Project description:BackgroundImproving patient safety has become a major focus of clinical care and research over the past two decades. An institution's patient safety climate represents an essential component of ensuring a safe environment and thereby can be vital to the prevention of adverse events. Covering six patient safety related factors, the Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure the patient safety climate in clinical areas. The objective of this study was to assess the psychometric properties of the German language version of the SAQ.MethodsA survey was carried out in two University Hospitals in Switzerland in autumn 2009 where the SAQ was distributed to a sample of 406 nurses and physicians in medical and surgical wards. Following the American Educational Research Association guidelines, we tested the questionnaire validity by levels of evidence: content validity, internal structure and relations to other variables. Confirmatory factor analysis was used to examine factor structure. Cronbach's alphas and inter-item correlations were calculated to examine internal consistency reliability.ResultsA total of 319 questionnaires were completed representing an overall response rate of 78.6%. For three items, the item content validity index was <0.75. Confirmatory factor analysis showed acceptable model fit (RMSEA = 0.045; CFI = 0.944) for the six-factor model. Additional exploratory factor analysis could not identify a better factor model. SAQ factor scores showed positive correlations with the Safety Organizing Scale (r = .56-.72). The SAQ German version showed moderate to strong internal consistency reliability indices (Cronbach alpha = .65-.83).ConclusionsThe German language version of the SAQ demonstrated acceptable to good psychometric properties and therefore shows promise to be a sound instrument to measure patient safety climate in Swiss hospital wards. However, the low item content validity and large number of missing responses for several items suggest that improvements and adaptations in translation are required for select items, especially within the perception of management scale. Following these revisions, psychometric properties should reassessed in a randomly selected sample and hospitals and departments prior to use in Swiss hospital settings.

Project description:BACKGROUND: How to protect patients from harm is a question of universal interest. Measuring and improving safety culture in care giving units is an important strategy for promoting a safe environment for patients. The Safety Attitudes Questionnaire (SAQ) is the only instrument that measures safety culture in a way which correlates with patient outcome. We have translated the SAQ to Norwegian and validated the translated version. The psychometric properties of the translated questionnaire are presented in this article. METHODS: The questionnaire was translated with the back translation technique and tested in 47 clinical units in a Norwegian university hospital. SAQ's (the Generic version (Short Form 2006) the version with the two sets of questions on perceptions of management: on unit management and on hospital management) were distributed to 1911 frontline staff. 762 were distributed during unit meetings and 1149 through the postal system. Cronbach alphas, item-to-own correlations, and test-retest correlations were calculated, and response distribution analysis and confirmatory factor analysis were performed, as well as early validity tests. RESULTS: 1306 staff members completed and returned the questionnaire: a response rate of 68%. Questionnaire acceptability was good. The reliability measures were acceptable. The factor structure of the responses was tested by confirmatory factor analysis. 36 items were ascribed to seven underlying factors: Teamwork Climate, Safety Climate, Stress Recognition, Perceptions of Hospital Management, Perceptions of Unit Management, Working conditions, and Job satisfaction. Goodness-of-Fit Indices showed reasonable, but not indisputable, model fit. External validity indicators - recognizability of results, correlations with "trigger tool"-identified adverse events, with patient satisfaction with hospitalization, patient reports of possible maltreatment, and patient evaluation of organization of hospital work - provided preliminary validation. CONCLUSION: Based on the data from Akershus University Hospital, we conclude that the Norwegian translation of the SAQ showed satisfactory internal psychometric properties. With data from one hospital only, we cannot draw strong conclusions on its external validity. Further validation studies linking the SAQ-scores to patient outcome data should be performed.

Project description:BackgroundChild mortality remains a global public health problem, particularly in Sub-Saharan Africa. After initiating ART, the mortality rate among HIV-infected children in Ethiopia was 12-17 deaths per 1000 child-year.ObjectiveTo determine the time to death and its predictors among under-five children on antiretroviral treatment in public hospitals of Addis Ababa, Ethiopia, from April 12, 2017, to May 12, 2022.MethodAn institution-based retrospective follow-up study was conducted among 415 HIV-infected children at selected public hospitals of the Addis Ababa town administration. Computer generated simple random sampling technique was used to select each sampling unit. Data was extracted using a structured data extraction checklist. Data were entered into EPI data 4.2 and analyzed using STATA 14. The child mortality rate was calculated. The Cox proportional hazards regression model was fitted to identify predictor factors. The result of the study was presented using text, tables, graphs, and charts. An adjusted hazard ratio with a 95% confidence interval and a p-value less than 0.05 was used to declare the level of significance.ResultA total of 415 (97.42%) of the 426 children on ART were included for analysis. Of these, 41(9.88%) children were died during the following period. The study participants were followed for a total of 8237 person- months of risk time. The overall mortality rate was 4.98 (95% CI: 3.67-6.77) per 1000 child-months. The estimated survival after starting ART was 61.42% at 56 months of follow-up. Severe underweight (AHR = 3.19; 95% CI: 1.32-7.71), tuberculosis (AHR = 3.86; CI: 1.76-8.47), low hemoglobin level (AHR = 2.51; CI: 1.02-6.20), and advanced WHO clinical stages at enrolment (AHR = 3.38; CI: 1.08-10.58) were predictors of death among HIV-infected under-five children on ART.ConclusionThe incidence of mortality was 4.98 per 1000 child-months. Severe underweight, tuberculosis infection, low hemoglobin level, and advanced WHO clinical stages at enrolment were predictors of death among under-five children on ART.

Project description:ObjectiveTo assess where the delays occur in the referral chain of most maternal health outcomes in Addis Ababa, Ethiopia, based on the three-delay model.DesignThe study was a facility-based, cross-sectional study.SettingTwo public and tertiary hospitals in Addis Ababa.ParticipantsAll pregnant women who were referred only for labour and delivery services after 28 weeks of gestation between December 2018 and February 2019 in Zewditu and Gandhi Memorial Hospitals.Primary and secondary outcome measuresThe primary outcome was the type of delays, from the three-delay model, which met operationally defined time. The secondary outcome was maternal health outcomes based on the three-delay model.ResultsA total of 403 pregnant women referred for delivery to the study hospitals were included in the study. Three-fourths (301, 74.7%) of the referred pregnant women experienced the third delay (delay in receiving appropriate care); 211 (52.4%) experienced the first delay (delay in making a decision to seek care). Overall 366 (90.8%) pregnant women had experienced at least one of the three delays and 71 (17.6%) experienced all three delays. Twenty-nine (7.2%) referred women had severe maternal outcomes. The leading causes/diagnoses of severe maternal outcomes were blood transfusion (17, 58.6%), followed by postpartum haemorrhage (15, 52%) and eclampsia (9, 31%). In addition, women who experienced severe maternal outcomes were 2.9 times more likely to have experienced at least one of the three delays.Conclusion and recommendationThis study highlights the persistence of delays at all levels, and especially the third delay and its contribution to severe maternal outcomes. We recommend strengthening the health referral systems and addressing specific health system bottlenecks during labour and birth in order to ensure no mother is endangered. We also recommend conducting a qualitative method of study (focus group discussion and indepth interview) and observing tertiary hospitals' set-up and readiness to manage obstetric emergencies.

Project description:IntroductionAutism is a neurodevelopmental disorder that occurs in the early childhood period and is characterized by altered social interaction, communication problems, repetitive, and stereotyped behavior. Genetic, environmental, or physical risk factors are associated with prenatal, natal, or postnatal complications, leading to the development of autism spectrum disorders. Prompt diagnosis and management should be an integral component of the care provision in countries like Ethiopia.ObjectiveThis study aimed to assess knowledge of childhood autism among nurses working in governmental hospitals in Addis Ababa, Ethiopia.MethodsInstitutional based cross-sectional study design was used. The sample size was calculated using the single population proportion formula, and the final sample size was 360. Final study subjects were selected by using the simple random sampling method. Data were collected using structured self-administered questionnaires and were then coded and entered into Epi-data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics were utilized to show frequencies and percentages, and analysis of variance was carried out to compute the association between the dependent and independent variables. Independent t-test was also done to see the association between dependent variables and independent variables with two means. A p-value of less than 0.05 was considered statistically significant.ResultsThe mean score for knowledge-related items was 8.79 ± 0.4. In this study, out of 331 nurses, 180 (54.35%) had good knowledge. Significant mean score difference was observed among age distribution (F-Ratio = 2.8, p-value = 0.04), level of education (F-ratio = 13.97, p < 0.001) and work experience (F-Ratio = 3.07 p-value = 0.017).ConclusionA significant gap was observed in the overall knowledge of childhood autism among nurses employed in the governmental hospitals of Addis Ababa. The respondents' knowledge level was significantly different among age group distributions, education levels, and work experience.

Project description:BackgroundBirth injury is harm that a baby suffers during the entire birth process. It includes both birth asphyxia and birth trauma. In Ethiopia, birth injury has become the leading cause of neonatal morbidity and mortality, accounting around 28%-31.6% of neonatal mortality. The study aimed to assess the prevalence and factors associated with birth injuries among newborns delivered in public hospitals Addis Ababa, Ethiopia, 2021.MethodsInstitution based cross-sectional study was conducted from February 15th to April 20th, 2021 in selected public hospitals of Addis Ababa, Ethiopia. Random sampling and systematic random sampling were used. Data was entered by using Epi data version 4.0.2 and exported in to SPSS Software version 25 for analysis. Both bivariate and multivariable logistic regressions analyses were used. Finally P-value <0.05 was used to claim statistically significant.ResultThe prevalence of birth injury was 24.7%. In the final model, birth asphyxia was significantly associated with the short height of the mothers (AOR = 10.7, 95% CI: 3.59-32.4), intrapartal fetal distress (AOR = 4.74, 95% CI: 1.81-12.4), cord prolapse (AOR = 7.7. 95% CI: 1.45-34.0), tight nuchal cord (AOR = 9.2. 95% CI: 4.9-35.3), birth attended by residents (AOR = 0.19, 95% CI: 0.05-0.68), male sex (AOR = 3.84, 95% CI: 1.30-11.3) and low birth weight (AOR = 5.28, 95% CI: 1.58-17.6). Whereas, birth trauma was significantly associated with gestational diabetic mellitus (AOR = 5.01, 95% CI: 1.38-18.1), prolonged duration of labor (AOR = 3.74, 95% CI: 1.52-9.20), instrumental delivery (AOR = 10.6, 95% CI: 3.45-32.7) and night time birth (AOR = 4.82, 95% CI: 1.84-12.6).ConclusionThe prevalence of birth injury among newborns has continued to increases and become life-threatening issue in the delivery and neonatal intensive care unit in the study area. Therefore, considering the prevailing factors, robust effort has to be made to optimize the quality obstetric care and follow up and emergency obstetrics team has to be strengthened to reduce the prevalence of birth injury.

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Validation study of the Amharic version Safety Attitudes Questionnaire (SAQ) in public hospitals of Addis Ababa, Ethiopia: a cross-sectional study

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