Survey and analysis of patient safety culture in a county hospital

Objective:This study aimed to survey patient safety culture in a county hospital and to pro-vide evidence for strategies to improve patient safety culture.Methods:Nine hundred and thirty-two medical staff in a county hospital were surveyed with use of the Hospital Survey on Patient Safety Culture.Information was analyzed by one-way ANO-VA and multiple linear regression analysis.Results:Nine hundred and thirty-two questionnaires were distributed,of which 661 of those returned were valid.The subscale-level results showed that the positive response rate for“team-work across units”was higher than 75.0%,indicating it was an area of strength.Five areas-“non-punitive response to error,”“staffing,”“communication openness,”“overall perceptions of patient safety,”and“frequency of event reporting”-had potential for improvement,with a positive re-sponsive rate lower than 50%.Twenty-nine percent of respondents gave their work area a patient safety grade of“excellent”or“very good.”Further,60.1%of respondents had reported no event in the previous 12 months.Multiple linear regression analysis indicated that position and number of years working in this hospital were the factors influencing patient safety culture.Conclusion:Patient safety culture in the county hospital has potential for improvement,especially in the areas of“nonpunitive response to error,”“staffing,”“overall perceptions of patient safety,”“communication openness,”and“frequency of event reporting.”

Endodontic management of the maxillary first molar with special root canals:A case report and review of the literature

BACKGROUND As the complex anatomy of maxillary first molars is one of the major challenges in endodontic therapy,knowledge of the complicated root canal anatomy and configuration is crucial to ensure the success of endodontic treatment and prognosis.This article presents an endodontically managed left maxillary first molar with an unusual palatal root morphology.The available literature on the anatomic variation of maxillary first molars is also reviewed.CASE SUMMARY A 36-year-old man with no medical history presented to the Stomatology Department of Peking University Third Hospital complaining of a toothache during mastication in the maxillary left posterior region for approximately 3 mo.He had a spontaneous and intermittent toothache that had worsened,particularly at night.The diagnosis based on clinical examination,X-ray imaging,and cone beam computed tomography(CBCT)was symptomatic irreversible pulpitis.Nonsurgical endodontic therapy was performed for the left maxillary first molar.Five root canals revealed by CBCT included a special palatal root canal(1-2-1-shaped),two mesiobuccal root canals,and one distobuccal root canal.Evaluation of the CBCT images confirmed the root canal morphology and the clinician performed more effective cleaning,obturation,and therapy.Finally,the tooth was restored using composite resin,and the patient was satisfied with the result.CONCLUSION CBCT and a complete review of the literature may be beneficial for investigating the root canal system to achieve a biological and functional therapeutic effect.