality. Logistic regression analysis showed that there is a relationship between the education level of the husband and maternal mortality. Considering the factors affecting maternal mortality, promoting hospital services, improving skills and knowledge of doctors, midwives and nurses and strengthening educational programs for the illiterate are the most effective measures to reduce maternal mortality.
文摘The electronic medical record is an essential technology tool to improve the quality of care. In present study we reported on the design and feasibility of electronic medical records in Female Pelvic Floor Dysfunction Ward. Our main goal was documentation with the least possible missed data, evidence-based decision making, documented active patient follow up and increasing patient’s satisfaction. The Electronic Registry System of Female Pelvic Floor Dysfunction (Vali e Asr Hospital, Tehran, Iran) was designed in mid 2014 and tested till March 2015. The software description was designed based on previous paper questionnaire used in this ward. The electronic questionnaires were filled in upon hospitalization and thereafter including follow ups. The questionnaire included 10 demographic and 15 main questions. A digital analog scale (1 - 10) in each part quantified the effects of problem on patient’s quality of life and also the effects of interventions as well. Entered information in each step was available for those with defined access. Reporting design was dependent on the needed data. Our supervised data entry was a guarantee to the quality of information with the least errors. Access to all para clinical data made rapid and evidence-based decision making. Patient satisfaction was achieved because of unified approach. The most interesting part was access to evidence-based results and data to be used in research projects. This study showed that EMRs in Female Pelvic Floor Dysfunction Wards could provide valuable information, improve the quality of care and increase patient’s satisfaction.
文摘Background: Risk management is improving quality of health care services and creating a safer system of care. We determined the main maternal and fetal risks in five Hospitals (Tehran-Iran) to offer some practical strategies to decline obstetric adverse events and provide better pregnancy outcome. Methods: A descriptive, cross-sectional study was carried out in 5 Iranian hospitals (2011-2012).?Twelve Obstetricians/perinatalogists and midwives from 5 hospitalswho were in charge of Maternity Units, were our assistants in these hospitals. We organized a secretariat including Obstetricians/perinatalogists and midwives. The principles of Obstetrics Risk Management were introduced to them in a 2 days’ workshop. Then the delegates from each hospital were asked to report the most common obstetrical complications of their hospitals. The main results were 24 complications. Then for sorting these risks we asked them to do scoring of the 24 complication with 1 - 10 grading in 4 aspects of probability of occurrence, possibility of prevention, priority of interventions and short term response to interventions. Post partum haemorrhage, labor management problems, and neonatal hypothermia got the highest scores in these regards, and then these 24 items were categorized in 2 groups of risk assessment and hospital management. Finally based on Risk Management Rules in Clinical Governance, the complications analysis was done with use of failure mode, effects analysis and practical strategies to decline obstetrical adverse events were suggested. Results: We understood all reported complications had common infrastructural problems: defects in Risk Assessment and Hospital Management Policies. We focused on basic infrastructural management in these 2 main subjects and in these two: our main problems were related to staff management and hospital management issues. Conclusion: Since managerial and staff dependent problems were our main problems, these two should be considered as our main priorities in risk management program.
