Analysis of the Implementation of Patient Safety Targets at the Makassar City Regional General Hospital

The Patient Safety Goals (SKP) drive specific improvements in patient safety. These objectives highlight problematic areas of health care in a system implemented in hospitals to make patient care safer. This study aims to analyze the implementation of patient safety goals in Makassar City Hospital. This type of research is mixed methods research. The research uses a sequential explanatory strategy. The results showed that the implementation of patient safety targets based on the Hospital Patient Safety Target Standards (SNARS) at Makassar City Hospital has a good implementation of patient safety targets. The implementation of patient safety targets in terms of leadership in the Makassar City Regional General Hospital (RSUD), namely the awarding of awards has never been done, and supervision is carried out by looking at patient safety reports. In terms of human resources, training related to patient safety is still lacking and only during accreditation. Regarding policies, there are SOPs related to patient safety incidents and there is no clear sanction, only a warning. For teamwork, there is no availability of a patient safety team in the treatment room, only KMKP has a patient safety team. In addition, the implementation of patient safety goals in terms of communication, namely the existence of positive feedback given and followed up by the Patient Safety and Quality Committee (KMKP), as well as lack of socialization by KMKP, only at the time of accreditation.

Resource Partitioning Among Sympatric Carnivore Species at Pir Lasura National Park, Azad Jammu & Kashmir, Pakistan

The current study aimed at investigating resource partitioning among sympatric carnivore species inhabiting Pir Lasura National Park (PLNP), AJ&K during 2014-2017. The main objectives included documenting the diversity and distribution of carnivores, investigation of the diet composition of carnivores, prey species availability, niche breadth and niche overlap among sympatric carnivores and the human- carnivore conflict at PLNP. We used direct (direct sightings, road killing) and indirect signs (scats) to document diversity and distribution of carnivore species. Scat analysis was used for diet composition study. Prey species abundance was estimated utilizing standardize method for different taxa. Niche breadth and niche overlap was computed using Levins and Pianka’s index while, human carnivore interaction was studied using questionnaire survey. The study recorded seven different species of carnivores in the Park including; common leopard (Panthera pardus), Asiatic jackal (Canis aureus), Kashmir hill fox (Vulpes vulpes griffithi), Asian palm civet (Paradoxurus hermaphroditus), small Indian civet (Viverricula indica), Indian grey mongoose (Herpestes edwardsii), and the small Indian mongoose (Herpestes javanicus). Direct and indirect signs of common leopard, Asiatic jackal, Kashmir hill fox, Asian palm civet and small Indian mongoose were recorded in all 30 sampling sites having different elevational range. Indian grey mongoose was found at 15 different sampling sites while signs of small Indian civet were recorded at 7 sites. The collected scats tested using molecular identification technique to confirm for the carnivore species. Accuracy for common leopard scats was found to be 95.8%, Kashmir hill fox 88.9%, Asiatic jackal 90.3%, Asian palm civet 74.3%, and small Indian civet 92.4%. Morphological characteristics of scats showed that they overlap greatly among different species based on their diameter and length. Diet of common leopard comprised of 17 prey species (10 wild and 7 domestic). Frequency of occurrence of wild prey was 34.85 % of total leopard diet whereas domestic prey contributed 59.1%. Sixteen species of mammals, birds, insects and plants were identified from diet of Asiatic jackal. Among these species 10 were wild, 5 were domestic and 1 species of plant. Frequency of wild prey in diet of jackal was 18.48% and domestic was 59.78%. We recorded 21 species of mammals, birds, plants and insects in diet of fox. Among these 21 species 10 were wild, 5 domestic and 6 plant species. Frequency of occurrence of wild prey was 17.96%, domestic prey 50.9%, plants 27.54%. Analysis of 108 scats samples of Asian palm civet showed that 27 species of mammals, birds, invertebrates and plants were consumed. Among all recorded species 9 were wild, 3 domestic, and 15 plant species. Consumption of wild prey was 33.68% compared to 10.88% domestic prey species and 53.37% plants. Analysis of 44 scats showed that 17 prey species occurred in diet of small Indian civet. Among them 8 were wild, 1 domestic, and 8 were plant species. Frequency of occurrence of wild prey in diet of small Indian civet was 30.65%, domestic prey 14.52%, and plants 51.61%. Analysis of 57 scat samples showed that 22 prey species occurred in diet of small Indian mongoose. Among them 15 were wild, 1 domestic, and 6 plant species. Diet of Indian grey mongoose consisted of (60%) wild species, (19%) domestic prey species, and (14%) plant species. Analysis of 69 scat samples of small Indian mongoose showed that 17 prey species occurred in diet. Among them 10 were wild prey species, only 1 domestic prey species and 6 plant species. Frequency of occurrence of wild prey was (59.68%), domestic prey (16.94%) and plant matter (11.29%). The abundance of different vertebrate and invertebrate prey species was also estimated in the study area to confirm the availability of wild prey. Among seven sympatric carnivores. Niche breadth niche breadth of Indian grey mongoose was widest 18 (0.72) followed by Asiatic jackal 14.2 (0.78), common leopard 13.88 (0.72), small Indian mongoose 12 (0.64), small Indian civet 10(0.52), Asian palm civet 9.69 (0.31), and Kashmir hill fox 7.89(0.31). High niche overlap was found between Asian palm civet and small Indian civet (0.9), Indian grey mongoose and small Indian mongoose (0.89), Asiatic jackal and Kashmir hill fox (0.81), while lowest niche overlap was recorded common leopard and small Indian civet (0.04). Data on livestock depredation by carnivores showed that 170 people lost 306 livestock, poultry, dogs, and pets to four different carnivore species; common leopard being the major predator killing (88.5%) livestock, with minor contributions from Asiatic jackal (5.2%), small Indian civet (3.2%) and Indian grey mongoose (2.9%). The depredated livestock by leopard mainly included goats (82.2%) and dogs (9.2%). Common leopard was responsible for majority of the financial loss estimated approximately at US$ 80,000 and it negatively affected local people tolerance towards this top predator. The study concludes, niche of seven sympatric carnivore species overlaps in the study area with high overlap recorded for Asian palm civet and small Indian civet (0.9) and lowest was recorded for the leopard and small Indian civet (0.04).