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Introduction: Adverse Events (AE) are one of the main problems in healthcare. Therefore, many policies have been developed worldwide to mitigate their impact. The Patient Safety Incident Study in Hospitals in the Community of Madrid (ESHMAD) measures the results of them in the region. Methods: Cross‐sectional study, conducted in May 2019, in hospitalised patients in 34 public hospitals using the Harvard Medical Practice Study methodology. A logistic regression model was carried out to study the association of the variables with the presence of AE, calibrated and adjusted by patient. Results: A total of 9975 patients were included, estimating a prevalence of AE of 11.9%. A higher risk of AE was observed in patients with surgical procedures (OR[CI95%]: 2.15[1.79 to 2.57], vs. absence), in Intensive Care Units (OR[CI95%]: 1.60[1.17 to 2.17], vs. Medical) and in hospitals of medium complexity (OR[CI95%]: 1.45[1.12 to 1.87], vs. low complexity). A 62.6% of AE increased the length of the stay or it was the cause of admission, and 46.9% of AE were considered preventable. In 11.5% of patients with AE, they had contributed to their death. Conclusions: The prevalence of AE remains similar to the previously estimated one in studies developed with the same methodology. AE keep leading to longer hospital stays, contributing to patient's death, showing that it is necessary to put focus on patient safety again. A detailed analysis of these events has enabled the detection of specific areas for improvement according to the type of care, centre and patient. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To evaluate the association between mode of birth and the resumption of sexual intercourse, self‐reported decline in sexual intercourse and dyspareunia in women at the 6th week and 6th month postpartum. Background: Interest in the relationship between mode of birth and postpartum sexual functioning is increasing. However, previous findings are contradictory. Design: Prospective, longitudinal, observational study. Method: The participants comprised 552 healthy primiparous women aged 18–45 years who gave birth at a hospital between February 2013 ‐ April 2014. Interviews were performed at the hospital and via telephone at the 6th week and 6th month postpartum. We constructed multivariate logistic regression models to examine the relationship between mode of birth and resumption of intercourse, self‐reported decline in sexual intercourse and dyspareunia at the 6th week and 6th month postpartum. Results: At the 6th week postpartum, forceps‐assisted birth, combination of episiotomy plus perineal tear and belonging to a higher socio‐economic status were related to a higher risk of non‐resumption of sexual intercourse, while breastfeeding was related to a higher probability of dyspareunia. At the 6th month postpartum, the likelihood of self‐reported decline in sexual intercourse was higher among women who screened positive for postpartum depression and a higher number of breastfeeding women reported a decline in sexual intercourse and dyspareunia. Furthermore, at the 6th month postpartum, women who reported the use of emergency services for a health problem had a higher risk of not having resumed intercourse and of experiencing dyspareunia. [ABSTRACT FROM AUTHOR]

Introduction: the implementation of quality management systems (QMS) in the health sector has made great progress in recent years, remains a key tool for the management and improvement of services provides to patients. Aim: to describe the process of implementing a quality management system (QMS) according to the standard ISO 9001:2008 in a Nutrition Unit. Methods: the implementation began in October 2012. Nutrition Unit was supported by Hospital Preventive Medicine and Quality Management Service (PMQM). Initially training sessions on QMS and ISO standards for staff were held. Quality Committee (QC) was established with representation of the medical and nursing staff. Every week, meeting took place among members of the QC and PMQM to define processes, procedures and quality indicators. We carry on a 2 months follow-up of these documents after their validation. Results: a total of 4 processes were identified and documented (Nutritional status assessment, Nutritional treatment, Monitoring of nutritional treatment and Planning and control of oral feeding) and 13 operating procedures in which all the activity of the Unit were described. The interactions among them were defined in the processes map. Each process has associated specific quality indicators for measuring the state of the QMS, and identifying opportunities for improvement. All the documents associated with requirements of ISO 9001:2008 were developed: quality policy, quality objectives, quality manual, documents and records control, internal audit, nonconformities and corrective and preventive actions. The unit was certified by AENOR in April 2013. [ABSTRACT FROM AUTHOR]