Browsing by Author "Topal, Mehmet"

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    Effect of accreditation and certification on the quality management system: Analysis based on Turkish hospitals.
    (2019-10-01T00:00:00Z) Yıldız, Mustafa Said; Öztürk, Zekai; Topal, Mehmet; Khan, M Mahmud
    Effects of certification and accreditation on hospital quality management systems (QMS) are measured to better understand the value of external recognitions. This study identifies the QMS dimensions that show significant improvements with hospital certification and/or accreditation. Data were collected from 350 Turkish hospitals using a structured questionnaire. Mean scores of nine domains of QMS were used as outcome variables. Although quality policy documents, quality monitoring by board, and training of professionals are the focus of generic QMS, ISO certification did not affect these scores significantly. Formal protocols for infection control scores are affected by hospital size and certification status. Adoption of Ministry of Health's (MOH) infection control initiatives has improved this score for all hospital types. Formal protocols for medication and patient handling, analyzing performance of care processes, and evaluating results improved with accreditation and certification status. Larger hospitals were better able to implement application of protocols, analyzing care process and evaluating results. For improvements in the QMS scores, external assessments are valuable, but quality-focused governmental regulations appear important for improving QMS of small and medium-sized hospitals. Higher QMS scores, however, may not lead to improved quality. Future studies should explore the relationship between QMS scores and service quality.
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    Pubmed
    Role of methemoglobin and carboxyhemoglobin levels in predicting COVID-19 prognosis: an observational study.
    (2020-12-25) Oktem, Begüm; Üzer, Fatih; Kukul Güven, Fatma Mutlu; Kırhan, İdris; Topal, Mehmet
    World Health Organization has declared coronavirus disease-19 (COVID-19) as a pandemic. Although there are studies about this novel virus, our knowledge is still limited. There is limited information about its diagnosis, treatment and prognosis. We aimed to investigate the effect of methemoglobin and carboxyhemoglobin levels on the prognosis of COVID-19. In this observational study, patients who were diagnosed with COVID-19 during March 1-April 31, 2020 in a secondary-level state hospital in Turkey were included in the study. COVID-19 diagnosis was confirmed with reverse transcription polymerase chain reaction method, with nasal, oral or sputum specimens. During the period this study was performed, 3075 patients were tested for COVID-19 and 573 of them were hospitalized. Among the hospitalised patients, 23.2% (133) of them had a positive polymerase chain reaction result for COVID-19. A total of 125 patients, 66 (52.8%) males and 59 (47.2%) females, with an average age of 50.2 ± 19.8 years, were included in the study. The most common findings in chest radiogram were ground-glass areas and consolidations, while one-third of the patients had a normal chest radiogram. Computed thorax tomography was performed for 77.6% (97/125) of the patients. The 24.7% of computed tomographies (24/97) did not reveal any pathological findings, and the most common findings were ground-glass appearance and consolidation. Those who needed intensive care had statistically significantly lower platelet count (P = 0.011) and higher lactate dehydrogenase levels (P < 0.001). No statistically significant difference was found in carboxyhemoglobin (P = 0.395) and methemoglobin (P = 1.000) levels. We found that carboxyhemoglobin and methemoglobin levels had no effect on COVID-19 prognosis, but low platelet level played a role in predicting COVID-19 prognosis. This study was approved by the Ethical Committee of Harran University Faculty of Medicine on May 11, 2020 with approval No. 09.