Abstract The research programme described in this paper focuses on the human component of system failure in general, and more specifically on the design and implementation of information systems for registration and analysis of so called near misses (or: near accidents) in the chemical process industry. Its final goal is to enhance industrial safety and reliability by applying cognitive psychological models of human behaviour as the basis of a safety management tool. Main activities have been the organisation of an international workshop on Near Miss Reporting which was sponsored by the European Commission, and a 3-year contract to design and implement a “Near Miss Management System” for a chemical plant in Rotterdam. Conclusions concerning success factors will involve both cognitive-theoretical design aspects, and organisational issues related to the introduction and maintenance of such safety programmes.

Abstract: Near miss reporting in the chemical process industry: an overview

Results: Doctors had majority of those with good knowledge and attitude, nurses had the same in practice while cleaning staff had majority of those with poor KAP as compared to all other categories. An average level of KAP was most prevalent in each category. Knowledge and Practice were found to have significant positive correlation with professional category (p-value= 0.002 and p-value <0.001) respectively but not attitude (p-value=0.110).

Knowledge, Attitude and Practice Regarding Biomedical Waste Management amongst Health Care Personnel in a Medical College Hospital in Trivandrum -

Knowledge, attitute and practice of healthcare workers on waste segregation at two public training hospitals

Perspectives of Colombian medicine students about their formation on breaking bad news: A cross-sectional study

Cancer affects more than 175,000 Pakistanis every year, imposing cost strains and increased financial, psychological and social burden on an already struggling populace. With a dearth of trained oncologists, the burden of advanced cancer in Pakistan is irrationally high, contributing to avoidably high mortality and morbidity rates. The involvement of primary care physicians in cancer screening, treatment decision making, and advanced care can be an effective strategy in the mitigation of this problem, without imposing any additional burden on the health resources. This integrated healthcare delivery approach needs to be encouraged and modeled to handle the growing cancer burden and to improve cancer survivorship in the country.

Primary care physicians and cancer care in Pakistan: A short narrative

Objective To evaluate the skill of postgraduate residents in breaking bad news to the patients in a tertiary care hospital. Methods The cross-sectional study was conducted at King Edward Medical university, Lahore, Pakistan, from January to April 2016, and comprised postgraduate residents of different specialties at Mayo Hospital, Lahore. The subjects were examined in terms of their personal experience in breaking bad news to the patients by means of a specifically-designed questionnaire based on six-step protocol of Setting, Perception, Invitation, Knowledge, Empathy and Summarising model. Data was qualitatively and quantitatively analysed using SPSS 22. Results Of the 200 respondents, 141(70.5%) were males and 59(29.5%) were females. Overall mean age of the sample was 23 } 2.55years. Of the total, 94(47%) respondents were only fairly satisfied with their breaking bad news skill, while 130(65%) were eager to get training in this regard. The knowledge regarding breaking bad news protocols was lacking across all comparisons (p>0.05). Conclusions Majority of the residents had little satisfaction regarding their breaking bad news skill. It is necessary to plan special training for the residents in this key area.

Breaking Bad News Skill of Postgraduate Residents of Tertiary Care Hospital of Lahore, Pakistan: A Cross-Sectional Survey

.. Objectives: This study has been designed to assess the knowledge, attitude and practices of healthcare workers at Mayo Hospital regarding biomedical waste segregation. Study Design: Cross-sectional study. Setting: Teaching Hospital of King Edward Medical University Lahore, Pakistan. Period: February 2018 to January 2019. Material & Methods: Structured questionnaires in English and Urdu were employed to collect data from healthcare workers (nurses and doctors) on duty in different wards of Mayo Hospital. The demographics, level of knowledge, practices and attitude regarding biomedical waste segregation are reported using descriptive statistics. The comparison of doctors and nurses is done using chisquare. Results: Significantly fewer number of doctors correctly identified the container for bio hazardous waste (p=0.016), while majority (89.4%) of respondents were able to correctly identify the container for sharps and general waste. Significantly more (p=0.00) number of nurses had training in waste segregation as compared with doctors. Majority (95.0%) of nurses acknowledged that guidelines regarding waste segregation were available in their departments, whereas significantly lesser number (64.5%) of doctors acknowledged existence of guidelines at their workplace (p=0.00). 21.3% of respondents claimed to have acquired infection from waste with no statistical difference between the two groups (p=0.19). A minority of the participants agreed that the practices were satisfactory (14.6%) and the required equipment was available (27.7%), yet there was a significant difference between the responses of doctors and nurses with the nurses being more satisfied with the available facilities and equipment (p=0.00) than doctors. Conclusion: The knowledge of the healthcare workers regarding waste segregation is better than their practices, nonetheless there is a dire need to improve the quality of training of these health care workers in and emphases must be put on ensuring that correct practices are adopted.

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Knowledge, attitude and practices of healthcare workers regarding biomedical waste segregation at Mayo Hospital Lahore.

Background: Needle stick injuries have a fairly common incidence in surgical practice exposing surgeons to an array of transmissible diseases. The aim of the study was to assess the prevalence of needle stick injury, and their reporting among surgeons in tertiary hospital setting. Study Design: Cross-sectional study. Setting: Various tertiary care hospital of Lahore. Period: January 2016 through April, 2016. Methods: Our sample size was 935 Surgeons. We determined the prevalence of needle stick injuries, reporting of NSI, the reasons for not reporting and the reasons for acquired injuries. Results: Needle stick injury was reported by only 85 (9.1%) participants. The reasons for not reporting varied; 363 (38.8%) did not report due to unawareness of the existence of a relevant system, 250 (26.7%) did not know whom to report, 86 (9.2%) were not able to spare time to report, 81 (8.7%) were afraid of results, 48 (5.1%) thought that patient was low risk and 107 (11.4%) did not bother. Conclusion: There was a lack of hospital policy to cater to the reporting of injuries sustained during surgical practice. A dire need for a system was observed to educate the healthcare workers and provide a medium to assist the process of reporting.

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Needle stick injury reporting among surgeons in tertiary hospitals of Lahore

Objective To evaluate pre-microscopic errors in anatomical pathology. Methods The cross-sectional descriptive study was conducted at the Department of Pathology of a tertiary care hospital in Lahore, Pakistan, from September, 2016, to January, 2017, and comprised surgical pathology specimens. Errors were noted across the pre-microscopic process. Defects per million opportunities were calculated to determine sigma metric value in every step, from requisition to slide preparation. Root cause analysis was applied to the process of histology preparation to identify the root cause of each previously identified problem using Eindhoven classification. All errors were recorded on a pre-designed proforma. Results There were 2420 specimens. While errors were encountered in all phases of the pre-microscopic process, but the (G6: n=1085, 44.83%), followed by requisition (R3: n=893, 36.9%) and cover slipping (C1: n=776, 32.06%). Conclusions Development of standard procedures and protocols with staff training is likely to help in controlling the errors.

Root cause analysis of pre-microscopic errors in anatomical pathology using Eindhoven classification.

.. Objectives: Adenoid cystic carcinoma (AdCC) and mucoepidermoid carcinoma (MEC) are the commonest salivary gland malignancies in Pakistan constituting almost 75% of all malignant salivary gland tumours. The objective of this study was explore the clinical & morphological spectrum of these tumours in local population and to grade them w.r.t. modern grading criteria. Study Design: Descriptive study. Setting: Department of Morbid Anatomy and Histopathology/ Oral Pathology, University of Health Sciences Lahore, Pakistan. Period: Jan. 2014 to Sep. 2015. Method: Paraffin embedded blocks and detailed clinical data of 20 cases each of adenoid cystic carcinoma and mucoepidermoid carcinoma reported at local tertiary care hospitals. The histologic diagnosis was made on Hematoxylin and Eosin staining. The tumours were graded into grades I, II & III according to the most recent grading criteria. AdCC was studied with respect to its morphological patterns (tubular, cribriform and solid) while MEC was studied with special concern to the cell types seen in it (mucous, intermediate, squamous and clear cells). Results: The most frequently observed age group for the patients of AdCC was the 5th (45%) decade with mean age of 41.50±12.224 years and a female predilection of 1.5:1. Minor salivary glands were the commonest site involved (80%) of which palate was most frequently affected (37.5%) followed by maxilla (25%). Grade I (75%) was most frequently noted grade in AdCC. Cribriform pattern (60%) was the most frequently encountered predominant histological pattern followed by equal distribution of tubular and solid Patterns (20% each). MEC affected most patients in 3rd (30%) decade with mean age of and 32.35±13.674 years and male predilection (60%). Parotid gland (70%) was the commonest site involved followed by maxilla (10%). Histologically, grade III (40%) was most frequently noted followed by grade I (35%) and grade II (25%). Squamous cells (65%) were the predominant cell type in most cases followed by mucous cells in (35%) cases. Conclusion: Adenoid cystic carcinoma and mucoepidermoid carcinoma both affect a younger age group in our population with a female (1.5:1) and male (1:1.5) predilection respectively. The most favoured site for AdCC and MEC is palate and parotid gland respectively. Grade I AdCC and cribriform pattern are the commonest grade and pattern encountered in this study. On the other hand, high grade (Grade III) MEC is the most regularly encountered grade in MEC. So, proper grading and staging along with meticulous surgical approach is needed to improve the life expectancy in these patients.

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Salivary glands; clinical & histopathological spectrum of adenoid cystic carcinoma & mucoepidermoid carcinomas reported at tertiary care hospitals in lahore

Fakeha Rehman

Papers

Breaking Bad News Skill of Postgraduate Residents of Tertiary Care Hospital of Lahore, Pakistan: A Cross-Sectional Survey

Knowledge, attitude and practices of healthcare workers regarding biomedical waste segregation at Mayo Hospital Lahore.

Needle stick injury reporting among surgeons in tertiary hospitals of Lahore

Root cause analysis of pre-microscopic errors in anatomical pathology using Eindhoven classification.

Salivary glands; clinical & histopathological spectrum of adenoid cystic carcinoma & mucoepidermoid carcinomas reported at tertiary care hospitals in lahore