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Sample records for bugabo ward kagera

  1. Ethnomedicine of the Kagera Region, north western Tanzania. Part 2: The medicinal plants used in Katoro Ward, Bukoba District

    Directory of Open Access Journals (Sweden)

    Mbabazi Pamela K

    2010-07-01

    Full Text Available Abstract Background The Kagera region of north western Tanzania has a rich culture of traditional medicine use and practices. The dynamic inter-ethnic interactions of different people from the surrounding countries constitute a rich reservoir of herbal based healing practices. This study, the second on an ongoing series, reports on the medicinal plant species used in Katoro ward, Bukoba District, and tries to use the literature to establish proof of the therapeutic claims. Methodology Ethnomedical information was collected using Semi-structured interviews in Kyamlaile and Kashaba villages of Katoro, and in roadside bushes on the way from Katoro to Bukoba through Kyaka. Data collected included the common/local names of the plants, parts used, the diseases treated, methods of preparation, dosage, frequency and duration of treatments. Information on toxicity and antidote were also collected. Literature was consulted to get corroborative information on similar ethnomedical claims and proven biological activities of the plants. Results Thirty three (33 plant species for treatement of 13 different disease categories were documented. The most frequently treated diseases were those categorized as specific diseases/conditions (23.8% of all remedies while eye diseases were the least treated using medicinal plants (1.5% of all remedies. Literature reports support 47% of the claims including proven anti-malarial, anti-microbial and anti-inflammatory activity or similar ethnomedical uses. Leaves were the most frequently used plant part (20 species followed by roots (13 species while making of decoctions, pounding, squeezing, making infusions, burning and grinding to powder were the most common methods used to prepare a majority of the therapies. Conclusion Therapeutic claims made on plants used in traditional medicine in Katoro ward of Bukoba district are well supported by literature, with 47% of the claims having already been reported. This study further

  2. Ethnomedicine of the Kagera Region, north western Tanzania. Part 3: plants used in traditional medicine in Kikuku village, Muleba District

    Directory of Open Access Journals (Sweden)

    Moshi Mainen J

    2012-04-01

    Full Text Available Abstract Background The Kagera region of north western Tanzania has a rich culture of traditional medicine use and practice. Traditional medicines are the mainstay of healthcare in this region and are known to support the management of many illnesses such as malaria, bacterial infections, epilepsy, gynecological problems and others. However, most of the plants being used have either not been documented or evaluated for safety and efficacy or both. This study, the sixth of an ongoing series, reports on the medicinal plants that are used at Kikuku village, Muleba District. Methodology A semi-structured questionnaire was used to collect information on the common/local names of the plants, parts of the plants used, diseases treated, methods of preparing the herbal remedies, dosage of the remedies administered, frequency and duration of treatment and toxicity of the medicines. A literature review was carried out for information on the ethnomedical uses of the reported plants. Results A total of 49 plant species belonging to 47 genera and 24 plant families were documented. The family Euphorbiaceae and Asteraceae had the highest representation. The plants are used for the treatment of skin conditions (10 plants; 20%, bacterial infections and wounds (14 plants; 28.6%, malaria (14 plants; 28.6%, gastrointestinal disorders (11 plants; 22.4%, gynecological problems including infertility (8 plants; 16.3%, hypertension (5 plants; 10.2%, viral infections (7 plants; 14.3%, chest problems (5 plants; 10.2%, diabetes (3 plants; 6.1%, cancer (2 plants; 4.1%, inflammatory conditions (arthritis, rheumatism, HIV and AIDS, and hernia each treated by 1 plant (3 plants in total; 6.1%. Information obtained from the literature indicate that 25 (51.0% of the therapeutic claims are supported by laboratory results or have similar claims of ethnomedical use from other countries. Conclusion Herbal remedies comprise an important and effective component of the healthcare system

  3. Castle Ward, County Down

    OpenAIRE

    Fisher, Jonathan

    2008-01-01

    Fisher was a painter and engraver in Ireland, working after the Dutch and Italian landscape painting tradition. He is best known by engravings after his designs, of which a large number were produced during his career.[notes from Irish Paintings in the `National Gallery of Ireland?, 2001]The present painting depicts Castle Ward in the distance, an 18th century dwelling famed for its mix of Classical and Gothic architecture.

  4. Splitting Ward identity

    CERN Document Server

    Safari, Mahmoud

    2015-01-01

    Within the background field framework we present a path integral derivation of the splitting Ward identity for the one-particle irreducible effective action in the presence of an infrared regulator, and make connection with earlier works on the subject. The approach is general in the sense that it does not rely on how the splitting is performed. This identity is then used to address the problem of background dependence of the effective action at an arbitrary energy scale. We finally introduce the modified master equation and emphasize its role in constraining the effective action.

  5. Splitting Ward identity

    Energy Technology Data Exchange (ETDEWEB)

    Safari, Mahmoud [Institute for Research in Fundamental Sciences (IPM), School of Particles and Accelerators, P.O. Box 19395-5531, Tehran (Iran, Islamic Republic of)

    2016-04-15

    Within the background-field framework we present a path integral derivation of the splitting Ward identity for the one-particle irreducible effective action in the presence of an infrared regulator, and make connection with earlier works on the subject. The approach is general in the sense that it does not rely on how the splitting is performed. This identity is then used to address the problem of background dependence of the effective action at an arbitrary energy scale. We next introduce the modified master equation and emphasize its role in constraining the effective action. Finally, application to general gauge theories within the geometric approach is discussed. (orig.)

  6. Ward identity in noncommutative QED

    OpenAIRE

    Mariz, T.; Pires, C. A. de S.; R F Ribeiro

    2002-01-01

    Although noncommutative QED presents a nonabelian structure, it does not present structure constants. In view of this we investigate how Ward identity is satisfied in pair annihilation process and $\\gamma \\gamma \\to \\gamma \\gamma$ scattering in noncommutative QED.

  7. Exploring the role of cognitive and structural forms of social capital in HIV/AIDS trends in the Kagera region of Tanzania - a grounded theory study.

    Science.gov (United States)

    Frumence, Gasto; Eriksson, Malin; Nystrom, Lennarth; Killewo, Japhet; Emmelin, Maria

    2011-04-01

    The article presents a synthesis of data from three village case studies focusing on how structural and cognitive social capital may have influenced the progression of the HIV epidemic in the Kagera region of Tanzania. Grounded theory was used to develop a theoretical model describing the possible links between structural and cognitive social capital and the impact on sexual health behaviours. Focus group discussions and key informant interviews were carried out to represent the range of experiences of existing social capital. Both structural and cognitive social capital were active avenues for community members to come together, empower each other, and develop norms, values, trust and reciprocal relations. This empowerment created an enabling environment in which members could adopt protective behaviours against HIV infection. On the one hand, we observed that involvement in formal and informal organisations resulted in a reduction of numbers of sexual partners, led people to demand abstinence from sexual relations until marriage, caused fewer opportunities for casual sex, and gave individuals the agency to demand the use of condoms. On the other hand, strict membership rules and regulations excluded some members, particularly excessive alcohol drinkers and debtors, from becoming members of the social groups, which increased their vulnerability in terms of exposure to HIV. Social gatherings (especially those organised during the night) were also found to increase youths' risk of HIV infection through instances of unsafe sex. We conclude that even though social capital may at times have negative effects on individuals' HIV-prevention efforts, this study provides initial evidence that social capital is largely protective through empowering vulnerable groups such as women and the poor to protect against HIV infection and by promoting protective sexual behaviours.

  8. Psychiatric wards: places of safety?

    Science.gov (United States)

    Jones, J; Nolan, P; Bowers, L; Simpson, A; Whittington, R; Hackney, D; Bhui, K

    2010-03-01

    In recent years, the purpose and quality of provision delivered in acute inpatient psychiatric settings have been increasingly questioned. Studies from a service user perspective have reported that while some psychiatric inpatients feel safe and cared for, others feel their time in hospital is neither safe nor therapeutic. This paper explores the experiences of service users on acute inpatient psychiatric wards in England, with a particular focus on their feelings of safety and security. Interviews were conducted with 60 psychiatric inpatients in England. The majority of service users felt safe in hospital and felt supported by staff and other service users. However, anything that threatened their sense of security such as aggression, bullying, theft, racism and the use of alcohol and drugs on the ward, made some respondents feel insecure and unsafe. Psychiatric wards are still perceived by many as volatile environments, where service users feel forced to devise personal security strategies in order to protect themselves and their property. It would appear that there remains much to do before research findings and policies are implemented in ways that facilitate all service users to derive the maximum benefit from their inpatient experience.

  9. Anatomy of the ward round.

    Science.gov (United States)

    O'Hare, James A

    2008-07-01

    The ward round has been a central activity of hospital life for hundreds of years. It is hardly mentioned in textbooks. The ward round is a parade through the hospital of professionals where most decision making concerning patient care is made. However the traditional format may be intimidating for patients and inadequate for communication. The round provides an opportunity for the multi-disciplinary team to listen to the patient's narrative and jointly interpret his concerns. From this unfolds diagnosis, management plans, prognosis formation and the opportunity to explore social, psychological, rehabilitation and placement issues. Physical examination of the patient at the bedside still remains important. It has been a tradition to discuss the patient at the bedside but sensitive matters especially of uncertainty may better be discussed elsewhere. The senior doctor as round leader must seek the input of nursing whose observations may be under-appreciated due to traditional professional hierarchy. Reductions in the working hours of junior doctors and shortened length of stay have reduced continuity of patient care. This increases the importance of senior staff in ensuring continuity of care and the need for the joint round as the focus of optimal decision making. The traditional round incorporates teaching but patient's right to privacy and their preferences must be respected. The quality and form of the clinical note is underreported but the electronic record is slow to being accepted. The traditional multi-disciplinary round is disappearing in some centres. This may be regrettable. The anatomy and optimal functioning of the ward round deserves scientific scrutiny and experimentation.

  10. Anatomy of the ward round.

    LENUS (Irish Health Repository)

    O'Hare, James A

    2008-07-01

    The ward round has been a central activity of hospital life for hundreds of years. It is hardly mentioned in textbooks. The ward round is a parade through the hospital of professionals where most decision making concerning patient care is made. However the traditional format may be intimidating for patients and inadequate for communication. The round provides an opportunity for the multi-disciplinary team to listen to the patient\\'s narrative and jointly interpret his concerns. From this unfolds diagnosis, management plans, prognosis formation and the opportunity to explore social, psychological, rehabilitation and placement issues. Physical examination of the patient at the bedside still remains important. It has been a tradition to discuss the patient at the bedside but sensitive matters especially of uncertainty may better be discussed elsewhere. The senior doctor as round leader must seek the input of nursing whose observations may be under-appreciated due to traditional professional hierarchy. Reductions in the working hours of junior doctors and shortened length of stay have reduced continuity of patient care. This increases the importance of senior staff in ensuring continuity of care and the need for the joint round as the focus of optimal decision making. The traditional round incorporates teaching but patient\\'s right to privacy and their preferences must be respected. The quality and form of the clinical note is underreported but the electronic record is slow to being accepted. The traditional multi-disciplinary round is disappearing in some centres. This may be regrettable. The anatomy and optimal functioning of the ward round deserves scientific scrutiny and experimentation.

  11. Food hygiene on the wards.

    Science.gov (United States)

    Steuer, Walter

    2007-09-13

    A PROBLEM THAT IS OFTEN OVERLOOKED OR SIMPLY NOT GIVEN ENOUGH ATTENTION: the food served to patients from the kitchen is not sterile. If food is allowed to stand at room temperature for a long time, both in the case of food cooked for lunch and of food intended for supper which has been previously chilled, there is the possibility of massive spore germination or of dangerous toxin formation. Therefore regulations on how to handle food and beverages (e.g. tea) must be set out in the infection control policy, and checks carried out to monitor compliance with the rules relating to temperature checks, duration and type of storage, need for reheating, etc. Making staff aware of the issues involved is of paramount importance. These include monitoring hygiene standards in the ward kitchen, formulation of a cleaning policy, periodic bacteriological checks (not only of workstations but also of the dishwasher results), whenever possible the use of disposable cloths for working surfaces and equipment, changing cleaning cloths at least once daily and hygienic hand disinfection before and after handing out food. Foodstuffs brought in by visitors represent a special hygienic and organizational problem because in many cases they already have a high baseline microbial count. Visitors must be made aware that, for example, slices of cake left in the patient's room and often eaten only hours later can pose a risk of infection.In summary, the following principles of food hygiene must be observed on the wards:Maintenance of the cold-hot chainNot only reheat food, but ensure it is well heated throughout Avoid situations giving rise to spore germination in foodstuffs brought in by visitorsCleanliness and minimal contamination of kitchen worktopsCleanliness of crockery and kitchen towels Do not allow food to stand at room temperature for a long time, in particular desserts and confectionery A standard policy must be enforced to define the hygienic status and organization for food

  12. Light Atmosphere in Hospital Wards

    DEFF Research Database (Denmark)

    Stidsen, Lone Mandrup

    . The four key aspects are: ‘Light’, ‘Space’, ‘Users’ and ‘Time’. The ‘Light’ aspect describes, as shown in (Fig 0.6), the character of the light, light information and light effect i.e. function, aesthetics or symbolism. The ‘Space’ aspect looks into the dimension of the space, geographical orientation...... in Denmark are lastly an investigation on light zones at the hospital ward defined in order to optimize the illumination. The third cycle of iteration is an experimental study testing a lighting concept developed and grounded in the knowledge gained through the first and second cycle. The fourth cycle...

  13. Light atmosphere in hospital wards

    DEFF Research Database (Denmark)

    Stidsen, Lone Mandrup

    Sociocultural aspects of light are important for the user experience of the atmosphere in a ward. According to the Danish Regulation for light in hospitals (DS703, 1983), a home-like feeling is required to support the patients, as they needa pleasant environment for their recovery. The term ‘Light...... the requirements. What does it mean to create a 'home-like' and 'pleasant or appealing' light in this context? Does the composition of CRI and degree of Kelvin tell it all? Is it enough information to provide a proper illumination in which the patient can have a homely and pleasant experience? The 'Model of Light...... from the Danish interior design magazine BO BEDRE.The findings show that the placement of light atmosphere in Denmark are determined as three horizontal light zones: 'High Lighting Zone', 'Center Lighting Zone' and 'Low Lighting Zone' An experimental study evaluates the experience of the atmosphere...

  14. Three point SUSY Ward identities without Ghosts

    CERN Document Server

    Walker, M L

    2004-01-01

    We utilise a non-local gauge transform which renders the entire action of SUSY QED invariant and respects the SUSY algebra modulo the gauge-fixing condition, to derive two- and three-point ghost-free SUSY Ward identities in SUSY QED. We use the cluster decomposition principle to find the Green's function Ward identities and then takes linear combinations of the latter to derive identities for the proper functions.

  15. "Ward v. Wilbanks": Counselor Educators Respond

    Science.gov (United States)

    Burkholder, David; Hall, Stephanie F.; Burkholder, Jessica

    2014-01-01

    This article investigated 71 counselor educators' perspectives and pedagogical practices related to "Ward v. Wilbanks" (2009) and the American Counseling Association (ACA) response to the case. The authors used qualitative content analysis to identify 6 themes from survey data: (a) views on gatekeeping and student training; (b)…

  16. Limits of Freedom: The Ward Churchill Case

    Science.gov (United States)

    O'Nell, Robert M.

    2006-01-01

    The University of Colorado's Ward Churchill is but the latest in a long line of professors whose volatile statements have created controversy for themselves and their universities. Specific personnel matters in the case have been meticulously addressed in Boulder, but several larger questions have been curiously neglected. One might well ask, for…

  17. Optimizing Lighting Design for Hospital Wards by Defining User Zones

    DEFF Research Database (Denmark)

    Thuesen, Niels; Stidsen, Lone; Kirkegaard, Poul Henning

    2011-01-01

    of lighting design, so it has the ability to support the different users activity and behavior on the ward. By using RFID tracking and manual observations we have analyzed and evaluated the ward functionality as working environment for the staff. The method creates a higher understanding of the ward...

  18. Ward identities for amplitudes with reggeized gluons

    Energy Technology Data Exchange (ETDEWEB)

    Bartles, J. [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik; Universidad Tecnica Federico Santa Maria, Valparaiso (Chile). Dept. de Fisica; Lipatov, L.N. [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik; St. Petersburg Nuclear Physics Institute (Russian Federation); Vacca, G.P. [INFN, Sezione di Bologna (Italy)

    2012-05-15

    Starting from the effective action of high energy QCD we derive Ward identities for Green's functions of reggeized gluons. They follow from the gauge invariance of the effective action, and allow to derive new representations of amplitudes containing physical particles as well as reggeized gluons. We explicitly demonstrate their validity for the BFKL kernel, and we present a new derivation of the kernel.

  19. The Ward ansaetze and Painleve tau function

    Energy Technology Data Exchange (ETDEWEB)

    Mo, M Y [Department of Mathematics, University of Bristol, University Walk, Bristol, BS8 ITW (United Kingdom)

    2008-10-03

    We have classified a tau function for the hypergeometric solutions of the Painleve VI equation constructed by Shah and Woodhouse (2006 J. Phys. A: Math. Gen. 39, 12265-9) through twistor methods. We have shown that the tau function is the product of a Toeplitz determinant and a power of the time variable t. In a suitable trivialization of the twistor bundle, the symbol of this Toeplitz determinant is the minus of the off-diagonal entry in the patching matrix. The method can also be applied to other solutions obtained from the Ward ansaetze.

  20. Ideal ward round making in neurosurgical practice.

    Directory of Open Access Journals (Sweden)

    Pathak A

    2000-07-01

    Full Text Available The success of a perfect ward round lies in the role of the consultant leading the ′round making group′ (RMG as well as the hallmark of effective questioning and participation of each member. Twelve senior consultants with more than 10 years′ experience in neurosurgical practice at three different university hospitals were observed during round making by a participant observer. Observations were made on the group climate of the RMG, the leadership pattern and language expressed by the clinician conducting the round and the effectiveness in his performance as a leader during clinical discussions. The group climate showed evidence of good productivity and flexibility with 92% and 75% consultants, pleasantness of climate was above average with only 50% (6/12 and poor objectivity with 42% (5/12 consultants. Forty two percent of the consultants were not always very well comprehensible, while only 50% (6/12 spoke exactly fitting the occasion. Only 33% (4/12 of the consultants used humour effectively, while 42% (5/12 spoke unnecessarily in between discussion and were poor in introducing the problems of patient to the round making group. Ward round making in neurosurgical practice needs a holistic approach with motivation, planning, leadership skills and structured curriculum to fulfill its objectives.

  1. Nurse rostering at a Danish ward

    DEFF Research Database (Denmark)

    Bæklund, Jonas

    2014-01-01

    This paper considers a nurse rostering problem from a ward at a Danish hospital.  The problem is highly constrained and comprises a large set of different constraints. A branch-and-price method for solving the problem exactly is proposed. The master problem is to assign schedules to the nurses......, and its linear relaxation is solved by means of column generation. The pricing sub-problem is to generate feasible schedules for the nurses and -- as a couple of different constraints including several special Danish regulations have to be observed -- is solved by constraint programming. A number...... of specific algorithms for handling these constraints are proposed. The method is very flexible regarding the rules a schedule should comply with, which is a key concern when creating solution methods for nurse rostering problems.  Computational tests show that optimal solutions can be found for instances...

  2. Patients Light Preferences in Hospital Wards

    DEFF Research Database (Denmark)

    Stidsen, Lone; Bjerrum, H. S.; Kirkegaard, Poul Henning;

    2011-01-01

    it can have a positive influence on the recovery process. The present paper introduces the human perspective and the Danish cultural approach in illuminating homes and how it can contribute to innovative lighting design at hospitals. The importance of having a holistic approach to lighting design...... is introduced based on the theory by Gernot Böhmes i.e. “concept of atmosphere” dealing with the effect of experiencing atmosphere. The aim of this study for design of a lighting concept for wards is to get qualified information on patients light preferences for light atmosphere by studying the everyday use...... of light in homes. This explorative study displays the preferred light atmosphere in Danish homes in the age group of 60-85 years old people. With an anthropologically approach to the subject using semi structured interviews, the goal is to explore preferences for light atmosphere when the user...

  3. Chiral susceptibility and the scalar Ward identity.

    Energy Technology Data Exchange (ETDEWEB)

    Chang, L.; Liu, Y.-X.; Roberts, C. D.; Shi, Y.-M.; Sun, W.-M.; Zong, H.-S.; Physics; Inst. of Applied Physics and Computational Mathematics; Peking Univ.; National Lab. of Heavy Ion Accelerator; Univ. of New South Wales; Nanjing Univ.; Joint Center for Particle, Nuclear Physics and Cosmology

    2009-03-01

    The chiral susceptibility is given by the scalar vacuum polarization at zero total momentum. This follows directly from the expression for the vacuum quark condensate so long as a nonperturbative symmetry preserving truncation scheme is employed. For QCD in-vacuum the susceptibility can rigorously be defined via a Pauli-Villars regularization procedure. Owing to the scalar Ward identity, irrespective of the form or Ansatz for the kernel of the gap equation, the consistent scalar vertex at zero total momentum can automatically be obtained and hence the consistent susceptibility. This enables calculation of the chiral susceptibility for markedly different vertex Ansaetze. For the two cases considered, the results were consistent and the minor quantitative differences easily understood. The susceptibility can be used to demarcate the domain of coupling strength within a theory upon which chiral symmetry is dynamically broken. Degenerate massless scalar and pseudoscalar bound-states appear at the critical coupling for dynamical chiral symmetry breaking.

  4. Ward leadership: balancing the clinical and managerial roles.

    Science.gov (United States)

    Firth, Kate

    2002-04-01

    This qualitative study investigated ward managers' experiences of combining a clinical leadership role with the managerial and administrative parts of their job. Ward managers saw their main task as one of developing their staff and improving the quality of their service, yet found balancing their different roles problematic.

  5. On Hospital Wards, Patient Crises May Have 'Domino Effect'

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_162758.html On Hospital Wards, Patient Crises May Have 'Domino Effect' When ... should serve as a wake-up call for hospital-based physicians," study author Dr. Matthew Churpek, an ...

  6. Developing skills in clinical leadership for ward sisters.

    Science.gov (United States)

    Fenton, Katherine; Phillips, Natasha

    The Francis report has called for a strengthening of the ward sister's role. It recommends that sisters should operate in a supervisory capacity and should not be office bound. Effective ward leadership has been recognised as being vital to high-quality patient care and experience, resource management and interprofessional working. However, there is evidence that ward sisters are ill equipped to lead effectively and lack confidence in their ability to do so. University College London Hospitals Foundation Trust has recognised that the job has become almost impossible in increasingly large and complex organisations. Ward sisters spend less than 40% of their time on clinical leadership and the trust is undertaking a number of initiatives to support them in this role.

  7. Electronic Printed Ward Round Proformas: Freeing Up Doctors' Time

    Science.gov (United States)

    Fernandes, Darren; Eneje, Philip

    2017-01-01

    The role of a junior doctor involves preparing for the morning ward round. At a time when there are gaps on rotas and doctors' time is more stretched, this can be a source of significant delay and thus a loss of working time. We therefore looked at ways in which we could make the ward round a more efficient place by introducing specific electronic, printed ward round proformas. We used the average time taken to write proformas per patient and the average time taken per patient on the ward round. This would then enable us to make fair comparisons with future changes that were made using the plan, do, study, and act principles of quality improvement. Our baseline measurement found that the average time taken to write up the proforma for each patient was 1 minute 9 seconds and that the average time taken per patient on the ward round was 8 minutes 30 seconds. With the changes we made during our 3 PDSA cycles and the implementation of an electronic, printed ward round proforma, we found that we were able to reduce the average time spent per patient on the ward round to 6 minutes 32 seconds, an improvement of 1 min 58 seconds per patient. The project has thus enabled us to reduce the time taken per patient during the ward round. This improved efficiency will enable patients to be identified earlier for discharge. It will also aid in freeing up the time of junior doctors, allowing them to complete discharge letters sooner, order investigations earlier and enable them to complete their allocated tasks within contracted hours. PMID:28352467

  8. Ward Identities for Scale and Special Conformal Transformations in Inflation

    CERN Document Server

    Kundu, Nilay; Trivedi, Sandip P

    2016-01-01

    We derive the general Ward identities for scale and special conformal transformations in theories of single field inflation. Our analysis is model independent and based on symmetry considerations alone. The identities we obtain are valid to all orders in the slow roll expansion. For special conformal transformations, the Ward identities include a term which is non-linear in the fields that arises due to a compensating spatial reparametrization. Some observational consequences are also discussed.

  9. Noise Pollution in Intensive Care Units and Emergency Wards

    Directory of Open Access Journals (Sweden)

    Gholamreza Khademi

    2011-03-01

    Full Text Available Introduction: The improvement of technology has increased noise levels in hospital Wards to higher than international standard levels (35-45 dB. Higher noise levels than the maximum level result in patient’s instability and dissatisfaction. Moreover, it will have serious negative effects on the staff’s health and the quality of their services. The purpose of this survey is to analyze the level of noise in intensive care units and emergency wards of the Imam Reza Teaching Hospital, Mashhad. Procedure: This research was carried out in November 2009 during morning shifts between 7:30 to 12:00. Noise levels were measured 10 times at 30-minute intervals in the nursing stations of 10 wards of the emergency, the intensive care units, and the Nephrology and Kidney Transplant Departments of Imam Reza University Hospital, Mashhad. The noise level in the nursing stations was tested for both the maximum level (Lmax and the equalizing level (Leq. The research was based on the comparison of equalizing levels (Leq because maximum levels were unstable. Results: In our survey the average level (Leq in all wards was much higher than the standard level. The maximum level (Lmax in most wards was 85-86 dB and just in one measurement in the Internal ICU reached 94 dB. The average level of Leq in all wards was 60.2 dB. In emergency units, it was 62.2 dB, but it was not time related. The highest average level (Leq was measured at 11:30 AM and the peak was measured in the Nephrology nursing station. Conclusion:  The average levels of noise in intensive care units and also emergency wards were  more than the standard levels and as it is known these wards have vital roles in treatment procedures, so more attention is needed in this area.

  10. [Nursing Education Utilizing Experiences in a Virtual Hospital Ward].

    Science.gov (United States)

    Tsuji, Keiko; Matsumoto, Maki; Takai, Kiyako; Kodama, Hiromi; Hagiwara, Tomoko; Iwata, Naomi

    2015-06-01

    Environmental design should be required at medical facilities for conducting medical practice safely and for making hospitalization comfortable. Many medical nursing students cannot imagine medical facilities, especially hospital wards, when they study medical environments in a basic nursing lecture. As a result, they cannot connect well with patient assistance. We employed a computer assisted designing software, "3D My Home Designer" (Mega Soft Company) that runs on Windows 8, and considered the usefulness of it for lectures on environmental design showing how to design a hospital ward for patients' optimal hospital stay. We drew a medical facility in 2-D first, transformed it into 3D images, and then created movies of a virtual hospital ward in which a patient walked around. These movies consisted of 3 kinds: a) hospital room with changeable wall color, b) different allocations of hospital room and nurse station, and c) a blurred ward which corresponded to how a patient with poor eyesight (cataract) would see a ward. We prepared as controls: a') still images of a hospital room, b') still images of ward, and c') a documentation on how a ward is seen by a patient with a cataract. We gave a questionnaire to students and nurses about these movies and still images (controls). In a) and b), there were no differences between the movies and still images in both students and nurses. In c), both students and nurses had a viewpoint from the patient with poor eyesight. From these results, we consider that the students, who have fewer experiences in a hospital, may understand the environments well by movies and the application of a virtual movie ward to nursing education may be useful in a lecture, depending on the readiness of the students.

  11. Exploring the experiences of young people nursed on adult wards.

    Science.gov (United States)

    Dean, Linda; Black, Sharon

    This paper reports on a study of experiences of young people aged 14 to 18 years who were nursed on acute adult hospital wards in NHS hospitals in England. In spite of British government guidelines, young people from 14 years of age continue to be admitted to adult wards in the UK. Although much has been written about the transition of the young person to adult services, there is little research about the experiences of young people who are nursed on adult wards. Hermeneutic phenomenology was used to explore the lived experiences of eight young people who had been nursed on adult wards between 2004 and 2010. Data were collected in 2010. In-depth interviews were recorded, transcribed and analysed using Colaizzi's framework ( Colaizzi, 1978 ). Themes explored included expectations of what the experience may be like, young people's first impressions of the ward environment, the feelings of the young person while in hospital, the attitudes of people towards them including, both staff and other patients, and future admissions and how they would cope with readmissions. Better provision needs to be made for young people including appropriately trained staff, adolescent-friendly environments and areas in adult wards that are dedicated to adolescents.

  12. Study of the effect of humanistic nursing care model wards in Children Caring Ward School on the nurses' caring ability

    Institute of Scientific and Technical Information of China (English)

    Jiao He; De-Ying Hu; Yi-Lan Liu; Li-Fen Wu; Lian Liu

    2016-01-01

    Objective: To understand the effect of humanistic nursing care model wards in Children Caring Ward School (CCWS) on the nurses' caring ability. Methods: Questionnaire 25 nurses of humanistic nursing care model wards in CCWS using the Nkongho Caring Ability Inventory (CAI) before and after implement the humanistic nursing care model, including reform the systems of nursing care, introduce humanistic care model, implement the humanistic care, to measure the nurses' caring ability. Results: The nurses' caring ability had significantly developed on total, cognition dimension, courage dimension and patience dimension after all measures considered (p Conclusions: The humanistic nursing care model wards in CCWS has a positive effect on the nurses' caring ability, not only to help build great relationships between nurses and patients but also to enhance the patients' satisfaction.

  13. [Comment on “Ward Off?”] Ward Valley Report deserves better coverage

    Science.gov (United States)

    Thompson, George A.

    Eos, Transactions, AGU, which is bannered as “The Newspaper of the Geophysical Sciences,” carried an “In Brief” article in the issue of May 23 that does a serious disservice to the geophysical sciences. It was written in a flip editorial style that questioned the usefulness of the Ward Valley report (Secretary Babbitt found it useful enough to act decisively) and the integrity of the NAS/NRC committee members who wrote it.The 17 committee members, most of whom are AGU members, studied the issues as a public service at the request of the NAS in response to Babbitt's request. They documented the evidence and conclusions thoroughly in a report of over 200 pages. Surely, scientific input is needed for decisions about complex issues in our society.

  14. Ward Valley status report: Science versus politics. Which will win?

    Energy Technology Data Exchange (ETDEWEB)

    Pasternak, A.D. [California Radioactive Materials Management Forum, Lafayette, CA (United States)

    1996-10-01

    The State of California has issued a license to US Ecology, Inc. to construct and operate a disposal facility for low-level radioactive waste (LLRW) at the remote, arid Ward Valley site in the Mojave Desert. The license and certification of the associated environmental documentation have been upheld by the California courts. The Ward Valley license is the first and, so far, only license to be issued for a new LLRW disposal facility pursuant to the Low-Level Radioactive Waste Policy Act enacted in 1980 and amended in 1985. However, the dates of construction and operation of the disposal facility are uncertain because the federal government has refused to sell land in Ward Valley to the State of California for the site of the Southwestern Compact`s regional disposal facility. The Clinton Administration`s repeated excuses for delaying the land transfer, and the circumstances of these delays, indicate that prospects for success of the Ward Valley project, and perhaps the Policy Act itself, depend on the outcome of a battle between science and politics. In view of these delays by the administration, Congressional action to Transfer the Ward Valley lands to California will serve both state and federal goals for safe disposal of LLRW.

  15. Occurrence of hypoxia in the wards of a teaching hospital

    Directory of Open Access Journals (Sweden)

    Virendra Singh

    2012-01-01

    Full Text Available Objective : Appearance of hypoxia in a patient may be an indicator of a serious medical condition that can have grave consequences. Clinical evaluation fails to detect majority of the patients of hypoxia, and therefore, it may remain unnoticed in the wards. We planned to assess the magnitude of hypoxia in different wards of our tertiary care hospital. Materials and Methods: We studied all the patients admitted in various medical and surgical wards during 1 week of study. Oxygen saturation (SpO 2 was measured with the help of a pulse oximeter in all the patients who remained admitted for at least 24 h. Hypoxia was diagnosed in a patient when he had SpO 2 less than 90%. Results: During the study period, 1167 patients were admitted in various wards of the hospital. Hypoxia was detected in 121 patients (10.36%. Among them, 7 (0.59% patients were already having a diagnosis of respiratory failure, but were not on oxygen therapy while 5 (0.42% patients were having SpO 2 less than 90% despite of oxygen therapy. In 109 (9.34% patients, hypoxia was detected incidentally. Conclusion: Unnoticed hypoxia was detected in a significant number of the patients admitted in the wards of the hospital. Therefore, it is concluded that oxygen saturation measurements should be included with other vital parameters like pulse, temperature, and blood pressure, in the monitoring chart of all the admitted patients.

  16. Creating a simulated Mental Health Ward: lessons learned.

    Science.gov (United States)

    Rossetti, Jeanette; Musker, Kathleen; Smyth, Siobhan; Byrne, Evelyn; Maney, Catherine; Selig, Kristen; Jones-Bendel, Trish

    2014-10-01

    The future of psychiatric-mental health nursing depends on the preparation of nurses who will meet the mental health care needs of society. The current article discusses the development of the "Mental Health Ward," a simulated mental health experience that was offered for the first time to undergraduate baccalaureate nursing students at a Midwestern university in the United States. The Mental Health Ward is an innovative simulated hospital environment that includes the use of standardized patients and role play scenarios, resulting in a full mission simulation whereby students learn various psychiatric diagnoses and practice various pertinent skills, including nursing assessments, admission and discharge processes, medication administration, and therapeutic communication. Lessons learned by faculty and students in formulating the Mental Health Ward are presented.

  17. Ward Identity Constraints on Ladder Kernels in Transport Coefficient Calculations

    Energy Technology Data Exchange (ETDEWEB)

    Gagnon, J.-S. [Department of Physics, McGill University, 3600 University Street, Montreal, H3A 2T8 (Canada); Jeon, S. [Department of Physics, McGill University, 3600 University Street, Montreal, H3A 2T8 (Canada)

    2007-03-15

    Using diagrammatic methods, we show how the Ward identity can be used to constrain the ladder kernel in transport coefficients calculations. More specifically, we use the Ward identity to determine the necessary diagrams that must be resummed (using the usual integral equation). Our main result is an equation relating the kernel of the integral equation with functional derivatives of the full (imaginary) self-energy; it is similar to what is obtained with 2PI effective action methods. However, since we use the Ward identity as our starting point, gauge invariance is preserved. Using power counting arguments, we also show which self-energies must be included in the resummation at leading order, including 2 to 2 scatterings and 1 to 2 collinear scatterings with the Landau-Pomeranchuk-Migdal (LPM) effect. In this study we restrict our discussion to electrical conductivity and shear viscosity in QED, but our method can in principles be generalized to other transport coefficients and other theories.

  18. Dynamic isolation technologies in negative pressure isolation wards

    CERN Document Server

    Xu, Zhonglin

    2017-01-01

    This book presents novel design principles and technologies for dynamic isolation based on experimental studies. These approaches have now become the local standard in Beijing and are currently being promoted for use nationwide. Further, the book provides details of measures and guidelines for the design process. Departing from the traditional understanding that isolation wards should be designed with high negative pressure, airtight doors and fresh air, it establishes the basis for designing biological clean rooms, including isolation wards, using a simple and convenient scientific approach. This book is intended for designers, engineers, researchers, hospital management staff and graduate students in heating ventilation air conditioning (HVAC), air cleaning technologies and related areas.

  19. Holographic Ward identities: Examples from 2+1 gravity

    CERN Document Server

    Bañados, M; Banados, Maximo; Caro, Rodrigo

    2004-01-01

    In the AdS/CFT correspondence the boundary Ward identities are encoded in the bulk constraints. We study the three-dimensional version of this result using the Chern-Simons formulation of gravity. Due the metric boundary conditions the conformal identities cannot be derived in a straightforward way from the chiral ones. We pay special attention to this case and find the necessary modifications to the chiral currents in order to find the two Virasoro operators. The supersymmetric Ward identities are studied as well.

  20. The holographic ward identity: examples from 2+1 gravity

    Energy Technology Data Exchange (ETDEWEB)

    Banados, Maximo [Departamento de Fisica, P. Universidad Catolica de Chile, Casilla 306, Santiago 22 (Chile)]. E-mail: mbanados@fis.puc.cl; Caro, Rodrigo [Departamento de Fisica, P. Universidad Catolica de Chile, Casilla 306, Santiago 22 (Chile)]. E-mail: mbanados@fis.puc.cl

    2004-12-01

    In the AdS/CFT correspondence the boundary Ward identities are encoded in the bulk constraints. We study the three-dimensional version of this result using the Chern-Simons formulation of gravity. Due to the metric boundary conditions the conformal identities cannot be derived in a straightforward way from the chiral ones. We pay special attention to this case and find the necessary modifications to the chiral currents in order to find the two Virasoro operators. The supersymmetric Ward identities are studied as well. (author)

  1. Transverse Ward-Takahashi Relation to One Loop

    Institute of Scientific and Technical Information of China (English)

    HEHan-Xin

    2005-01-01

    We calculate the transverse Ward-Takahashi relation for the vector vertex in momentum space at one-loop order in four-dimensional Abelian gauge theory. We demonstrate explicitly that the result is exactly the same as that derived by using one-loop vector vertex calculations.

  2. Ward Identities, B-> \\rho Form Factors and |V_ub|

    CERN Document Server

    Gilani, A H S; Riazuddin, M; Gilani, Amjad Hussain Shah

    2003-01-01

    The exclusive FCNC beauty semileptonic decay B-> \\rho is studied using Ward identities in a general vector meson dominance framework, predicting vector meson couplings involved. The long distance contributions are discussed which results to obtain form factors and |V_ub|. A detailed comparison is given with other approaches.

  3. Structure of fluctuation terms in the trace dynamics Ward identity

    Energy Technology Data Exchange (ETDEWEB)

    Adler, Stephen L [Institute for Advanced Study Princeton, NJ 08540 (United States)

    2006-02-10

    We give a detailed analysis of the anti-self-adjoint operator contribution to the fluctuation terms in the trace dynamics Ward identity. This clarifies the origin of the apparent inconsistency between two forms of this identity discussed in chapter 6 of our recent book on emergent quantum theory.

  4. 'Real life' clinical learning on an interprofessional training ward.

    Science.gov (United States)

    Freeth, D; Reeves, S; Goreham, C; Parker, P; Haynes, S; Pearson, S

    2001-07-01

    This paper describes the multi-method evaluation of an interprofessional training ward placement for medical, nursing, occupational therapy and physiotherapy students. Unique in the UK, and an extension of pioneering work in Sweden (Wahlström et al. 1997, Wahlstroöm & Sandén 1998), this interprofessional clinical placement allowed senior pre-qualifying students, under the supervision of practitioners, to plan and deliver interprofessional care for a group of orthopaedic and rheumatology patients. This responsibility enabled students to develop both their profession-specific skills in a real-world setting and the quality of their interprofessional teamwork. Student teams were supported by facilitators who led reflective sessions and acted as a resource for the students' problem-based learning. The training ward was evaluated by a multi-method approach, incorporating interviews, observations and questionnaires with students, patients and clinical staff. The evaluation findings have been grouped into a number of themes which offer an insight into the varying perspectives of training ward students, patients and staff. This paper pays particular attention to the nursing perspective of the interprofessional training ward pilot.

  5. Accounting for Inpatient Wards When Developing Master Surgical Schedules

    NARCIS (Netherlands)

    Vanberkel, Peter T.; Boucherie, Richard J.; Hans, Erwin W.; Hurink, Johann L.; Lent, van Wineke A.M.; Harten, van Wim H.

    2011-01-01

    Background:As the demand for health care services increases, the need to improve patient flow between departments has likewise increased. Understanding how the master surgical schedule (MSS) affects the inpatient wards and exploiting this relationship can lead to a decrease in surgery cancellations,

  6. The relationship between leadership, teamworking, structure, burnout and attitude to patients on acute psychiatric wards

    NARCIS (Netherlands)

    Bowers, L.; Nijman, H.L.I.; Simpson, A.; Jones, J.

    2011-01-01

    Background: Conflict (aggression, substance use, absconding, etc.) and containment (coerced medication, manual restraint, etc.) threaten the safety of patients and staff on psychiatric wards. Previous work has suggested that staff variables may be significant in explaining differences between wards

  7. Comorbid depression in dementia on psychogeriatric nursing home wards: which symptoms are prominent?

    NARCIS (Netherlands)

    Verkaik, R.; Francke, A.L.; Meijel, B. van; Ribbe, M.W.; Bensing, J.M.

    2009-01-01

    OBJECTIVE: To provide insight into the prevalence and clinically relevant symptoms of comorbid depression among dementia patients in psychogeriatric nursing home wards, to enhance depression recognition. DESIGN: Cross-sectional analyses of multicenter diagnostic data. SETTING: Psychogeriatric wards

  8. Perturbative Correction to Transverse Ward-Takahashi Relation for the Vector Vertex

    Institute of Scientific and Technical Information of China (English)

    HE Han-Xin; YU Hong-Wei

    2003-01-01

    We re-derive exactly the transverse Ward-Takahashi relation for the vector vertex in momentum space.The result shows that this transverse Ward-Takahashi relation in momentum space involves a perturbative correction term. We demonstrate explicitly that this transverse Ward-Takahashi relation is satisfied indeed at one-loop order.

  9. Supporting Information Access in a Hospital Ward by a Context-Aware Mobile Electronic Patient Record

    DEFF Research Database (Denmark)

    Skov, Mikael B.; Høegh, Rune Thaarup

    2006-01-01

    Ward is to support nurses in conducting morning procedures in a hospital ward. MobileWard is context-aware as it is able to discover and react autonomously according to changes in the environment and since it integrates the ability to provide information and services to the user where the relevancy depends...

  10. 75 FR 81269 - Ward Transformer Superfund Site Raleigh, Wake County, NC; Notice of Settlements

    Science.gov (United States)

    2010-12-27

    ... AGENCY Ward Transformer Superfund Site Raleigh, Wake County, NC; Notice of Settlements AGENCY... Ward Transformer Superfund Site located in Raleigh, Wake County, North Carolina for publication. DATES... your comments, identified by Docket ID No. EPA-RO4- SFUND-2010-1053 or Site name Ward...

  11. 78 FR 14543 - Ward Transformer Superfund Site; Raleigh, Wake County, NC; Notice of Settlement

    Science.gov (United States)

    2013-03-06

    ... AGENCY Ward Transformer Superfund Site; Raleigh, Wake County, NC; Notice of Settlement AGENCY... Agency has entered into a settlement at the Ward Transformer Superfund Site located in Raleigh, Wake... EPA Region 4 contact Ms. Paula V. Painter. Submit your comments by Site name Ward...

  12. Modelling of coughed droplets in a hospital ward

    DEFF Research Database (Denmark)

    Sadrizadeh, Sasan; Nielsen, Peter Vilhelm

    2016-01-01

    Coughing and its importance for spreading respiratory infectious diseases has been confirmed in many previous studies. The dispersion process of respiratory droplets released by the coughing of a patient in a hospital ward was studied using computational fluid dynamics simulation. Two relatively...... realistic three-dimensional thermal mannequins with a parallel bed arrangement simulated the patients. The maximum dispersion distances in time under ward ventilation conditions were studied. A velocity profile simulated a time-dependent cough with total duration of 0.4 s. The results indicated...... that the transport characteristic of droplets due to coughing is highly influenced by their size. Although the effects of gravity or inertia on small droplets ( 40 μm are significantly affected by gravity and soon fall...

  13. Drug dispensing errors in a ward stock system

    DEFF Research Database (Denmark)

    Andersen, Stig Ejdrup

    2010-01-01

    wards, samples of dispensed solid drugs were collected prospectively and compared with the prescriptions. Data were evaluated using multivariable logistic regression. Overall, 2173 samples were collected, 95.5% of which were correctly dispensed (95% CI 94.5-96.2). In total, 124 errors in 6715......The aim of this study was to determine the frequency of drug dispensing errors in a traditional ward stock system operated by nurses and to investigate the effect of potential contributing factors. This was a descriptive study conducted in a teaching hospital from January 2005 to June 2007. In five...... opportunities for error were identified; error rate of 1.85 errors per 100 opportunities for error (95% CI 1.54-2.20). Omission of a dose was the predominant type of error while vitamins and minerals, drugs for acid-related diseases and antipsychotic drugs were the drugs most frequently affected by errors...

  14. Liouville theory Ward identities for generating functional and modular geometry

    CERN Document Server

    Takhtajan, L A

    1994-01-01

    We continue the study of quantum Liouville theory through Polyakov's functional integral \\cite{Pol1,Pol2}, started in \\cite{T1}. We derive the perturbation expansion for Schwinger's generating functional for connected multi-point correlation functions involving stress-energy tensor, give the "dynamical" proof of the Virasoro symmetry of the theory and compute the value of the central charge, confirming previous calculation in \\cite{T1}. We show that conformal Ward identities for these correlation functions contain such basic facts from Kähler geometry of moduli spaces of Riemann surfaces, as relation between accessory parameters for the Fuchsian uniformization, Liouville action and Eichler integrals, Kähler potential for the Weil-Petersson metric, and local index theorem. These results affirm the fundamental role, that universal Ward identities for the generating functional play in Friedan-Shenker modular geometry \\cite{FS}.

  15. Noether's Second Theorem and Ward Identities for Gauge Symmetries

    CERN Document Server

    Avery, Steven G

    2015-01-01

    Recently, a number of new Ward identities for large gauge transformations and large diffeomorphisms have been discovered. Some of the identities are reinterpretations of previously known statements, while some appear to be genuinely new. We use Noether's second theorem with the path integral as a powerful way of generating these kinds of Ward identities. We reintroduce Noether's second theorem and discuss how to work with the physical remnant of gauge symmetry in gauge fixed systems. We illustrate our mechanism in Maxwell theory, Yang-Mills theory, p-form field theory, and Einstein-Hilbert gravity. We comment on multiple connections between Noether's second theorem and known results in the recent literature. Our approach suggests a novel point of view with important physical consequences.

  16. Prevalence of delirium among patients at a cancer ward

    DEFF Research Database (Denmark)

    Grandahl, Mia Gall; Nielsen, Svend Erik; Kørner, Ejnar Alex;

    2016-01-01

    Background Delirium is a frequent psychiatric complication to cancer, but rarely recognized by oncologists. Aims 1. To estimate the prevalence of delirium among inpatients admitted at an oncological cancer ward 2. To investigate whether simple clinical factors predict delirium 3. To examine...... the value of cognitive testing in the assessment of delirium. Methods On five different days, we interviewed and assessed patients admitted to a Danish cancer ward. The World Health Organization International Classification of Diseases Version 10, WHO ICD-10 Diagnostic System and the Confusion Assessment...... Method (CAM) were used for diagnostic categorization. Clinical information was gathered from medical records and all patients were tested with Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test. Results 81 cancer patients were assessed and 33% were diagnosed with delirium. All delirious...

  17. The background scale Ward identity in quantum gravity

    CERN Document Server

    Percacci, Roberto

    2016-01-01

    We show that with suitable choices of parametrization, gauge fixing and cutoff, the anomalous variation of the effective action under global rescalings of the background metric is identical to the derivative with respect to the cutoff, i.e. to the beta functional, as defined by the exact RG equation. The Ward identity and the RG equation can be combined, resulting in a modified flow equation that is manifestly invariant under global background rescalings.

  18. Ward Identities for Transport in 2+1 Dimensions

    CERN Document Server

    Hoyos, Carlos; Oz, Yaron

    2015-01-01

    We use the Ward identities corresponding to general linear transformations, and derive relations between transport coefficients of $(2+1)$-dimensional systems. Our analysis includes relativistic and Galilean invariant systems, as well as systems without boost invariance such as Lifshitz theories. We consider translation invariant, as well as broken translation invariant cases, and include an external magnetic field. Our results agree with effective theory relations of incompressible Hall fluid, and with holographic calculations in a magnetically charged black hole background.

  19. Ward identities and relations between conductivities and viscosities in holography

    CERN Document Server

    Hoyos, Carlos

    2015-01-01

    We derive relations between viscosities and momentum conductivity in $2+1$ dimensions by finding a generalization of holographic Ward identities for the energy-momentum tensor. The generalization is novel in the sense that it goes beyond the usual identities obtained from holographic renormalization. Our results are consistent with previous field theory analysis. The main tools we use are a constant `probability current' in the gravity dual, that we are able to define for any system of linear ODEs, and parity symmetry.

  20. Ward-Takahashi Identity on the Light-Front

    CERN Document Server

    Naus, H W L; Frederico, T

    1998-01-01

    The Ward-Takahashi identity, reflecting local gauge invariance, is perturbatively verified for a boson model in light front field theory. A careful integration over the light front energy, corresponding to exactly taking into account pair terms, which are the contributions of the zero longitudinal momentum mode, is crucial to obtain this result. Furthermore, the one-loop boson form factors are calculated for arbitrary off-shell momenta.

  1. Delirium in elderly patients hospitalized in internal medicine wards.

    Science.gov (United States)

    Fortini, Alberto; Morettini, Alessandro; Tavernese, Giuseppe; Facchini, Sofia; Tofani, Lorenzo; Pazzi, Maddalena

    2014-06-01

    A prospective observational study was conducted to evaluate the impact of delirium on geriatric inpatients in internal medical wards and to identify predisposing factors for the development of delirium. The study included all patients aged 65 years and older, who were consecutively admitted to the internal medicine wards of two public hospitals in Florence, Italy. On admission, 29 baseline risk factors were examined, cognitive impairment was evaluated by Short Portable Mental Status Questionnaire, and prevalent delirium cases were diagnosed by Confusion Assessment Method (CAM). Enrolled patients were evaluated daily with CAM to detect incident delirium cases. Among the 560 included patients, 19 (3 %) had delirium on admission (prevalent) and 44 (8 %) developed delirium during hospitalization (incident). Prevalent delirium cases were excluded from the statistical analysis. Incident delirium was associated with increased length of hospital stay (p delirium during hospitalization. Results show that delirium impact is relevant to older patients hospitalized in internal medicine wards. The present study confirms cognitive impairment as a risk factor for incident delirium. The cognitive evaluation proved to be an important instrument to improve identification of patients at high risk for delirium. In this context, our study may contribute to improve application of preventive strategies.

  2. Medical academia clinical experiences of Ward Round Teaching curriculum

    Directory of Open Access Journals (Sweden)

    Fariba Haghani

    2014-01-01

    Full Text Available Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members′ experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9. Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation.Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability were employed (Guba and Lincoln. Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1 tangible teachings (analytic intelligence, technical intelligence, legal duties and (2 implied teachings (professionalism, professional discipline, professional difficulties. Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

  3. Development and validation of scales to measure organisational features of acute hospital wards.

    Science.gov (United States)

    Adams, A; Bond, S; Arber, S

    1995-12-01

    In order to make comparisons between wards and explain variations in outcomes of nursing care, there is a growing need in nursing research for reliable and valid measures of the organisational features of acute hospital wards. This research developed The Ward Organisational Features Scales (WOFS); each set of six scales comprising 14 subscales which measure discrete dimensions of acute hospital wards. A study of a nationally representative sample of 825 nurses working in 119 acute wards in 17 hospitals, drawn from seven Regional Health Authorities in England provides evidence for the structure, reliability and validity of this comprehensive set of measures related to: the physical environment of the ward, professional nursing practice, ward leadership, professional working relationships, nurses' influence and job satisfaction. Implications for further research are discussed.

  4. Words in Maternity Wards: An Aproximation to Perinatal Psychology

    Directory of Open Access Journals (Sweden)

    Alicia Oiberman

    2016-02-01

    Full Text Available The acknowledgment that just born babies interact with human and physical contexts originated changes in behaviors of health teems working in maternity wards settings. Concepts such as initial interactions, attachment, dyads, maternal vulnerability, behavioral competences of the just born babies and their applications to perinatal psychology, marked a transformation in different professionals involved in birth’s approaches. From one side, it can be said that medicalization of the birth act in Western societies had allowed to minimize risk factors. But this progress had been carried out without taking into account emotional expressions. The introduction of psychological interventions in neonatal periods is a new field of knowledge. History shows that in different periods and cultures there were amulets, potions and other elements associated with magic that were used to swear baby or mother’s death risk during childbirth. All these practices were taken the place of words, in a hard emotional moment: parturition. It was necessary to walk a long and difficult road for Perinatal Psycholy to recuperate the ancient place of old good women and incorporate words in maternity wards, knowing that the main scenery is first occupied by the mother’s body and then by the baby. Our daily job in a maternity ward, working together with pediatricians and neonatologists, allowed us to verify that words come out when psychologists themselves “include their body” as well as do mothers, babies and the medical teem. Words contribute to facilitate emotional expressions related to motherhood and place the baby in the family history, making able his or her “psychological birth”. 

  5. Ward identities and Wilson renormalization group for QED

    CERN Document Server

    Bonini, M; Marchesini, G

    1994-01-01

    We analyze a formulation of QED based on the Wilson renormalization group. Although the ``effective Lagrangian'' used at any given scale does not have simple gauge symmetry, we show that the resulting renormalized Green's functions correctly satisfies Ward identities to all orders in perturbation theory. The loop expansion is obtained by solving iteratively the Polchinski's renormalization group equation. We also give a new simple proof of perturbative renormalizability. The subtractions in the Feynman graphs and the corresponding counterterms are generated in the process of fixing the physical conditions.

  6. Ward identities and Wilson renormalization group for QED

    Science.gov (United States)

    Bonini, M.; D'Attanasio, M.; Marchesini, G.

    1994-04-01

    We analyze a formulation of QED based on the Wilson renormalization group. Although the "effective lagrangian" used at any given scale does not have simple gauge symmetry, we show that the resulting renormalized Green's function correctly satisfies Ward identities to all orders in perturbation theory. The loop expansion is obtained by solving iteratively the Polchinski renormalization group equation. We also give a new simple proof of perturbative renormalizability. The subtractions in the Feynman graphs and the corresponing counter-terms are generated in the process of fixing the physical conditions.

  7. Dealing with conflict - The role of the ward sister

    Directory of Open Access Journals (Sweden)

    L.M. Cremer

    1980-09-01

    Full Text Available In the course of her duties, the ward sister has to contend with many forms of conflict, discord and dissension. These involve conflict of the intrapersonal, interpersonal and intergroup varieties. Conflict is in the main, disruptive and dysfunctional. Skilful management, however, embodying cooperative effort in its reduction can produce constructive and positive results. Conflict management strategies are therefore either restrictive or constructive. Persons in serious conflict suffer varied degrees of personality disequilibrium, which necessitates emotional first aid or crisis intervention. Such primary preventive care is applicable to patients, their relatives, and members of the nursing staff in such need.

  8. The educational value of ward rounds for junior trainees

    Directory of Open Access Journals (Sweden)

    Faidon-Marios Laskaratos

    2015-04-01

    Full Text Available The ward round (WR is a complex task and medical teachers are often faced with the challenge of finding a balance between service provision and clinical development of learners. The educational value of WRs is an under-researched area. This short communication aims to evaluate the educational role of WRs for junior trainees and provides insight into current practices. It also identifies obstacles to effective teaching/training in this setting and provides suggestions for improving the quality of WR teaching.

  9. Ventilation of wards and nosocomial outbreak of severe acute respiratory syndrome among healthcare workers

    Institute of Scientific and Technical Information of China (English)

    江山平; 黄莉文; 陈锡龙; 王景峰; 伍卫; 尹松梅; 陈为宪; 詹俊; 严励; 马丽萍; 李建国; 黄子通

    2003-01-01

    Objective To identify valid measures for preventing outbreaks of severe acute respiratory syndrome (SARS) among protected healthcare workers in isolation units.Methods Architectural factors, admitted SARS cases and infection of healthcare workers in different isolation wards between January 30 and March 30, 2003 were analyzed.Results Four types of isolation wards were analyzed, including the ward where the thirty-first bed was located on the twelfth floor, the laminar flow ward in the Intensive Care Unit where the tenth bed was located on the fifteenth floor, the ward where the twenty-seventh bed was located on the thirteenth floor of the Lingnan Building, and thirty wards on the fourteenth to eighteenth floors of the Zhongshan Building. The ratios (m2/m3) of the area of the ventilation windows to the volume of the rooms were 0, 0, 1∶ 95 and 1∶ 40, respectively. Numbers of SARS cases in the wards mentioned above were 1, 1, 1 and 96, respectively. Total times of hospitalization were 43, 168, 110 and 1272 hours, respectively. The infection rates of the healthcare workers in the areas mentioned above were 73.2%, 32.1%, 27.5% and 1.7%, respectively. The difference in the infection rates was of statistical significance.Conclusions Isolating SARS cases in wards with good ventilation could reduce the viral load of the ward and might be the key to preventing outbreaks of SARS among healthcare workers along with strict personal protection measures in isolation units.

  10. Hybrid Patient Record – Supporting Hybrid Interaction in Clinical Wards

    DEFF Research Database (Denmark)

    Houben, Steven; Schmidt, Mathias; Frost, Mads

    2015-01-01

    Despite the widespread dissemination of the electronic health record, the paper medical record remains an important central artefact in modern clinical work. A number of new technological solutions have been proposed to mitigate some of the configuration, mobility and awareness problems that emerge...... when using this dual record setup. In this paper, we present one such technology, the HyPR device, in which a paper record is augmented with an electronic sensing platform that is designed to reduce the configuration overhead, provide awareness cues and support mobility across the patient ward. Our...... demo will show the HyPR device and setup in order for conference attendees to experience the technology `in action'....

  11. Design Proposal for Pleasurable Light Atmosphere in Hospital Wards

    DEFF Research Database (Denmark)

    Stidsen, Lone; Kirkegaard, Poul Henning; Fisker, Anna Marie

    2010-01-01

    When constructing and designing Danish hospitals for the future, patients, staff and guests are in focus. It is found important to have a starting point in healing architecture and create an environment with knowledge of users sensory and functionally needs and looks at how hospital wards can...... support patients’ experience or maybe even have a positive influence on the recovery process. Thus at a general level, it is a crucial task to investigate how aspects such as the design of the environment, arts, lights, sounds can support and improve the patients’ recovery rate and the satisfaction...... of staff and guests in the future hospital. This paper introduce the concept of atmosphere based on the theory of Gernot Böhmes and it is dealing with the effect of light in experiencing atmosphere, looking at the importance having a holistic approach to lighting design. The paper displays important design...

  12. Lighting quality in hospital wards - State of the art

    DEFF Research Database (Denmark)

    Stidsen, Lone; Kirkegaard, Poul Henning; Fisker, Anna Marie

    When constructing and designing hospitals for the future, patients, staff and guests are in focus. Designing a healing hospital environment is a very important factor when planning new hospitals. How can aspects such as design, architecture, arts, lights, sounds and materials support and improve...... the patients' recovery rate and the satisfaction of staff and guests? Literature and research on this subject are full of contrasting theories, myths and contradictions as well as lack of understanding of the interplay between different design parameters in an integrated design. The physical settings...... and a multitude of users with many different needs and requirements. It is a public domain with many references to the design of homes in the private sphere. The aim of the report is to display the existing research in the area of lighting design in hospital wards, and to present new lighting design strategies...

  13. Prevention of measles spread on a paediatric ward.

    Science.gov (United States)

    Tapisiz, A; Polat, M; Kara, S S; Tezer, H; Simsek, H; Aktas, F

    2015-03-01

    Since measles is a highly contagious respiratory infection with significant airborne transmission risk in hospitals, effective prevention measures are crucial. After a mother accompanying her child on a paediatric ward lacking a negative pressure room was diagnosed with measles, exposed persons without evidence of immunity (documentary evidence of receiving two doses of measles-mumps-rubella vaccine) were treated with vaccination or intravenous immunoglobulin (IVIG). The interruption of transmission with these treatments was evaluated. There were 44 children and 101 adults exposed to the index patient. Twenty-five children and 88 adults were considered immune, providing evidence of immunity. Nineteen children and 13 adults were either given vaccination or IVIG for post-exposure prophylaxis (PEP). There were no additional cases of measles after 3 weeks follow-up. We conclude that measles is highly preventable by adequate PEP with vaccination or IVIG in a healthcare setting that lacks the benefit of a negative pressure room.

  14. 4WARD: A European Perspective towards the Future Internet

    Science.gov (United States)

    Brunner, Marcus; Abramowicz, Henrik; Niebert, Norbert; Correia, Luis M.

    In this paper, we describe several approaches to address the challenges of the network of the future. Our main hypothesis is that the Future Internet must be designed for the environment of applications and transport media of the 21st century, vastly different from the initial Internet's life space. One major requirement is the inherent support for mobile and wireless usage. A Future Internet should allow for the fast creation of diverse network designs and paradigms and must also support their co-existence at run-time. We detail the technical and business scenarios that lead the development in the EU FP7 4WARD project towards a framework for the Future Internet.

  15. Ward identities and gauge independence in general chiral gauge theories

    CERN Document Server

    Anselmi, Damiano

    2015-01-01

    Using the Batalin-Vilkovisky formalism, we study the Ward identities and the equations of gauge dependence in potentially anomalous general gauge theories, renormalizable or not. A crucial new term, absent in manifestly nonanomalous theories, is responsible for interesting effects. We prove that gauge invariance always implies gauge independence, which in turn ensures perturbative unitarity. Precisely, we consider potentially anomalous theories that are actually free of gauge anomalies thanks to the Adler-Bardeen theorem. We show that when we make a canonical transformation on the tree-level action, it is always possible to re-renormalize the divergences and re-fine-tune the finite local counterterms, so that the renormalized $\\Gamma $ functional of the transformed theory is also free of gauge anomalies, and is related to the renormalized $\\Gamma $ functional of the starting theory by a canonical transformation. An unexpected consequence of our results is that the beta functions of the couplings may depend on...

  16. Christmas cards workshop in a Restricted Access Ward

    Directory of Open Access Journals (Sweden)

    Teresa García

    2003-12-01

    Full Text Available The Christmas cards workshop is an intervention study made in the Restricted Access Ward (RAW of Hospital Gregorio Marañón (Madrid, in December 2001, from the 5th to the 22nd. The object of this study was to assess the effectiveness of this workshop to improve the quality of the RAW patients´ hospital day, through their participation. They made 47 cards, the mean per patient was 1,52. Participation: 91,2% of the patients that fulfilled the inclusion criteria. Drawings and texts alluded to the convict´s perspective of Christmas time, from their own experience. The Christmas cards were exhibited in the hospital and they also were sent to different penitentiary institutions in Madrid, to make the RAW known. The course “Education for health for interdisciplinary projects in penitentiary institutions” was the frame of this workshop.

  17. $B_7$, $B_8$ and chiral Ward identities

    CERN Document Server

    Lee, W; Lee, Weonjong; Fleming, George T.

    2005-01-01

    We present recent progress in understanding weak matrix elements on the lattice. We use HYP staggered fermions in quenched QCD to study numerically various properties of the $K^+\\to\\pi^+$ amplitudes of the electroweak penguin operators $Q_7$ and $Q_8$. We check chiral Ward identities to probe the validity of using improved staggered fermions in the calculation of weak matrix elements. We address the issue of mixing with unphysical lower dimension operators, which causes a divergent term in the case of the $\\Delta I = 1/2$ amplitudes. We propose a particular subtraction method as the best choice. We also measure the gold-plated ratio $R$ originally suggested by Becirevic and Villadoro.

  18. Nosocomial klebsiellas. II. Transfer in a hospital ward.

    Science.gov (United States)

    Haverkorn, M J; Michel, M F

    1979-04-01

    During a 6-month period an epidemiological survey of the carriage of Klebsiella was conducted in a hospital ward where no outbreak of nosocomial infection occurred. In this endemic situation the regular sampling of several sites of patients, members of the nursing staff, and the environment, and the biotyping of Klebsiella made it possible to analyse the patterns of transmission between sites. There was abundant evidence for striking transmission of Klebsiella between the throat, hands, and faeces of patients. Transmission between patients seemed to be mainly through hands. The role of nurses' hands in transmission was not evident from this survey, probably due to the relatively long interval (a week) between samplings. Through the hands of patients, wash stands and the surrounding floor were contaminated with Klebsiella. The biotyping of Klebsiella facilitated the epidemiological analysis of the results.

  19. Clinical ethics ward rounds: building on the core curriculum.

    Science.gov (United States)

    Parker, Lisa; Watts, Lisa; Scicluna, Helen

    2012-08-01

    The clinical years of medical student education are an ideal time for students to practise and refine ethical thinking and behaviour. We piloted a new clinical ethics teaching activity this year with undergraduate medical students within the Rural Clinical School at the University of New South Wales. We used a modified teaching ward round model, with students bringing deidentified cases of ethical interest for round-table discussion. We found that students were more engaged in the subject of clinical ethics after attending the teaching sessions and particularly appreciated having structured time to listen to and learn from their peers. Despite this, we found no change in student involvement in managing or planning action in situations that they find ethically challenging. A key challenge for educators in clinical ethics is to address the barriers that prevent students taking action.

  20. Nursing safety management in onco-hematology pediatric wards

    Directory of Open Access Journals (Sweden)

    Marcelle Miranda da Silva

    2015-02-01

    Full Text Available This study aimed at identifying how safety management is applied by nurses to manage the nursing care, and at analyzing their challenges in onco-hematology pediatric wards. Descriptive and qualitative research, conducted at the Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti, Rio de Janeiro, Brazil, in August 2013. Six nurses were interviewed, and the content analysis was used. The key aspects relate to the importance of training and continuing education, teamwork, with the challenges in the care of hospitalized children and particularities of the disease, and the systematization, use of instruments and protocols. For child safety, the relationship between the administration and support is critical to the quality of care.

  1. The full Ward-Takahashi Identity for colored tensor models

    CERN Document Server

    Pérez-Sánchez, Carlos I

    2016-01-01

    We derive the full $\\mathrm{U}(\\infty)$-Ward-Takahashi Identities for random colored tensor models. The strategy is to expand the free energy in boundary graphs that determine the combinatorics of the sources. This contributes to the organization of the correlation functions of colored tensor models and is carried out for arbitrary interactions of any rank, $D$, with subsequent focus on the $\\varphi^4$-theories. The result is that the boundary sector of quartic melonic interactions suffices to generate all $D$-colored graphs. For the rank-$3$ $\\varphi^4$-theory we derive the exact integral-like equation for the 2-point function. Our results hold for some Group Field Theories as well. Altogether, our non-perturbative approach trades graph theory for analytical methods.

  2. Door locking and exit security measures on acute psychiatric admission wards

    NARCIS (Netherlands)

    Nijman, H.L.I.; Bowers, L.; Haglund, K.; Muir-Cochrane, E.; Simpson, A.; Merwe, M. van der

    2011-01-01

    Locking the exit doors of psychiatric wards is believed to reduce the risk of patients absconding. The aims of the study were to investigate both the prevalence of door locking and other exit security measures on UK admission wards, as well as whether door locking appears to be effective in keeping

  3. Incidence, staff awareness and mortality of patients at risk on general wards

    DEFF Research Database (Denmark)

    Fuhrmann, L.; Lippert, A.; Perner, A.;

    2008-01-01

    The aim of this study was to estimate the incidence, staff awareness and subsequent mortality of patients with abnormal vital signs on general wards in a Danish university hospital.......The aim of this study was to estimate the incidence, staff awareness and subsequent mortality of patients with abnormal vital signs on general wards in a Danish university hospital....

  4. Insider action research and the microsystem of a Danish surgical ward

    DEFF Research Database (Denmark)

    Paltved, Charlotte; Mørcke, Anne Mette; Musaeus, Peter

    2015-01-01

    This insider action research project aimed to improve interprofessional team performance at a surgical ward. The purpose of the project was (1) to critically appraise potential deficiencies in staffs’ identification, clinical judgment, and management of deteriorating ward patients, (2) to develop...

  5. Cross Infection in a Hospital Ward and Deposition of Particles Exhaled from a Source Manikin

    DEFF Research Database (Denmark)

    Nielsen, Peter V.; Li, Yuguo; Buus, Morten;

    2009-01-01

    The cross infection in a hospital ward is studied. Deposition of particles exhaled from a source manikin is investigated in a full-scale hospital ward ventilated by downward directed ventilation. Deposition on vertical surfaces close to the source shows distribution of particles directed upwards...

  6. Controlled Confrontation: The Ward Grievance Procedure of the California Youth Authority. An Exemplary Project.

    Science.gov (United States)

    National Inst. of Law Enforcement and Criminal Justice (Dept. of Justice/LEAA), Washington, DC.

    The Ward Grievance Procedure of the California Youth Authority is one of 17 programs that earned the National Institute's "Exemplary" label. This brochure provides the requisite practical information for those who wish to test or consider testing the ward grievance procedure. The program was developed as a way of dealing with the questions raised…

  7. Patient safety culture lives in departments and wards: Multilevel partitioning of variance in patient safety culture

    Directory of Open Access Journals (Sweden)

    Hofoss Dag

    2010-03-01

    Full Text Available Abstract Background Aim of study was to document 1 that patient safety culture scores vary considerably by hospital department and ward, and 2 that much of the variation is across the lowest level organizational units: the wards. Setting of study: 500-bed Norwegian university hospital, September-December 2006. Methods Data collected from 1400 staff by (the Norwegian version of the generic version of the Safety Attitudes Questionnaire (SAQ Short Form 2006. Multilevel analysis by MLwiN version 1.10. Results Considerable parts of the score variations were at the ward and department levels. More organization level variation was seen at the ward level than at the department level. Conclusions Patient safety culture improvement efforts should not be limited to all-hospital interventions or interventions aimed at entire departments, but include involvement at the ward level, selectively aimed at low-scoring wards. Patient safety culture should be studied as closely to the patient as possible. There may be such a thing as "hospital safety culture" and the variance across hospital departments indicates the existence of department safety cultures. However, neglecting the study of patient safety culture at the ward level will mask important local variations. Safety culture research and improvement should not stop at the lowest formal level of the hospital (wards, out-patient clinics, ERs, but proceed to collect and analyze data on the micro-units within them.

  8. Authenticity in Learning--Nursing Students' Experiences at a Clinical Education Ward

    Science.gov (United States)

    Manninen, Katri; Henriksson, Elisabet Welin; Scheja, Max; Silen, Charlotte

    2013-01-01

    Purpose: This study aims to explore and understand first year nursing students' experiences of learning at a clinical education ward. Design/methodology/approach: The setting is a clinical education ward for nursing students at a department of infectious diseases. A qualitative study was carried out exploring students' encounters with patients,…

  9. [Reasons for Hospital Treatment of Psychiatric Patients before and after the Opening of a Satellite Ward].

    Science.gov (United States)

    Gebhardt, R P; Schmidt-Michel, P O

    2002-04-01

    A satellite ward is a psychiatric ward at a general hospital settled within the catchment area that is administered by a psychiatric hospital. The objective of the satellite model is to approach community treatment on the one hand and somatic medicine on the other hand, consequently diminishing the threshold for hospital treatment. This study investigated whether the diagnostic, psychopathologic and social reasons for admissions changed from this catchment area due to the lower threshold of a satellite ward. The results were controlled with another catchment area's admissions to the 30 km distant psychiatric hospital. The opening of the satellite ward was followed by an 81 % increase of admissions. In particular, admissions of patients with neuroses and personality disorders were more frequent. There was no change of the severity code of psychopathology at admission. From the catchment area of the satellite ward less patients were admitted involuntarily whereas more admissions happened due to social reasons and after patients' own decision.

  10. The acoustic environment of intensive care wards based on long period nocturnal measurements

    Directory of Open Access Journals (Sweden)

    Hui Xie

    2012-01-01

    Full Text Available The patients in the Intensive Care Units are often exposed to excessive levels of noise and activities. They can suffer from sleep disturbance, especially at night, but they are often too ill to cope with the poor environment. This article investigates the acoustic environment of typical intensive care wards in the UK, based on long period nocturnal measurements, and examines the differences between singlebed and multibed wards, using statistical analysis. It has been shown that the acoustic environment differs significantly every night. There are also significant differences between the noise levels in the singlebed and multibed wards, where acoustic ceilings are present. Despite the similar background noises in both ward types, more intrusive noises tend to originate from the multibed wards, while more extreme sounds are likely to occur in the single wards. The sound levels in the measured wards for each night are in excess of the World Health Organization′s (WHO guide levels by at least 20 dBA, dominantly at the middle frequencies. Although the sound level at night varies less than that in the daytime, the nocturnal acoustic environment is not dependant on any specific time, thus neither the noisiest nor quietest period can be determined. It is expected that the statistical analysis of the collected data will provide essential information for the development of relevant guidelines and noise reduction strategies.

  11. The acoustic environment of intensive care wards based on long period nocturnal measurements.

    Science.gov (United States)

    Xie, Hui; Kang, Jian

    2012-01-01

    The patients in the Intensive Care Units are often exposed to excessive levels of noise and activities. They can suffer from sleep disturbance, especially at night, but they are often too ill to cope with the poor environment. This article investigates the acoustic environment of typical intensive care wards in the UK, based on long period nocturnal measurements, and examines the differences between singlebed and multibed wards, using statistical analysis. It has been shown that the acoustic environment differs significantly every night. There are also significant differences between the noise levels in the singlebed and multibed wards, where acoustic ceilings are present. Despite the similar background noises in both ward types, more intrusive noises tend to originate from the multibed wards, while more extreme sounds are likely to occur in the single wards. The sound levels in the measured wards for each night are in excess of the World Health Organization's (WHO) guide levels by at least 20 dBA, dominantly at the middle frequencies. Although the sound level at night varies less than that in the daytime, the nocturnal acoustic environment is not dependant on any specific time, thus neither the noisiest nor quietest period can be determined. It is expected that the statistical analysis of the collected data will provide essential information for the development of relevant guidelines and noise reduction strategies.

  12. Students' Perceptions on an Interprofessional Ward Round Training – A Qualitative Pilot Study

    Directory of Open Access Journals (Sweden)

    Nikendei, C.

    2016-04-01

    Full Text Available Introduction: Ward rounds are an essential activity for interprofessional teams in hospital settings and represent complex tasks requiring not only medical knowledge but also communication skills, clinical technical skills, patient management skills and team-work skills. The present study aimed to analyse final year students’, nurses’ as well as physiotherapists’ views on a simulation-based interprofessional ward round training.Methods: In two successive passes a total number of 29 final year students, nursing students and physiotherapy students (16 in the first run, 13 in the second volunteered to participate in two standardized patient ward round scenarios: (1 patient with myocardial infarction, and (2 patient with poorly controlled diabetes. Views on the interprofessional ward round training were assessed using focus groups.Results: Focus group based feedback contained two main categories (A ward round training benefits and (B difficulties. Positive aspects enfolded course preparation, setting of the training, the involvement of the participants during training and the positive learning atmosphere. Difficulties were seen in the flawed atmosphere and realization of ward rounds in the daily clinical setting with respect to inter-professional aspects, and course benefit for the different professional groups.Conclusion: The presented inter-professional ward round training represents a well received and valuable model of interprofessional learning. Further research should assess its effectiveness, processes of interprofessional interplay and transfer into clinical practice.

  13. The Importance of a Role-Specific, In-Hospital Ward Clerk Education Program.

    Science.gov (United States)

    Kennedy, Maggie

    2016-01-01

    Ward clerks are essential members of the healthcare team, providing administrative and organizational support to acute care units and clinics. This role influences such matters as nurses' direct patient-care time, timeliness of patient discharges, and patient safety. To support ward clerks in the varying responsibilities and complex scope of this role, a formal orientation and ongoing education program is imperative. Whereas corporate orientation informs new employees of overall organizational processes, a ward clerk-specific workplace education program prepares individuals for the demands of the position, ultimately supporting the healthcare team and patient safety.

  14. An Analysis On Ward Identity For Multi-Field Inflation

    CERN Document Server

    Parthasarathy, Varadarajan

    2013-01-01

    Given a correlation function (or n-point function), can the corresponding nature of space-time be determined ? To answer this question it is required to derive the Ward Identity (WI), analyse the symmetries and arrive at the law of conservation. Modus operandi involves Lie differentiating two-point function considering the symmetry to be non-anomalous. The WI so obtained is shown to form a Lie algebra which determines the nature of space-time. Solving the identity results in a law of conservation, which physically explains the reason for WI to form an algebra and contains in it an equation of motion for four-point function. As a special case, a relation between mass and potential involving the spatial derivatives of four- and five- point function is obtained. Finally, the conservation equation is exploited to get the probability amplitude for the two-point function which shows how correlation functions provide an opportunity to probe the fundamental laws of physics.

  15. BED UTILIZATION IN CARDIO VASCULAR AND THORACIC SURGERY WARD

    Directory of Open Access Journals (Sweden)

    Ishtyak

    2015-11-01

    Full Text Available BACKGROUND: Of all the subsystems of a hospital, inpatient care occupies prime place in terms of resource consumed, use of specialized technical man power, technology and skill. In spite of the huge investment of money, material and the manpower at times even the basic needs of patients are not met. AIMS: The study was conducted, to observe the average length of stay (ALS of patients in cardio vascular and thoracic Surgery (CVTS ward, and to find out the bed occupancy rate. METHODS: The admission and discharge record of all the patients was recorded from the report books, hospital files of all the patients were checked to know complete biodata. Medical record section was consulted and admission discharge register/files were recorded to know the symptomatology, clinical findings, diagnosis and the management thereof. Mortality and morbidity was recorded from admission files. RESULTS: A total of 732 patients were admitted on a bed complement of 11712 days having 8639 bed days. 84.28% of the patients underwent surgical procedures. Daily average beds occupied were 23.60 beds per day, average length of stay was 11.23 days, and 73.76% was the bed occupancy rate. CONCLUSION: Patients having major operations had more length of stay compared to patients who were admitted after pre anesthetic checkup and full planning from outdoor departments. Preadmission evaluation, pre anesthetic checkup and preventing post-operative morbidity decrease length of stay

  16. Strange and Charm Quark Spins from Anomalous Ward Identity

    CERN Document Server

    Gong, Ming; Alexandru, Andrei; Draper, Terrence; Liu, Keh-Fei

    2015-01-01

    We present a calculation of the strange and charm quark contributions to the nucleon spin from anomalous Ward identity (AWI). It is performed with overlap valence quarks on 2+1-flavor domain-wall fermion gauge configurations on a $24^3 \\times 64$ lattice with the light sea mass at $m_{\\pi} = 330$ MeV. To satisfy the AWI, the overlap fermion for the pseudoscalar density and the overlap Dirac operator for the topological density, which do not have multiplicative renormalization, are used to renormalize the form factor of the local axial-vector current at finite $q^2$. For the charm quark, we find the positive pseudoscalar term almost cancels the negative topological term for each $q^2$, leading to a very small net contribution. For the strange quark, the pseudoscalar term is less positive than that of the charm and this results in a negative strange quark spin when combined with the topological contribution. The $g_A(q^2)$ at $q^2 =0$ is obtained by a global fit of the pseudoscalar and the topological form fact...

  17. Antimicrobial stewardship: Improving antibiotic prescribing practice in a respiratory ward.

    Science.gov (United States)

    Yeo, Jing Ming

    2016-01-01

    International efforts have mandated guidelines on antibiotic use and prescribing, therefore the focus is now on encouraging positive behavioral changes in antibiotic prescribing practice. Documentation of indication and intended duration of antibiotic use in drug charts is an evidence-based method of reducing inappropriate antibiotic prescribing. It is also a standard detailed in our local antimicrobial guidelines. We collected baseline data on compliance with documentation of indication and duration in drug charts in a respiratory ward which revealed compliance rates of 24% and 39% respectively. We introduced interventions to improve accessibility to the guideline and to increase awareness by distributing antibiotic guardian pocket cards with a three-point checklist and strategically-placed mini-posters. We also aim to increase team motivation by obtaining their feedback in multidisciplinary team meetings and by introducing certificates for their involvement in the quality improvement process. The results of the second cycle post-intervention showed an increase in compliance rates for documentation of indication and duration of 97% and 69% respectively. After a further awareness and discussion session at the multidisciplinary team meeting with the local antimicrobial management team audit nurses, a third cycle showed compliance rates of 94% and 71% for indication and duration respectively. This project has highlighted the importance of improving accessibility and of encouraging interventions that would bring about a change in personal value and subsequently in behavior and individual practice.

  18. Caring for cancer patients on non-specialist wards.

    LENUS (Irish Health Repository)

    Gill, Finola

    2012-02-01

    As cancer is the leading cause of death worldwide, every nurse will be required to care for patients with the condition at some point in his\\/her career. However, non-specialized oncology nurses are often ill-prepared to nurse patients suffering from cancer. This literature review aims to provide an overview of current trends and developments in cancer care nursing in an attempt to identify the range of previous research pertaining to caring for patients with cancer on non-specialist wards. The review finds that non-specialized cancer nurses report a lack of education and training with regard to cancer care and cancer treatments, which acts as a barrier to providing quality nursing care. Emotional and communication issues with patients and their families can also cause non-specialist nurses significant distress. International research has shown that specialist oncology nurses make a considerable difference to physical and psychosocial patient care. It is therefore paramount that non-speciality nurses\\' educational needs are met to develop clinical competence and to provide supportive holistic care for both patients and their families.

  19. Validation of a checklist to assess ward round performance in internal medicine

    DEFF Research Database (Denmark)

    Nørgaard, Kirsten; Ringsted, Charlotte; Dolmans, Diana

    2004-01-01

    BACKGROUND: Ward rounds are an essential responsibility for doctors in hospital settings. Tools for guiding and assessing trainees' performance of ward rounds are needed. A checklist was developed for that purpose for use with trainees in internal medicine. OBJECTIVE: To assess the content...... construct validity, an observer assessed 4 groups of doctors during performance of a complete ward round (n = 32). The nurse who accompanied the doctor on rounds made a global assessment of the performance. RESULTS: The response rate to the questionnaire was 80.7%. The respondents found that all 10 items...... on the checklist were relevant to ward round performance and that the item collection was comprehensive. Checklist mean-item scores differed between levels of expertise: junior house officers 1.4 (1.0-1.9); senior house officers 2.0 (1.5-2.9); specialist trainees 2.5 (1.8-2.8), and specialists 2.7 (2...

  20. Attitudes of parents and staff towards medical students on the paediatric wards.

    Science.gov (United States)

    Duignan, A; Kennedy, C; Canas-Martinez, A; Gildea, D; Jamaludin, M A; Moore, M; Meehan, J; Nadeem, M

    2014-01-01

    This study investigates attitudes of parents and staff to medical students on paediatric wards in a Dublin teaching hospital. We invited 100 parents of patients and 30 staff involved in the care of children on the paediatric wards to participate. The majority of parents agreed or strongly agreed that they would be happy for a student to interview them (n = 87; (87%)), interview their child (80%) or examine their child (74%). Of 30 staff, 12 (40%) staff agreed that the presence of medical students on the ward increased their job satisfaction, 13 (43%) agreed or strongly agreed that medical student presence encouraged them to keep up to date with recent medical developments and 6 (20%) felt that it increased the quality of patient care. Attitudes of both parents and staff to medical students on paediatric wards are positive with both emphasising the need for professional behaviour.

  1. [Effects of Ward Interventions on Repeated Critical Incidents in Child and Adolescent Psychiatric Inpatient Care].

    Science.gov (United States)

    Ulke, Christine; Klein, Annette M; von Klitzing, Kai

    2014-01-01

    Effects of Ward Interventions on Repeated Critical Incidents in Child and Adolescent Psychiatric Inpatient Care. The aim of this study was to evaluate the effects of several ward interventions (transition to an open ward concept, individualized treatment plans, tiered crisis-management, staff training, quality control) on repeated critical incidents, non-restrictive and restrictive measures. The outcome variables were compared in two time periods, 2007 and 2011. The study included 74 critical incident reports of 51 child and adolescent inpatients that had at least one hospital stay and one critical incident in the selected time periods. Aggressive, self-harming, and absconding incidents were included. The quantitative results suggest that ward interventions can contribute to a reduction of repeated critical incidents and restrictive measures. The qualitative evaluation suggests a cultural change of crisis management.

  2. Classifying nursing organization in wards in Norwegian hospitals: self-identification versus observation

    Directory of Open Access Journals (Sweden)

    Helgeland Jon

    2010-02-01

    Full Text Available Abstract Background The organization of nursing services could be important to the quality of patient care and staff satisfaction. However, there is no universally accepted nomenclature for this organization. The objective of the current study was to classify general hospital wards based on data describing organizational practice reported by the ward nurse managers, and then to compare this classification with the name used in the wards to identify the organizational model (self-identification. Methods In a cross-sectional postal survey, 93 ward nurse managers in Norwegian hospitals responded to questions about nursing organization in their wards, and what they called their organizational models. K-means cluster analysis was used to classify the wards according to the pattern of activities attributed to the different nursing roles and discriminant analysis was used to interpret the solutions. Cross-tabulation was used to validate the solutions and to compare the classification obtained from the cluster analysis with that obtained by self-identification. The bootstrapping technique was used to assess the generalizability of the cluster solution. Results The cluster analyses produced two alternative solutions using two and three clusters, respectively. The three-cluster solution was considered to be the best representation of the organizational models: 32 team leader-dominated wards, 23 primary nurse-dominated wards and 38 wards with a hybrid or mixed organization. There was moderate correspondence between the three-cluster solution and the models obtained by self-identification. Cross-tabulation supported the empirical classification as being representative for variations in nursing service organization. Ninety-four per cent of the bootstrap replications showed the same pattern as the cluster solution in the study sample. Conclusions A meaningful classification of wards was achieved through an empirical cluster solution; this was, however, only

  3. Outbreak of staphylococcal bullous impetigo in a maternity ward linked to an asymptomatic healthcare worker.

    Science.gov (United States)

    Occelli, P; Blanie, M; Sanchez, R; Vigier, D; Dauwalder, O; Darwiche, A; Provenzano, B; Dumartin, C; Parneix, P; Venier, A G

    2007-11-01

    An outbreak of staphylococcal bullous impetigo occurred over a period of five months in a maternity ward involving seven infected and two colonised neonates. The skin lesions were due to epidermolytic toxin A-producing Staphylococcus aureus. Infection control measures were implemented and a retrospective case-control study performed. Contact with an auxiliary nurse was the only risk factor for cases of bullous impetigo (Pimpetigo and the auxiliary nurse was reassigned to an adult ward.

  4. Medication prescribing errors and associated factors at the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia

    OpenAIRE

    Zeleke, Abebe; Chanie, Tesfahun; Woldie, Mirkuzie

    2014-01-01

    Background Medication error is common and preventable cause of medical errors and occurs as a result of either human error or a system flaw. The consequences of such errors are more harmful and frequent among pediatric patients. Objective To assess medication prescribing errors and associated factors in the pediatric wards of Dessie Referral Hospital, Northeast Ethiopia. Methods A cross-sectional study was carried out in the pediatric wards of Dessie Referral Hospital from February 17 to Marc...

  5. Training program conference of "Good Pain Management Ward" was launched in Wuhan

    Institute of Scientific and Technical Information of China (English)

    Yi Cheng

    2012-01-01

    @@ On March 6th, the training program conference of "Good Pain Management Ward" (GPM ward) was launched in the conference hall of Westin Hotel, Wuhan.The conference was hosted by Clinics Medical Secretary, Ministry of Health, and undertaken by CSCO and Mundipharma (China) Pharmaceutical Co., Ltd.Three hundreds experts, doctors and nurses, from departments of oncology, pain, anesthesiology and pharmacy, in 6 provinces (including Hubei, Hunan, Jiangxi, Shanxi, Shanxi, Henan), attended the conference.

  6. Observations on Henneguya salminicola Ward, a myxosporidian parasitic in Pacific salmon

    Science.gov (United States)

    Fish, F.F.

    1939-01-01

    Henneguya salminicola was described in 1919 by Dr. H. B. Ward from cysts found in the body musculature of a silver salmon (Oncorhynchus kisutch Walbaum) taken from the Stickeen River in southeastern Alaska. Ward described the cysts as “pyriform, fairly uniform in size, and hard to the touch. . . . The cysts measured 3 to 6 mm in diameter and were found everywhere through the muscle mass.”

  7. Feasibility and acceptability of rapid HIV screening in a labour ward in Togo

    OpenAIRE

    Pitche, Vincent P; Renaud Becquet; Mathieu Sibe; François Dabis; Albert Tatagan; Annette Lawson-Evi; Koffi Akpadza; Marthe-Aline Jutand; Coffie, Patrick A.; Benjamin G Kariyiare; Ekouevi, Didier K; Mireille David

    2012-01-01

    Background: HIV screening in a labour ward is the last opportunity to initiate an antiretroviral prophylaxis among pregnant women living with HIV to prevent mother-to-child HIV transmission. Little is known about the feasibility and acceptability of HIV screening during labour in West Africa. Findings: A cross-sectional survey was conducted in the labour ward at the Tokoin Teaching Hospital in Lomé (Togo) between May and August 2010. Pregnant women admitted for labour were randomly sel...

  8. Patient safety culture lives in departments and wards: Multilevel partitioning of variance in patient safety culture

    OpenAIRE

    Hofoss Dag; Deilkås Ellen

    2010-01-01

    Abstract Background Aim of study was to document 1) that patient safety culture scores vary considerably by hospital department and ward, and 2) that much of the variation is across the lowest level organizational units: the wards. Setting of study: 500-bed Norwegian university hospital, September-December 2006. Methods Data collected from 1400 staff by (the Norwegian version of) the generic version of the Safety Attitudes Questionnaire (SAQ Short Form 2006). Multilevel analysis by MLwiN vers...

  9. Psychiatric wards in general hospitals - the opinions of psychiatrists employed there

    Directory of Open Access Journals (Sweden)

    Janusz Chojnowski

    2016-04-01

    The psychiatrists employed in the psychiatric wards in general hospitals in Poland evaluate this organisational model positively. However, the destabilisation of economic foundations of these wards reported in the world literature was also reflected in the results of a survey conducted in Poland. There is a need to develop standards for the organisation and financing departments of psychiatry in general hospitals providing them stable status in the healthcare system in Poland.

  10. Neonatal abstinence syndrome: Diagnostic dilemmas in the maternity ward

    Directory of Open Access Journals (Sweden)

    Lazić-Mitrović Tanja

    2015-01-01

    Full Text Available Introduction. Neonatal abstinence syndrome (NAS refers to a newborn neurological, gastrointestinal and/or respiratory disorder if a newborn was exposed to psychoactive substances in the intrauterine period. NAS is difficult to diagnose due to unreliability of the data on addictive substances use during pregnancy, limited possibilities of the prenatal exposure diagnosis and postnatal substance detection, which all lead to diagnostic dilemmas. Objective. The aim of this study was to indicate the problems in patients with early NAS diagnosis in the maternity ward and the importance of clinical presentation used as a guide toward the diagnosis. Methods. This retrospective study included five term eutrophic newborns with high Apgar score, good adaptation in the first day and with clinical presentation of NAS during the second day of life. The clinical presentation was dominated by irritability, increased wakefulness, increased muscle tone, shrilly crying, tremors, problems with accepting food, tachypnea, subfebrility and hyperhidrosis. Finnegan scale was introduced in order to diagnose NAS and apply the therapy. Single-medication therapy of phenobarbitone was applied in four cases and a combination of phenobarbitone and morphine in one case. For toxicological analysis newborns’ urine samples were used. Results. Conditions such as perinatal asphyxia, infection, hunger, polycythemia, hypoglycemia or hypocalcemia were excluded. Finnegan score implied that pharmacological treatment had to be administered. The discrepancy between the NAS anamnesis and toxicological analysis existed. Response to the treatment was positive in all cases. Conclusion. NAS is a multisystemic disorder and should be suspected when it is noticed that children exhibit characteristic signs. However, other pathological conditions have to be excluded. Quantification according to the adopted scales for NAS leads toward appropriate treatment and recovery of the newborns.

  11. [Airborne Fungal Aerosol Concentration and Distribution Characteristics in Air- Conditioned Wards].

    Science.gov (United States)

    Zhang, Hua-ling; Feng, He-hua; Fang, Zi-liang; Wang, Ben-dong; Li, Dan

    2015-04-01

    The effects of airborne fungus on human health in the hospital environment are related to not only their genera and concentrations, but also their particle sizes and distribution characteristics. Moreover, the mechanisms of aerosols with different particle sizes on human health are different. Fungal samples were obtained in medicine wards of Chongqing using a six-stage sampler. The airborne fungal concentrations, genera and size distributions of all the sampling wards were investigated and identified in detail. Results showed that airborne fungal concentrations were not correlated to the diseases or personnel density, but were related to seasons, temperature, and relative humidity. The size distribution rule had roughly the same for testing wards in winter and summer. The size distributions were not related with diseases and seasons, the percentage of airborne fungal concentrations increased gradually from stage I to stage III, and then decreased dramatically from stage V to stage VI, in general, the size of airborne fungi was a normal distribution. There was no markedly difference for median diameter of airborne fungi which was less 3.19 μm in these wards. There were similar dominant genera in all wards. They were Aspergillus spp, Penicillium spp and Alternaria spp. Therefore, attention should be paid to improve the filtration efficiency of particle size of 1.1-4.7 μm for air conditioning system of wards. It also should be targeted to choose appropriate antibacterial methods and equipment for daily hygiene and air conditioning system operation management.

  12. Is clinical competence perceived differently for student daily performance on the wards versus clerkship grading?

    Science.gov (United States)

    Wimmers, Paul F; Kanter, Steven L; Splinter, Ted A W; Schmidt, Henk G

    2008-12-01

    Clinical rotations play an important role in the medical curriculum and are considered crucial for student learning. However, competencies that should be learned can differ from those that are assessed. In order to explore which competencies are considered important for daily performance of student on the wards and to what extent clinical teachers consider the same competencies important for clerkship grading, a survey that consisted of 21 different student characteristics was administered to clinical teachers. Two independent factor analyses using structural equation modeling were conducted to abstract underlying latent relationships among the different student characteristics and to define a clinical competence profile for daily performance of students on the wards and clerkship grading. Differences between the degree of importance for student daily ward performance and clerkship grading are considered and discussed. The results of the survey indicate that the degree of importance of competencies are rated different for daily performance of students on the wards and clerkship grades. Competencies related to the diagnostic process are more important for clerkship grading, whereas interpersonal skills, professional qualities, and motivation are more important for daily ward performance. It is concluded that the components of clinical competence considered important for adequate performance are not necessarily in alignment with what is required for grading. Future research should focus on an explanation why clinical educators think differently about the importance of competencies for student examination in contrast to what is required for adequate daily performance on the wards.

  13. Ophthalmology hospital wards contamination to pathogenic free living Amoebae in Iran.

    Science.gov (United States)

    Lasjerdi, Zohreh; Niyyati, Maryam; Lorenzo-Morales, Jacob; Haghighi, Ali; Taghipour, Niloofar

    2015-09-01

    The present study was conducted to determine the occurrence of potentially pathogenic free-living amoeba in ophthalmology wards in reference hospitals in Iran. Since an increasing number of Acanthamoeba Keratitis cases after eye surgery and eye trauma have been recently observed in this country, it could be possible that the disinfection procedures undertaken in the clinical setting may not have a good hygiene and disinfection procedures, hence the aim of this study. Therefore, 42 dust and biofilm samples were collected from different areas of ophthalmology wards and checked for the presence of FLA using morphological criteria, PCR based analysis and DNA sequencing. Of the 42 samples from dust and biofilm sources, 18(42.86%) isolates were found to contain FLA and 12(92.3%) isolates belonged to Acanthamoeba T4 genotype. Isolation of the pathogenic genotype T4 from medical instruments, including slit lamp in corneal wards, may be a threat for patients undergoing eye surgery in these wards. Other FLA isolated in this study included Acanthamoeba genotype T5, Vahlkampfia sp, Naegleria australiensis, Vermamoeba vermiformis and Echinamoeba exudans. To our knowledge, this is the first report of the presence of potentially pathogenic FLA in ophthalmology wards in Iran. Improved disinfection methods and monitoring of hospitals ward are thus necessary in this area in order to minimize the risk of infection in patients.

  14. Assesment of psychosocial work conditions of nurses at selected hospital wards

    Directory of Open Access Journals (Sweden)

    Iwona Rotter

    2014-04-01

    Full Text Available Background: Good organisation of work, clear division of responsibilities, support from superiors are factors that positively influence the satisfaction of the profession. The purpose of the work was the assessment of psychosocial working conditions of nurses. Material and Methods: The research included 388 nurses working at surgical wards, medical treatment wards, and psychiatric wards. The research method was a diagnostic survey carried out by means of a questionnaire called Psychosocial Work Conditions. The obtained results were statistically analysed. Results: Nearly a half of the nurses considers the requirements at work as moderate, and 36.66% as high. Nurses from medical treatment wards indicate the highest level of requirements. Nurses working at psychiatric wards and in a shift system significantly more often feel the requirements relating to overload and resulting from a conflict of roles. Nurses working in the profession for more than 10 years considerably more often describe the level of behavioural control as high in comparison to those working for a shorter time. Regardless of the character of a ward, nurses most often (44.33% assess the support from co-workers as average, and 1/5 considered this as low. Conclusions: The results indicate the correctness of introducing psychosocial training for professionally active nurses. Med Pr 2014;65(2:173–179

  15. Interprofessional communication between surgery trainees and nurses in the inpatient wards: Why time and space matter.

    Science.gov (United States)

    Fernando, Oshan; Coburn, Natalie G; Nathens, Avery B; Hallet, Julie; Ahmed, Najma; Conn, Lesley Gotlib

    2016-09-01

    Optimal interprofessional communication (IPC) is broadly viewed as a prerequisite to providing quality patient care. In this study, we explored the enablers and barriers to IPC between surgical trainees and ward nurses with a view towards improving IPC and the quality of surgical patient care. We conducted an ethnography in two academic centres in Canada totalling 126 hours of observations and 32 semi-structured interviews with trainees and nurses. Our findings revealed constraints on IPC between trainees and nurses derived from contested meanings of space and time. Trainees experienced the contested spatial boundaries of the surgical ward when they perceived nurses to project a sense of territoriality. Nurses expressed difficulty getting trainees to respond and attend to pages from the ward, and to have a poor understanding of the nurses' role. Contestations over time spent in training and patient care were found in trainee-nurse interactions, wherein trainees perceived seasoned nurses to devalue their clinical knowledge on the ward. Nurses viewed the limited time that trainees spent in clinical rotation in the ward as adversely affecting communication. This study underscores that challenges to enhancing IPC at academic health centres are rooted in team and professional cultures. Efforts to improve IPC should therefore: identify and target the social and cultural dimensions of healthcare team member relations; recognise how power is deployed and experienced in ways that negatively impact IPC; and enhance an understanding and appreciation in the temporal and spatial dimensions of IPC.

  16. Mini outbreak of Kaposi′s varicelliform eruption in skin ward: A study of five cases

    Directory of Open Access Journals (Sweden)

    Rao GRR

    2007-01-01

    Full Text Available Background: Kaposi`s varicelliform eruption (KVE represents widespread cutaneous herpes simplex virus (HSV infection in patients with preexisting dermatoses. Occasionally, this infection can present as a nosocomial infection in skin wards, if adequate bed-spacing and barrier nursing methods are not followed. We are reporting five cases of KVE; four cases acquired the infection in a makeshift ward after admission of the first case in May 2005, due to the renovation work of the regular skin ward. Aim: The purpose of this study is to create clinical awareness about this uncommon dermatologic entity and to stress upon the importance of bed-spacing and barrier nursing in skin wards. Methods: Five cases of KVE, three females and two males with different primary dermatoses (pemphigus foliaceus - one, pemphigus vulgaris - two, paraneoplastic pemphigus - one and toxic epidemal necrolysis - one were included in this study. Diagnosis was made clinically and supported with Tzanck smear and HSV serology. All the cases were treated with oral acyclovir. Results: Four out of five cases of KVE recovered with treatment, one case of extensive pemphigus vulgaris with KVE succumbed to death. Conclusion: Mini outbreaks of KVE can occur in skin wards with inadequate bed-spacing and overcrowding of patients. Therefore adequate bed-spacing, barrier nursing and isolation of suspected cases are mandatory to prevent such life-threatening infections.

  17. [Intercommunication and information flow. An explorative study about ward rounds and patients' documentation].

    Science.gov (United States)

    Maier, Uwe; Fotuhi, Parwis; Seele, Anja; Nikolic, Djordje

    2008-07-01

    In modern patient interprofessional communication is an impor tant factor of good outcome. The aim of this study was to analyse the intercommunication during ward rounds and information passed by patients' documentation on an internal and geriatric medicine ward. Beside frequent interruptions the ward rounds showed a restricted flow of information that is based and targeted on the chief physician Nursing staff felt excluded from the informational flow. Regarding patients' documentation staff complained about lack of information and illegible notes. Availability of written information was found to be problematic. A team-orientated approach could help to improve interprofessional communication in the future. Besides the importance of carefully performed documentation as a reliable form of communication, communicative contribution of the nursing staff has to be upvalued.

  18. Implementation and Evaluation of a Ward-Based eLearning Program for Trauma Patient Management.

    Science.gov (United States)

    Curtis, Kate; Wiseman, Taneal; Kennedy, Belinda; Kourouche, Sarah; Goldsmith, Helen

    2016-01-01

    The majority of trauma nursing education is focused on the emergency phases of care. We describe the development and evaluation of a trauma eLearning module for the ward environment. The module was developed using adult learning principles and implemented in 2 surgical wards. There were 3 phases of evaluation: (1) self-efficacy of nurses; (2) relevance and usability of the module and; (3) application of knowledge learnt. The majority indicated they had applied new knowledge, particularly when performing a physical assessment (85.7%), communicating (91.4%), and identifying risk of serious illness (90.4%). Self-efficacy relating to confidence in caring for patients, communication, and escalating clinical deterioration improved (p = .023). An eLearning trauma patient assessment module for ward nursing staff improves nursing knowledge and self-efficacy.

  19. Particle Removal Efficiency of the Portable HEPA Air Cleaner in a Simulated Hospital Ward

    DEFF Research Database (Denmark)

    Qian, Hua; Li, Yuguo; Sun, Hequan

    2010-01-01

    of beds in an isolation ward is insufficient. An experiment was conducted in a full scale experimental ward with a dimension of 6.7 m × 6 m × 2.7 m and 6 beds to test these hypotheses for a portable HEPA filter. The removal efficiency for different size particles was measured at different locations....... The influence of the portable HEPA air cleaner on the airflow pattern was also studied through smoke visualization and computational fluid dynamics (CFD) simulations. Results show that the HEPA filter can effectively decrease the particle concentration level. The effective air change rate achieved by the HEPA......Use of a HEPA (high efficiency particulate air) filter in a room is believed to assist in reducing the risk of transmission of infectious diseases through removing the particles or large droplets to which pathogens may be attached. Use of a portable HEPA filter(s) in hospital wards is hypothesized...

  20. Acceptance of the 2009 Henry Baldwin Ward Medal: The accidental parasitologist

    Science.gov (United States)

    Lafferty, Kevin D.

    2009-01-01

    Members of the Society, President Conn, colleagues, friends, and particularly students, the Ward Medal recipient, from Clarke Read onward, traditionally recounts how their career was shaped. A decade ago, in a crumbling Kona hotel, the ASP's own tattooed lady, Janine Caira, opened her Ward Medal address with: “To all future Ward Medalists, many of whom I trust are sitting in the audience out there today, I say: savor the moment! You have no idea how much easier it is to be sitting out there where you are than standing up here where I am” (Caira 1998). I certainly didn't imagine that Janine was delivering her advice to me and it is presumptuous to imagine my story is a template for shaping a career. As the title of my talk indicates, it was an accident.

  1. Respiratory rates measured by a standardised clinical approach, ward staff, and a wireless device

    DEFF Research Database (Denmark)

    Granholm, A; Pedersen, N E; Lippert, A.

    2016-01-01

    BACKGROUND: Respiratory rate is among the first vital signs to change in deteriorating patients. The aim was to investigate the agreement between respiratory rate measurements by three different methods. METHODS: This prospective observational study included acutely admitted adult patients...... in a medical ward. Respiratory rate was measured by three methods: a standardised approach over 60 s while patients lay still and refrained from talking, by ward staff and by a wireless electronic patch (SensiumVitals). The Bland-Altman method was used to compare measurements and three breaths per minute (BPM...... of agreement were -13.3 (95% CI: -17.2 to -9.5) BPM and 16.8 (95% CI: 13.0 to 20.6) BPM. CONCLUSION: A concerning lack of agreement was found between a wireless monitoring system and a standardised clinical approach. Ward staff's measurements also seemed to be inaccurate....

  2. Mobile and fixed computer use by doctors and nurses on hospital wards

    DEFF Research Database (Denmark)

    Andersen, Pia; Lindgaard, Anne-Mette; Prgomet, M.

    2009-01-01

    , computers on wheels (COWs) and tablet PCs-was made. Two types of COWs were available on the wards: generic COWs (laptops mounted on trolleys) and ergonomic COWs (an integrated computer and cart device). Heuristic evaluation of the user interfaces was also carried out. RESULTS: The majority (93......BACKGROUND: Selecting the right mix of stationary and mobile computing devices is a significant challenge for system planners and implementers. There is very limited research evidence upon which to base such decisions. OBJECTIVE: We aimed to investigate the relationships between clinician role......, clinical task, and selection of a computer hardware device in hospital wards. METHODS: Twenty-seven nurses and eight doctors were observed for a total of 80 hours as they used a range of computing devices to access a computerized provider order entry system on two wards at a major Sydney teaching hospital...

  3. Dispersion of Exhalation Pollutants in a Two-bed Hospital Ward with a Downward Ventilation System

    DEFF Research Database (Denmark)

    Qian, Hua; Nielsen, Peter V.; Hyldgård, Carl-Erik

    2006-01-01

    heavier clean air from a ceiling diffuser to push down contaminants, which would then be removed via outlets at floor level. A "laminar" (strictly speaking, unidirectional) flow is expected to be produced to avoid flow mixing and thus reduce cross-infection risk. Experiments were carried out in a full......-scale experimental hospital ward with a downward ventilation system to investigate the possibility of applying downward ventilation in a general hospital ward. Two life-sized breathing thermal manikins were used to simulate a source patient and a receiving patient. Computation fluid dynamics was also used...... to investigate the airflow pattern and pollutant dispersion in the test ward. Based on both experimental and numerical results, the laminar airflow pattern was shown to be impossible to achieve due to turbulent flow mixing and flow entrainment into the supply air stream. The thermal plumes produced above people...

  4. Care practices of older people with dementia in the surgical ward: A questionnaire survey

    Directory of Open Access Journals (Sweden)

    Nina Hynninen

    2016-11-01

    Full Text Available Objectives: The objective of this study was to describe the care practices of nursing staff caring older people with dementia in a surgical ward. Methods: The data were collected from nursing staff (n = 191 working in surgical wards in one district area in Finland during October to November 2015. Data were collected using a structured questionnaire and analyzed statistically. The instrument consists of a total number of 141 items and four dimensions. The dimensions were as follows: background information (12 of items, specific characteristics of older people with dementia in a surgical ward (24 of items, specific characteristics of their care in a surgical ward (66 of items and use of physical restraints and alternative models for use of restraints for people with dementia (39 of items. Results: The questions which measure the nursing staff’s own assessment of care practices when caring for people with dementia in surgical wards were selected: counseling people with dementia, reaction when a surgical patient with dementia displays challenging behavior and use of alternative approach instead of physical restraints. Most commonly the nursing staff pay attention to patient’s state of alertness before counseling older people with dementia. Instead of using restraints, nursing staff gave painkillers for the patient and tried to draw patients’ attention elsewhere. The nursing staff with longer work experience estimate that they can handle the patients’ challenging behavior. They react by doing nothing more often than others. They pretend not to hear, see or notice anything. Conclusion: The findings of this study can be applied in nursing practice and in future studies focusing on the care practices among older people with dementia in acute care environment. The results can be used while developing patient treatments process in surgical ward to meet future needs.

  5. Does doctors’ workload impact supervision and ward activities of final-year students? A prospective study

    Directory of Open Access Journals (Sweden)

    Celebi Nora

    2012-06-01

    Full Text Available Abstract Background Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload arising from increased patient care interferes with student supervision and is associated with more non-medical activities of final-year medical students. Methods A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities – both medical and non-medical - according to whether they had: (1 only watched, (2 assisted the ward resident, (3 performed the activity themselves under supervision of the ward resident, or (4 performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL, and the number of admissions and discharges. Both students and ward residents were blinded to the study question. Results A total of 32 diaries (59 %, 442 recorded working days were handed back. Overall, the students reported 1.2 ± 1.3 supervised, 1.8 ±1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p  Conclusions There was a significant association between ward doctors’ supervision of students and the number of medical activities performed by medical students. The workload had no significant effect on supervision or the number of medical or non-medical activities of final-year students.

  6. Poverty and violence, frustration and inventiveness: hospital ward life in Bangladesh.

    Science.gov (United States)

    Zaman, Shahaduz

    2004-11-01

    An ethnographic exploration was done in an orthopaedic ward of a government teaching hospital in Bangladesh to understand the nature of hospital culture in the context of Bangladeshi society at large. Life and work in the ward result in a culture that is simultaneously created by its inhabitants and the conditions in which they are situated. The study shows that biomedicine is a product of particular social conditions and that the hospital reflects features of its society. Behind the injuries and broken limbs in the ward are stories of violence, crime, and intolerance occurring in a society where masses of people fight over limited resources. In the ward people interact in an extremely hierarchical manner. The patients, who are mainly from poor economic backgrounds, remain at the bottom of the hierarchy. Doctors and other staff members are often professionally frustrated. Strikes related to hospital staff's various professional demands hamper the regular flow of work in the ward. Family members are engaged in nursing and provide various kinds of support to their hospitalized relatives. Patients give small bribes to ward boys and cleaners to obtain their day-to-day necessities. Patients joke with each other and mock senior doctors. Thus, they neutralize their powerlessness and drive away the monotony of their stay. Doctors develop 'indigenous' solutions to orthopaedic problems. Instead of using high-tech devices, they employ instruments made of bamboo, bricks, and razor blades. This study shows how medical practice takes shape in an understaffed, under-resourced and poorly financed hospital operating in a low-income country.

  7. Predicting Spatial Distribution of Infection Risk of Airborne Transmission Diseases in a Hospital Ward

    DEFF Research Database (Denmark)

    Qian, Hua; Li, Yuguo; Nielsen, Peter V.;

    2007-01-01

    This study attempt to integrate the Wells-Riley equation and computational fluid dynamics for analyzing the risk of airborne transmission diseases in a building. The new method can predict the spatial distribution of the infection risk of the airborne transmission diseases in a large hospital ward......, while the Wells-Riley equation alone can only predict the overall infection risk in the whole building assuming a uniform distribution of the droplet nuclei concentration. This new method is applied to analyze the transmission risk in the well documented 8A ward SARS outbreak in a Hong Kong hospital...

  8. Experience based co-design reduces formal complaints on an acute mental health ward.

    Science.gov (United States)

    Springham, Neil; Robert, Glenn

    2015-01-01

    An acute mental health triage ward at Oxleas NHS Foundation Trust was attracting high levels of formal service user and family complaints. The Trust used experience based co-design to examine the issues and redesign procedures. This resulted in an immediate eradication of formal complaints for a period of 23 months. This paper describes two outcomes: firstly, the successful adaptations made to the experience based co-design methodology from its origins in physical care, in order to ensure it was safe and effective in an acute mental health setting; and, secondly, the changes made to the ward as a result of this quality improvement intervention.

  9. Functional flows in QED and the modified Ward-Takahashi identity

    Science.gov (United States)

    Igarashi, Yuji; Itoh, Katsumi; Pawlowski, Jan M.

    2016-10-01

    In the functional renormalisation group approach to gauge theory, the Ward-Takahashi identity is modified due to the presence of an infrared cutoff term. It take the most accessible form for the Wilsonian effective action. In the present work we solve these identities, partially, for the Wilsonian effective action of QED. In particular, we compute the longitudinal part of the photon two point vertex function as a momentum-dependent function in the presence of the cutoff k. The resultant Wilsonian effective action carries form factors that originate from the modified Ward-Takahashi identity. We show how this result carries over to the one-particle-irreducible effective action.

  10. Functional flows in QED and the modified Ward-Takahashi identity

    CERN Document Server

    Igarashi, Yuji; Pawlowski, Jan M

    2016-01-01

    In the functional renormalisation group approach to gauge theory, the Ward-Takahashi identity is modified due to the presence of an infrared cutoff term. It take the most accessible form for the Wilsonian effective action. In the present work we solve these identities, partially, for the Wilson effective action of QED. In particular, we compute the longitudinal part of the photon two point vertex function as a momentum- dependent function in the presence of the cutoff k. The resultant Wilsonian effective action carries form factors that originate from the modified Ward-Takahashi identity. We show how this result carries over to the one-particle-irreducible effective action.

  11. Lung ultrasound and chest x-ray for detecting pneumonia in an acute geriatric ward

    OpenAIRE

    2016-01-01

    Abstract Background: Our aim was to compare the accuracy of lung ultrasound (LUS) and standard chest x-ray (CXR) for diagnosing pneumonia in older patients with acute respiratory symptoms (dyspnea, cough, hemoptysis, and atypical chest pain) admitted to an acute-care geriatric ward. Methods: We enrolled 169 (80 M, 89 F) multimorbid patients aged 83.0 ± 9.2 years from January 1 to October 31, 2015. Each participant underwent CXR and bedside LUS within 6 hours from ward admission. LUS was perfo...

  12. The effect of pharmacy restriction of clindamycin on Clostridium difficile infection rates in an orthopedics ward.

    Science.gov (United States)

    Cruz-Rodríguez, Nora Cecilia; Hernández-García, Raúl; Salinas-Caballero, Ana Gabriela; Pérez-Rodríguez, Edelmiro; Garza-González, Elvira; Camacho-Ortiz, Adrián

    2014-06-01

    A high consumption of clindamycin was noted in an orthopedics ward with high rates of Clostridium difficile infection (CDI). We restricted clindamycin for the entire ward. A reduction of 88% in CDI (1.07 to 0.12 × 1,000 patients-days, P = .056) and 84% for all-cause diarrhea (2.40 to 0.38 × 1,000 patients-days, P = .021) was achieved. Clindamycin was reduced 92.61% without an increase in other antibiotics. We identified high consumption of clindamycin as a risk factor for CDI.

  13. [The leadership style exercised by nurses in surgical wards focuses on situational leadership].

    Science.gov (United States)

    Galvão, C M; Trevizan, M A; Sawada, N O; Fávero, N

    1997-04-01

    The present study was oriented to the leadership theme focussing nurses inside surgical ward unities. As a theoretical reference, the authors used the Situational Leadership Model proposed by Hersey and Blanchard. This study aimed at analysing the correspondence between the opinions of nurses and auxiliary personnel about the leadership style exerted by nurses in the surgical ward unit regarding the six categories of the assistance activity that were studied. Authors noticed that nurses, from the two studied hospitals, adopted the directive leadership styles (E2/selling or E1/telling) with the auxiliary personnel.

  14. Less is more: a project to reduce the number of PIMs (potentially inappropriate medications) on an elderly care ward

    Science.gov (United States)

    Aung, Tin Htun; Judith Beck, Adèle; Siese, Thomas; Berrisford, Richard

    2016-01-01

    Potentially inappropriate prescribing in healthcare of the elderly (HCE) is associated with avoidable adverse drug events (ADEs).1,2 A recent set of prescribing criteria has been designed and validated, called “Screening Tool of Older Persons' Prescriptions” (STOPP), to rationalise prescribing in hospitalised patients on HCE wards.1,3 The aim of this quality improvement project was to identify how many potentially inappropriate medications (PIMs) were prescribed on these wards, and remove them. This was executed by implementing a ward round checklist, which incorporated STOPP criteria, for the twice weekly, consultant led ward rounds. This quality improvement project was carried out over four months. In a pilot study, we identified eight inappropriate medical prescriptions among 148 medications (5.4% ) prescribed on one ward. After applying a checklist for a structured ward round, we reviewed the medications prescribed on that ward, and found 10 PIMs out of 192 (5.2% ). Utilising the increasingly recognised “plan, do, study, act” (PDSA) cycle,4 we implemented departmental teaching and meetings with other members of the multidisciplinary team, which raised awareness of PIMs among junior doctors, as well as involving our pharmacists in drug chart screening. During this process we continued with a further six cycles on a bi-weekly basis, and saw a gradual decrease in PIM to 1.5%. In conclusion, a structured ward round, facilitated by a checklist that included review of drug charts based on STOPP criteria, demonstrated a considerable reduction of PIMs. It would be interesting to apply this quality improvement project to non-HCE wards, including general surgical wards or adult psychiatry wards, as a means of not only reducing the effects of ADEs, but also the expenditure associated with unnecessary drug prescriptions, and the costs associated with additional care arising from associated ADEs. PMID:27096089

  15. The effect of an out-of-hours reform on attendance at casualty wards. The Danish example

    DEFF Research Database (Denmark)

    Vedsted, Peter; Christensen, Morten Bondo

    2001-01-01

    in the attendance rate with casualty wards after the reform was statistically insignificant. CONCLUSIONS: The decrease in the total number of contacts with the out-of-hours primary health care after the reform was not met by a corresponding increase in casualty ward contacts. A clear-cut significant increase...

  16. Proposed Reference Model for Guiding Teachers to Perform Ward Round Teaching

    Directory of Open Access Journals (Sweden)

    Luís Alberto Corona Martínez

    2014-06-01

    Full Text Available Ward round teaching is an essential professional medical activity as an organizational form of teaching in undergraduate medical education. Its great importance for shaping a professional "personality" is well recognized by the faculty; as well as its extremely complex implementation and development of the necessary skills. The problem to be solved in this paper is related to the need to help younger clinical teachers in undergraduate medical education to develop the skills to conduct ward round teaching; which would be achieved through appropriate guidance on how to perform this activity. Based on this, the teaching staff in the Department of Clinical Sciences of the Dr. Raúl Dorticós Torrado Faculty of Medical Sciences in Cienfuegos has designed a model or representation of ward round teaching to be used as a guide. The main results include the development of a model with two variants, according to the care provided to a recently admitted patient or an already known patient; and the definition of conditions, both in practical and educational areas, which should be considered for the proper implementation of the activity. The model is not a complete representation of the ward round teaching, thus the proposal is open to review and improvement; and its use is based on its adaptation to the particularities of the different disciplines and learning scenarios.

  17. HRM and strategic climates in hospitals: does the message come accross at the ward level?

    NARCIS (Netherlands)

    Veld, M.; Paauwe, J.; Boselie, J.P.P.E.F.

    2010-01-01

    This study examined how employees perceive intended strategic goals and HRM at the ward level, and if these perceptions generate the desired effects. The qualitative part of the research reveals that the hospital pursues two strategic goals (i.e. quality and safety). Analysis of the questionnaire da

  18. Is Clinical Competence Perceived Differently for Student Daily Performance on the Wards versus Clerkship Grading?

    Science.gov (United States)

    Wimmers, Paul F.; Kanter, Steven L.; Splinter, Ted A. W.; Schmidt, Henk G.

    2008-01-01

    Clinical rotations play an important role in the medical curriculum and are considered crucial for student learning. However, competencies that should be learned can differ from those that are assessed. In order to explore which competencies are considered important for daily performance of student on the wards and to what extent clinical teachers…

  19. Vertices RR$\\to$RP and RR$\\to$RRP with Ward identities

    CERN Document Server

    Braun, M A

    2016-01-01

    Ward identities for reggeons are studied in the framework of effective action approach to the QCD in Regge kinematics. It is shown that they require introduction of new contributions not present in the reggeon diagrams initially. Application to vertices RR$\\to$RP and RR$\\to$RRP are considered and diagrams which have to be added to the QCD ones are found.

  20. Inappropriate use of urinary catheters and its common complications in different hospital wards

    Directory of Open Access Journals (Sweden)

    Parivash Davoodian

    2012-01-01

    Full Text Available Inappropriate use of indwelling urinary catheters (IUCs and their related complications is one of the most important problems in hospital wards. The aim of this study was to evaluate inappropriate use of IUCs and their complications among patients in Tehran, Iran. Two hundred and six consecutive patients hospitalized in the intensive care unit (ICU as well as medical and surgical wards at the Shahid Mohammadi Hospital in Bandarabbas from September 1 to 30, 2005 and in whom IUCs were used, were studied. Data collected included age of the patients, diagnoses, reason for use of IUC and the complications related to it. Overall, 164 patients (79.6% had IUCs used appropriately while 42 of them (20.6% were catheterized unjustifiably. Inappropriate use of IUCs in the ICU, medical and surgical wards was reported in 12 (18.5%, 16 (19.0% and 14 patients (24.6%, respectively. The most common complication of IUCs was urinary tract infection, which occurred in 91 patients (44.2% and hematuria, which was seen in 3.9% of the patients. Our study suggests that inappropriate use of IUCs is prevalent, particularly in the surgical wards, and the most common complication observed was catheter-associated urinary tract infection.

  1. "Living My Native Life Deadly": Red Lake, Ward Churchill, and the Discourses of Competing Genocides

    Science.gov (United States)

    Byrd, Jodi A.

    2007-01-01

    In an attempt to understand how rival narratives of genocide compete even at the cost of disavowing other historical experiences, this article considers how the U.S. national media represented and framed Red Lake in the wake of Ward Churchill's emergence on the national radar. The first section of this article examines how nineteenth-century…

  2. Audit of a ward-based patient-controlled epidural analgesia service in Ireland.

    LENUS (Irish Health Repository)

    Tan, T

    2012-02-01

    BACKGROUND: Ward-based patient-controlled epidural analgesia (PCEA) for postoperative pain control was introduced at our institution in 2006. We audited the efficacy and safety of ward-based PCEA from January 2006 to December 2008. METHOD: Data were collected from 928 patients who received PCEA in general surgical wards for postoperative analgesia using bupivacaine 0.125% with fentanyl 2 mug\\/mL. RESULTS: On the first postoperative day, the median visual analogue pain score was 2 at rest and 4 on activity. Hypotension occurred in 21 (2.2%) patients, excessive motor blockade in 16 (1.7%), high block in 5 (0.5%), nausea in 5 (0.5%) and pruritus in only 1 patient. Excessive sedation occurred in two (0.2%) patients but no intervention was required. There were no serious complications such as epidural abscess, infection or haematoma. CONCLUSION: Effective and safe postoperative analgesia can be provided with PCEA in a general surgical ward without recourse to high-dependency supervision.

  3. Potentially pathogenic free-living amoebae isolated from hospital wards with immunodeficient patients in Tehran, Iran.

    Science.gov (United States)

    Lasjerdi, Zohreh; Niyyati, Maryam; Haghighi, Ali; Shahabi, Saed; Biderouni, Farid Tahvildar; Taghipour, Niloofar; Eftekhar, Mohamad; Nazemalhosseini Mojarad, Ehsan

    2011-09-01

    This study investigated the occurrence of free-living amoebae (FLA) in immunodeficiency wards of hospitals in Tehran, Iran. A total of 70 dust and biofilm samples from wards serving transplant, pediatric (malignancies), HIV, leukemia and oncology patients of five university hospitals were collected and examined for the presence of FLA using culturing and molecular approaches. Based on the morphology of the amoebae in plate cultures, primer sets were applied for molecular identification of Acanthamoeba, vahlkampfiid amoebae and Hartmannella. Out of 70 samples, 37 (52.9%) were positive for FLA. Acanthamoeba belonged to the T4 genotype was the most prevalent isolate. Presence of the T4 genotype on medical instruments, including an oxygen mask in an isolation room of an immunodeficiency pediatric ward, should be of concern for health authorities. Acanthamoeba T5 genotypes, Hartmannella vermiformis, and Vahlkampfia avara were also present. These results highlight a clear need for greater attention to improved disinfection, especially where susceptible patients, such as those who are immune-suppressed, are served. To our knowledge, this is the first report of these FLA in immunodeficiency wards in Iran, and also the first to identify Acanthamoeba T5, Hartmannella, and Vahlkampfia in moist habitats, such as biofilms, in this country.

  4. As His Day in Court Arrives, Ward Churchill Is Depicted in Sharply Different Lights

    Science.gov (United States)

    Schmidt, Peter

    2009-01-01

    The trial in Ward Churchill's lawsuit against the University of Colorado got under way here last week with lawyers for the opposing sides painting starkly different pictures of both the controversial ethnic-studies professor and the circumstances surrounding his dismissal by the university in 2007. In delivering their opening remarks in a crowded…

  5. Participatory Action Research in clinical nursing practice in a medical ward

    DEFF Research Database (Denmark)

    Kjerholt, Mette; Wagner, Lis; Lindhardt, Tove;

    2016-01-01

    roles, responsibility. Conclusion: Before using PAR it is crucial to investigate if the organization and the participants at all levels are suited and agree to participate actively. The findings indicate, that to carry out PAR in a busy medical ward, it is necessary to evaluate whether the necessary...

  6. Improving the communication between teams managing boarded patients on a surgical specialty ward.

    Science.gov (United States)

    Puvaneswaralingam, Shobitha; Ross, Daniella

    2016-01-01

    Transferring patients from the ward of their specialty or consultant is described as boarding. 1 Boarding patients is becoming increasingly prevalent due to greater pressure on hospital capacity. This practice compromises patient safety through delayed investigations, prolonged hospital stays, and increased risk of hospital-acquired infections. 1 2 We evaluated how regularly boarded patients were reviewed, and how effectively information regarding their management was communicated from their primary specialty to ward staff. We aimed to improve the frequency of patient reviews by ensuring that each patient was reviewed every weekday and increase communication between primary specialty, and medical and nursing teams by 20% from baseline during the data collection period. The project was based in the Otolaryngology ward in Ninewells Hospital, Dundee, where there was a high prevalence of boarded patients. Baseline data showed a clear deficit in communication between the primary specialty and ward staff with only 31% of patient reviews being communicated to ward doctors. We designed and implemented a communication tool, in the form of a sticker, to be inserted into patients' medical notes for use by the primary specialty. Implementation of the sticker improved communication between teams as stickers were completed in 93% of instances. In 88% of patient reviews, the junior doctor was informed of the management plan, showing a large increase from baseline. Through PDSA cycles, we aimed to increase the sustainability and reliability of the sticker; however, we faced challenges with sustainability of sticker insertion. We aim to engage more stakeholders to raise awareness of the problem, brainstorm solutions together, and review the production and implementation of stickers with senior hospital management to discuss the potential use of this tool within practice. There is potentially a large scope for utilisation of this communication tool on a local level, which we hope

  7. Comparison of maternal anxiety scores in pediatric intensive care unit and general ward parents

    Directory of Open Access Journals (Sweden)

    Lie Affendi Kartikahadi

    2012-02-01

    Full Text Available Background Hospitalization of a child is known to be a dreadful and stressful situation for parents. One study reported that admitting a child to a general ward caused mild anxiety to mothers, while admitting a child to the pediatric intensive care unit (PICU caused moderate anxiety to mothers. Objective To compare Hamilton anxiety scores of mothers whose children were admitted to the PICU to those of mothers whose children were admitted to the general ward. Methods A cross-sectional study was done on mothers of children aged 1 month-12 years. Children were admitted to either the intensive care unit or the general ward from October 2010-January 2011. All subjects were assessed by Hamilton anxiety scores and questioned for risk factors and other causes of maternal anxiety. Consecutive sampling was used to allocate the subjects. Differences were considered statistically significant for P < 0.05. Results Of the 72 subjects, the median Hamilton anxiety score in mothers of children admitted to the PICU was 20.5 (interquartile range 14-29.75, higher than that of mothers of children admitted to the general ward (14, interquartile range 9-16.75. Mann-Whitney U test revealed a statistically significant difference in scores between the two groups (P = 0.001. Ancova multivariate analysis showed the admission location to be the only significant relationship to Hamilton anxiety score (P = 0.0001. Conclusion Hamilton anxiety scores were higher for mothers of children admitted to the PICU than that of mothers with children admitted to the general ward. [Paediatr Indones.2012;52:95-8].

  8. Improving the communication between teams managing boarded patients on a surgical specialty ward

    Science.gov (United States)

    Puvaneswaralingam, Shobitha; Ross, Daniella

    2016-01-01

    Transferring patients from the ward of their specialty or consultant is described as boarding. 1 Boarding patients is becoming increasingly prevalent due to greater pressure on hospital capacity. This practice compromises patient safety through delayed investigations, prolonged hospital stays, and increased risk of hospital-acquired infections. 1 2 We evaluated how regularly boarded patients were reviewed, and how effectively information regarding their management was communicated from their primary specialty to ward staff. We aimed to improve the frequency of patient reviews by ensuring that each patient was reviewed every weekday and increase communication between primary specialty, and medical and nursing teams by 20% from baseline during the data collection period. The project was based in the Otolaryngology ward in Ninewells Hospital, Dundee, where there was a high prevalence of boarded patients. Baseline data showed a clear deficit in communication between the primary specialty and ward staff with only 31% of patient reviews being communicated to ward doctors. We designed and implemented a communication tool, in the form of a sticker, to be inserted into patients' medical notes for use by the primary specialty. Implementation of the sticker improved communication between teams as stickers were completed in 93% of instances. In 88% of patient reviews, the junior doctor was informed of the management plan, showing a large increase from baseline. Through PDSA cycles, we aimed to increase the sustainability and reliability of the sticker; however, we faced challenges with sustainability of sticker insertion. We aim to engage more stakeholders to raise awareness of the problem, brainstorm solutions together, and review the production and implementation of stickers with senior hospital management to discuss the potential use of this tool within practice. There is potentially a large scope for utilisation of this communication tool on a local level, which we hope

  9. The effect of multi-professional education on the recognition and outcome of patients at risk on general wards

    DEFF Research Database (Denmark)

    Fuhrmann, L.; Perner, A.; Klausen, T.W.;

    2009-01-01

    The aim of this study was to evaluate the effect of multi-professional full-scale simulation-based education of staff on the mortality and staff awareness of patients at risk on general wards. DESIGN, SETTINGS AND PATIENTS: A prospective before-and-after study conducted on four general wards...... at Herlev Hospital, Denmark. In the pre-intervention period (June-July 2006) and post-intervention period (November-December 2007), all patients on the wards had vital signs measured in the evening by study personnel, who also asked nursing staff questions about patients with abnormal vital signs...

  10. Relatives' view on collaboration with nurses in acute wards: development and testing of a new measure

    DEFF Research Database (Denmark)

    Lindhardt, Tove; Nyberg, Per; Hallberg, Ingalill Rahm

    2008-01-01

    BACKGROUND: Collaboration between relatives and nurses in acute care settings is sparsely investigated, and that mostly from nurses' point of view. Feasible and valid instruments are needed for assessing collaboration, its prerequisites and outcome. OBJECTIVES: To develop and test an instrument...... to assess, from the relatives' perspective, collaboration between relatives of frail elderly patients and nurses in acute hospital wards, as well as prerequisites for, and outcome of, collaboration. DESIGN: Instrument development and psychometric testing. SETTING: Acute medical and geriatric wards....... PARTICIPANTS: One hundred fifty-six relatives. Women constituted 74.8%, offspring 63.9% and spouses 20%, respectively. METHODS: A model for collaboration was developed and underpinned the development and construction of the instrument. Face and content validity was examined by relatives and an expert panel...

  11. Parenteral Admixture Compatibility in Neurosurgery Ward in Prof. Dr. Margono Soekarjo Regional Public Hospital

    Directory of Open Access Journals (Sweden)

    Laksmi Maharani

    2014-03-01

    Full Text Available Parenteral admixtures (intravenous admixtures have been done commonly in hospitals. However, it has a possibility of failures, like incompatibilities and changes in drug stabilities. The aim of this study was to determine the rate of drug incompatibilities in mixing parenteral preparations in neurosurgery ward in Prof. Dr. Margono Soekarjo Regional Public Hospital which undergo physical incompatibility observed in organoleptic. This study was a prospective descriptive research for one month period. Data were collected and analyzed descriptively. The results showed that from 667 parenteral admixtures in neurosurgery ward in Prof Dr Margono Soekarjo Hospital in February 2010, there were 0.45% potential incompatibility and 2.55% actual incompatibility happened. Actual incompatibility shown as crystal 0.17%, sediment 0.17%, and 2.04% was non-permanent haze in phenytoin and sodium chloride or ringer lactate admixtures.

  12. Develop high quality nursing service and normalize management of neonatal ward

    Directory of Open Access Journals (Sweden)

    Hua YANG

    2014-08-01

    Full Text Available Objective: To tamp basic neonatal care, provide high quality nursing service, improve the quality of neonatal care, guarantee the safety of nursing care, achieve satisfactory project. Methods:Adjust the staff of the neonatal ward , optimize schedule; strengthen the training and knowledge; strengthen the supervision and ensure the basic nursing; the nursing quality management group work out the rate of incidence of high quality nursing service, the incidence rate of hospital infection of the newborn as well as the satisfaction of their families. Results: The different data between the control group and observation group was statistically significant ( P < 0.05 . Conclusion: Develop the neonatal ward of high quality nursing service, ensure the basic nursing implement, significantly improve the quality of nursing, reduce nursing adverse events and neonatal hospital infection incidence to" zero defects and zero tolerance", and that ensures nursing safety, and achieve the goal of " quality care demonstration project" --- patient satisfaction, social satisfaction, and government satisfaction.

  13. Development of an adhesive surgical ward round checklist: a technique to improve patient safety.

    LENUS (Irish Health Repository)

    Dhillon, P

    2012-02-01

    Checklists have been shown to improve patient outcomes. Checklist use is seen in the pre-operative to post-operative phases of the patient pathway. An adhesive checklist was developed for ward rounds due to the positive impact it could have on improving patient safety. Over an eight day period data were collected from five consultant-led teams that were randomly selected from the surgical department and divided into sticker groups and control groups. Across the board percentage adherence to the Good Surgical Practice Guidelines (GSPG) was markedly higher in the sticker study group, 1186 (91%) in comparison with the control group 718 (55%). There was significant improvement of documentation across all areas measured. An adhesive checklist for ward round note taking is a simple and cost-effective way to improve documentation, communication, hand-over, and patient safety. Successfully implemented in a tertiary level centre in Dublin, Ireland it is easily transferable to other surgical departments globally.

  14. Validity of the Ward seven-subtest WAIS-III short form in a neuropsychological population.

    Science.gov (United States)

    Pilgrim, B M; Meyers, J E; Bayless, J; Whetstone, M M

    1999-01-01

    An investigation of the Ward 7-subtest short form of the Wechsler Adult Intelligence Scale-III (WAIS-III) in a neuropsychological clinic sample finds that the short form retains equivalent psychometric properties to those previously reported for the same short form of the Wechsler Adult Intelligence Scale-Revised (WAIS-R). The correlations found for the 7-subtest form of the WAIS-III were .95 for Performance IQ, .97 for Verbal IQ, and .98 for Full Scale IQ. The 7-subtest short form of the WAIS-III was also found to perform similarly to its WAIS-R counterpart on other markers of test accuracy. These results support the continued use of the Ward 7-subtest short form of the WAIS-III in a neuropsychological population.

  15. Risk of Cross-Infection in a Hospital Ward with Downward Ventilation

    DEFF Research Database (Denmark)

    Nielsen, Peter V.; Li, Yuguo; Buus, Morten;

    2010-01-01

    A two-bed hospital ward with one standing healthcare person and a ceiling-mounted lowimpulse semicircular inlet diffuser is simulated in a full-scale room. Tracer gas is used for simulating gaseous contaminants, and the concentration is measured at different air change rates and different postures...... of the patients. A textile partition between the beds, which is typical in a hospital ward, is used for protection of the patients in some of the experiments. Three different layouts of return openings are tested. One layout with one opening at the ceiling, another with four openings at the wall opposite...... to the inlet diffuser, and one with a high location of these four openings. The downward recirculating flow is on average parallel with the partition, and in most cases the partition does not decrease cross-infection. A high location of the four return openings decreases the risk of cross-infection....

  16. The Romano-Ward syndrome: a case presenting as near drowning with a clinical review.

    Science.gov (United States)

    Harris, E M; Knapp, J F; Sharma, V

    1992-10-01

    Patients with the Romano-Ward syndrome, a form of congenital long Q-T syndrome (LQTS), present with syncopal episodes and are at risk for sudden death. Patients with LQTS may be misdiagnosed if the physician is unaware of this entity. The risk of sudden death makes recognition important so that appropriate therapy can be initiated. A case is discussed in which the patient presented following a near-drowning episode. Family history revealed a familial "seizure disorder." After analysis of the patient's and father's ECGs, the diagnosis of Romano-Ward syndrome was made. A review of the literature was done, concentrating on presentation, pathophysiology, electrocardiographic findings, etiology, diagnosis, prognosis, and treatment of congenital LQTS. This paper is presented to emphasize the importance of physician awareness of LQTS because of the risk of sudden death. Proper diagnosis can lead to treatment that is effective in reducing mortality by more than 90%.

  17. Medication reconciliation and prescribing reviews by pharmacy technicians in a geriatric ward

    DEFF Research Database (Denmark)

    Buck, Thomas Croft; Gronkjaer, Louise Smed; Duckert, Marie-Louise

    2013-01-01

    OBJECTIVE: Incomplete medication histories obtained on hospital admission are responsible for more than 25% of prescribing errors. This study aimed to evaluate whether pharmacy technicians can assist hospital physicians' in obtaining medication histories by performing medication reconciliation...... and prescribing reviews. A secondary aim was to evaluate whether the interventions made by pharmacy technicians could reduce the time spent by the nurses on administration of medications to the patients. METHODS: This observational study was conducted over a 7 week period in the geriatric ward at Odense...... University Hospital, Denmark. Two pharmacy technicians conducted medication reconciliation and prescribing reviews at the time of patients' admission to the ward. The reviews were conducted according to standard operating procedures developed by a clinical pharmacist and approved by the Head of the Geriatric...

  18. Transverse Ward-Takahashi Relation for the Vector Vertex in Quantum Field Theory

    Institute of Scientific and Technical Information of China (English)

    HE Han-Xin

    2001-01-01

    The transverse Ward-Takahashi (W-T) relation for the vector vertex in quantum field theory is derived by calculating the curl of the time-ordered product of the three-point function including the vector current operator. This provides the constraint on the transverse part of the vertex. By combining the transverse and normal (longitudinal)W-T identities, we obtain the expression for the full vector vertex function.``

  19. Nature and frequency of medication errors in a geriatric ward: an Indonesian experience

    OpenAIRE

    2014-01-01

    Desak Ketut Ernawati,1,2 Ya Ping Lee,2 Jeffery David Hughes21Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia; 2School of Pharmacy and Curtin Health Innovation and Research Institute, Curtin University, Perth, WA, AustraliaPurpose: To determine the nature and frequency of medication errors during medication delivery processes in a public teaching hospital geriatric ward in Bali, Indonesia.Methods: A 20-week prospective study on medication errors occurring during the medicati...

  20. Exact Ward-Takahashi identity for the lattice N = 1 Wess-Zumino model

    Energy Technology Data Exchange (ETDEWEB)

    Feo, Alessandra [Dipartimento di Fisica, Universita di Parma, and INFN Gruppo Collegato di Parma, Parco Area delle Scienze 7/A. 43100 Parma (Italy)

    2006-03-01

    The latticeWess-Zumino model written in terms of the Ginsparg-Wilson relation is invariant under a generalized supersymmetry transformation which is determined by an iterative procedure in the coupling constant. By studying the associated Ward-Takahashi identity up to order g{sup 2} we show that this lattice supersymmetry automatically leads to restoration of continuum supersymmetry without fine tuning. In particular, the scalar and fermion renormalization wave functions coincide.

  1. Medication Prescribing Pattern at a Pediatric Ward of an Ethiopian Hospital

    Directory of Open Access Journals (Sweden)

    Fitsum Sebsibe Teni

    2014-11-01

    Full Text Available Introduction: drug use in pediatric patients is a unique dilemma in the management and monitoring of disease. This study aimed at assessing medication prescribing in a pediatric ward of an  Ethiopian hospital. Materials and Methods: a retrospective cross-sectional study was done by reviewing the medical records of 249 patients among those admitted in the period between 11th of September 2007 and 10th of September 2008 to the pediatric ward of Gondar University Referral Hospital, Northwest Ethiopia. Data on characteristics like age, sex and weight; the diagnoses for which patients were admitted and medications prescribed to them during their stay in the ward was collected from the medical records of the patients. Results: an average of 3 diagnoses per patient with the most frequently diagnosed being malnutrition (29.23%, severe community acquired pneumonia (12.96% and underweight (8.86% were reported. A mean of 4.5 medications per patient with the most commonly prescribed being antibacterials namely penicillins which constituted 25.42%, other antibacterials making up 19.61% and medications used for correcting water, electrolyte and acid-base disturbances accounting for 17.19% of the total number of medications prescribed in the ward. The most common individual medications prescribed to the patients included crystalline penicillin, gentamicin and maintenance fluid constituting 9.22, 7.52 and 6.45 percentages respectively most of them in solution forms which were administered dominantly intravenously. Conclusion In this study the common prescription of antibacterials and those used for correcting water, electrolyte and acid-base disturbances was observed which went with the common diagnoses of malnutrition and pneumonia. 

  2. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

    Directory of Open Access Journals (Sweden)

    Mekonnen AB

    2013-03-01

    Full Text Available Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods: The study was carried out in the internal medicine ward from March to April, 2011 at Jimma University Specialized Hospital. The study design was a prospective observational study where pharmaceutical care services provided by clinical pharmacists for inpatients were documented over a period of two months. Interventions like optimization of rational drug use and physician acceptance of these recommendations were documented. Clinical significance of interventions was evaluated by an independent team (1 internist, 1 clinical pharmacologist using a standardized method for categorizing drug related problems (DRPs. Results: A total of 149 drug related interventions conducted for 48 patients were documented; among which 133(89.3% were clinical pharmacists initiated interventions and 16(10.7% interventions were initiated by other health care professionals. The most frequent DRPs underlying interventions were unnecessary drug therapy, 36(24.2%; needs additional drug therapy, 34(22.8% and noncompliance, 29(19.5%. The most frequent intervention type was change of dosage/instruction for use, 23(15.4%. Acceptance rate by physicians was 68.4%. Among the interventions that were rated as clinically significant, 46(48.9% and 25(26.6% had major and moderate clinical importance respectively. Conclusion: Involving trained clinical pharmacists in the healthcare team leads to clinically relevant and well accepted optimization of medicine use in a resource limited settings. This

  3. Development of a nurse robot serving in infectious disease isolation wards

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    A prototype of nurse robot system serving in infectious disease wards is developed by analyzing the systems requirement. Firstly, the type synthesis and dimension synthesis for optimizing the workspace are presented. Secondly, the tele-control system based on velocity control mode is introduced, and tele-control program is written. Finally, the imitation of position workspace and experiment of transforming objects from buffer area to isolation area are carried out.

  4. Risk Assessment Tool for Pressure Ulcer Development in Indian Surgical Wards.

    Science.gov (United States)

    Kumari, Sushma; Sharma, Deborshi; Rana, Anshika; Pathak, Reetesh; Lal, Romesh; Kumar, Ajay; Biswal, U C

    2015-06-01

    The aims of this paper were to compare the predictive validity of three pressure ulcer (PU) risk scales-the Norton scale, the Braden scale, and the Waterlow scale-and to choose the most appropriate calculator for predicting PU risk in surgical wards of India. This is an observational prospective cohort study in a tertiary educational hospital in New Delhi among 100 surgical ward patients from April to July 2011. The main outcomes measured included sensitivity, specificity, positive predictive value (PVP) and negative predictive value (PVN), and the area under the curve of the receiver operating characteristic (ROC) curve of the three PU risk assessment scales. Based on the cutoff points found most appropriate in this study, the sensitivity, specificity, PVP, and PVN were as follows: the Norton scale (cutoff, 16) had the values of 95.6, 93.5, 44.8, and 98.6, respectively; the Braden scale (cutoff, 17) had values of 100, 89.6, 42.5, and 100, respectively; and the Waterlow scale (cutoff, 11) had 91.3, 84.4, 38.8, and 97, respectively. According to the ROC curve, the Norton scale is the most appropriate tool. Factors such as physical condition, activity, mobility, body mass index (BMI), nutrition, friction, and shear are extremely significant in determining risk of PU development (p nutrition, friction, and shear are the most significant factors in Indian surgical ward settings with necessity for future comparison with established scales.

  5. Neuroinfection survey at a neurological ward in a Brazilian tertiary teaching hospital

    Science.gov (United States)

    Marchiori, Paulo E; Lino, Angelina M M; Machado, Luis R; Pedalini, Livia M; Boulos, Marcos; Scaff, Milberto

    2011-01-01

    OBJECTIVES: This study was undertaken to characterize the neuroinfection profile in a tertiary neurological ward. INTRODUCTION: Neuroinfection is a worldwide concern and bacterial meningitis, tetanus and cerebral malaria have been reported as the commonest causes in developing countries. METHODS: From 1999 to 2007, all patients admitted to the Neurology Ward of Hospital das Clínicas, S�o Paulo University School of Medicine because of neuroinfection had their medical records reviewed. Age, gender, immunological status, neurological syndrome at presentation, infectious agent and clinical outcome were recorded. RESULTS: Three hundred and seventy four cases of neuroinfectious diseases accounted for 4.2% of ward admissions and the identification of infectious agent was successful in 81% of cases. Mean age was 40.5±13.4 years, 63.8% were male, 19.7% were immunocompromised patients and meningoencephalitis was the most common clinical presentation despite infectious agent. Viruses and bacteria were equally responsible for 29.4% of neuroinfectious diseases; parasitic, fungal and prion infections accounted for 28%, 9.6% and 3.5% respectively. Human immunodeficiency virus (HIV), herpes simplex virus 1 (HSV1), Mycobacterium tuberculosis, Treponema pallidum, Taenia solium, Schistosoma mansoni, Cryptococcus neoformans and Histoplasma capsulatum were the more common infectious pathogens in the patients. Infection mortality rate was 14.2%, of which 62.3% occurred in immunocompetent patients. CONCLUSION: Our institution appeared to share some results with developed and developing countries. Comparison with literature may be considered as quality control to health assistance. PMID:21808869

  6. Light-front zero-mode contribution to the Ward Identity

    Energy Technology Data Exchange (ETDEWEB)

    Sales, J.H.O. [Universidade Estadual de Santa Cruz, Departamento de Matematica, km 16 Rodovia Ilheus-Itabuna - 45662-000 - Ilheus, BA (Brazil); Suzuki, A.T. [Instituto de Fisica Teorica-Univ. Estadual Paulista, Rua Dr. Bento Teobaldo Ferraz 271, Bloco II - 01140-070 Sao Paulo, SP (Brazil)

    2010-02-15

    In a covariant gauge we implicitly assume that the Green's function propagates information from one point of the space-time to another, so that the Green's function is responsible for the dynamics of the relativistic particle. In the light front form one would naively expect that this feature would be preserved. In this manner, the fermionic field propagator can be split into a propagating piece and a non-propagating ('contact') term. Since the latter ('contact') one does not propagate information, and therefore, supposedly can be discarded with no harm to the field dynamics we wanted to know what would be the impact of dropping it off. To do that, we investigated its role in the Ward identity in the light front. Here we use the terminology Ward identity to identify the limiting case of photon's zero momentum transfer in the vertex from the more general Ward-Takahashi identity with nonzero momentum transfer.

  7. Improving Intensive Care Unit and Ward Utilization by Adapting Master Surgery Schedules.

    Science.gov (United States)

    Fügener, Andreas; Edenharter, Guenther Michael; Kiefer, Paskal; Mayr, Ulrike; Schiele, Julian; Steiner, Fabian; Kolisch, Rainer; Blobner, Manfred

    2016-03-15

    With increasing organizational and financial pressure on hospitals, each individual surgical treatment has to be reviewed and planned thoroughly. Apart from the expensive operating room facilities, proper staffing and planning of downstream units, like the wards or the intensive care units (ICUs), should be considered as well. In this article, we outline the relationship between a master surgery schedule (MSS), i.e., the assignment of surgical blocks to medical specialties, and the bed demand in the downstream units using an analytical model. By using historical data retrieved from the clinical information system and a patient flow model, we applied a recently developed algorithm for predicting bed demand based on the MSSs for patients of 3 surgical subspecialties of a hospital. Simulations with 3 different MSSs were performed. The impact on the required amount of beds in the downstream units was analyzed. We show the potential improvements of the current MSS considering 2 main goals: leveling workload among days and reduction of weekend utilization. We discuss 2 different MSSs, one decreasing the weekend ICU utilization by 20% and the other one reducing maximum ward bed demand by 7%. A test with 12 months of real-life data validates the results. The application of the algorithm provides detailed insights for the hospital into the impact of MSS designs on the bed demand in downstream units. It allowed creating MSSs that avoid peaks in bed demand and high weekend occupancy levels in the ICU and the ward.

  8. The permeable institution: an ethnographic study of three acute psychiatric wards in London.

    Science.gov (United States)

    Quirk, Alan; Lelliott, Paul; Seale, Clive

    2006-10-01

    In Asylums, Goffman [1961. Asylums. London: Penguin] identified some permeable features of the old mental hospitals but presented them as exceptions to the rule and focused on their impermeable aspects. We argue that this emphasis is no longer valid and offer an alternative ideal type that better represents the reality of everyday life in contemporary 'bricks and mortar' psychiatric institutions. We call this the "permeable institution". The research involved participant observation of between 3 and 4 months and interviews with patients, patient advocates and staff on 3 psychiatric wards. Evidence for permeability includes that ward membership is temporary and changes rapidly (patients tend to have very short stays and staff turnover is high); patients maintain contact with the outside world during their stay; and institutional identities are blurred to the point where visitors or new patients can easily mistake staff and patients for one another. Permeability has both positive consequences (e.g., reduced risk of institutionalism), and negative consequences (e.g., unwanted people coming into hospital to cause trouble, and illicit drug use among patients). Staff employ various methods to regulate their ward's permeability, within certain parameters. The metaphor of the total/closed institution remains valuable, but it fails to capture the highly permeable nature of the psychiatric institutions we studied. Analysts may therefore find the permeable institution a more helpful reference point or ideal type against which to examine and compare empirical cases. Perhaps most helpful is to conceptualise a continuum of institutional permeability with total and permeable institutions at each extreme.

  9. A safe place with space for learning: Experiences from an interprofessional training ward.

    Science.gov (United States)

    Hallin, Karin; Kiessling, Anna

    2016-01-01

    Interprofessional learning in a real ward context effectively increases collaborative and professional competence among students. However, less is known on the processes behind this. The aim of this study was to explore medical, nurse, physiotherapy, and occupational therapy students' perspectives on the process of their own learning at an interprofessional training ward (IPTW). We performed a qualitative content analysis on free-text answers of 333 student questionnaires from the years 2004 to 2011. Two main themes emerged: first, students found that the IPTW provided an enriching learning environment--a safe place with space. It included authentic and relevant patients, well-composed and functioning student teams, competent and supportive supervisors, and adjusted ward structures to support learning. Second, they developed an awareness of their own development with faith in the future--from chaos to clarity. It included personal, professional, and interprofessional development towards a comprehensive view of practice and a faith in their ability to work as professionals in the future. Our findings are discussed with a social constructivist perspective. This study suggests that when an IPTW provides a supportive and permissive learning environment with possibilities to interact with one another--a safe place with space--it enables students to move from insecurity to faith in their abilities--from chaos to clarity. However, if the learning environment is impaired, the students' development could be halted.

  10. Team climate and attitudes toward information and communication technology among nurses on acute psychiatric wards.

    Science.gov (United States)

    Koivunen, Marita; Anttila, Minna; Kuosmanen, Lauri; Katajisto, Jouko; Välimäki, Maritta

    2015-01-01

    Objectives: To describe the association of team climate with attitudes toward information and communication technology among nursing staff working on acute psychiatric wards. Background: Implementation of ICT applications in nursing practice brings new operating models to work environments, which may affect experienced team climate on hospital wards. Method: Descriptive survey was used as a study design. Team climate was measured by the Finnish modification of the Team Climate Inventory, and attitudes toward ICT by Burkes' questionnaire. The nursing staff (N = 181, n = 146) on nine acute psychiatric wards participated in the study. Results: It is not self-evident that experienced team climate associates with attitudes toward ICT, but there are some positive relationships between perceived team climate and ICT attitudes. The study showed that nurses' motivation to use ICT had statistically significant connections with experienced team climate, participative safety (p = 0.021), support for innovation (p = 0.042) and task orientation (p = 0.042). Conclusion: The results suggest that asserting team climate and supporting innovative operations may lead to more positive attitudes toward ICT. It is, in particular, possible to influence nurses' motivation to use ICT. More attention should be paid to psychosocial factors such as group education and co-operation at work when ICT applications are implemented in nursing.

  11. Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk

    Science.gov (United States)

    Sternal, Danuta; Wilczyński, Krzysztof; Szewieczek, Jan

    2017-01-01

    Background Prevention strategies for pressure ulcer formation remain critical in patients with an advanced illness. We analyzed factors associated with the development of pressure ulcers in patients hospitalized in a palliative care ward setting. Patients and methods This study was a retrospective analysis of 329 consecutive patients with a mean age (± standard deviation) of 70.4±11.8 years (range: 30–96 years, median 70.0 years; 55.3% women), who were admitted to the Palliative Care Department between July 2012 and May 2014. Results Patients were hospitalized for mean of 24.8±31.4 days (1–310 days, median 14 days). A total of 256 patients (77.8%) died in the ward and 73 patients (22.2%) were discharged. Two hundred and six patients (62.6%) did not develop pressure ulcers during their stay in the ward, 84 patients (25.5%) were admitted with pressure ulcers, and 39 patients (11.9%) developed pressure ulcers in the ward. Four factors assessed at admission appear to predict the development of pressure ulcers in the multivariate logistic regression model: Waterlow score (odds ratio [OR] =1.140, 95% confidence interval [CI] =1.057–1.229, P=0.001), transfer from other hospital wards (OR =2.938, 95% CI =1.339–6.448, P=0.007), hemoglobin level (OR =0.814, 95% CI =0.693–0.956, P=0.012), and systolic blood pressure (OR =0.976, 95% CI =0.955–0.997, P=0.023). Five other factors assessed during hospitalization appear to be associated with pressure ulcer development: mean evening body temperature (OR =3.830, 95% CI =1.729–8.486, P=0.001), mean Waterlow score (OR =1.194, 95% CI =1.092–1.306, P<0.001), the lowest recorded sodium concentration (OR =0.880, 95% CI =0.814–0.951, P=0.001), mean systolic blood pressure (OR =0.956, 95% CI =0.929–0.984, P=0.003), and the lowest recorded hemoglobin level (OR =0.803, 95% CI =0.672–0.960, P=0.016). Conclusion Hyponatremia and low blood pressure may contribute to the formation of pressure ulcers in patients with an

  12. Development of a self-assessment tool for measuring competences of obstetric nurses in rooming-in wards in China

    OpenAIRE

    Zhang, Ju; Ye, Wenqin; Fan, Fan

    2015-01-01

    Introduction: To provide high-quality nursing care, a reliable and feasible competency assessment tool is critical. Although several questionnaire-based competency assessment tools have been reported, a tool specific for obstetric nurses in rooming-in wards is lacking. Therefore, the purpose of this research is to develop a competency assessment tool for obstetric rooming-in ward nurses. Methods: A literature review was conducted to create an individual intensive interview with 14 nurse manag...

  13. EVALUATION OF THE NUTRITIONAL STATUS IN CHILDREN ADMITTED TO THE NEUROLOGY WARD OF MOFID CHILDREN’S HOSPITAL

    OpenAIRE

    Maryam BEHESHTI; Farid IMAN ZADEH; Noushin SHAHIDI

    2010-01-01

    ObjectiveMalnutrition is commonly considered as an important risk factor that can produce a negative influence on the prognosis of patients with chronic neurological diseases. We aimed to evaluate the nutritional status of patients admitted to the neurology ward of Mofid children's hospital via subjective and objective methods.Materials & Methods61 children (2-6 years of age) who were consecutively hospitalized at the neurology ward between January and March 2008 underwent objective (weight, ...

  14. The ward atmosphere important for the psychosocial work environment of nursing staff in psychiatric in-patient care

    Directory of Open Access Journals (Sweden)

    Wann-Hansson Christine

    2011-06-01

    Full Text Available Abstract Background The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. Methods 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. Results The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. Conclusions The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.

  15. Effectiveness of hospital-wide methicillin-resistant Staphylococcus aureus (MRSA infection control policies differs by ward specialty.

    Directory of Open Access Journals (Sweden)

    Rosemarie Sadsad

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is a major cause of preventable nosocomial infections and is endemic in hospitals worldwide. The effectiveness of infection control policies varies significantly across hospital settings. The impact of the hospital context towards the rate of nosocomial MRSA infections and the success of infection control is understudied. We conducted a modelling study to evaluate several infection control policies in surgical, intensive care, and medical ward specialties, each with distinct ward conditions and policies, of a tertiary public hospital in Sydney, Australia. We reconfirm hand hygiene as the most successful policy and find it to be necessary for the success of other policies. Active screening for MRSA, patient isolation in single-bed rooms, and additional staffing were found to be less effective. Across these ward specialties, MRSA transmission risk varied by 13% and reductions in the prevalence and nosocomial incidence rate of MRSA due to infection control policies varied by up to 45%. Different levels of infection control were required to reduce and control nosocomial MRSA infections for each ward specialty. Infection control policies and policy targets should be specific for the ward and context of the hospital. The model we developed is generic and can be calibrated to represent different ward settings and pathogens transmitted between patients indirectly through health care workers. This can aid the timely and cost effective design of synergistic and context specific infection control policies.

  16. Effectiveness of hospital-wide methicillin-resistant Staphylococcus aureus (MRSA) infection control policies differs by ward specialty.

    Science.gov (United States)

    Sadsad, Rosemarie; Sintchenko, Vitali; McDonnell, Geoff D; Gilbert, Gwendolyn L

    2013-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of preventable nosocomial infections and is endemic in hospitals worldwide. The effectiveness of infection control policies varies significantly across hospital settings. The impact of the hospital context towards the rate of nosocomial MRSA infections and the success of infection control is understudied. We conducted a modelling study to evaluate several infection control policies in surgical, intensive care, and medical ward specialties, each with distinct ward conditions and policies, of a tertiary public hospital in Sydney, Australia. We reconfirm hand hygiene as the most successful policy and find it to be necessary for the success of other policies. Active screening for MRSA, patient isolation in single-bed rooms, and additional staffing were found to be less effective. Across these ward specialties, MRSA transmission risk varied by 13% and reductions in the prevalence and nosocomial incidence rate of MRSA due to infection control policies varied by up to 45%. Different levels of infection control were required to reduce and control nosocomial MRSA infections for each ward specialty. Infection control policies and policy targets should be specific for the ward and context of the hospital. The model we developed is generic and can be calibrated to represent different ward settings and pathogens transmitted between patients indirectly through health care workers. This can aid the timely and cost effective design of synergistic and context specific infection control policies.

  17. One particle properties in the 2D Coulomb problem. Luttinger-Ward variational approach

    Energy Technology Data Exchange (ETDEWEB)

    Agnihotri, M.P.

    2007-04-27

    In this work, we have studied the 2D Coulomb problem. We used the Luttinger-Ward variational principle to determine the self-energy {sigma} in ring approximation. The use of an ansatz for {sigma} enables us to perform the frequency sums (integrals as T {yields} 0) analytically. Compared to the usual procedure of iterating the self consistency equation with free Green's function as starting points, the present approach is superior. It works for higher density parameter r{sub s} (low density) where the iteration already fails to converge. The motivation of the present work is the quantum Hall system at filling factor 1/2. The Luttinger-Ward procedure is a rather powerful method in particular if combined with an analytical ansatz for {sigma}. The computation performed here for 2DEG has to be seen as a first step: There, the experiment shows the features of a free Fermion system that is interpreted as a system of Composite Fermions. If one studies the self energy of the Composite Fermions in an conserved approximation that corresponds to the ring approximation, one encounters a self consistency equation. However, an iterative solution of this equation meets with a complication: Instead of the polarization part {pi}{sub 00}, in the case of the Composite Fermion there appears the longitudinal polarization part {pi}{sub LL} that has an additional factor (2k + q){sup 2} under the k integral. This integral converges only after the frequency integral is performed. It is highly difficult to reproduce this numerically. Here, the Luttinger-Ward variational approach applied to the 2D Coulomb problem in the present work looks promising. For the 2D Coulomb problem, in the ring approximation for the LW thermodynamic potential, that already leads to a formidable integral equation that has to be studied numerically. (orig.)

  18. Improving VTE risk assessment at point of admission to a tertiary centre cardiology ward

    Science.gov (United States)

    Wilson, Rachel

    2015-01-01

    Cardiology wards are generally high turnover units, which may receive primary PCI, high-risk NSTEMI patients, and other general cardiac admissions from a large geographical area. Many centres also provide national specialist services for rarer cardiac conditions for which admissions may be lengthy. Cardiac patients have significant risk factors for venous thromboembolism (VTE) as immobility may be due to systolic dysfunction, attachment to continuous monitoring and predisposition to chest pain, or cardiac syncope. It is recommended by NICE that an initial VTE risk assessment is undertaken at the time of patient admission, with reassessment within 24 hours. For this purpose a risk assessment tool is featured on the front of many Trust drug charts. It is noted that this risk assessment is electronic in other trusts. We undertook an audit into the drug chart documentation of VTE risk assessment on the cardiology ward and the Coronary Care Unit (CCU) at The Royal Free Hospital. It was evident that documentation of VTE risk assessment was poor. The audit interventions were; a teaching presentation to the cardiology department, an educational poster, several update emails to the department and the identification of a ‘VTE risk assessment champion’ to audit ongoing compliance. Following these measures the second audit round demonstrated that documentation of initial risk assessment was slightly improved, but significant improvement was seen in documentation of risk assessment at 24 hours post admission. Results from a third audit cycle indicated that the improvement in initial VTE risk assessment was sustained, and that there was a significant sustained improvement in risk assessment at 24 hours (p <0.05). Recommendations for sustained improvement included: redesigning the drug chart so that the VTE risk assessment tool was linked to the VTE prophylaxis prescription box, and designating the responsibility of the initial VTE risk assessment to the on call junior doctor

  19. OBSERVED HAND WASHING PRACTICES AMONG HEALTH WORKERS IN TWO CRITICAL PAEDIATRICS WARDS OF A SPECIALIST HOSPITAL

    Directory of Open Access Journals (Sweden)

    Balafama Abinye Alex-Hart

    2014-01-01

    Full Text Available Hand washing in between patient care by health workers is the single most important measure against occurrence and spread of nosocomial infections within health facilities. This study was done to observe health workers hand washing practices in two critical Paediatric wards of a specialist hospital. Trained observers observed and recorded health workers’ hand washing compliance while carrying out their routine patient care. Other information recorded included the time of observation and health workers’ occupation and rank. Data was fed in to excel spread sheet and analyzed using SPSS version 16.0. A total of 150 health workers were observed in this study. There were 116 (77.3% females and 34 (22.7% males giving a male: Female ratio of 1: 3.4. There were 86 (57.3% doctors and 64 (42.7% nurses. During the period of observation, soap with running water was found in only 39 (26.0% occasions. Common cotton towel was found in 78.7% of the period of observation as the only available hand drying facility. Doctors’ hand washing rates before and after patients contact were 17.4 and 64.0% respectively. Doctors’ hand washing rates before and after simple procedures ranged from 0 to 56.5 and 60.6 to 100% respectively. Nurses’ hand washing rates before and after simple procedures ranged from 1.3 to 28.6% and 19.7 to 88.4% respectively. Health workers (doctors and nurses hand washing rates on entering the wards was 4%. Hand washing rate before leaving the wards was 74.7%. Majority of the health workers dried their hands with non-disposable common cotton towels on 72.0% of the occasions. Hand washing rates was very low before patient contact and before simple procedures.

  20. Detection and management of medication errors in internal wards of a teaching hospital by clinical pharmacists.

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasinazari

    2013-07-01

    Full Text Available Any suboptimum treatment in the management of patients can lead to medication errors (MEs that may increase morbidity and mortality in hospitalized individuals. By establishing well-designed patient care activities within the managed care setting, clinical pharmacists can cooperate with other health care professionals to provide quality care and maximize safety. The aim of this study was to evaluate the frequency and prevention of MEs by clinical pharmacists. This was a cross-sectional interventional study conducted in internal wards of a teaching hospital during a two-month period. During this period, patient records, and physician orders were reviewed by clinical pharmacists. Any prescription error identified was documented. Incorrect drug selection, dose, dosage form, frequency, or route of administration all were considered as medication errors. Then, the clinical pharmacist discuss about findings with the clinical fellows to change faulty orders. The frequency and types of MEs in different wards that were detected and prevented by clinical pharmacists was documented. During the study period, in 132 patients, 262 errors were detected (1.98 per each. Wrong frequency 71 (27%, forget to order 37 (14.1%, wrong selection 33 (12.5%, drug interactions 26 (9.9%, forget to discontinue 25 (9.5% and inappropriate dose adjustment in renal impairment 25 (9.5% were the most types of errors. Cardiovascular medications were the class with the highest detected errors (31.6% followed by gastrointestinal agents (15.6%. Medication errors are common problems in medical wards that their frequency can be restricted by the intervention of clinical pharmacists.

  1. Census of Ligurian Internal Medicine Wards of non-teaching hospitals

    Directory of Open Access Journals (Sweden)

    Micaela La Regina

    2014-12-01

    Full Text Available What is the future of internal medicine in Italy? Which competencies? Which potentialities? To this aim Ligurian FADOI Regional Society performed a census among 18 Internal Medicine Wards (IMWs in non-teaching Ligurian Hospital. We administered, by email, a questionnaire to the heads of IMWs. Data about staffing, equipment, skills, competencies and productivity during 2011 were collected from 1st to 31st November 2012. A total of 15/18 (83.3% chiefs answered to the questionnaire. The number of beds was largely variable among the wards. In 2011, mean diagnosis-related group (DRG-weight was 1.09 (range 0.91-1.6 and that revenues/costs ratio much higher than 1.5. Staff was quite adequate to standards defined by current law, only 33% has got a doctor:patients ratio superior to 1:6.4. However, annual hospitalizations exceed the availability of beds in medicine and the complexity of the patients would require a lower doctor:patients ratio, at least for a group of patients. In fact, 4 wards have a progressive care organization with a defined area for more seriously ill patients. Mean length of stay was 10 days. Expertise was wide, covering almost all medical sub-specialties. Acquired skills such as abdominal, heart and vascular ultrasounds, invasive procedures and their comprehensive knowledge make internists complete and cost-effective specialists. IMWs, as a concentrate of medical knowledge and skills, are the natural destination of current patients with co-morbidities. Staffing and number of beds should be revised according to this new demand. Their revenues/costs ratio resulted favorable and their global approach to patients and not to disease can be useful for resource rationalization. Wider and further studies are needed to improve the awareness of stakeholders about Internal Medicine.

  2. Personnel exposure to violence in hospital emergency wards: a routine activity approach.

    Science.gov (United States)

    Landau, Simha F; Bendalak, Yehudit

    2008-01-01

    This study analyzes violence against personnel in the emergency wards of all 25 general hospitals in Israel using a self-report questionnaire (N=2,356). Informed by the routine activity theory, the hypotheses related to the major concepts of this approach: exposure, target suitability, guarding and proximity to offenders. A General Exposure to Violence Index (GEVI) was constructed, based on the participants' reports about type and frequency of their victimization to violence during the preceding year. The multiple regression analysis for explaining the GEVI was composed of 15 independent variables relating to participants' professional and personal characteristics as well as to structural features of hospitals. As predicted, higher exposure to violence was related to security or nursing staff and positions of authority; high weekly workload; working in a profession other than that of training; inability of coping with verbal violence; having no access to an emergency button, and working in settings restricting the number of accompanying persons to one only. Unexpectedly, previous training in coping with violence was related to higher victimization. Younger age, male gender and being of European/American origin (mainly from the former Soviet Union) was also related to higher risk of victimization. The results support the utility of the routine activities approach in explaining differences in emergency ward personnel victimization. The findings also indicate, however, the need to add domain-specific contextual analyses to this approach to reach a fuller understanding of the behaviors under discussion. Implications of the finding to coping with violence against emergency ward personnel are discussed, and suggestions are put forward for further study in this field.

  3. General ward and pneumonia size as predictors of noninvasive ventilation failure

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    Joveš-Sević Biljana

    2016-01-01

    Full Text Available Introduction. Shortage of intensive care beds has led to more frequent use of noninvasive ventilation (NIV outside respiratory units, and data on NIV efficacy and safety on general wards is lacking. Objective. The aim was to identify potential predictors for NIV failure. Methods. This was a retrospective analysis of patients treated with NIV at the Institute for Pulmonary Diseases of Vojvodina from 2009 to 2013. Demographics, blood gases, chest radiographs, setting, and outcomes were analyzed to identify predictors of NIV failure. Results. A total of 138 patients (65% men, mean age 66 ± 11 years were treated with NIV. Indications for NIV were acute exacerbation of chronic obstructive pulmonary disease (85% and cardiogenic pulmonary edema (7%, as well as respiratory insufficiency related to obesity and central hypoventilation (5% and neuromuscular disease (3%. Rate of NIV failure was 34.8%. In 86 patients NIV was applied in the High Dependency Unit (HDU, while 52 received NIV on the general ward. Baseline characteristics in terms of gender, arterial blood gases, and the extent of consolidation on chest radiographs were similar. Patients treated in HDU were younger (64.4 ± 1.2 vs. 69.4 ± 1.5 years, p < 0.001. NIV on the general ward compared to HDU had higher rates of NIV failure (28/52 vs. 20/86, p < 0.001. Presence of consolidation involving two or more quadrants on chest radiograph (55% vs. 29%, p < 0.001 was associated with NIV failure. When adjusted for age and the extent of consolidation on chest radiograph, NIV failure was still less likely in patients treated in HDU (OR 0.23, 95% CI 0.10-0.50. Conclusion. Patients with consolidation on chest X-ray and patients treated with NIV outside of dedicated respiratory units are at a higher risk for NIV failure.

  4. Feasibility and acceptability of rapid HIV screening in a labour ward in Togo

    Science.gov (United States)

    Ekouevi, Didier K; Kariyiare, Benjamin G; Coffie, Patrick A; Jutand, Marthe-Aline; Akpadza, Koffi; Lawson-Evi, Annette; Tatagan, Albert; Dabis, François; Sibe, Mathieu; Pitche, Vincent P; Becquet, Renaud; David, Mireille

    2012-01-01

    Background HIV screening in a labour ward is the last opportunity to initiate an antiretroviral prophylaxis among pregnant women living with HIV to prevent mother-to-child HIV transmission. Little is known about the feasibility and acceptability of HIV screening during labour in West Africa. Findings A cross-sectional survey was conducted in the labour ward at the Tokoin Teaching Hospital in Lomé (Togo) between May and August 2010. Pregnant women admitted for labour were randomly selected to enter the study and were interviewed on the knowledge of their HIV status. Clinical and biological data were collected from the individual maternal health chart. HIV testing or re-testing was systematically proposed to all pregnant women. Among 1530 pregnant women admitted for labour, 508 (32.2%) were included in the study. Information on HIV screening was available in the charts of 359 women (71%). Overall, 467 women accepted HIV testing in the labour ward (92%). The HIV prevalence was 8.8% (95% confidence interval: 6.4 to 11.7%). Among the 41 women diagnosed as living with HIV during labour, 34% had not been tested for HIV during pregnancy and were missed opportunities. Antiretroviral prophylaxis had been initiated antenatally for 24 women living with HIV and 17 in the labour room. Conclusions This study is the first to show in West Africa that HIV testing in a labour room is feasible and well accepted by pregnant women. HIV screening in labour rooms needs to be routinely implemented to reduce missed opportunities for intervention aimed at HIV care and prevention, especially PMTCT. PMID:22905362

  5. Feasibility and acceptability of rapid HIV screening in a labour ward in Togo

    Directory of Open Access Journals (Sweden)

    Vincent P Pitche

    2012-07-01

    Full Text Available Background: HIV screening in a labour ward is the last opportunity to initiate an antiretroviral prophylaxis among pregnant women living with HIV to prevent mother-to-child HIV transmission. Little is known about the feasibility and acceptability of HIV screening during labour in West Africa. Findings: A cross-sectional survey was conducted in the labour ward at the Tokoin Teaching Hospital in Lomé (Togo between May and August 2010. Pregnant women admitted for labour were randomly selected to enter the study and were interviewed on the knowledge of their HIV status. Clinical and biological data were collected from the individual maternal health chart. HIV testing or re-testing was systematically proposed to all pregnant women. Among 1530 pregnant women admitted for labour, 508 (32.2% were included in the study. Information on HIV screening was available in the charts of 359 women (71%. Overall, 467 women accepted HIV testing in the labour ward (92%. The HIV prevalence was 8.8% (95% confidence interval: 6.4 to 11.7%. Among the 41 women diagnosed as living with HIV during labour, 34% had not been tested for HIV during pregnancy and were missed opportunities. Antiretroviral prophylaxis had been initiated antenatally for 24 women living with HIV and 17 in the labour room. Conclusions: This study is the first to show in West Africa that HIV testing in a labour room is feasible and well accepted by pregnant women. HIV screening in labour rooms needs to be routinely implemented to reduce missed opportunities for intervention aimed at HIV care and prevention, especially PMTCT.

  6. Tracheostomy patients on the ward: multiple benefits from a multidisciplinary team?

    Science.gov (United States)

    Yu, Mihae

    2010-01-01

    Patients requiring tracheostomies tend to have a longer length of stay due to their underlying disease. After a thorough literature search, Garrubba and colleagues found only three studies assessing the impact of multidisciplinary teams (MDTs) on tracheostomy patients on the ward. One consistent observation was the decreased time to decannulation after institution of MDT care when compared with historical controls. Although a large prospective randomized trial is desirable before MDT is recommended, many institutions may have already formed a team approach to provide coordinated care resulting in improved outcome and length of stay.

  7. Validation of a checklist to assess ward round performance in internal medicine

    DEFF Research Database (Denmark)

    Nørgaard, Kirsten; Ringsted, Charlotte; Dolmans, Diana

    2004-01-01

    and construct validity of the task-specific checklist. METHODS: To determine content validity, a questionnaire was mailed to 295 internists. They were requested to give their opinion on the relevance of each item included on the checklist and to indicate the comprehensiveness of the checklist. To determine...... on the checklist were relevant to ward round performance and that the item collection was comprehensive. Checklist mean-item scores differed between levels of expertise: junior house officers 1.4 (1.0-1.9); senior house officers 2.0 (1.5-2.9); specialist trainees 2.5 (1.8-2.8), and specialists 2.7 (2...

  8. Note on Ward-Horadam H(x) - binomials' recurrences and related interpretations, II

    CERN Document Server

    Kwasniewski, Andrzej Krzysztof

    2011-01-01

    We deliver here second new $\\textit{H(x)}-binomials'$ recurrence formula, were $H(x)-binomials' $ array is appointed by $Ward-Horadam$ sequence of functions which in predominantly considered cases where chosen to be polynomials . Secondly, we supply a review of selected related combinatorial interpretations of generalized binomial coefficients. We then propose also a kind of transfer of interpretation of $p,q-binomial $ coefficients onto $q-binomial$ coefficients interpretations thus bringing us back to $Gy{\\"{o}}rgy P\\'olya $ and Donald Ervin Knuth relevant investigation decades ago.

  9. Transverse Vector Vertex Function and Transverse Ward-Takahashi Relations in QED

    Institute of Scientific and Technical Information of China (English)

    HE Han-Xin

    2006-01-01

    The transverse vector vertex function in momentum space in four-dimensional QED is derived in terms of a set of transverse Ward-Takahashi relations for the vector and the axial-vector vertices in the case of massless fermion.It is demonstrated explicitly that the transverse vector vertex function derived this way to one-loop order leads to the same result as one obtained in perturbation theory. This provides a basic approach to determine the transverse part of basic vertex function from the symmetry relations of the system.

  10. BRST quantization and canonical Ward identity of the supersymmetric electromagnetic interaction system

    Institute of Scientific and Technical Information of China (English)

    HUANG YongChang; JIANG YunGuo; LI XinGuo

    2007-01-01

    According to the method of path integral quantization for the canonical constrained system in Becchi-Rouet-Stora-Tyutin scheme, the supersymmetric electromagnetic interaction system was quantized. Both the Hamiltonian of the supersymmetric electromagnetic interaction system in phase space and the quantization procedure were simplified. The BRST generator was constructed, and the BRST transformations of supersymmetric fields were gotten; the effective action was calculated, and the generating functional for the Green function was achieved; also, the gauge generator was constructed, and the gauge transformation of the system was obtained. Finally, the Ward-Takahashi identities based on the canonical Noether theorem were calculated, and two relations between proper vertices and propagators were obtained.

  11. Frequency and severity of aggressive incidents in acute psychiatric wards in Switzerland

    Directory of Open Access Journals (Sweden)

    Fischer Joachim E

    2007-12-01

    Full Text Available Abstract Background Aggression and violence and negative consequences thereof are a major concern in acute psychiatric inpatient care globally. Variations in study designs, settings, populations, and data collection methods render comparisons of the incidence of aggressive behaviour in high risk settings difficult. Objective To describe the frequency and severity of aggressive incidents in acute psychiatric wards in the German speaking part of Switzerland. Methods We conducted a prospective multicentre study on 24 acute admission wards in 12 psychiatric hospitals in the German speaking part of Switzerland. Aggressive incidents were recorded by the revised Staff Observation Aggression Scale (SOAS-R and we checked the data collection for underreporting. Our sample comprised 2344 treatment episodes of 2017 patients and a total of 41'560 treatment days. Results A total of 760 aggressive incidents were registered. We found incidence rates per 100 treatment days between 0.60 (95% CI 0.10–1.78 for physical attacks and 1.83 (1.70–1.97 for all aggressive incidents (including purely verbal aggression. The mean severity was 8.80 ± 4.88 points on the 22-point SOAS-R-severity measure; 46% of the purely verbally aggression was classified as severe (≥ 9 pts.. 53% of the aggressive incidents were followed by a coercive measure, mostly seclusion or seclusion accompanied by medication. In 13% of the patients, one ore more incidents were registered, and 6.9% of the patients were involved in one ore more physical attack. Involuntary admission (OR 2.2; 1.6–2.9, longer length of stay (OR 2.7; 2.0–3.8, and a diagnosis of schizophrenia (ICH-10 F2 (OR 2.1; 1.5–2.9 was associated with a higher risk for aggressive incidents, but no such association was found for age and gender. 38% of the incidents were registered within the first 7 days after admission. Conclusion Aggressive incidents in acute admission wards are a frequent and serious problem. Due to the

  12. [When should a patient with abdominal pain be referred to the emergency ward?].

    Science.gov (United States)

    de Saussure, Wassila Oulhaci; Andereggen, Elisabeth; Sarasin, François

    2010-08-25

    When should a patient with abdominal pain be referred to the emergency ward? The following goals must be achieved upon managing patients with acute abdominal pain: 1) identify vital emergency situations; 2) detect surgical conditions that require emergency referral without further diagnostic procedures; 3) in "non surgical acute abdomen patients" perform appropriate diagnostic procedures, or in selected cases delay tests and reevaluate the patient after an observation period, after which a referral decision is made. Clues from the history and physical examination are critical to perform this evaluation. A good knowledge of the most frequent acute abdominal conditions, and identifying potential severity criteria allow an appropriate management and decision about emergency referral.

  13. Airflow and Contaminant Distribution in Hospital Wards with a Displacement Ventililation System

    DEFF Research Database (Denmark)

    Qian, H.; Nielsen, Peter Vilhelm; Li, Y.

    2004-01-01

    an appropriate turbulent model to simulate and reproduce the process of contaminant dispersion. The low Reynolds-number (LRN) k-e (Launder and Sharma, 1978) turbulence model with a damping function (Chikamoto et al., 1992) was considered and evaluated by experiment. We carried out an experimental study to test...... wards probably due to its inability to remove large particles and risk of particle deposition on horizontal surfaces in the occupied regions. However, the existing downward ventilation system commonly used in isolation rooms does not deliver the required performance. There is a need to develop effective...

  14. Ward and Nielsen Identities for ABJM Theory in ${\\cal N}=1$ Superspace

    CERN Document Server

    Upadhyay, Sudhaker

    2016-01-01

    The structures and the associated gauge algebra of ABJM theory in ${\\cal N}=1$ superspace are reviewed. We derive the Ward identities of the theory in the class of Lorentz-type gauges at quantum level to justify the renormalizability of the model. We compute the Nielsen identities for the two-point functions of the theory with the help of enlarged BRST transformation. The identities are derived in ABJM theory to ensure the gauge independence of the physical poles of the Green's functions.

  15. Severe exacerbations of chronic obstructive pulmonary disease: management with noninvasive ventilation on a general medicine ward

    Directory of Open Access Journals (Sweden)

    Sirio Fiorino

    2013-04-01

    Full Text Available Introduction: Recent evidence suggests that, with a well-trained staff, severe exacerbations of chronic obstructive pulmonary disease (COPD with moderate respiratory acidosis (pH > 7.3 can be successfully treated with noninvasive mechanical ventilation (NIMV on a general respiratory care ward. We conducted an open prospective study to evaluate the efficacy of this approach on a general medicine ward. Material and methods: This study population consisted in 27 patients admitted to a general medicine ward (median nurse:patient ratio 1:12 December 1, 2004 May 31, 2006 for acute COPD exacerbation with hypercapnic respiratory failure and acidosis (arterial pH < 7.34, PaC02 > 45 mmHg. All received assist-mode NIMV (average 12 h / day via oronasal masks (inspiratory pressure 10-25 cm H2O, expiratory pressure 4-6 cm H2O to maintain O2 saturation at 90-95%. Treatment was supervised by an experienced pulmonologist, who had also provided specific training in NIMV for medical and nursing staffs (90-day course followed by periodic refresher sessions. Arterial blood pressure, O2 saturation, and respiratory rate were continuously monitored during NIMV. Based on baseline arterial pH, the COPD was classified as moderate (7.25-7.34 or severe (< 7.25. Results: In patients with moderate and severe COPD, significant improvements were seen in arterial pH after 2 (p < 0.05 and 24 h (p< 0.05 of NIMV and in the PaC02 after 24 hours (p < 0.05. Four (15% of the 27 patients died during the study hospitalization (in-hospital mortality 15%, in 2 cases due to NIMV failure. For the other 23, mean long-term survival was 14.5 months (95% CI 10.2 to 18.8, and no significant differences were found between the moderate and severe groups. Over half (61% the patients were alive 1 year after admission. Conclusions: NIMV can be a cost-effective option for management of moderate or severe COPD on a general medicine ward. Its proper use requires: close monitoring of ventilated subjects

  16. Talking therapy groups on acute psychiatric wards: patients' experience of two structured group formats

    Science.gov (United States)

    Radcliffe, Jonathan; Bird, Laura

    2016-01-01

    Aims and method We report the results of a clinical audit of patients' reactions to two types of talking therapy groups facilitated by assistant psychologists and psychology graduates on three acute wards. Patients' experiences of problem-solving and interpersonal group formats were explored via focus groups and structured interviews with 29 group participants. Results Both group formats generated high satisfaction ratings, with benefits related mostly to generic factors. Clinical implications Adequately trained and supported assistant psychologists and psychology graduates can provide supportive talking groups that patients find helpful. PMID:27512586

  17. Mode analysis and Ward identities for perturbative quantum gravity in de Sitter space

    Science.gov (United States)

    Tsamis, N. C.; Woodard, R. P.

    1992-10-01

    We study linearized gravitons on the D-dimensional open submanifold spanned by de Sitter conformal coordinates. The physical modes are found in the same way as for flat space by imposing exact gauge conditions on the invariant field equations and then exploiting the residual gauge freedom of solutions. The resulting polatization tensors have vanishing zero components and are transverse and traceless, just as in flat space. We also show that vacua exist such that the ghost and graviton propagators obey the Ward identity relating them.

  18. Pharmacy sales data versus ward stock accounting for the surveillance of broad-spectrum antibiotic use in hospitals

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    Haug Jon B

    2011-12-01

    Full Text Available Abstract Background Antibiotic consumption in hospitals is commonly measured using the accumulated amount of drugs delivered from the pharmacy to ward held stocks. The reliability of this method, particularly the impact of the length of the registration periods, has not been evaluated and such evaluation was aim of the study. Methods During 26 weeks, we performed a weekly ward stock count of use of broad-spectrum antibiotics - that is second- and third-generation cephalosporins, carbapenems, and quinolones - in five hospital wards and compared the data with corresponding pharmacy sales figures during the same period. Defined daily doses (DDDs for antibiotics were used as measurement units (WHO ATC/DDD classification. Consumption figures obtained with the two methods for different registration intervals were compared by use of intraclass correlation analysis and Bland-Altman statistics. Results Broad-spectrum antibiotics accounted for a quarter to one-fifth of all systemic antibiotics (ATC group J01 used in the hospital and varied between wards, from 12.8 DDDs per 100 bed days in a urological ward to 24.5 DDDs in a pulmonary diseases ward. For the entire study period of 26 weeks, the pharmacy and ward defined daily doses figures for all broad-spectrum antibiotics differed only by 0.2%; however, for single wards deviations varied from -4.3% to 6.9%. The intraclass correlation coefficient, pharmacy versus ward data, increased from 0.78 to 0.94 for parenteral broad-spectrum antibiotics with increasing registration periods (1-4 weeks, whereas the corresponding figures for oral broad-spectrum antibiotics (ciprofloxacin were from 0.46 to 0.74. For all broad-spectrum antibiotics and for parenteral antibiotics, limits of agreement between the two methods showed, according to Bland-Altman statistics, a deviation of ± 5% or less from average mean DDDs at 3- and 4-weeks registration intervals. Corresponding deviation for oral antibiotics was ± 21% at a 4

  19. The impact of a large-scale quality improvement programme on work engagement: preliminary results from a national cross-sectional-survey of the 'Productive Ward'

    OpenAIRE

    White, Mark; Wells, John S G; Butterworth, Tony

    2014-01-01

    Background: Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to 'engage' and 'empower' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the 'engagement' of the clinical teams who participate and vice-versa. Objective: This paper explores and examines the impact of a large-scale QI programme, the Productive Ward, on the ...

  20. Medication communication through documentation in medical wards: knowledge and power relations.

    Science.gov (United States)

    Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

    2014-09-01

    Health professionals communicate with each other about medication information using different forms of documentation. This article explores knowledge and power relations surrounding medication information exchanged through documentation among nurses, doctors and pharmacists. Ethnographic fieldwork was conducted in 2010 in two medical wards of a metropolitan hospital in Australia. Data collection methods included participant observations, field interviews, video-recordings, document retrieval and video reflexive focus groups. A critical discourse analytic framework was used to guide data analysis. The written medication chart was the main means of communicating medication decisions from doctors to nurses as compared to verbal communication. Nurses positioned themselves as auditors of the medication chart and scrutinised medical prescribing to maintain the discourse of patient safety. Pharmacists utilised the discourse of scientific judgement to guide their decision-making on the necessity of verbal communication with nurses and doctors. Targeted interdisciplinary meetings involving nurses, doctors and pharmacists should be organised in ward settings to discuss the importance of having documented medication information conveyed verbally across different disciplines. Health professionals should be encouraged to proactively seek out each other to relay changes in medication regimens and treatment goals.

  1. Evaluation of the biological efficacy of hydrogen peroxide vapour decontamination in wards of an Australian hospital.

    Science.gov (United States)

    Chan, H-T; White, P; Sheorey, H; Cocks, J; Waters, M-J

    2011-10-01

    This study assessed the efficacy of a 'dry' hydrogen peroxide vapour decontamination in an Australian hospital via a two-armed study. The in vivo arm examined the baseline bacterial counts in high-touch zones within wards and evaluated the efficacy of cleaning with a neutral detergent followed by either hydrogen peroxide vapour decontamination, or a manual terminal clean with bleach or Det-Sol 500. The in vitro arm examined the efficacy of hydrogen peroxide vapour decontamination on a variety of different surfaces commonly found in the wards of an Australian hospital, deliberately seeded with a known concentration of vancomycin-resistant enterococci (VRE). All bacterial counts were evaluated by a protocol of contact plate method. In the in vivo arm, 33.3% of the high-touch areas assessed had aerobic bacterial count below the detection limit (i.e. no bacteria recoverable) post hydrogen peroxide decontamination, and in all circumstances the highest microbial density was ≤3 cfu/cm(2), while in the in vitro arm there was at least a reduction in bacterial load by a factor of 10 at all surfaces investigated. These results showed that dry hydrogen peroxide vapour room decontamination is highly effective on a range of surfaces, although the cleanliness data obtained by these methods cannot be easily compared among the different surfaces as recovery of organisms is affected by the nature of the surface.

  2. Large-eddy simulation of airflow and heat transfer in a general ward of hospital

    Science.gov (United States)

    Hasan, Md. Farhad; Himika, Taasnim Ahmed; Molla, Md. Mamun

    2016-07-01

    In this paper, a very popular alternative computational technique, the Lattice Boltzmann Method (LBM) has been used for Large-Eddy Simulation (LES) of airflow and heat transfer in general ward of hospital. Different Reynolds numbers have been used to study the airflow pattern. In LES, Smagorinsky turbulence model has been considered and a discussion has been conducted in brief. A code validation has been performed comparing the present results with benchmark results for lid-driven cavity problem and the results are found to agree very well. LBM is demonstrated through simulation in forced convection inside hospital ward with six beds with a partition in the middle, which acted like a wall. Changes in average rate of heat transfer in terms of average Nusselt numbers have also been recorded in tabular format and necessary comparison has been showed. It was found that partition narrowed the path for airflow and once the air overcame this barrier, it got free space and turbulence appeared. For higher turbulence, the average rate of heat transfer increased and patients near the turbulence zone released maximum heat and felt more comfortable.

  3. Challenges of the ward round teaching based on the experiences of medical clinical teachers

    Directory of Open Access Journals (Sweden)

    Kamran Soltani Arabshahi

    2015-01-01

    Full Text Available Background: Holding educational sessions in a clinical environment is a major concern for faculty members because of its special difficulties and restrictions. This study attempts to recognize the challenges of the ward round teaching through investigating the experiences of clinical teachers in 2011. Materials and Methods: This qualitative research is carried out through purposive sampling with maximum variation from among the clinical teachers of major departments in Isfahan University of Medical Sciences (9 persons. The sampling continued until data saturation. Data were collected through semi-structured interview and analyzed through Collaizzi method. Data reliability and validity was confirmed through the four aspects of Lincoln and Guba method (credibility, conformability, transferability, and dependability. Results: Three major themes and their related sub-themes (minor themes were found out including the factors related to the triad of clinical teaching (patient, learner, and clinical teacher (concern about patient′s welfare, poor preparation, lack of motivation, ethical problems, factors related to the educational environment (stressful environment, humiliating environment and poor communication and the factors related to the educational system of the clinical environment (poor organizing and arrangement of resources, poor system′s monitoring, bad planning and inadequate resource. Conclusion: Ward round teaching has many concerns for teachers, and this should be recognized and resolved by authorities and teachers. If these problems are not resolved, it would affect the quality of clinical teaching.

  4. Utilization Pattern of Antibiotics in Different Wards of Sari Imam Khomeini Teaching Hospital

    Directory of Open Access Journals (Sweden)

    M.A. Ebrahimzadeh, Ph.D.

    2007-01-01

    Full Text Available AbstractBackground and Purpose: Due to an increase in cases of irrational drug prescription and it's health and economic consequences, evaluation of the rational use of drugs seemed necessary. Among drug groups antibiotics are greatly significant.Materials and Methods: Utilization pattern of antibiotics in different wards of Sari Imam Khomeini teaching hospital in the first half of 2000 and 2005 were reviewed. ATC/DDD (Anatomic, Therapeutic, Chemical/ Defined Daily Dose methodology was used.Results: Data showed, use of antibiotics jumped from 95.4 DBDs (DDD per patient’s bed-days to 124 DBDs. Distribution of different class of anti-microbial, showed the highest increase in use of vancomycin and clindamycin. Use of cotrimoxazole and aminoglycosides remained fairly unchanged, howerrs consumption of Penicillin G dropped. In year 2005, ICU ward followed by gynecology, were among the University Hospital departments with the highest consumption of antibiotics. Cefazolin was the most prescribed antibiotics during this study.Conclusion: It appers that there is a need for more national drug policities and drug education program for health care professionals. Evaluation of drug distribution in hospitals seems to be necessary.Key words:

  5. Continuous pulse oximetry in the general surgical ward: Nellcor N-200 versus Nellcor N-3000

    DEFF Research Database (Denmark)

    Christensen, M; Lie, C; Rosenberg, J

    1999-01-01

    Symphony N-3000 with the Nellcor N-200 pulse oximeter, when monitoring patients in the general surgical ward. Twenty-two patients were monitored during unrestricted ward activities for a total of 275 h with a N-3000 and a N-200 pulse oximeter simultaneously. Data were analysed for lack of concordance...... between the two pulse oximeters with respect to frequency of registered hypoxaemic episodes and thus the amount of time spent in the alarm state. The median number of desaturation episodes with the N-200 was 18 (range 0-511) compared with four (range 0-476) with the N-3000 (p ... of drop-outs (loss of signal) was 13 (range 1-46) with the N-200 compared with nine (2-41) with the N-3000 (p = 0.06). The N-200 registered saturation values of 85% or below for 23% of the observation time compared with 6% of the observation time with the N-3000 pulse oximeter (p

  6. Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward

    Directory of Open Access Journals (Sweden)

    de Araújo Carlos José Soares

    2012-11-01

    Full Text Available Abstract Background Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. Methods This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failure treatment in a tertiary cardiology hospital. Patients in the intervention group performed a conventional rehabilitation and neuromuscular electrostimulation. Patients underwent 60 minutes of electrostimulation (wave frequency was 20 Hz, pulse duration of 20 us two times a day for consecutive days until hospital discharge. Results The walked distance in the six-minute walking test improved 75% in the electrostimulation group (from 379.7 ± 43.5 to 372.9 ± 46.9 meters to controls and from 372.9 ± 62.4 to 500 ± 68 meters to electrostimulation, p Conclusion The neuromuscular electrostimulation group showed greater improvement in the walked distance in the six-minute walking test in patients admitted to ward for compensation of heart failure.

  7. Etiologies of Prolonged Unconjugated Hyperbilirubinemia in Neonates Admitted to Neonatal Wards

    Directory of Open Access Journals (Sweden)

    Mohammad Kazem Sabzehei

    2015-12-01

    Full Text Available Background: Jaundice is a common condition among neonates. Prolonged unconjugated hyperbilirubinemia occurs when jaundice persists beyond two weeks in term neonates and three weeks in preterm neonates. This study aimed to determine the etiologies of prolonged unconjugated hyperbilirubinemia in infants admitted to the neonatal ward of Besat Hospital in Hamadan, Iran. Methods: This study was conducted on all infants diagnosed with prolonged unconjugated hyperbilirubinemia during 2007-2012 in the neonatal ward of Besat Hospital in Hamadan, Iran. Demographic characteristics of infants, physical examination and laboratory findings were collected and analyzed to determine the etiologies of neonatal hyperbilirubinemia. Results: In total, 100 infants diagnosed with neonatal hyperbilirubinemia were enrolled in this study, including 49 male and 51 female neonates with mean age of 20±1 days and mean bilirubin level of 17.5±4.0 mg/dL. Main causes of hyperbilirubinemia were urinary tract infection, ABO incompatibility, hypothyroidism and glucose-6-phosphate dehydrogenase deficiency in 14%, 5%, 6% and 5% of neonates, respectively. Moreover, unknown etiologies, such as breastfeeding, were detected in 70% of the studied infants. Conclusion: According to the results of this study, determining the main causes of prolonged unconjugated hyperbilirubinemia in neonates is of paramount importance. In the majority of cases, neonatal hyperbilirubinemia is associated with physiological factors, such as breastfeeding.

  8. Student attitudes towards the goals of an inter-professional training ward.

    Science.gov (United States)

    Wijma, M B

    1999-01-01

    For some years, a 14-day practice period in an inter-professional, integrated training ward has been a compulsory element for students in six programmes at the Faculty of Health Sciences (FHS) in Linkoping, Sweden.The main purposes of the training are to enable students to collaborate in teams and to understand the competences and skills of the other students, to recognize the needs of the patients and to practise and develop their own professional role. A process evaluation of the first year of this training ward focused on students' attitudes towards the goals of the integrated learning activity.Results show that students from all programmes, generally speaking, entered the training with high expectations and that these expectations changed very little, i.e.their expectations were satisfied.The ability to 'understand other competences and skills' had an impact as a result of the training and was the only goal showing a measurable change in a positive direction. As regards programmes, the student nurses were the most positive group. It seems that students representing caring professions, who will cooperate closely in the future, have the highest expectations of teamwork and development of their own professional role and that these expectations are satisfied. Students from medicine and the paramedical programmes were less positive regarding the goal of developing their own professional role. A possible goal conflict between teamwork and practising one's own professional role is discussed.

  9. Multidisciplinary case management for patients at high risk of hospitalization: comparison of virtual ward models in the United kingdom, United States, and Canada.

    Science.gov (United States)

    Lewis, Geraint; Wright, Lorraine; Vaithianathan, Rhema

    2012-10-01

    Virtual wards are a model for delivering multidisciplinary case management to people who are at high predicted risk of unplanned acute care hospitalization. First introduced in Croydon, England, in 2006, this concept has since been adopted and adapted by health care organizations in other parts of the United Kingdom and internationally. In this article, the authors review the model of virtual wards as originally described-with its twin pillars of (1) using a predictive model to identify people who are at high risk of future emergency hospitalization, and (2) offering these individuals a period of intensive, multidisciplinary preventive care at home using the systems, staffing, and daily routines of a hospital ward. The authors then describe how virtual wards have been modified and implemented in 6 sites in the United Kingdom, United States, and Canada where they are subject to formal evaluation. Like hospital wards, virtual wards vary in terms of patient selection, ward configuration, staff composition, and ward processes. Policy makers and researchers should be aware of these differences when considering the evaluation results of studies investigating the cost-effectiveness of virtual wards.

  10. The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors

    Directory of Open Access Journals (Sweden)

    Dijkgraaf Marcel G

    2011-05-01

    Full Text Available Abstract Background The potential of clinical interventions, aiming at reduction of preventable Adverse Drug Events (preventable ADEs during hospital stay, have been studied extensively. Clinical Pharmacy is a well-established and effective service, usually consisting of full-time on-ward participation of clinical pharmacists in medical teams. Within the current Hospital Pharmacy organisation in the Netherlands, such on-ward service is less feasible and therefore not yet established. However, given the substantial incidence of preventable ADEs in Dutch hospitals found in recent studies, appears warranted. Therefore, "Ward-Oriented Pharmacy", an on-ward service tailored to the Dutch hospital setting, will be developed. This service will consist of multifaceted interventions implemented in the Internal Medicine wards by hospital pharmacists. The effect of this service on preventable ADEs in elderly inpatients will be measured. Elderly patients are at high risk for ADEs due to multi-morbidity, concomitant disabilities and polypharmacy. Most studies on the incidence and preventability of ADEs in elderly patients have been conducted in the outpatient setting or on admission to a hospital, and fewer in the inpatient setting. Moreover, recognition of ADEs by the treating physicians is challenging in elderly patients because their disease presentation is often atypical and complex. Detailed information about the performance of the treating physicians in ADE recognition is scarce. Methods/Design The design is a multi-centre, interrupted time series study. Patients of 65 years or older, consecutively admitted to Internal Medicine wards will be included. After a pre-measurement, a Ward-Oriented Pharmacy service will be introduced and the effect of this service will be assessed during a post-measurement. The primary outcome measures are the ADE prevalence on admission and ADE incidence during hospital stay. These outcomes will be assessed using structured

  11. Conflicting priorities: evaluation of an intervention to improve nurse-parent relationships on a Tanzanian paediatric ward

    DEFF Research Database (Denmark)

    Manongi, Rachel N; Nasuwa, Fortunata R; Mwangi, Rose

    2009-01-01

    BACKGROUND: Patient, or parent/guardian, satisfaction with health care provision is important to health outcomes. Poor relationships with health workers, particularly with nursing staff, have been reported to reduce satisfaction with care in Africa. Participatory research approaches...... on a paediatric ward in a busy regional hospital in Tanzania. METHODS: The intervention consisted of six workshops, attended by 29 of 31 trained nurses and nurse attendants working on the paediatric ward. Parental satisfaction with nursing care was measured with 288 parents before and six weeks after...... such as the Health Workers for Change initiative have been successful in improving provider-client relationships in various developing country settings, but have not yet been reported in the complex environment of hospital wards. We evaluated the HWC approach for improving the relationship between nurses and parents...

  12. Clinical assessment and treatment in paediatric wards in the north-east of the United Republic of Tanzania

    DEFF Research Database (Denmark)

    Reyburn, Hugh; Mwakasungula, Emmanuel; Chonya, Semkini

    2008-01-01

    ; appropriate feeds were not present in any of the hospitals. A diagnosis of HIV-AIDS was made in only two cases while approximately 5% children admitted were expected to be infected with HIV in this area. CONCLUSION: Clinical assessment of children admitted to paediatric wards is disturbingly poor...... outpatient consultations were observed, and a record of care was extracted from the case notes of children on the paediatric ward. Additional data were collected from inspection of ward supplies and hospital reports. FINDINGS: Of 1181 outpatient consultations, basic clinical signs were often not checked; e.......g. of 895 children with a history of fever, temperature was measured in 57%, and of 657 of children with cough or dyspnoea only 57 (9%) were examined for respiratory rate. Among 509 inpatients weight was recorded in the case notes in 250 (49%), respiratory rate in 54 (11%) and mental state in 47 (9...

  13. Respiratory clinical guidelines inform ward-based nurses' clinical skills and knowledge required for evidence-based care.

    Science.gov (United States)

    Johnson, Alisha M; Smith, Sheree M S

    2016-09-01

    Respiratory clinical guidelines provide clinicians with evidence-based guidance for practice. Clinical guidelines also provide an opportunity to identify the knowledge and technical and non-technical skills required by respiratory ward-based registered nurses. The aim of this review was to use a systematic process to establish the core technical and non-technical skills and knowledge identified in evidence-based clinical guidelines that enable the care of hospitalised adult respiratory patients. 17 guidelines were identified in our systematic review. The quality assessment demonstrated variability in these guidelines. Common core knowledge and technical and non-technical skills were identified. These include pathophysiology, understanding of physiological measurements and monitoring, education, counselling, and ward and patient management. The knowledge and skills extracted from respiratory clinical guidelines may inform a curriculum for ward-based respiratory nursing to ensure optimal care of adult patients.

  14. Methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii on computer interface surfaces of hospital wards and association with clinical isolates

    Directory of Open Access Journals (Sweden)

    Ma Ling

    2009-10-01

    Full Text Available Abstract Background Computer keyboards and mice are potential reservoirs of nosocomial pathogens, but routine disinfection for non-water-proof computer devices is a problem. With better hand hygiene compliance of health-care workers (HCWs, the impact of these potential sources of contamination on clinical infection needs to be clarified. Methods This study was conducted in a 1600-bed medical center of southern Taiwan with 47 wards and 282 computers. With education and monitoring program of hand hygiene for HCWs, the average compliance rate was 74% before our surveillance. We investigated the association of methicillin-resistant Staphylococcus aureus (MRSA, Pseudomonas aeruginosa and Acinetobacter baumannii, three leading hospital-acquired pathogens, from ward computer keyboards, mice and from clinical isolates in non-outbreak period by pulsed field gel electrophoresis and antibiogram. Results Our results revealed a 17.4% (49/282 contamination rate of these computer devices by S. aureus, Acinetobacter spp. or Pseudomonas spp. The contamination rates of MRSA and A. baumannii in the ward computers were 1.1% and 4.3%, respectively. No P. aeruginosa was isolated. All isolates from computers and clinical specimens at the same ward showed different pulsotypes. However, A. baumannii isolates on two ward computers had the same pulsotype. Conclusion With good hand hygiene compliance, we found relatively low contamination rates of MRSA, P. aeruginosa and A. baumannii on ward computer interface, and without further contribution to nosocomial infection. Our results suggested no necessity of routine culture surveillance in non-outbreak situation.

  15. Four Simple Ward Based Initiatives to Reduce Unnecessary In-Hospital Patient Stay: A Quality Improvement Project

    Science.gov (United States)

    Shabbir, Asad; Wali, Gorav; Steuer, Alan

    2015-01-01

    Prolonged hospital stay not only increases financial stress on the National Health Service but also exposes patients to an unnecessarily high risk of adverse ward events. Each day accumulates approximately £225 in bed costs with additional risks of venousthromboembolism, hospital acquired infections, prescription errors, and falls. Despite being medically fit for discharge (MFFD), patients awaiting care packages with prolonged length of stay (LoS) have poorer outcomes and experience increased rates of mortality as a result. A six cycle prospective audit was carried out to investigate if four simple ward based initiatives could optimise patient flow through a medical ward and reduce LoS of inpatients awaiting social packages and placement. The four daily initiatives were: A morning board round between nurses and doctors to prioritise new or sick patients for early review.A post ward round meeting between the multidisciplinary team to expedite rehabilitation and plan discharges early.An evening board round to highlight which patients needed discharge paperwork for the next day to alleviate the wait for pharmacy.A ‘computer on wheels’ on ward rounds so investigations could be ordered and reviewed at the bedside allowing more time to address patient concerns. A control month in August 2013 and five intervention cycles were completed between September 2013 and January 2014. Prior to intervention, mean time taken for patients to be discharged with a package of care, once declared MFFD, was 25 days. With intervention this value dropped to 1 day. The total LoS fell from 46 days to 16 days. It was also found that the time taken from admission to MFFD status was reduced from 21 days to 15 days. In conclusion this data shows that with four simple modifications to ward behaviour unnecessary inpatient stay can be significantly reduced. PMID:26734432

  16. Four Simple Ward Based Initiatives to Reduce Unnecessary In-Hospital Patient Stay: A Quality Improvement Project.

    Science.gov (United States)

    Shabbir, Asad; Wali, Gorav; Steuer, Alan

    2015-01-01

    Prolonged hospital stay not only increases financial stress on the National Health Service but also exposes patients to an unnecessarily high risk of adverse ward events. Each day accumulates approximately £225 in bed costs with additional risks of venousthromboembolism, hospital acquired infections, prescription errors, and falls. Despite being medically fit for discharge (MFFD), patients awaiting care packages with prolonged length of stay (LoS) have poorer outcomes and experience increased rates of mortality as a result. A six cycle prospective audit was carried out to investigate if four simple ward based initiatives could optimise patient flow through a medical ward and reduce LoS of inpatients awaiting social packages and placement. The four daily initiatives were: A morning board round between nurses and doctors to prioritise new or sick patients for early review.A post ward round meeting between the multidisciplinary team to expedite rehabilitation and plan discharges early.An evening board round to highlight which patients needed discharge paperwork for the next day to alleviate the wait for pharmacy.A 'computer on wheels' on ward rounds so investigations could be ordered and reviewed at the bedside allowing more time to address patient concerns. A control month in August 2013 and five intervention cycles were completed between September 2013 and January 2014. Prior to intervention, mean time taken for patients to be discharged with a package of care, once declared MFFD, was 25 days. With intervention this value dropped to 1 day. The total LoS fell from 46 days to 16 days. It was also found that the time taken from admission to MFFD status was reduced from 21 days to 15 days. In conclusion this data shows that with four simple modifications to ward behaviour unnecessary inpatient stay can be significantly reduced.

  17. [Medium-term strategy for the specific management of pneumology hospitals and wards after the decentralization of the sanitary system].

    Science.gov (United States)

    Muşat, Simona Nicoleta; Ioniţa, Diana; Paceonea, Mirela; Chiriac, Nona Delia; Stoicescu, Ileana Paula; Mihălţan, F D

    2011-01-01

    Identifying and promoting new management techniques for the descentralized pneumology hospitals or wards was one of the most ambitious objectives of the project "Quality in the pneumology medical services through continuous medical education and organizational flexibility", financed by the Human Resourses Development Sectorial Operational Programme 2007-2013 (ID 58451). The "Medium term Strategy on the specific management of the pneumology hospitals or wards after the descentralization of the sanitary system" presented in the article was written by the project's experts and discussed with pneumology managers and local authorities representatives. This Strategy application depends on the colaboration of the pneumology hospitals with professional associations, and local and central authorities.

  18. Utilizing distributional analytics and electronic records to assess timeliness of inpatient blood glucose monitoring in non-critical care wards

    Directory of Open Access Journals (Sweden)

    Ying Chen

    2016-04-01

    Full Text Available Abstract Background Regular and timely monitoring of blood glucose (BG levels in hospitalized patients with diabetes mellitus is crucial to optimizing inpatient glycaemic control. However, methods to quantify timeliness as a measurement of quality of care are lacking. We propose an analytical approach that utilizes BG measurements from electronic records to assess adherence to an inpatient BG monitoring protocol in hospital wards. Methods We applied our proposed analytical approach to electronic records obtained from 24 non-critical care wards in November and December 2013 from a tertiary care hospital in Singapore. We applied distributional analytics to evaluate daily adherence to BG monitoring timings. A one-sample Kolmogorov-Smirnov (1S-KS test was performed to test daily BG timings against non-adherence represented by the uniform distribution. This test was performed among wards with high power, determined through simulation. The 1S-KS test was coupled with visualization via the cumulative distribution function (cdf plot and a two-sample Kolmogorov-Smirnov (2S-KS test, enabling comparison of the BG timing distributions between two consecutive days. We also applied mixture modelling to identify the key features in daily BG timings. Results We found that 11 out of the 24 wards had high power. Among these wards, 1S-KS test with cdf plots indicated adherence to BG monitoring protocols. Integrating both 1S-KS and 2S-KS information within a moving window consisting of two consecutive days did not suggest frequent potential change from or towards non-adherence to protocol. From mixture modelling among wards with high power, we consistently identified four components with high concentration of BG measurements taken before mealtimes and around bedtime. This agnostic analysis provided additional evidence that the wards were adherent to BG monitoring protocols. Conclusions We demonstrated the utility of our proposed analytical approach as a monitoring

  19. Bacterial contamination of the hands of doctors: A study in the medicine and dermatology wards

    Directory of Open Access Journals (Sweden)

    Rudrajit Paul

    2011-01-01

    Full Text Available Background: Doctors′ hands are a common source of bacterial contamination. Often, these organisms are found to be virulent species with multidrug-resistance patterns. These are the sources of nosocomial infections in many patients. Aims: The present study was undertaken to find out the prevalence of bacterial contamination in the hands of doctors in the Medicine and Dermatology wards of a tertiary care hospital. Methods: The hands of 44 doctors were swabbed and cultured at entry to ward and at exit. Then, tap water and alcohol swab wash techniques were used and further swabs were done at each step. Thus, each doctor was sampled four-times for the study. The antibiotic-sensitivity pattern of the organisms was determined by the disc-diffusion method. Results: There was a significant contamination of the doctors′ hands at entry (59.1% and at exit (90.9%. Overall, Staphylococcus was the predominant organism (59% at entry and 85% at exit; coagulase-negative ones were more prevalent at entry (32% and coagulase-positive ones were more prevalent at exit (54%. There was no difference in the hand contamination rates of junior and senior doctors. Also, the contamination rates were similar in the Medicine and Dermatology wards. Among the Gram negative organisms, Escherichia coli (4.5%, Pseudomonas (4.5%, Enterococci (13.6% and Klebsiella (9% were the main ones isolated. Gram negative organisms were significantly more prevalent at exit (P = 0.009 compared with their numbers at entry. Hand washing techniques reduced the contamination rates significantly, 76% with tap water wash and further 16.5% with alcohol swab. The removal rate for both groups of organisms was similar. Also, coagulase-positive and -negative Staphylococci showed equal rates of removal with hand washing (P = 0.9793. The organisms were found to be resistant to most of the commonly used antibiotics; the beta-lactam group was especially largely resistant both for Gram positive and Gram

  20. A Nurse's Survival Guide to the Ward - Third edition Richards Ann Edwards Sharon A Nurse's Survival Guide to the Ward - Third edition 500pp £19.99 Elsevier 978 0 7020 4603 2 0702046035 [Formula: see text].

    Science.gov (United States)

    2013-05-08

    This guide is a useful 'friend and companion' to keep close at hand. It is an essential reference for nurses, not only on the ward but in every field of practice where patient care is given. In fact, it makes an accessible guide for all healthcare practitioners.

  1. Using Gamification Combined with Indoor Location to Improve Nurses' Hand Hygiene Compliance in an ICU Ward.

    Science.gov (United States)

    Lapão, Luís Velez; Marques, Rita; Gregório, João; Pinheiro, Fernando; Póvoa, Pedro; Mira da Silva, Miguel

    2016-01-01

    Healthcare acquired infections are among the biggest unsolved problems in healthcare, implying an increasing number of deaths, extra-days of hospital stay and hospital costs. Performing hand hygiene is a simple and inexpensive prevention measure, but healthcare workers compliance with it is still far from optimal. Recognized hurdles are lack of time, forgetfulness, wrong technique and lack of motivation. This study aims at exploring gamification to promote nurses' HH compliance self-awareness and action. Real-time data collected from an indoor location system will provide feedback information to a group of nurses working in an ICU ward. In this paper both the research's motivation and methods is presented, along with the first round of results and its discussion.

  2. Design Parameters for Evaluating Light Settings and Light Atmosphere in Hospital Wards

    DEFF Research Database (Denmark)

    Stidsen, Lone; Kirkegaard, Poul Henning; Fisker, Anna Marie

    2010-01-01

    When constructing and designing Danish hospitals for the future, patients, staff and guests are in focus. It is found important to have a starting point in healing architecture and create an environment with knowledge of users sensory and functionally needs and looks at how hospital wards can...... support patients’ experience or maybe even have a positive influence on the recovery process. Thus at a general level, it is a crucial task to investigate how aspects such as the design of the environment, arts, lights, sounds can support and improve the patients’ recovery rate and the satisfaction...... of staff and guests in the future hospital. This paper is based on Böhmes G. concept of atmosphere dealing with the effect of light in experiencing atmosphere, and the importance having a holistic approach when designing a pleasurable light atmosphere. It shows important design parameters for pleasurable...

  3. Patients' experiences of postoperative intermediate care and standard surgical ward care after emergency abdominal surgery

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Vester-Andersen, Morten; Nielsen, Martin Vedel

    2015-01-01

    AIMS AND OBJECTIVES: To elicit knowledge of patient experiences of postoperative intermediate care in an intensive care unit and standard postoperative care in a surgical ward after emergency abdominal surgery. BACKGROUND: Emergency abdominal surgery is common, but little is known about how...... patients experience postoperative care. The patient population is generally older with multiple comorbidities, and the short-term postoperative mortality rate is 15-20%. Thus, vigilant surgeon and nursing attention is essential. The present study is a qualitative sub-study of a randomised trial evaluating...... postoperative intermediate care after emergency abdominal surgery, the InCare trial. DESIGN: A qualitative study with individual semi-structured interviews. METHODS: We analysed interviews using Systematic Text Condensation. RESULTS: Eighteen patients (nine intervention/nine controls) were strategically sampled...

  4. HOSPITAL’S WALL COLOUR IMPACT ON STROKE PATIENTS’ WARD USERS IN SURABAYA

    Directory of Open Access Journals (Sweden)

    Tanuwidjaja GUNAWAN

    2015-12-01

    Full Text Available The Cardiovascular diseases have become the top killer since 1970 worldwide. In 2005, it was recorded the present of 5.7 million stroke survivors. On the other hand, healing stroke and its related complications required much more considerable time. So the patients’ wards quality especially related to wall colour become very important for the patients' recovery. The study was conducted with exploratory methods combining visual methods of research and Luscher colour test. Series of interviews were conducted to gather the users’ perception. So, it was found on that blue wall colour calmed the medical personals, patients, and their family. The most soothing Blue colour variant according to respondents was the Artic Blue (hue 9.8 B, value 7.4 and chroma 5.6.

  5. Ventilatory pattern and associated episodic hypoxaemia in the late postoperative period in the general surgical ward

    DEFF Research Database (Denmark)

    Rosenberg, J; Rasmussen, G I; Wøjdemann, K R;

    1999-01-01

    Episodic oxygen desaturation is frequent in the late postoperative period and seems most pronounced on the second and third postoperative nights. However, the ventilatory pattern has not been described systematically during this period. We studied the ventilatory pattern and associated arterial...... oxygenation using the Edentrace II equipment (impedance pneumography and pulse oximetry) on the second and third postoperative nights in 28 patients undergoing major abdominal surgery. Ventilatory disturbances were common and included periods of hypopnoea, and obstructive, central and mixed apnoeas. Overall...... disturbances. Overall, 23% (0-100) of the hypopnoeas and 7% (0-100) of the apnoeas were associated with episodic hypoxaemia. In conclusion, ventilatory disturbances were common in the late postoperative period in the general surgical ward and often associated with episodes of oxygen desaturation....

  6. Paediatric early warning scores on a children's ward: a quality improvement initiative.

    LENUS (Irish Health Repository)

    Ennis, Linda

    2014-09-09

    The aim of this quality improvement initiative was to incorporate a paediatric early warning score (PEWS) and track and trigger system in the routine care of children in an acute general children\\'s ward at a regional hospital in the Republic of Ireland. In the absence of a nationally recommended specific PEWS strategy, a local plan was developed. The experience of structuring and implementing the PEWS and track and trigger system is presented in this article. Data from the first year of use were collected to evaluate the clinical utility and effectiveness of this system. In the busy acute children\\'s service, the PEWS initiative was found to benefit processes of early detection, prompt referral and timely, appropriate management of children at potential risk of clinical deterioration. Nursing staff were empowered and supported to communicate concerns immediately and to seek rapid medical review, according to an agreed PEWS escalation plan. Outcomes were significantly improved.

  7. Effects of discontinuing cover gowns on a postpartal ward upon cord colonization of the newborn.

    Science.gov (United States)

    Renaud, M T

    1983-01-01

    To determine if the incidence of bacterial cord colonization in neonates increased when cover gowns were discontinued on a postpartal ward, a study was conducted. All infants who were admitted to and discharged from the well infant nursery at an Army medical center in Denver, Colorado, were cultured at the umbilicus at the time of admission and at discharge. The control group (N = 74) continued to gown as usual; the experimental group (N = 50) did not wear gowns. Visitors in both groups received the same instructions regarding handwashing. For all organisms, the control group demonstrated 80% colonization of infants who were negative on admission, and the experimental group demonstrated a colonization rate of 62%. When the chi square is applied, these data are statistically significant for P = 0.02 and P = 0.05. The experimental group had less colonization than the control group.

  8. An analysis of population and social change in London wards in the 1980s.

    Science.gov (United States)

    Congdon, P

    1989-01-01

    "This paper discusses the estimation and projection of small area populations in London, [England] and considers trends in intercensal social and demographic indices which can be calculated using these estimates. Information available annually on vital statistics and electorates is combined with detailed data from the Census Small Area Statistics to derive demographic component based population estimates for London's electoral wards over five year periods. The availability of age disaggregated population estimates permits derivation of small area social indicators for intercensal years, for example, of unemployment and mortality. Trends in spatial inequality of such indicators during the 1980s are analysed and point to continuing wide differentials. A typology of population and social indicators gives an indication of the small area distribution of the recent population turnaround in inner London, and of its association with other social processes such as gentrification and ethnic concentration."

  9. Acute bacterial skin and skin structure infections in internal medicine wards: old and new drugs.

    Science.gov (United States)

    Falcone, Marco; Concia, Ercole; Giusti, Massimo; Mazzone, Antonino; Santini, Claudio; Stefani, Stefania; Violi, Francesco

    2016-08-01

    Skin and soft tissue infections (SSTIs) are a common cause of hospital admission among elderly patients, and traditionally have been divided into complicated and uncomplicated SSTIs. In 2010, the FDA provided a new classification of these infections, and a new category of disease, named acute bacterial skin and skin structure infections (ABSSSIs), has been proposed as an independent clinical entity. ABSSSIs include three entities: cellulitis and erysipelas, wound infections, and major cutaneous abscesses This paper revises the epidemiology of SSTIs and ABSSSIs with regard to etiologies, diagnostic techniques, and clinical presentation in the hospital settings. Particular attention is owed to frail patients with multiple comorbidities and underlying significant disease states, hospitalized on internal medicine wards or residing in nursing homes, who appear to be at increased risk of infection due to multi-drug resistant pathogens and treatment failures. Management of ABSSSIs and SSTIs, including evaluation of the hemodynamic state, surgical intervention and treatment with appropriate antibiotic therapy are extensively discussed.

  10. Self-Dual Supersymmetry and Supergravity in Atiyah-Ward Space-Time

    CERN Document Server

    Ketov, S V; Gates, S J; Ketov, Sergei V.; Nishino, Hitoshi

    1993-01-01

    We study supersymmetry and self-duality in a four-dimensional space-time with the signature (2,2), that we call the Atiyah-Ward space-time. Dirac matrices and spinors, in particular Majorana-Weyl spinors, are investigated in detail. We formulate $ N\\ge 1 $ supersymmetric self-dual Yang-Mills theories and self-dual supergravities. An N=1 ``self-dual'' tensor multiplet is constructed and a possible ten-dimensional theory that gives rise to the four-dimensional self-dual supersymmetric theories is found. Instanton solutions are given as the zero modes in the N=2 self-dual Yang-Mills theory. The N=2 superstrings are conjectured to have no possible counter-terms at quantum level to all orders. These self-dual supersymmetric theories are to generate exactly soluble supersymmetric systems in lower dimensions.

  11. The effects of introducing a clinical pharmacist on orthopaedic wards in Denmark

    DEFF Research Database (Denmark)

    Buck, Thomas Croft; Brandstrup, Lene; Brandslund, Ivan;

    2007-01-01

    prescription practice. Prescriptions not following good practice in these intervention areas were defined as "sub-optimal prescriptions," and then discussed between a physician and a clinical pharmacist. The primary parameter was the difference in the number of days with a sub-optimal prescription (Mann...... sub-optimal prescriptions were changed, 43% resulted in cost reductions. The reductions achieved could cover 47% of the costs of clinical pharmacy service. CONCLUSION: Clinical pharmacy services offered to four orthopaedic surgical wards resulted in reduction of sub-optimal prescriptions. Every time...... the pharmacist screened seven patients one sub-optimal prescription was found and adjusted. The reduction in medicine costs due to adjusted sub-optimal prescriptions could not cover the whole cost of clinical pharmacy service....

  12. Causal perturbation theory in terms of retarded products, and a proof of the action Ward identity

    Energy Technology Data Exchange (ETDEWEB)

    Duetsch, M. [Zurich Univ. (Switzerland). Inst. fuer Theoretische Physik; Fredenhagen, K. [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik

    2004-09-01

    In the framework of perturbative algebraic quantum field theory a local construction of interacting fields in terms of retarded products is performed, based on earlier work of Steinmann. In our formalism the entries of the retarded products are local functionals of the off shell classical fields, and we prove that the interacting fields depend only on the action and not on terms in the Lagrangian which are total derivatives, thus providing of proof of Stora's Action Ward Identity'. The theory depends on free parameters which flow under the renormalization group. This flow can be derived in our local framework independently of the infrared behavior, as was first established by Hollands and Wald. We explicitly compute non-trivial examples for the renormalization of the interaction and the field. (orig.)

  13. Estimating the unquenched strange quark mass from the lattice axial Ward identity

    Energy Technology Data Exchange (ETDEWEB)

    Goeckeler, M. [Regensburg Univ. (Germany). Inst. fuer Physik 1 - Theoretische Physik; Horsley, R.; Zanotti, J.M. [Edinburgh Univ. (United Kingdom). School of Physics; Irving, A.C.; Rakow, P.E.L. [Liverpool Univ. (United Kingdom). Dept. of Mathematical Sciences; Pleiter, D. [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC; Schierholz, G. [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC]|[Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Stueben, H. [Konrad-Zuse-Zentrum fuer Informationstechnik Berlin (ZIB) (Germany)

    2006-01-15

    We present a determination of the strange quark mass for two flavours (n{sub f}=2) of light dynamical quarks using the axial Ward identity. The calculations are performed on the lattice using O(a) improved Wilson fermions and include a fully non-perturbative determination of the renormalisation constant. In the continuum limit we find m{sub s}{sup MS} (2 GeV)=111(6)(4)(6) MeV, using the force scale r{sub 0}=0.467 fm, where the first error is statistical, the second and third are systematic due to the fit and scale uncertainties respectively. Results are also presented for the light quark mass and the chiral condensate. The corresponding results are also given for r{sub 0}=0.5 fm. (orig.)

  14. Changes in Emotion Work at Interdisciplinary Conferences Following Clinical Supervision in a Palliative Outpatient Ward

    DEFF Research Database (Denmark)

    Nordentoft, Helle Merete

    2008-01-01

    In this article, I describe changes in emotion work at weekly interdisciplinary conferences in a palliative1 outpatient ward following clinical supervision (CS). I conceive emotions as constantly negotiated in interaction, and I researched the similarity between how this is done during CS...... and at interdisciplinary conferences following CS. In this respect, CS is seen as a particular discursive practice for emotion work. The findings show how conferences following supervision become inspired by the "language game" in CS, initiating metaperspectives on the care and treatment of patients....... These metaperspectives illuminate a dual aspect of care in the sense that it serves the needs not only of patients but also team members. I argue that this recognition captures one of the great challenges in palliative care, namely, to separate the carer's own needs and emotions from those of patients. I therefore...

  15. Patients' characteristics and healthcare providers' perceived workload in French hospital emergency wards.

    Science.gov (United States)

    Schoenenberger, Sandrine; Moulin, Pierre; Brangier, Eric; Gilibert, Daniel

    2014-01-01

    The aim of this research is to understand how patients' characteristics increase healthcare providers' perceived workload. Patients' characteristics and dependency, technical and relational complexities of care seem to increase healthcare providers' workload. As workload is multidimensional, we examine which dimensions are affected by patients' characteristics. Our methodology is based on 121 patients assessed with the NASA task load index (NASA-TLX) and a questionnaire filled in by 57 health providers in 2 emergency wards in French hospital settings, to evaluate their attitudes to different patients' characteristics. Our results show that physical demand is the dimension most affected by patients' behaviour and characteristics. Next, we observe that workload increases more due to patients' behaviour than their social characteristics. We propose that a regulation mechanism be taken into account in further research, using methodology based on observations to identify how healthcare providers might adapt their activities to compensate for workload variations caused by patients.

  16. Cultural Construction of Military Patients Ward%谈军人病区文化建设

    Institute of Scientific and Technical Information of China (English)

    闫军峰; 周文斌; 李丹

    2014-01-01

    More and more attentions have been paid to the military grassroots culture and hospital culture . As a special unit of military hospital serving the army , military patients ward focused on building culture , promoting the physical and mental health of patients and a speedy recovery , ensuring battle effectiveness, increasing the mili-tary patients’satisfaction.%部队基层文化和医院文化都受到越来越多的重视。军人病区作为部队医院为部队服务的一个特殊单元,建设军人病区文化,促进伤病员的身心健康和早日康复,保障部队战斗力,提高部队满意度,本院作了一些初步的尝试和探索。

  17. Ward Identity and Homes' Law in a Holographic Superconductor with Momentum Relaxation

    CERN Document Server

    Kim, Keun-Young; Park, Miok

    2016-01-01

    We study three properties of a holographic superconductor related to conductivities, where momentum relaxation plays an important role. First, we find that there are constraints between electric, thermoelectric and thermal conductivities. The constraints are analytically derived by the Ward identities regarding diffeomorphism from field theory perspective. We confirm them by numerically computing all two-point functions from holographic perspective. Second, we investigate Homes' law and Uemura's law for various high-temperature and conventional superconductors. They are empirical and (material independent) universal relations between the superfluid density at zero temperature, the transition temperature, and the electric DC conductivity right above the transition temperature. In our model, it turns out that the Homes' law does not hold but the Uemura's law holds at small momentum relaxation related to coherent metal regime. Third, we explicitly show that the DC electric conductivity is finite for a neutral sc...

  18. BRST quantization and canonical Ward identity of the supersymmetric electromagnetic interaction system

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    According to the method of path integral quantization for the canonical constrained system in Becchi-Rouet-Stora-Tyutin scheme, the supersymmetric electromagnetic interaction system was quantized. Both the Hamiltonian of the supersymmetric electromagnetic interaction system in phase space and the quantization procedure were simplified. The BRST generator was constructed, and the BRST transforma- tions of supersymmetric fields were gotten; the effective action was calculated, and the generating functional for the Green function was achieved; also, the gauge generator was constructed, and the gauge transformation of the system was ob- tained. Finally, the Ward-Takahashi identities based on the canonical Noether theorem were calculated, and two relations between proper vertices and propaga- tors were obtained.

  19. Feasibility of Progressive Strength Training Implemented in the Acute Ward after Hip Fracture Surgery

    DEFF Research Database (Denmark)

    Kronborg, Lise; Bandholm, Thomas; Palm, Henrik;

    2014-01-01

    IMPORTANCE: Patients with a hip fracture lose more than 50% knee-extension strength in the fractured limb within one week of surgery. Hence, immediate progressive strength training following hip fracture surgery may be rational, but the feasibility unknown. OBJECTIVE: To examine the feasibility...... of in-hospital progressive strength training implemented in the acute ward following hip fracture surgery, based on pre-specified criteria for feasibility. DESIGN, SETTING AND PATIENTS: A prospective cohort study conducted in an acute orthopedic hip fracture unit at a university hospital. A consecutive...... sample of 36 patients, 18 with a cervical and 18 with a trochanteric hip fracture (27 women and 9 men, mean (SD) age of 79.4 (8.3) years) were included between June and December 2012. INTERVENTION: A daily (on weekdays) program of progressive knee-extension strength training for the fractured limb, using...

  20. Assessing the safety and quality of ward-based renal transplant biopsies

    Directory of Open Access Journals (Sweden)

    Kenneth Wu

    2010-10-01

    Full Text Available Kenneth Wu1, Bindhu Musunuru1, Chera Arunachalam1, Aung Sett1, Paul Musker21Renal Unit, St James’ University Hospital, Leeds, West Yorkshire, UK; 2Renal Unit, St Luke’s Hospital, Bradford, West Yorkshire, UKAbstract: The aim of this pilot study was to compare renal transplant biopsies carried out by ward-based nephrology trainees and departmental based radiologists, primarily reviewing major complications and glomerular yield. There was only one patient who developed a single episode of major complication out of the 145 procedures recorded. We concluded there is no significant difference in complication rate and glomerular yield for renal allograft biopsies between nephrology trainees and radiologists, regardless of location.Keywords: renal transplant, kidney biopsy complications, renal hemorrhage, glomerular yield

  1. Leadership in practice: an analysis of collaborative leadership in the conception of a virtual ward.

    Science.gov (United States)

    Stockham, Alayne

    2016-09-30

    The National Health Service (NHS) in the UK is evolving to meet the needs of society, but success depends on effective leadership. The World Health Organization identified intersectoral and multidisciplinary working as key to improving the quality and sustainability of the service, highlighting the need for a new leadership style. This article describes how collaborative leadership was used to successfully implement a virtual ward in the primary care setting in south-east Powys, Wales. The author describes the leadership style and addresses strategies used to manage the change process. The journey demonstrates how collaborative leadership and working collectively enabled a new service to be developed, and established a mutual respect for different professionals' roles.

  2. Interaction between Nurses and Hospitalized Drug Users in Somatic Hospital Wards

    DEFF Research Database (Denmark)

    Kappel, Nanna

    drugs are inpatients in somatic hospital wards. Aim: The project wants to enlighten the meeting between the drug user and the nurse in the hospital. Which roles do the nurses and the users carry and what will the meaning be of former experiences of the drug users of the health care system in the meeting...... the understandings of the nurses which will contribute to the feeling of stigmatization of users of hard drugs when in contact with the health care system. By virtue of their profession and position nurses have a big influence on how citizens while admitted to hospital feel accepted and welcomed. Nurses are subdued...... rules and regulations when performing their task, but are also obliged to offer nursing of high quality to all patients. Drug users have high frequency of morbidity compared to other citizens. Due to their somewhat chaotic lifestyle they get severe infections, wounds, injection damages, and therefore...

  3. Oxygen therapy multicentric study--a nationwide audit to oxygen therapy procedures in internal medicine wards.

    Science.gov (United States)

    Neves, J T; Lobão, M J

    2012-01-01

    Oxygen therapy is a common and important treatment in Internal Medicine wards, however, several studies report that it isn't provided accordingly with the best of care. The goal of this work is to evaluate oxygen therapy procedures in Portuguese Internal Medicine wards, comparing them to the standards established by the British Thoracic Society (BTS) in its consensus statement "BTS guideline for emergency oxygen use in adult patients". Between September 3rd and 23rd 2010, each one of the 24 enrolled hospitals audited the oxygen therapy procedures for one randomly chosen day. All Internal Medicine inpatients under oxygen therapy or with oxygen prescription were included. Data was collected regarding oxygen prescription, administration and monitoring. Of the 1549 inpatients, 773 met inclusion criteria. There was an oxygen prescription in 93,4%. Most prescriptions were by a fixed dose (82,4%), but only 11,6% of those stated all the required parameters. Absence of oxygen therapy duration and monitoring were the most frequent errors. Oxygen was administered to only 77,0% of the patients with fixed dose prescriptions. FiO(2) or flow rate and the delivery device were the same as prescribed in 70,9 and 89,2% of the patients, respectively. Out of the 127 patients with oxygen therapy prescriptions by target SatO(2) range, 82,7% were on the prescribed SatO(2) objective range. Several errors were found in oxygen therapy procedures, particularly regarding fixed dose prescriptions, jeopardizing the patients. Although recommended by BTS, oxygen therapy prescriptions by target SatO(2) range are still a minority.

  4. Frequency, types, and direct related costs of medication errors in an academic nephrology ward in Iran.

    Science.gov (United States)

    Gharekhani, Afshin; Kanani, Negin; Khalili, Hossein; Dashti-Khavidaki, Simin

    2014-09-01

    Medication errors are ongoing problems among hospitalized patients especially those with multiple co-morbidities and polypharmacy such as patients with renal diseases. This study evaluated the frequency, types and direct related cost of medication errors in nephrology ward and the role played by clinical pharmacists. During this study, clinical pharmacists detected, managed, and recorded the medication errors. Prescribing errors including inappropriate drug, dose, or treatment durations were gathered. To assess transcription errors, the equivalence of nursery charts and physician's orders were evaluated. Administration errors were assessed by observing drugs' preparation, storage, and administration by nurses. The changes in medications costs after implementing clinical pharmacists' interventions were compared with the calculated medications costs if the medication errors were continued up to patients' discharge time. More than 85% of patients experienced medication error. The rate of medication errors was 3.5 errors per patient and 0.18 errors per ordered medication. More than 95% of medication errors occurred at prescription nodes. Most common prescribing errors were omission (26.9%) or unauthorized drugs (18.3%) and low drug dosage or frequency (17.3%). Most of the medication errors happened on cardiovascular drugs (24%) followed by vitamins and electrolytes (22.1%) and antimicrobials (18.5%). The number of medication errors was correlated with the number of ordered medications and length of hospital stay. Clinical pharmacists' interventions decreased patients' direct medication costs by 4.3%. About 22% of medication errors led to patients' harm. In conclusion, clinical pharmacists' contributions in nephrology wards were of value to prevent medication errors and to reduce medications cost.

  5. Incidence of nutritional support complications in patient hospitalized in wards. multicentric study

    Directory of Open Access Journals (Sweden)

    Gloria María Agudelo Ochoa

    2012-06-01

    Full Text Available Introduction: Nutritional support generates complications that must be detected and treated on time. Objective: To estimate the incidence of some complications of nutritional support in patients admitted to general hospital wards who received nutritional support in six high-complexity institutions. Methods: Prospective, descriptive and multicentric study in patients with nutritional support; the variables studied were medical diagnosis, nutritional condition, nutritional support duration, approach, kind of formula, and eight complications. Results: A total of 277 patients were evaluated; 83% received enteral nutrition and 17% received parenteral nutrition. Some 69.3% presented risk of malnourishment or severe malnourishment at admittance. About 35.4% of those receiving enteral nutrition and 39.6% of the ones who received parenteral nutrition had complications; no significant difference per support was found (p = 0.363. For the enteral nutrition, the most significant complication was the removal of the catheter (14%, followed by diarrhea (8.3%; an association between the duration of the enteral support with diarrhea, constipation and removal of the catheter was found (p < 0.05. For parenteral nutrition, hyperglycemia was the complication of highest inci­dence (22.9%, followed by hypophosphatemia (12.5%; all complications were associated with the duration of the support (p < 0.05. Nutritional support was suspended in 24.2% of the patients. Conclusions: Complications with nutritional support in hospital-ward patients were frequent, with the removal of the catheter and hyperglycemia showing the highest incidence. Duration of the support was the variable that revealed an asso­ciation with complications. Strict application of protocols could decrease the risk for complications and boost nutritional support benefits.

  6. Nature and frequency of medication errors in a geriatric ward: an Indonesian experience

    Directory of Open Access Journals (Sweden)

    Ernawati DK

    2014-06-01

    Full Text Available Desak Ketut Ernawati,1,2 Ya Ping Lee,2 Jeffery David Hughes21Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia; 2School of Pharmacy and Curtin Health Innovation and Research Institute, Curtin University, Perth, WA, AustraliaPurpose: To determine the nature and frequency of medication errors during medication delivery processes in a public teaching hospital geriatric ward in Bali, Indonesia.Methods: A 20-week prospective study on medication errors occurring during the medication delivery process was conducted in a geriatric ward in a public teaching hospital in Bali, Indonesia. Participants selected were inpatients aged more than 60 years. Patients were excluded if they had a malignancy, were undergoing surgery, or receiving chemotherapy treatment. The occurrence of medication errors in prescribing, transcribing, dispensing, and administration were detected by the investigator providing in-hospital clinical pharmacy services.Results: Seven hundred and seventy drug orders and 7,662 drug doses were reviewed as part of the study. There were 1,563 medication errors detected among the 7,662 drug doses reviewed, representing an error rate of 20.4%. Administration errors were the most frequent medication errors identified (59%, followed by transcription errors (15%, dispensing errors (14%, and prescribing errors (7%. Errors in documentation were the most common form of administration errors. Of these errors, 2.4% were classified as potentially serious and 10.3% as potentially significant.Conclusion: Medication errors occurred in every stage of the medication delivery process, with administration errors being the most frequent. The majority of errors identified in the administration stage were related to documentation. Provision of in-hospital clinical pharmacy services could potentially play a significant role in detecting and preventing medication errors.Keywords: geriatric, medication errors, inpatients, medication delivery process

  7. Teaching teamwork: an evaluation of an interprofessional training ward placement for health care students

    Directory of Open Access Journals (Sweden)

    Morphet J

    2014-06-01

    Full Text Available Julia Morphet,1 Kerry Hood,2 Robyn Cant,2 Julie Baulch,3 Alana Gilbee,3 Kate Sandry4 1School of Nursing and Midwifery, Monash University, Frankston, Victoria, Australia; 2School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia; 3Southern Clinical School, Monash University, Monash Health, Clayton, Victoria, Australia; 4Dandenong Emergency Department, Monash Health, David St, Dandenong, Victoria, Australia Abstract: The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students' educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student "teams" leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the "inner circle", or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38, students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students' clinical learning and preparation for practice

  8. The impact of a large-scale quality improvement programme on work engagement: Preliminary results from a national cross-sectional-survey of the 'Productive Ward'

    LENUS (Irish Health Repository)

    White, Mark

    2014-05-14

    Quality improvement (QI) Programmes, like the Productive Ward: Releasing-time-to-care initiative, aim to \\'engage\\' and \\'empower\\' ward teams to actively participate, innovate and lead quality improvement at the front line. However, little is known about the relationship and impact that QI work has on the \\'engagement\\' of the clinical teams who participate and vice-versa.

  9. Exploration of staff attitudes and experiences towards mixed- and single-sex wards in the National Secure Forensic Service for Young People.

    Science.gov (United States)

    Crutchley, Michael; O'Brien, Aileen

    2012-10-01

    Mixed-sex wards in adult forensic secure services have been abolished and replaced by single-sex services. The National Secure Forensic Service for Young People (NSFSYP) continues to use a mixture of single-sex male and mixed-sex wards. This study aimed to explore staff experiences and attitudes towards placing young people in mixed- or single-sex wards in the NSFSYP. Mixed methodology was adopted in the form of focus groups (qualitative) and questionnaires (semi-quantitative). Content analyses of the qualitative data revealed five themes: care of female patients, normalization, safety, commissioning and social representation of women. The questionnaire was developed from the qualitative findings and comprised 22 statements measuring attitudes towards mixed- and single-sex wards. One hundred and forty-five questionnaires were returned: a 44% total response rate. Overall, the responses to the questionnaire confirmed the focus group data. There were statistically significant differences in responses between staff working on mixed- and single-sex wards. Staff working on mixed-sex wards felt that mixing genders on wards is a crucial part of adolescent forensic inpatient treatment. For them, mixed wards provide a more developmentally appropriate environment for young people. The needs of female patients broaden the debate beyond segregating and mixing gender.

  10. Expectations and needs of persons with family members in an intensive care unit as opposed to a general ward.

    Science.gov (United States)

    Foss, K R; Tenholder, M F

    1993-04-01

    The positive effect of family support on the outcome from serious illness that requires intensive care has been recognized by clinicians for decades. We have all seen that family visitation and an intensive care environment more similar to that of a general ward (sunlight, radio, television) can benefit patients with psychosis related to intensive care. The severity of illness of the individual patient exerts a powerful stress on the family unit, but it has been difficult to measure this effect. We used a 40-question family needs survey with a degree of importance scale to compare the intensive care unit (ICU) with the general ward in terms of impact on the family. Five needs were found to discriminate these two environments. The family members of patients in an ICU considered it very important (1) for staff to give directions on what to do at the bedside, (2) to receive more support from their own family unit, (3) to have a place to be alone as a family unit in the hospital, (4) to be informed in advance of any transfer plan, and (5) to have flexibility in the time allowed for visitation. Family members are willing to accept decreased visitation time if the physicians and nurses can equate this decrease with the complexity of care in the ICU. The results of this survey have helped us modify and individualize our approach based on family expectations especially when patients are transferred from the general ward to the ICU or from the ICU to the ward.

  11. Prevalence of potential drug–drug interactions among internal medicine ward in University of Gondar Teaching Hospital, Ethiopia

    Directory of Open Access Journals (Sweden)

    Akshaya Srikanth Bhagavathula

    2014-05-01

    Conclusion: We have recorded a high rate of prevalence of potential DDI in the internal medicine ward of UOG hospital and a high number of clinically significant DDIs which the most prevalent DDI were of moderate severity. Careful selection of drugs and active pharmaceutical care is encouraged in order to avoid negative consequences of these interactions.

  12. Cross Infection in Hospital Wards with Downward Ventilation - Different Locations of Return Openings without and with Partitions between Beds

    DEFF Research Database (Denmark)

    Nielsen, Peter V.; Li, Yuguo; Buus, Morten;

    2009-01-01

    A two-bed hospital ward with one standing healthcare assistant and a ceiling-mounted low-impulse semicircular inlet diffuser is simulated in a full-scale room. Tracer gas is used for simulating gaseous contaminants, and the concentration is measured at different air change rates and different pos...

  13. Non-linear supersymmetric {sigma}-models and their gauging in the Atiyah-Ward space-time

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, M.; Vilar, L.C.Q.; Helayel-Neto, J.A.

    1995-10-01

    We present a supersymmetric non-linear {sigma}-model built up in the N 1 superspace of Atiyah-ward space-time. A manifold of the Kaehler type comes out that is restricted by a a particular decomposition of the Kaehler potential. The gauging of the {sigma}-model isometries is also accomplished in superspace. (author). 20 refs.

  14. Identification and characteristics of imipenem-resistant Acinetobacter baumannii in surgical wards in a Chinese university hospital.

    Science.gov (United States)

    Wang, Dalin; Ma, Linlin; Wu, Zhenyu; Li, Mingcheng; Li, Xiaohan; Zhang, Wei; Chen, Kun

    2015-03-01

    The aim of this study was to investigate the prevalence and characteristics of imipenem-resistant Acinetobacter baumanni isolated from surgical wards in a university hospital, China. A total of 143 non-duplicate A. baumannii were isolated from 517 inpatients in surgery intensive care units (ICUs), burn wards, and general surgery wards. Of these, 102 isolates of A. baumannii (71.3%) were resistant to imipenem. Among imipenem-resistant isolates, all isolates were resistant to almost all antimicrobial agents except polymyxin E, all isolates were positive for blaOXA-23 and blaOXA-51 in addition to ISAba1, 52 (51%) were positive for blaOXA-58, 8 (7.8%) contained blaVIM-2, which co-harbored with blaOXA-58. Molecular typing revealed the presence of three clones among imipenem-resistant isolates. This study confirmed that A. baumannii strains harboring OXA or VIM type β-lactamases are widely distributed throughout the surgery wards. The data demonstrate that there was a high prevalence of imipenem-resistant A. baumannii infection in the region.

  15. Automated auditory brainstem response: Its efficacy as a screening tool for neonatal hearing screening in the postnatal ward

    Directory of Open Access Journals (Sweden)

    Chavakula Rajkumar

    2016-01-01

    Full Text Available Introduction: This observational study was carried out to determine the sensitivity and specificity of MB11 BERAphone® , when used for neonatal hearing screening in a postnatal ward setting in comparison against the gold standard, auditory brainstem response (ABR. Materials and Methods: Thirty-seven consecutive newborns (74 ears who either unilaterally or bilaterally failed hearing screening with MB11 BERAphone in the postnatal ward were recruited and a second screening with BERAphone was performed after 1 week along with confirmatory testing using ABR. Results: MB11 BERAphone showed sensitivity of 92.9%, specificity of 50%, positive predictive value of 30.23%, and negative predictive value of 96.77% for the diagnosis of hearing loss. The prevalence of confirmed hearing impairment was 18.9%. The rate of unilateral impairment was 10.8%, and the rate of bilateral impairment was 13.5%. The average ambient noise levels in the postnatal ward setting was 62.1 dB. Conclusion: Although the sensitivity of MB11 BERAphone is good, the specificity is significantly lower when the test is performed in the postnatal ward setting with high ambient noise. Neonates who fail the two-step screening should undergo auditory response for confirming the diagnosis of hearing loss.

  16. 特需病房优质护理服务探讨%High Quality Nursing Serviceof Special Wards

    Institute of Scientific and Technical Information of China (English)

    曹小丽

    2016-01-01

    Special wards is hospital in order to meet the needs of special treatment,and set up a special ward,many kinds of diseases. Patients with high quality,in order to improve the quality of nursing in our hospital ward,to carry out high quality nursing service mode in special wards,through perfect the rules and regulations of the department,make abundant nursing content and target,strengthen the nursing staff's professional knowledge and professional skil s training,pay attention to patients' end-of-life care measures,make the special wards of holistic nursing quality and patient satisfaction has been significantly improved,effectively reduce the incidence of nursing mistakes and accidents.%特需病房是医院为了满足特殊治疗需要而专门设置的病区,疾病种类较多,患者素质较高,为了提高我院特需病房护理质量,在特需病房率先开展优质护理服务工作模式,通过完善科室相关规章制度,制定丰富的护理内容及目标,加强护理人员的专业知识和专科操作技能培训,注重患者临终护理等措施,使特需病房整体护理质量和患者满意度得到大幅提升,有效降低护理差错事故发生率。

  17. Use and performance of non-invasive ventilation in Internal Medicine ward: a real-life study

    Directory of Open Access Journals (Sweden)

    Francesco Ventrella

    2015-01-01

    Full Text Available Controlled trials demonstrated efficacy and safety of non-invasive ventilation (NIV in treatment of acute respiratory failure, initially in Intensive Care Units, then in other care settings (semi-intensive care units, emergency departments, and also in the wards, more often pneumological ones. Few studies have been published about NIV in Italian wards of Internal Medicine with full self-management of NIV by internists in a normal ward setting. We performed a prospective real-life study about the use of NIV in Internal Medicine ward devoid of a critical area of semi-intensive therapy, with the aim of confirming, in this setting, the effectiveness of NIV. During a period of 13 months, 42 patients with hypercapnic respiratory failure of different etiology and acidosis (pH<7.25were treated by NIV. NIV was successful in 81% of patients. In-hospital mortality was 9.5%. Safety of NIV is demonstrated by the absence of serious complications: only 7 patients showed poor compliance and 2 patients had facial pressure ulcer due to the mask. There were not statistical differences in success rate of NIV according to severity of acidosis at admission (pH<7.25 vs pH>7.25, neither according to the acute physiology and chronic health evaluation II score and the national early warning score, but the modified early warning score only showed statistically significant difference with lower values in the success group: 2.82±1.57 vs 4.13±1.46 (P<0.05. NIV has proven to be effective and safe in Internal Medicine ward.

  18. Community-Based Wetland Restoration Workshop in the Lower Ninth Ward, New Orleans

    Science.gov (United States)

    Wang, H. F.; Craig, L.; Ross, J. A.; Zepeda, L.; Carpenter, Q.

    2010-12-01

    Since 2007 a workshop class of University of Wisconsin-Madison students has participated in a community-based project in New Orleans to investigate the feasibility of restoring the Bayou Bienvenue Wetland Triangle (BBWT), which is adjacent to the Lower 9th Ward in New Orleans. This 440-acre region is currently open water but was a cypress forest until the 1970s. Restoration would provide protection from storm surges, restored ecological services, and recreational use. The workshop introduced students to the multidisciplinary skills needed to work effectively with the complex and interconnected issues within a project involving many stakeholders. The stakeholders included the Center for Sustainable Engagement and Development (CSED), Lower 9th Ward residents, non-profits (e.g., Sierra Club, Environmental Defense, Lake Pontchartrain Basin Foundation, National Wildlife Federation), government agencies (e.g., New Orleans Sewerage and Water Board, Army Corps of Engineers), neighborhood groups (e.g., Holy Cross Neighborhood Association, The Village), and universities (Tulane, U. of New Orleans, LSU, U. Colorado-Denver, Southeastern Louisiana). The course ran initially as a Water Resources Management practicum in the first two summers and then as a broader multidisciplinary project with student expertise in hydrology, social science, law, planning, policy analysis, community development, GIS, public health, environmental education and ecological restoration. The project divided into three main components: wetland science, social science, and land tenure and planning. Principal activities in wetland science were to monitor water levels and water quality, inventory flora and fauna, and plant grasses on small “floating islands.” The principal social science activity was to conduct a neighborhood survey about knowledge of the wetland and interest in its restoration. The land tenure and planning activity was to investigate ownership and transfer of property within the

  19. Patient risk factors for developing a drug-related problem in a cardiology ward

    Directory of Open Access Journals (Sweden)

    Urbina O

    2014-12-01

    Full Text Available Olatz Urbina,1 Olivia Ferrández,1 Sònia Luque,1 Santiago Grau,1,2 Sergi Mojal,3 Rosa Pellicer,1 Marta Riu,4 Esther Salas,1 Josep Comin-Colet5 1Pharmacy Department, Hospital Universitari del Mar, Barcelona, Spain; 2Universitat Autònoma de Barcelona, Barcelona, Spain; 3Department of Statistics, Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain; 4Department of Epidemiology and Health Services Evaluation, CIBER de Epidemiología y Salud Pública (CIBERESP, Hospital Universitari del Mar, Barcelona, Spain; 5Heart Failure Unit, Cardiology Department, Hospital Universitari del Mar, Barcelona, Spain Background: Because of the high incidence of drug-related problems (DRPs among hospitalized patients with cardiovascular diseases and their potential impact on morbidity and mortality, it is important to identify the most susceptible patients, who therefore require closer monitoring of drug therapy.Purpose: To identify the profile of patients at higher risk of developing at least one DRP during hospitalization in a cardiology ward.Method: We consecutively included all patients hospitalized in the cardiology ward of a teaching hospital in 2009. DRPs were identified through a computerized warning system designed by the pharmacy department and integrated into the electronic medical record.Results: A total of 964 admissions were included, and at least one DRP was detected in 29.8%. The variables associated with a higher risk of these events were polypharmacy (odds ratio [OR]=1.228; 95% confidence interval [CI]=1.153–1.308, female sex (OR=1.496; 95% CI=1.026–2.180, and first admission (OR=1.494; 95% CI=1.005–2.221.Conclusion: Monitoring patients through a computerized warning system allowed the detection of at least one DRP in one-third of the patients. Knowledge of the risk factors for developing these problems in patients admitted to hospital for cardiovascular problems helps in identifying the most susceptible patients. Keywords

  20. An Improvement on Precision in D-WARD Detection System with CUSUM Algorithm%基于CUSUM算法提高 D-WARD 系统检测精度

    Institute of Scientific and Technical Information of China (English)

    康健; 张喆; 鞠九滨

    2006-01-01

    在深入分析了具有代表性的DDoS源端检测系统 D-WARD 检测算法的基础上,引入统计学中非参数改变点检测方法,使用非参数化递归CUSUM算法对 D-WARD 进行了改进.同时,借鉴负载平衡中Load-Shedding的思想,应用Kaufman算法动态调整和更新阈值Threshold,并对检测性能进行详细比较.实验证明,改进的系统具有更低的误报率和漏报率,能够适应更复杂的网络检测环境.

  1. Effects of antidiabetes drugs on functional independence measure on a subacute rehabilitation ward for stroke patients.

    Science.gov (United States)

    Kose, E; Toyoshima, M; Tachi, T; Teramachi, H; Kawakubo, T; Hayashi, H

    2015-07-01

    It has been reported that the improvement of activities of daily living (ADL) by rehabilitation affects glycemic control. However, there are no reports about antidiabetes drugs as factors affecting the outcomes of rehabilitation. Therefore, we investigated the effects of antidiabetes drugs on functional independence measure (FIM) [total (T), motor (M), and cognition (C) items] in stroke patients with diabetes who were discharged from the subacute rehabilitation ward. We chose the frequently used antidiabetes drugs [sulfonylurea (SU), dipeptidyl peptidase-IV inhibitors (DPP-IVIs), and α-glycosidase inhibitors (α-GIs)] as the basis for categorizing the patients. We compared the patients' background features and laboratory data among the three groups. As a result, when SU was used in stroke patients with diabetes, it is difficult to obtain significant FIM-M gain, FIM-C gain, FIM-M efficiency, and FIM-C efficiency compared with of-GIs. As a reason for this, we hypothesize the possibility of the involvement of insulin resistance. Therefore, we consider that insulin resistance should be determined early and that it is important to reduce insulin resistance comprehensively by involving experts.

  2. Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

    Directory of Open Access Journals (Sweden)

    Papamichael Georgios

    2011-02-01

    Full Text Available Abstract Background There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries. Methods A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010 were examined. Results Chemical restraint was applied in 33 cases (10.5% of total admissions. From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases, usually in combination with a benzodiazepine (61.7% of cases. In 36.4% of cases the patient was further subjected to restraint or seclusion. Conclusions In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.

  3. Correlation functions of twist fields from Ward identities in the massive Dirac theory

    CERN Document Server

    Doyon, Benjamin

    2011-01-01

    We derive non-linear differential equations for correlation functions of U(1) twist fields in the two-dimensional massive Dirac theory. Primary U(1) twist fields correspond to exponential fields in the sine-Gordon model at the free-fermion point, and it is well-known that their vacuum two-point functions are determined by integrable differential equations. We extend part of this result to more general quantum states (pure or mixed) and to certain descendents, showing that some two-point functions are determined by the sinh-Gordon differential equations whenever there is translation and parity invariance, and the density matrix is the exponential of a bilinear expression in fermions. We use methods involving Ward identities associated to the copy-rotation symmetry in a model with two independent, anti-commuting copies. Such methods were used in the context of the thermally perturbed Ising quantum field theory model. We show that they are applicable to the Dirac theory as well, and we suggest that they are like...

  4. Correlation functions of twist fields from Ward identities in the massive Dirac theory

    Science.gov (United States)

    Doyon, Benjamin; Silk, James

    2011-07-01

    We derive non-linear differential equations for correlation functions of U(1) twist fields in the two-dimensional massive Dirac theory. Primary U(1) twist fields correspond to exponential fields in the sine-Gordon model at the free-fermion point, and it is well-known that their vacuum two-point functions are determined by integrable differential equations. We extend part of this result to more general quantum states (pure or mixed) and to certain descendents, showing that some two-point functions are determined by the sinh-Gordon differential equations whenever there is translation and parity invariance, and the density matrix is the exponential of a bilinear expression in fermions. We use methods involving Ward identities associated to the copy-rotation symmetry in a model with two independent, anti-commuting copies. Such methods were used in the context of the thermally perturbed Ising quantum field theory model. We show that they are applicable to the Dirac theory as well, and we suggest that they are likely to have a much wider applicability to free fermion models in general. Finally, we note that our form-factor study of descendents twist fields combined with a CFT analysis provides a new way of evaluating vacuum expectation values of primary U(1) twist fields: by deriving and solving a recursion relation.

  5. Factors Influencing communication between the patients with cancer and their nurses in oncology wards

    Directory of Open Access Journals (Sweden)

    Vahid Zamanzadeh

    2014-01-01

    Full Text Available Aims: The purpose of this study was to demonstrate the factors influencing nurse-patient communication in cancer care in Iran. Materials and Methods: This study was conducted with a qualitative conventional content analysis approach in oncology wards of hospitals in Tabriz. Data was collected through purposive sampling by semi-structured deep interviews with nine patients, three family members and five nurses and analyzed simultaneously. Robustness of data analysis was evaluated by the participants and external control. Results: The main theme of the research emerged as "three-factor effects" that demonstrates all the factors related to the patient, nurse, and the organization and includes three categories of "Patient as the center of communication", "Nurse as a human factor", and "Organizational structures". The first category consists of two sub-categories of "Imposed changes by the disease" and "the patient′s particular characteristics". The second category includes sub-categories of "sense of vulnerability" and "perception of professional self: Pre-requisite of patient-centered communication". The third category consists of the sub-categories of "workload and time imbalance", "lack of supervision", and "impose duties in context of neglecting nurse and patient needs". Characteristics of the patients, nurses, and care environment seemed to be the influential factors on the communication. Conclusions: In order to communicate with cancer patients effectively, changes in philosophy and culture of the care environment are essential. Nurses must receive proper trainings which meet their needs and which focus on holistic and patient-centered approach.

  6. Inpatients' attitudes towards the rationale use of drugs at a cardiology ward

    Directory of Open Access Journals (Sweden)

    Ugur Ugrak

    2015-04-01

    Full Text Available AIM: This descriptive survey purposed to evaluate inpatients' attitudes towards the rationale use of drugs at a cardiology ward in GATA. METHODS: Rational Drug Use Questionnaire designed by T.C. Health Ministry was performed. The patients hospitalized during the research period were tried to be reached and 121 inpatients completed the questionnaire. SPSS 15.0 program was used for data evaluation. Descriptive statistics were indicated with mean, standard deviation, frequency. Pearsons Chi-Square Test was used for comparison of groups. Statistical significance at p<0.05 was adopted. RESULTS: Mean age of patient surveyed was 29.3+/-16.4 year and 68.6% of the patients were male. It was seen that 49.6% of the patients reserved residual drugs of a treatment at home to reuse, 87.6% of the patients applied to a physician when drug side effect was seen. 42.1% of female and 36.2% of married participants were seen to use painkiller without prescription. Additionally, significant relationship was observed between attitude of using painkiller without prescription and gender, marital status. CONCLUSION: Our research participants' attitudes towards rational drug use found more positive than previous researches performed in Turkey. It is assessed this difference resulted from participant's high education level and participants' obligation to use drugs for long time because most of them had chronic or congenital heart disease. [TAF Prev Med Bull 2015; 14(2.000: 137-144

  7. Persuade Mothers in Post Natal Ward for Timely Initiation of Breastfeeding

    Directory of Open Access Journals (Sweden)

    Mamtarani, Ratan K Srivastava, B.Divakar

    2011-01-01

    Full Text Available Objective: Timely initiation of breast feeding has been an important issue since last many decades. However, encouragement and early initiation of breast feeding gained momentum since last 20 years. The traditional wisdom and scientific research have proved that mother’s milk is the best. Design: It is a Cross sectional study conducted in urban tertiary care teaching hospital. Methods: a pretested semi-structured questionnaire was used to interview hospitalised mothers. This paper is the result of the interview of 600 women who delivered babies in the hospital. Their Details of socio-demographic features were enquired in addition to the questions related to their initiation of breast feeding after the birth of baby. Timely initiation of breast-feeding was calculated in this paper as percent of infants (0 - <12 months who were put to the breast within one hour of delivery. Results: Out of all deliveries, breast feeding was timely initiated with in one hour only by 1.0 percent of mothers. However 30 percent mothers initiated breast feeding within two hours. Conclusion: The observations of the present study supports that the health functionaries must utilise the opportunity to persuade mothers in the postnatal ward after delivery of their babies for early initiation of breast feeding.

  8. Anti-anxiety Activity Studies on Homoeopathic Formulations of Turnera aphrodisiaca Ward

    Directory of Open Access Journals (Sweden)

    Suresh Kumar

    2005-01-01

    Full Text Available Turnera aphrodisiaca Ward (Turneraceae has been traditionally used for the treatment of anxiety neurosis, and as an aphrodisiac. Mother tinctures (85% ethanol extracts of T. aphrodisiaca have also been used for the treatment of central nervous system disorders. In the present investigation, T. aphrodisiaca mother tinctures formulated by three reputed manufacturers of homoeopathic medicines (NLK, DWSG and SBL were evaluated for their anxiolytic activity. Dried mother tinctures of T. aphrodisiaca were subjected to anxiolytic activity evaluation at various doses, i.e. 50, 75, 100, 125 or 150 mg/kg p.o. in mice using elevated plus maze apparatus. Dried mother tinctures exhibited significant anxiolytic activity at 50 mg/kg (NLK, 75 mg/kg (DWSG and 125 mg/kg (SBL, respectively, with reference to control as well as standard (diazepam, 2 mg/kg p.o.. Mother tinctures of T. aphrodisiaca available in the market, have significant anxiolytic activity. Amongst the three mother tinctures of T. aphrodisiaca analyzed, the dry residue of NLK possesses the highest amount of anxiolytic constituent(s. To ensure uniformity and consistency of biological effects in herbal formulations, these should be standardized on the basis of bioactive markers. The authors are actively involved in isolating the bioactive constituent(s from T. aphrodisiaca so that the plant can be standardized on the basis of biologically active constituent(s.

  9. Hand contamination during routine care in medical wards: the role of hand hygiene compliance.

    Science.gov (United States)

    Monistrol, Olga; López, M Liboria; Riera, Montserrat; Font, Roser; Nicolás, Carme; Escobar, Miguel Angel; Freixas, Núria; Garau, Javier; Calbo, Esther

    2013-04-01

    The hands of healthcare workers (HCWs) are the most common vehicle for the transmission of micro-organisms from patient to patient and within the healthcare environment. The aim of this study was to evaluate the impact of a multimodal campaign on the type and amount of resident and transient flora and the presence of potential risk factors for hand contamination during routine care. A before-after (PRE and POST periods) interventional study was carried out in medical wards of a tertiary care hospital. Eighty-nine samples were analysed. Samples were cultured immediately before patient contact using a glove-juice method. Data collected included socio-demographic and risk factors for hand contamination. Flora was measured as log10 c.f.u. ml(-1) and evaluated by comparing median values in the PRE and POST periods. Transient flora was isolated from the hands of 67.4 and 46.1 % of HCWs in the PRE and POST periods, respectively (Phand hygiene (HH) (P = 0.007) and an increased use of alcohol-based hand rub instead of soap (Phand contamination.

  10. The prevalence of depression among elderly warded in a tertiary care centre in Wilayah Persekutuan.

    Science.gov (United States)

    Sherina, M S; Rampal, L; Hanim, M Arfah; Thong, P L

    2006-03-01

    Depression is characterized by symptoms like disturbance in behavior, cognition and mood. This is commonly known to affect people aged 60 years and above especially those who are also afflicted with illnesses. The objectives of this study were to determine the prevalence of depression and its associated factors among the elderly in a tertiary care centre in Wilayah Persekutuan. A cross sectional study design was done. Stratified cluster sampling method was used to select the respondents. All elderly patients were selected from the orthopaedic, surgical, gynaecology and medical wards in a government hospital in Wilayah Persekutuan. A 30-item Geriatric Depression Scale questionnaire was used as a screening instrument. Out of the 246 elderly subjects, 198 were interviewed giving a response rate of 80.5%. The results showed that 54% of the elderly respondents were found to have depressive symptoms. Age (p=0.022), sex (p=0.008), ethnicity (p=0.022) and functional disabilities in bathing (p=0.001), grooming (p=0.007), dressing (p= 0.007), using the toilet (p=0.002), transferring from bed to chair and back (p=0.000), mobility (p=0.000) and climbing stairs (p=0.000) were all found to be significantly associated with depression among the elderly respondents. The outcome of this study will have an important impact on the implementation of the health policy for the elderly patients admitted to hospitals.

  11. Observations on BI from $\\mathcal{N}=2$ Supergravity and the General Ward Identity

    CERN Document Server

    Andrianopoli, Laura; D'Auria, Riccardo; Rodriguez, Evelyn; Trigiante, Mario

    2015-01-01

    The multi-vector generalization of a rigid, partially-broken $\\mathcal{N}=2$ supersymmetric theory is presented as a rigid limit of a suitable gauged $\\mathcal{N}=2$ supergravity with electric, magnetic charges and antisymmetric tensor fields. This on the one hand generalizes a known result by Ferrara, Girardello and Porrati while on the other hand allows to recover the multi-vector BI models from $\\mathcal{N}=2$ supergravity as the end-point of a hierarchical limit in which the Planck mass first and then the supersymmetry breaking scale are sent to infinity. We define, in the parent supergravity model, a new symplectic frame in which, in the rigid limit, manifest symplectic invariance is preserved and the electric and magnetic Fayet-Iliopoulos terms are fully originated from the dyonic components of the embedding tensor. The supergravity origin of several features of the resulting rigid supersymmetric theory will be elucidated, such as the presence of a traceless ${\\rm SU}(2)$- Lie algebra term in the Ward i...

  12. Positive behavioral intervention in children who were wards of the court attending a mainstream school.

    Science.gov (United States)

    Navarro, Jose I; Aguilar, Manuel; Aguilar, Concepcion; Alcalde, Concepcion; Marchena, Esperanza

    2007-12-01

    This report looked at the effects of treatment using contingency contracts and token economy procedures in three children, two 14 yr. and one 8 yr., who were wards of the court and attending a mainstream school. Students presented problems of adaptation to school, such as making constant noises with the mouth, hands, or pencil on the desk; frequently emitted raucous cries in the classroom; destruction of school resource materials; verbal aggression to classmates and teachers; verbal rejection of all academic work, refusing to do it, making negative comments prior to starting any school activity, in addition to lack of motivation for undertaking school activities. A 4-mo. individual treatment using contingency contracts and token economy behavioral procedures was implemented, with several follow-up sessions. The results indicated an adaptation of behavior to the school environment, confirmed by teachers, significantly reducing the incidence of insults, the destruction of school materials, and indolence during class sessions. These students are at high risk for social exclusion. Interventions have potential social importance in possible prevention of adult criminality, increasing academic achievement, and decreasing social exclusion.

  13. Ending preventable child deaths in South Africa: What role can ward-based outreach teams play?

    Science.gov (United States)

    Doherty, Tanya; Kroon, Max; Rhoda, Natasha; Sanders, David

    2016-06-17

    South Africa (SA) has emerged from the Millennium Development Goal era with a mixture of success and failure. The successful national scale-up of prevention of mother-to-child transmission of HIV services with increasingly efficacious antiretroviral regimens has reduced the mother-to-child transmission rate dramatically; however, over the same period there appears to have been no progress in coverage of high-impact interventions for pneumonia and diarrhoea, which are now leading causes of under-5 mortality. SA embarked on a strategy to re-engineer the primary healthcare system in 2011, which included the creation of ward-based outreach teams consisting of community health workers (CHWs). In this article we argue that the proposed ratio of CHWs to population is too low for public health impact and that the role and scope of CHWs should be extended beyond giving of health information to include assessment and treatment of childhood illnesses (particularly diarrhoea and suspected pneumonia). Evidence and experience amply demonstrate that CHWs in sufficient density can have a rapid and positive impact on neonatal and young child mortality, especially when they are allowed to treat common acute conditions. SA's mediocre performance in child survival could be dramatically improved if there were more CHWs who were allowed to do more.

  14. Ward round documentation in a major trauma centre: can we improve patient safety?

    Science.gov (United States)

    Green, Gemma; Aframian, Arash; Bernard, Jason

    2014-01-01

    Our objective was to improve documentation and patient safety in a major trauma centre. A retrospective audit was undertaken in March 2014. Ward round entries for each orthopaedic patients on three dates were assessed against standards and analysed. The audit was repeated in April 2014, and again in August 2014. Thorough documentation is paramount in a major trauma centre. It forms a useful record of the patients hospital stay, is a legal document and is highlighted in national guidelines. It provides a basis for good handover, ensuring continuation of care and maintaining patient safety. Resultant poor compliance with Royal College guidelines in the initial audit led to the production of a new electronic based note keeping system. A meeting was held with all staff prior to introduction. Our initial results gained 75 entries, and none showed full compliance. Mean compliance per entry was 59% (0-81%). The second attempt gained 90 entries, with 30 from the weekend. Mean compliance per entry 97%. Third attempt received 61 entries, with 27 from the weekend. Mean compliance was 96%, meaning that the improvement was being maintained. Recent distressing reports regarding patient highlighted the importance of patient. Our initial audit proved there were many areas lacking in our documentation and improvement was necessary. Prior to introducing electronic systems, the implemented change has produced improvement in documentation, and provides a useful handover tool for staff.

  15. An Infinite Set of Ward Identities for Adiabatic Modes in Cosmology

    CERN Document Server

    Hinterbichler, Kurt; Khoury, Justin

    2014-01-01

    We show that the correlation functions of any single-field cosmological model with constant growing-modes are constrained by an infinite number of novel consistency relations, which relate N+1-point correlation functions with a soft-momentum scalar or tensor mode to a symmetry transformation on N-point correlation functions of hard-momentum modes. We derive these consistency relations from Ward identities for an infinite tower of non-linearly realized global symmetries governing scalar and tensor perturbations. These symmetries can be labeled by an integer n. At each order n, the consistency relations constrain --- completely for n=0,1, and partially for n\\geq 2 --- the q^n behavior of the soft limits. The identities at n=0 recover Maldacena's original consistency relations for a soft scalar and tensor mode, n=1 gives the recently-discovered conformal consistency relations, and the identities for n\\geq 2 are new. As a check, we verify directly that the n=2 identity is satisfied by known correlation functions ...

  16. Mechanical and pharmacological restraints in acute psychiatric wards--why and how are they used?

    Science.gov (United States)

    Knutzen, Maria; Bjørkly, Stål; Eidhammer, Gunnar; Lorentzen, Steinar; Helen Mjøsund, Nina; Opjordsmoen, Stein; Sandvik, Leiv; Friis, Svein

    2013-08-30

    Restraint use has been reported to be common in acute psychiatry, but empirical research is scarce concerning why and how restraints are used. This study analysed data from patients' first episodes of restraint in three acute psychiatric wards during a 2-year study period. Logistic regression analyses were used to identify predictors for type and duration of restraint. The distribution of restraint categories for the 371 restrained patients was as follows: mechanical restraint, 47.2%; mechanical and pharmacological restraint together, 35.3%; and pharmacological restraint, 17.5%. The most commonly reported reason for restraint was assault (occurred or imminent). It increased the likelihood of resulting in concomitant pharmacological restraint. Female patients had shorter duration of mechanical restraint than men. Age above 49 and female gender increased the likelihood of pharmacological versus mechanical restraint, whereas being restrained due to assault weakened this association. Episodes with mechanical restraint and coinciding pharmacological restraint lasted longer than mechanical restraint used separately, and were less common among patients with a personality disorder. Diagnoses, age and reason for restraint independently increased the likelihood for being subjected to specific types of restraint. Female gender predicted type of restraint and duration of episodes.

  17. Epidemiologic features of early onset sepsis in neonatal ward of Shabih Khani hospital in Kashan

    Directory of Open Access Journals (Sweden)

    Ziba Mosayebi

    2015-02-01

    Full Text Available Background and objective: Neonatal sepsis is defined as presence of clinical signs accompanied by positive blood culture in newborns less than one month of age. Sepsis is a common cause of hospital admission in neonates, and it is known as one of the main causes of mortality among them, not only in developed countries but in developing ones. Delay in diagnosis and appropriate antibiotic therapy would result in death. The aim of this study is to find the main pathogens of sepsis and evaluate sensitivity changes of organisms to antibiotics in comparison with the past. Method: In this descriptive study, 104 (files of neonates, admitted to the neonatal ward of Shabih Khani Hospital, with positive blood culture over a 24-month period ( 2005-2007 were assessed. Data were extracted for analysis. Results: Over this 24-month study on 104 neonates with sepsis, the most common organisms included flavobacterium 43.3% , pseudomonas 33.3%, coagulase negative staphylococcus 17.3%, coagulase positive staphylococcus 5.9% followed by enterobacter , E.coli, beta-haemolytic streptococcus, klebsiella, diphtheriod and lysteria. Conclusion: In this study Flavobacterium is found to be the most common organism for early sepsis. Although infection with flavobacterium is rare, its rate of mortality is high and it is resistant to majority of common antibiotics. Therefore, early diagnosis and appropriate antibiotic prescription helps reduce its complications.

  18. N=1 supersymmetry and super-QED in Atiyah-Ward space-time

    CERN Document Server

    D'Andrade, M A; Magalhães, M N P; De Andrade, M A; Del Cima, O M; Magalhães, M N P

    1995-01-01

    In this work the supersymmetric gauge invariant action for the massive Abelian N=1 super-{\\QED} in the Atiyah-Ward space-time ({\\DDdd}) is formulated. The questions concerning the scheme of the gauge invariance in {\\DDdd} by means of gauging the massive N=1 super-{\\QED} are investigated. We study how to ensure the gauge invariance at the expenses of the introduction of a complex vector superfield. We discuss the Wess-Zumino gauge and thereupon we conclude that in this gauge, only the imaginary part of the complex vector field, B_{\\m}, gauges a U(1)-symmetry, whereas its real part gauges a Weyl symmetry. We build up the gauge invariant massive term by introducing four scalar superfields: a pair of chiral and a pair of anti-chiral superfields; the supermultiplets of each pair have opposite U(1)-charges. We carry out a dimensional reduction {\\it{\\`a la}} Scherk of the massive N=1 super-{\\QED} action from {\\DDdd} to {\\Ddd}. Truncations are needed in order to suppress unphysical modes and one ends up with a parity...

  19. An infinite set of Ward identities for adiabatic modes in cosmology

    Energy Technology Data Exchange (ETDEWEB)

    Hinterbichler, Kurt [Perimeter Institute for Theoretical Physics, 31 Caroline St. N, Waterloo, Ontario, N2L 2Y5 (Canada); Hui, Lam [Physics Department and Institute for Strings, Cosmology and Astroparticle Physics, Columbia University, 538 W 120 St., New York, NY 10027 (United States); Khoury, Justin, E-mail: khinterbichler@perimeterinstitute.ca, E-mail: lh399@columbia.edu, E-mail: jkhoury@sas.upenn.edu [Center for Particle Cosmology, Department of Physics and Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, PA 19104 (United States)

    2014-01-01

    We show that the correlation functions of any single-field cosmological model with constant growing-modes are constrained by an infinite number of novel consistency relations, which relate N+1-point correlation functions with a soft-momentum scalar or tensor mode to a symmetry transformation on N-point correlation functions of hard-momentum modes. We derive these consistency relations from Ward identities for an infinite tower of non-linearly realized global symmetries governing scalar and tensor perturbations. These symmetries can be labeled by an integer n. At each order n, the consistency relations constrain — completely for n = 0,1, and partially for n ≥ 2 — the q{sup n} behavior of the soft limits. The identities at n = 0 recover Maldacena's original consistency relations for a soft scalar and tensor mode, n = 1 gives the recently-discovered conformal consistency relations, and the identities for n ≥ 2 are new. As a check, we verify directly that the n = 2 identity is satisfied by known correlation functions in slow-roll inflation.

  20. Correlation functions of twist fields from Ward identities in the massive Dirac theory

    Energy Technology Data Exchange (ETDEWEB)

    Doyon, Benjamin [Department of Mathematics, King' s College London, Strand WC2R 2LS (United Kingdom); Silk, James [Department of Mathematical Sciences, Durham University, Science Laboratories, South Road, Durham DH1 3LE (United Kingdom)

    2011-07-22

    We derive non-linear differential equations for correlation functions of U(1) twist fields in the two-dimensional massive Dirac theory. Primary U(1) twist fields correspond to exponential fields in the sine-Gordon model at the free-fermion point, and it is well-known that their vacuum two-point functions are determined by integrable differential equations. We extend part of this result to more general quantum states (pure or mixed) and to certain descendents, showing that some two-point functions are determined by the sinh-Gordon differential equations whenever there is translation and parity invariance, and the density matrix is the exponential of a bilinear expression in fermions. We use methods involving Ward identities associated to the copy-rotation symmetry in a model with two independent, anti-commuting copies. Such methods were used in the context of the thermally perturbed Ising quantum field theory model. We show that they are applicable to the Dirac theory as well, and we suggest that they are likely to have a much wider applicability to free fermion models in general. Finally, we note that our form-factor study of descendents twist fields combined with a CFT analysis provides a new way of evaluating vacuum expectation values of primary U(1) twist fields: by deriving and solving a recursion relation.

  1. Creation and validation of an instrument to identify nursing activities in pediatric wards: information for determining workload

    Directory of Open Access Journals (Sweden)

    Nanci Cristiano Santos

    2013-10-01

    Full Text Available The aim of this study was to develop and validate an instrument for identifying nursing activities performed in a pediatric ward and to provide a basis for defining the workload of these units. The instrument was developed by selecting the activities relevant to pediatric nursing from the Nursing Intervention Classification and then submitting them to a panel of judges for validation. The panel considered the selected activities relevant and representative of pediatric nursing practice. Now that representative activities for the nursing workload have been identified, we envision new studies to verify their usefulness in practice. Determining the amount of time each activity takes to perform will help to develop a system for measuring the workloads of nursing teams in pediatric wards.

  2. [Creation and validation of an instrument to identify nursing activities in pediatric wards: information for determining workload].

    Science.gov (United States)

    Santos, Nanci Cristiano; Fugulin, Fernanda Maria Togeiro

    2013-10-01

    The aim of this study was to develop and validate an instrument for identifying nursing activities performed in a pediatric ward and to provide a basis for defining the workload of these units. The instrument was developed by selecting the activities relevant to pediatric nursing from the Nursing Intervention Classification and then submitting them to a panel of judges for validation. The panel considered the selected activities relevant and representative of pediatric nursing practice. Now that representative activities for the nursing workload have been identified, we envision new studies to verify their usefulness in practice. Determining the amount of time each activity takes to perform will help to develop a system for measuring the workloads of nursing teams in pediatric wards.

  3. Bridging the gap: an innovative dementia learning program for healthcare assistants in hospital wards using facilitator-led discussions.

    Science.gov (United States)

    Chapman, Alan; Law, Shirley

    2009-04-01

    Nursing a person with dementia in a ward setting can be stressful and a challenge for staff and patients alike. Healthcare assistants are identified as requiring a specific training program. They form part of the front-line workforce and yet have the least access to training but often most contact with patients. The program in this study focused on person-centered care and used six self-study workbooks. Experienced registered nurses are trained to be facilitators of 12 group discussions in the ward setting. The training program viewed the facilitator as playing a key role in empowering the healthcare assistant but also in promoting reflective practice. The outcomes to date have been positive and showed a development in confidence and competence of the healthcare assistants involved.

  4. Improving smoking cessation policy by assessing user demand for an inpatient smoking cessation service in adult psychiatric wards.

    Science.gov (United States)

    Liu, Kathy; Creamer, Andrew

    2015-01-01

    Smoking rates are higher among people with mental health conditions compared to the general population. Smoking reduces physical, mental and financial well-being, and interacts with psychotropic drugs. An inpatient admission provides an opportunity to engage and support smokers in smoking cessation. Compliance with Trust/NICE smoking cessation guidelines was assessed in two inpatient wards, and a questionnaire evaluated user demand for an inpatient smoking cessation service. A need for improved documentation of smoking status to identify and treat smokers routinely was revealed. A new electronic health form was designed and introduced, and a clear pathway for onward referrals was developed. This intervention preceded the introduction of the Trust-wide smoke free policy from October 2014. The intervention doubled rates of documentation of smoking status, cessation advice and offer of NRT/referral. There were large differences between the two wards, highlighting the need for a tailored approach.

  5. Dispersion of exhaled droplet nuclei in a two-bed hospital ward with three different ventilation systems

    DEFF Research Database (Denmark)

    Qian, H.; Li, Y.; Nielsen, Peter V.

    2006-01-01

    hospital ward with three ventilation systems, i.e. mixing, downward and displacement ventilation. Two life-size breathing thermal manikins were used to simulate a source patient and a receiving patient. The exhalation jet from a bed-lying manikin was visualized using smoke. N2O was used as tracer gas...... to simulate the droplet nuclei exhaled by patients; and the spatial distribution of its concentrations was measured. Our experimental results show that for both mixing and downward ventilation, the exhaled jet penetrates a short distance and is diluted quickly by ventilation air. The exhaled droplet nuclei...... are well mixed in the ward. Bed distance does not affect the personal exposure of the receiving patient. For displacement ventilation, the exhaled jet can penetrate a long distance. A high concentration layer of exhaled droplet nuclei because of thermal stratification locking has also been observed...

  6. A qualitative assessment of implementing a cross-cultural survey on cancer wards in Denmark--a description of barriers

    DEFF Research Database (Denmark)

    Kristiansen, Maria; Hassani, Amani; Krasnik, Allan

    2010-01-01

    Research into migration and health is often confronted with methodological challenges related to the identification of migrants in various settings. Furthermore, it is often difficult to reach an acceptable level of participation among migrant groups in quantitative research. The aim of this study...... is to conduct a qualitative assessment of the barriers encountered during the implementation of a cross-cultural survey on cancer wards in Copenhagen, Denmark....

  7. Does antimicrobial use density at the ward level influence monthly central line-associated bloodstream infection rates?

    Directory of Open Access Journals (Sweden)

    Yoshida J

    2014-12-01

    Full Text Available Junichi Yoshida, Yukiko Harada, Tetsuya Kikuchi, Ikuyo Asano, Takako Ueno, Nobuo Matsubara Infection Control Committee, Shimonoseki City Hospital, Shimonoseki, Japan Abstract: The aim of this study was to elucidate risk factors, including ward antimicrobial use density (AUD, for central line-associated bloodstream infection (CLABSI as defined by the Centers for Disease Control and Prevention in a 430-bed community hospital using central venous lines with closed-hub systems. We calculated AUD as (total dose/(defined daily dose × patient days ×1,000 for a total of 20 drugs, nine wards, and 24 months. Into each line day data, we inputed AUD and device utilization ratios, number of central line days, and CLABSI. The ratio of susceptible strains in isolates were subjected to correlation analysis with AUD. Of a total of 9,997 line days over 24 months, CLABSI was present in 33 cases (3.3 ‰, 14 (42.4% of which were on surgical wards out of nine wards. Of a total of 43 strains isolated, eight (18.6% were methicillin-resistant Staphylococcus aureus (MRSA; none of the MRSA-positive patients had received cefotiam before the onset of infection. Receiver-operating characteristic analysis showed that central line day 7 had the highest accuracy. Logistic regression analysis showed the central line day showed an odds ratio of 5.511 with a 95% confidence interval of 1.936–15.690 as did AUD of cefotiam showing an odds ratio of 0.220 with 95% confidence interval of 0.00527–0.922 (P=0.038. Susceptible strains ratio and AUD showed a negative correlation (R2=0.1897. Thus, CLABSI could be prevented by making the number of central line days as short as possible. The preventative role of AUD remains to be investigated. Keywords: bloodstream infection, central line, antimicrobial use density

  8. The Effect of Stress Management on Occupational Stress and Satisfaction among Midwives in Obstetrics and Gynecology Hospital Wards in Iran

    OpenAIRE

    Jahromi, Mahdi Karimyar; Minaei, Shahnaz; Abdollahifard, Sareh; Maddahfar, Majid

    2015-01-01

    Introduction: Occupational stress is one of the major problems of health care staff, substantially affecting their professional and personal performance. This research has been conducted with the aim of determining the effect of stress management on occupational stress and satisfaction among the Midwives in Obstetrics and Gynecology Hospital wards at Motahari Hospital in Jahrom, Iran 2013-2014. Methods: This is a Quasi-experimental study of the pre- and post-clinical trials type. The study po...

  9. Fostering interprofessional communication through case discussions and simulated ward rounds in nursing and medical education: A pilot project

    Directory of Open Access Journals (Sweden)

    Wershofen, Birgit

    2016-04-01

    Full Text Available Background: Poor communication between physicians and nursing staff could result in inadequate interprofessional collaboration with negative effects on patient health. In order to ensure optimal health care for patients, it is important to strengthen interprofessional communication and collaboration between physicians and nurses during their education. Aim: The aim of this project is to foster communication for medical and nursing students through interprofessional case discussions and simulated ward rounds as a form of training.Method: In 2013-15 a total of 39 nursing students and 22 medical students participated in eight seminars, each covering case discussions and simulated ward rounds. The seminar was evaluated based on student assessment of the educational objectives.Results: Students who voluntarily signed up for the seminar profited from the interprofessional interaction and gathered positive experiences working in a team.Conclusion: Through practicing case discussions and ward rounds as a group, interprofessional communication could be fostered between medical and nursing students. Students took advantage of the opportunity to ask those from other profession questions and realized that interprofessional interaction can lead to improved health care.

  10. Maintaining connections: some thoughts on the value of intensive care unit rounding for general medicine ward teams.

    Science.gov (United States)

    Howell, Joel D

    2011-09-06

    When established ward patients are unexpectedly transferred to an intensive care unit (ICU), the ward team should continue to follow them. Although there may be reasons not to do so, the advantages outweigh the obstacles. Great pedagogic value can be gained from following patients after acute decompensation, but a more important reason is that by following patients into the ICU, the ward team can enact for both patients and their families the twin virtues of caring and continuity. Doing so also demonstrates the highest ideals of medicine-that we are focused not on defined areas of turf, but on our patient's well-being. It shows that we are not merely doing narrowly defined "shift work," but that we truly care about our patients. Rounding on established patients who have been transferred into the ICU is the sort of behavior that undergirds the fundamental bases of professionalism. It takes a few minutes from a busy day, but it can be incredibly beneficial for families, patients, and the ideals of medicine.

  11. Care of severe head injury patients in the Sarawak General Hospital: intensive care unit versus general ward.

    Science.gov (United States)

    Sim, S K; Lim, S L; Lee, H K; Liew, D; Wong, A

    2011-06-01

    Intensive care for severe head injury patients is very important in the prevention and treatment of secondary brain injury. However, in a resources constraint environment and limited availability of Intensive Care Unit (ICU) beds in the hospitals, not all severe head injury patients will receive ICU care. This prospective study is aimed to evaluate the outcome of severe head injured patients who received ICU and general ward care in Sarawak General Hospital (SGH) over a 6-month period. A total of thirty five severe head injury patients were admitted. Twenty three patients (65.7%) were ventilated in general ward whereas twelve patients (34.3%) were ventilated in ICU. Overall one month mortality in this study was 25.7%. Patients who received ICU care had a lower one month mortality than those who received general ward care (16.7% vs 30.4%), although it was not statistically different. Multivariate analysis revealed only GCS on admission (OR 0.731; 95% CI 0.460 to 0.877; P=0.042) as the independent predictive factor for one month mortality in this study.

  12. Assessment the Bio-Aerosols Type and Concentration in Various Wards of Valiasr Hospital, Khorramshahr during 2011

    Directory of Open Access Journals (Sweden)

    Zohreh Sadeghi Hasanvand1,

    2013-09-01

    Results: The highest average concentration of pollution occurred in Infectious Ward (238.51 CFU/ M3 in spring and 167.02 CFU/M3 in autumn and the lowest one was related to the CCU, where showed no fungi growth during both seasons. Despite the environment sterilization, the highest percentage of fungi (Aspergillus Niger and yeast observed in the hospital air was 42.45 percent in spring and 44.26 percent in autumn respectively. Moreover, Staphillus Epidermithis (25.93 percentand gram-positive bacillus were the highest percentage of bacteria identified in air samples. Conclusion: From the findings of this study, it can be concluded that the concentration of bio-aerosols in different hospital wards expect in CCU was more than recommended and similar studies and in terms of species was similar to other studies. Therefore, the hospital authority is recommended to reduce the amount of the pathogenic and environmental bio-aerosols through controlling individual traffic, changing the disinfectants and their applying procedure on the wards surface, establishing standard and suitable ventilation systems.

  13. Prevalence of potential drug-drug interactions among internal medicine ward in University of Gondar Teaching Hospital, Ethiopia

    Institute of Scientific and Technical Information of China (English)

    Akshaya Srikanth Bhagavathula; Alemayehu Berhanie; Habtamu Tigistu; Yishak Abraham; Yosheph Getachew; Tahir Mehmood Khan; Chandrashekhar Unakal

    2014-01-01

    Objective: To determine the prevalence, clinical significance and the associated risk factors of potential drug-drug interactions (DDIs) at internal medicine ward of University of Gondar (UOG) hospital.Method:medicine ward of UOG hospital from April 29, 2013 to June 2, 2013. Data was collected from medical records and by interviewing the patients face to face. Descriptive analysis was conducted for back ground characteristics and logistic regression was used to determine the associated risk factors.Result:A prospective cross-sectional study was conducted on patients treated in internal interacting combinations with 4.13 potential DDIs per patient. Among 413 potential DDIs most were of moderate interactions 61.2% (n=253) followed by 26% (n=107) of minor interactions and 12.8% (n=53) of major interactions. There was significant association of occurrence of potential DDIs only with taking three or more medications.Conclusion:We have recorded a high rate of prevalence of potential DDI in the internal In our study, we have identified a total number of 413 potential DDIs and 184 types of medicine ward of UOG hospital and a high number of clinically significant DDIs which the most prevalent DDI were of moderate severity. Careful selection of drugs and active pharmaceutical care is encouraged in order to avoid negative consequences of these interactions.

  14. The team builder: the role of nurses facilitating interprofessional student teams at a Swedish clinical training ward.

    Science.gov (United States)

    Elisabeth, Carlson; Ewa, Pilhammar; Christine, Wann-Hansson

    2011-09-01

    Interprofessional education (IPE) is an educational strategy attracting increased interest as a method to train future health care professionals. One example of IPE is the clinical training ward, where students from different health care professions practice together. At these wards the students work in teams with the support of facilitators. The professional composition of the team of facilitators usually corresponds to that of the students. However, previous studies have revealed that nurse facilitators are often in the majority, responsible for student nurses' profession specific facilitation as well as interprofessional team orientated facilitation. The objective of this study was to describe how nurses act when facilitating interprofessional student teams at a clinical training ward. The research design was ethnography and data were collected through participant observations and interviews. The analysis revealed the four strategies used when facilitating teams of interprofessional students to enhance collaborative work and professional understanding. The nurse facilitator as a team builder is a new and exciting role for nurses taking on the responsibility of facilitating interprofessional student teams. Future research needs to explore how facilitating nurses balance profession specific and team oriented facilitating within the environment of an interprofessional learning context.

  15. Antibiotic resistance and OXA-type carbapenemases-encoding genes in airborne Acinetobacter baumannii isolated from burn wards.

    Science.gov (United States)

    Gao, Jing; Zhao, Xiaonan; Bao, Ying; Ma, Ruihua; Zhou, Yufa; Li, Xinxian; Chai, Tongjie; Cai, Yumei

    2014-03-01

    The study was conducted to investigate drug resistance, OXA-type carbapenemases-encoding genes and genetic diversity in airborne Acinetobacter baumannii (A. baumannii) in burn wards. Airborne A. baumannii were collected in burn wards and their corridors using Andersen 6-stage air sampler from January to June 2011. The isolates susceptibility to 13 commonly used antibiotics was examined according to the CLSI guidelines; OXA-type carbapenemases-encoding genes and molecular diversity of isolates were analyzed, respectively. A total of 16 non-repetitive A. baumannii were isolated, with 10 strains having a resistance rate of greater than 50% against the 13 antibiotics. The resistance rate against ceftriaxone, cyclophosvnamide, ciprofloxacin, and imipenem was 93.75% (15/16), but no isolate observed to be resistant to cefoperazone/sulbactam. Resistance gene analyses showed that all 16 isolates carried OXA-51, and 15 isolates carried OXA-23 except No.15; but OXA-24 and OXA-58 resistance genes not detected. The isolates were classified into 13 genotypes (A-M) according to repetitive extragenic palindromic sequence PCR (REP-PCR) results and only six isolates had a homology ≥90%. In conclusion, airborne A. baumannii in the burn wards had multidrug resistance and complex molecular diversity, and OXA-23 and OXA-51 were dominant mechanisms for resisting carbapenems.

  16. Assessment of Electromagnetic Fields around High Voltage Power Supply in Hamadan Hospital Wards

    Directory of Open Access Journals (Sweden)

    Nima Rostampour

    2012-10-01

    Full Text Available Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background and Objectives: Biological effects of non-ionizing radiation on the body of living organisms have been studied by researchers in recent years. High Voltage medical equipments are one of the sources generating electromagnetic fields. The electromagnetic field intensity of the medical equipment installed at Hamadan hospitals and the potential hazards were investigated. The main purpose of this study was to determine the intensity of the electromagnetic field around high voltage power supplies in radiology ward of the Hamadan hospitals. Materials and Methods: This was a cross-sectional study and we investigated the electromagnetic fields intensity around high voltage power supplies at Hamadan hospital wards. All measurements were performed using a calibrated Tesla-meter (HI-3603. The measurements were conducted at a range of distances varying from 25 cm to 3 m around the supporting high voltage power supply. Results: We found that the maximum intensity of the magnetic and electric fields at a distance of less than 1 m around the high voltage power supply was 29.625±5.738 mGauss and 25.17±0.92 V/m respectively, which is less than the safe amounts recommended by the ICNIRP for occupational exposure (5000 mG and 10000 V/m and even for public exposure (1000 mG and and 5000 V/m. The minimum intensity of EM fields for a less than 3 m distance was found to be 0.1±0.005 mGauss, which relates to a CT-scanner system installed at Farshchian hospital. Among the whole equipments evaluated in the current survey, the most intense magnetic and electric field was found to be for imaging technician office, which was 3.050±0.004 mGauss and 128.88±0.05 V/m respectively; it is lower than the tolerances recommended by the ICNIRP. Conclusion: According to our results, it seems that the EM field occupational exposure for radiation workers working at Hamadan hospitals does not exceed

  17. A preliminary study of Patient Dignity Inventory validation among patients hospitalized in an acute psychiatric ward

    Directory of Open Access Journals (Sweden)

    Di Lorenzo R

    2017-01-01

    Full Text Available Rosaria Di Lorenzo,1 Giulio Cabri,2 Eleonora Carretti,3 Giacomo Galli,4 Nina Giambalvo,4 Giulia Rioli,4 Serena Saraceni,4 Giulia Spiga,4 Cinzia Del Giovane,5 Paola Ferri6 1Mental Health Department, Service of Psychiatric Diagnosis and Treatment in NOCSAE General Hospital, 2Private Accredited Psychiatric Hospital villa Igea, Modena, 3Nursing Home of Rubiera, Reggio Emilia, 4Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, 5PhD Statistics Unit, Department of Diagnostic, Clinical and Public Health Medicine, 6Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy Purpose: To investigate the perception of dignity among patients hospitalized in a psychiatric setting using the Patient Dignity Inventory (PDI, which had been first validated in oncologic field among terminally ill patients. Patients and methods: After having modified two items, we administered the Italian version of PDI to all patients hospitalized in a public psychiatric ward (Service of Psychiatric Diagnosis and Treatment of a northern Italian town, who provided their consent and completed it at discharge, from October 21, 2015 to May 31, 2016. We excluded minors and patients with moderate/severe dementia, with poor knowledge of Italian language, who completed PDI in previous hospitalizations and/or were hospitalized for <72 hours. We collected the demographic and clinical variables of our sample (n=135. We statistically analyzed PDI scores, performing Cronbach’s alpha coefficient and principal factor analysis, followed by orthogonal and oblique rotation. We concomitantly administered to our sample other scales (Hamilton Rating Scales for Depression and Anxiety, Global Assessment of Functioning and Health of the Nation Outcome Scales to analyze the PDI concurrent validity. Results: With a response rate of 93%, we obtained a mean PDI score of 48.27 (±19.59 SD with

  18. A Survey of the quantity and type of biological aerosols in selected wards of a teaching hospital in Ghazvin

    Science.gov (United States)

    Eslami, Akbar; Karimi, Fatemeh; Karimi, Zainab; Rajabi, Zahra

    2016-01-01

    Introduction Bioaerosols are agents that can cause infection, allergy or induce other toxic effects in the human body. If the person exposed to such particles is not capable of their destruction or elimination from the body, the established chemical and physiological disorders can result in disease or death. The aim of this study was to assess the concentrations of bioaerosols in several wards of a teaching hospital. Methods Given that gas air-conditioners (split and window types) were used for ventilation in the eye operating room, internal intensive care unit, and the respiratory isolation room, these wards were selected for passive sampling. Sterile plates containing culture medium were exposed for two hours to the wards’ indoor ambient air. After this time, they were transferred to a lab to undergo incubation, colony count, and identification of the microorganisms. The data were analyzed using SPSS software, version 18, and the significance level of less than 0.05 was used. Results Based on our findings, the highest colony-forming bacterial unit was observed 22 cfu/plate/h in the eye operating room and, the highest colony-forming fungal unit was observed 4 cfu/plate/h in the internal intensive care unit. Based on the results of the differential tests, the most prevalent bacteria identified were Staphylococcus epidermidis (75%) in the air of eye operating room and Staphylococcus saprophyticus (52%) in the internal intensive care unit and isolation room. The most prevalent identified fungi in the air of selected wards were related to Alternaria alternata (43%), Aspergillus flavus (24%), Penicillium (36%) and Curvularia (21%) types. Based on Spearman’s correlation test, no significant relationship was observed between the factor of temperature and the number of fungal and bacterial colonies (r = 0.201, p = 0.42; r = −0.197, p = 0.41). Moreover, a meaningful relationship was observed only between the number of individuals and the bacterial colonies present in

  19. Small-scale, homelike facilities versus regular psychogeriatric nursing home wards: a cross-sectional study into residents' characteristics

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    Kempen Gertrudis IJM

    2010-01-01

    Full Text Available Abstract Background Nursing home care for people with dementia is increasingly organized in small-scale and homelike care settings, in which normal daily life is emphasized. Despite this increase, relatively little is known about residents' characteristics and whether these differ from residents in traditional nursing homes. This study explored and compared characteristics of residents with dementia living in small-scale, homelike facilities and regular psychogeriatric wards in nursing homes, focusing on functional status and cognition. Methods A cross-sectional study was conducted, including 769 residents with dementia requiring an intensive level of nursing home care: 586 from regular psychogeriatric wards and 183 residents from small-scale living facilities. Functional status and cognition were assessed using two subscales from the Resident Assessment Instrument Minimum Data Set (RAI-MDS: the Activities of Daily Living-Hierarchy scale (ADL-H and the Cognitive Performance Scale (CPS. In addition, care dependency was measured using Dutch Care Severity Packages (DCSP. Finally, gender, age, living condition prior to admission and length of stay were recorded. Descriptive analyses, including independent samples t- tests and chi-square tests, were used. To analyze data in more detail, multivariate logistic regression analyses were performed. Results Residents living in small-scale, homelike facilities had a significantly higher functional status and cognitive performance compared with residents in regular psychogeriatric wards. In addition, they had a shorter length of stay, were less frequently admitted from home and were more often female than residents in regular wards. No differences were found in age and care dependency. While controlling for demographic variables, the association between dementia care setting and functional status and cognition remained. Conclusions Although residents require a similar intensive level of nursing home care

  20. Investigation on Depression of Inpatients in Medical Ward in General Hospital%综合医院内科住院病人抑郁状况调查

    Institute of Scientific and Technical Information of China (English)

    陈庆红; 舒德海; 刘宇宁; 曹伟; 张可

    2003-01-01

    Objective:To investigate the depression of inpatients in general hospital. Methods:252 inpatients in medical ward were investigated by SDS. Results:there were 100(39.7 % ) cases with depression symptoms according to SDS(SDS total scores 1>50) .There were significant correlations between the incidence of depression and kind of disease or education level. Conclusion:There are 39.7% patients with depression sympoms in medical ward of general hosoital.

  1. The Changing Pattern of Hospital Admission to Medical Wards: Burden of non-communicable diseases at a hospital in a developing country

    OpenAIRE

    Noor, Sufian K.; Elmadhoun, Wadie M.; Bushara, Sarra O.; Ahmed, Mohamed H

    2015-01-01

    Objectives: This study aimed to determine the pattern of hospital admissions and patient outcomes in medical wards at Atbara Teaching Hospital in River Nile State, Sudan. Methods: This retrospective cross-sectional study was conducted from August 2013 to July 2014 and included all patients admitted to medical wards at the Atbara Teaching Hospital during the study period. Morbidity and mortality data was obtained from medical records. Diseases were categorised using the World Healt...

  2. Characterization of colonizing Staphylococcus aureus isolated from surgical wards' patients in a Nigerian university hospital.

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    Deboye O Kolawole

    Full Text Available In contrast to developed countries, only limited data on the prevalence, resistance and clonal structure of Staphylococcus aureus are available for African countries. Since S. aureus carriage is a risk factor for postoperative wound infection, patients who had been hospitalized in surgical wards in a Nigerian University Teaching Hospital were screened for S. aureus carriage. All S. aureus isolates were genotyped (spa, agr and assigned to multilocus sequence types (MLST. Species affiliation, methicillin-resistance, and the possession of pyrogenic toxin superantigens (PTSAg, exfoliative toxins (ETs and Panton-Valentine Leukocidin (PVL were analyzed. Of 192 patients screened, the S. aureus carrier rate was 31.8 % (n = 61. Of these isolates, 7 (11.5% were methicillin-resistant (MRSA. The isolates comprised 24 spa types. The most frequent spa types were t064, t084, t311, and t1931, while the most prevalent MLST clonal complexes were CC5 and CC15. The most frequent PTSAg genes detected were seg/sei (41.0% followed by seb (29.5%, sea (19.7%, seh (14.7% and sec (11.5. The difference between the possession of classical and newly described PTSAg genes was not significant (63.9% versus 59.0% respectively; P = 0.602. PVL encoding genes were found in 39.3% isolates. All MRSA isolates were PVL negative, SCCmec types I and VI in MLST CC 5 and CC 30, respectively. Typing of the accessory gene regulator (agr showed the following distribution: agr group 1 (n = 20, group II (n = 17, group III (n = 14 and group IV (n = 10. Compared to European data, enterotoxin gene seb and PVL-encoding genes were more prevalent in Nigerian methicillin-susceptible S. aureus isolates, which may therefore act as potential reservoir for PVL and PTSAg genes.

  3. Clinical features of severe malnutrition at the pediatric ward of Dr. Pirngadi Hospital Medan.

    Science.gov (United States)

    Barus, S T; Rani, R; Lubis, N U; Hamid, E D; Tarigan, S

    1990-01-01

    A retrospective study on severe malnutrition concerning children hospitalized at the Pediatric ward of Dr. Pirngadi Hospital, Medan from January 1 to December 31, 1988 was conducted. Patients less than five years old were included in this study. The purpose of this study was to know the incidence of severe malnutrition, its symptoms and signs, the immunization status, feeding pattern and socio-economic factors. Out of the 3370 hospitalized patients, 2453 (72.78%) were children under five years old. Of these, 312 (12%) suffered from severe malnutrition. It consisted of marasmus 131 (41.9%), marasmic kwashiorkor 94 (30.1%) and kwashiorkor 87 (27.8%). The highest incidence was found in the age group of 0-2 years (58%). Clinical manifestation of marasmus were old man face (131 or 100%), muscular hypotrophy (118 or 71.9%) and decreased subcutaneous fat (116 or 71.1%) in marasmic kwashiorkor children 46 or 50% had their hair easily picked out, 45 or 46.3% showed hyperpigmentation and 48 or 52% had pretibial edema in the kwashiorkor group 29 or 63% had moon face, 52 or 60.4% showed crazy pavement dermatosis, 77 or 51.3% had hepatomegaly and 87 or 48% pretebial edema. Moon face was seen in 29 (63%), crazy Pavement Dermatosis in 52 (60.4%), hepatomegaly in 77 (51.3%), and pretebial edema in 87 (48%) of kwashiorkor cases. The accompanying diseases were mostly diarrhea (95%) and bronchopneumonia (22%). Immunization status showed that BCG comprised 50.6%, while DPT III and OPV III in 13.7% and 10.5% respectively and measles only 0.64%. More than half (59.6%) of them were breast-fed up to 6 months.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Assessment of the early effectiveness of a stroke unit in comparison to the general ward

    Institute of Scientific and Technical Information of China (English)

    马锐华; 王拥军; 曲辉; 杨中华

    2004-01-01

    Background Stroke unit is the most effective treatment method to benefit stroke patients. Our study is to evaluate the early effectiveness of a hospital stroke unit (SU). Methods Three hundred and ninety-two patients who had suffered from acute strokes and who were admitted to our hospital between December 2001 and January 2003 were recruited for this controlled study. All patients were sent at random to either the SU or the general ward (GW) for treatment. The following indices were measured by: Barthel Index (BI), National Institute of Health Stroke Scale (NIHSS), Oxford Handicap Scale (OHS). Results The mean change in BI score between the day of admission and the day of discharge was 20.00±24.36 for the SU group and 10.63±23.59 for the GW group. A difference that is statistically significant (P=0.000). The mean change in NIHSS score was -2.01±6.61 for the SU group and 0.55±7.44 for the GW group. A difference that is also statistically significant (P=0.000). Finally, the mean change in OHS score was -0.74±1.04 for the SU group and -0.28±0.98 for the GW group, also a statistically significant difference (P=0.000). Among SU patients, patient satisfaction was higher (P=0.000), the rehabilitation success rate was higher (P=0.000), and there were fewer complications (P=0.000).Conclusion Compared to GW patients, stroke patients treated in a special SU were able to return to normal daily activities earlier, with better social abilities, and have reduced neurological defects, without increasing the overall economic burden.

  5. Interprofessional collaboration on an internal medicine ward: role perceptions and expectations among nurses and residents.

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    Virginie Muller-Juge

    Full Text Available BACKGROUND: Effective interprofessional collaboration requires that team members share common perceptions and expectations of each other's roles. OBJECTIVE: Describe and compare residents' and nurses' perceptions and expectations of their own and each other's professional roles in the context of an Internal Medicine ward. METHODS: A convenience sample of 14 residents and 14 nurses volunteers from the General Internal Medicine Division at the University Hospitals of Geneva, Switzerland, were interviewed to explore their perceptions and expectations of residents' and nurses' professional roles, for their own and the other profession. Interviews were analysed using thematic content analysis. The same respondents also filled a questionnaire asking their own intended actions and the expected actions from the other professional in response to 11 clinical scenarios. RESULTS: Three main themes emerged from the interviews: patient management, clinical reasoning and decision-making processes, and roles in the team. Nurses and residents shared general perceptions about patient management. However, there was a lack of shared perceptions and expectations regarding nurses' autonomy in patient management, nurses' participation in the decision-making process, professional interdependence, and residents' implication in teamwork. Results from the clinical scenarios showed that nurses' intended actions differed from residents' expectations mainly regarding autonomy in patient management. Correlation between residents' expectations and nurses' intended actions was 0.56 (p=0.08, while correlation between nurses' expectations and residents' intended actions was 0.80 (p<0.001. CONCLUSIONS: There are discordant perceptions and unmet expectations among nurses and residents about each other's roles, including several aspects related to the decision-making process. Interprofessional education should foster a shared vision of each other's roles and clarify the boundaries

  6. N=1 supersymmetry and super quantum electrodynamic in Atiyah-Ward space-time

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, M.A. de; Cima, O.M. Del; Magalhaes, M.N.P.

    1994-12-01

    The supersymmetric gauge invariant action for the massive Abelian N=1 super-QED{sub 2+2} in the Atiyah-Ward space-time (D=2+2) is formulated. The questions concerning the scheme of the gauge invariance in D=2+2 by means of gauging the massive N=1 super-QED{sub 2+2} are investigated. It is studied how to ensure the gauge invariance at the expenses of the introduction of a complex vector superfield. It is discussed the Wess-Zumino gauge and thereupon we conclude that in this gauge, only the imaginary part of the complex vector field, B{sub {mu}}, gauges a U(1)-symmetry, whereas its real part gauges a Weyl symmetry. It is build up the gauge invariant massive term by introducing four scalar superfields: a pair of chiral and a pair of anti-chiral superfields; the supermultiplets of each pair have opposite U (1)-changes. It is carried out a dimensional reduction a la Scherk of the massive N=1 super-QED{sub 2+2} action from D=2+2 to D=1+2. Truncations are needed in order to suppress unphysical modes and one ends up with a parity-preserving N=1 super QED{sub 1+2} (rather than N=2) in D=1+2 which spectrum is free from tachyons and ghosts at tree-level. Finally it is show that the N=1 super-QED{sub 1+2} obtained is the supersymmetry version of the {sub {phi}3} QED. (author). 27 refs.

  7. Evaluation of the Septifast MGrade Test on Standard Care Wards--A Cohort Study.

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    Franz Ratzinger

    Full Text Available The immediate need for appropriate antimicrobial therapy in septic patients requires the detection of the causative pathogen in a timely and reliable manner. In this study, the real-time PCR Septifast MGrade test was evaluated in adult patients meeting the systemic inflammatory response syndrome (SIRS criteria that were treated at standard care wards.Patients with clinical suspected infection, drawn blood cultures (BC, the Septifast M(Grade test (SF and sepsis biomarkers were prospectively screened for fulfillment of SIRS criteria and evaluated using the criteria of the European Centre of Disease Control (ECDC for infection point prevalence studies.In total, 220 patients with SIRS were prospectively enrolled, including 56 patients with detection of bacteria in the blood (incidence: 25.5%. BC analysis resulted in 75.0% sensitivity (95% confidence interval, CI: 61.6%- 85.6% with 97.6% specificity (CI: 93.9%- 99.3% for detecting bacteria in the blood. In comparison to BC, SF presented with 80.4% sensitivity (CI: 67.6%- 89.8% and with 97.6% specificity (CI: 93.9%- 99.3%. BC and SF analysis yielded comparable ROC-AUCs (0.86, 0.89, which did not differ significantly (p = 0.558. A trend of a shorter time-to-positivity of BC analysis was not seen in bacteremic patients with a positive SF test than those with a negative test result. Sepsis biomarkers, including PCT, IL-6 or CRP, did not help to explain discordant test results for BC and SF.Since negative results do not exclude bacteremia, the Septifast M(Grade test is not suited to replacing BC, but it is a valuable tool with which to complement BC for faster detection of pathogens.

  8. Outcome risk factors during respiratory infections in a paediatric ward in Antananarivo, Madagascar 2010-2012.

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    Soatiana Rajatonirina

    Full Text Available BACKGROUND: Acute respiratory infections are a leading cause of infectious disease-related morbidity, hospitalisation and mortality among children worldwide, and particularly in developing countries. In these low-income countries, most patients with acute respiratory infection (ARI, whether it is mild or severe, are still treated empirically. The aim of the study was to evaluate the risk factors associated with the evolution and outcome of respiratory illnesses in patients aged under 5 years old. MATERIALS AND METHODS: We conducted a prospective study in a paediatric ward in Antananarivo from November 2010 to July 2012 including patients under 5 years old suffering from respiratory infections. We collected demographic, socio-economic, clinical and epidemiological data, and samples for laboratory analysis. Deaths, rapid progression to respiratory distress during hospitalisation, and hospitalisation for more than 10 days were considered as severe outcomes. We used multivariate analysis to study the effects of co-infections. RESULTS: From November 2010 to July 2012, a total of 290 patients were enrolled. Co-infection was found in 192 patients (70%. Co-infections were more frequent in children under 36 months, with a significant difference for the 19-24 month-old group (OR: 8.0. Sixty-nine percent (230/290 of the patients recovered fully and without any severe outcome during hospitalisation; the outcome was scored as severe for 60 children and nine patients (3% died. Risk factors significantly associated with worsening evolution during hospitalisation (severe outcome were admission at age under 6 months (OR = 5.3, comorbidity (OR = 4.6 and low household income (OR = 4.1. CONCLUSION: Co-mordidity, low-income and age under 6 months increase the risk of severe outcome for children infected by numerous respiratory pathogens. These results highlight the need for implementation of targeted public health policy to reduce the contribution of

  9. Recognition of Radiological Protection of Ward Staff after Brachytherapy for Malignant Tumor with Radioiodine Seeds

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    HU Shu

    2016-02-01

    Full Text Available Through radiation measurement of the patients after brachytherapy with radioiodine seeds for malignant tumor at different distances and shielding condition, the importance, optimization and individualization of the radiological protection are well recognized. The 35 patients were randomly selected in the minimally invasive interventional ward of Peking University Shenzhen Hospital who underwent brachytherapy for malignant tumor with radioiodine seeds. Within 2 hours after the brachytherapy, the radiation of the patients without shielding, with 0.25 mmPb and 0.5 mmPb shielding were detected by an x-γ ray detector at different distances (equivalent dose rate. The results were analysed by SPSS19.0 t test. Annual equivalent dose was calculated by the average close contact time (two hours everyone per day. The average annual equivalent dose of the 35 patients without shielding was below 20 mSv at 0.5 meter, close to the public limit 1 mSv at 2 meters and equivalent to the background at 4 meters. Under 0.25 mmPb shielding, 6 patients’ radiation was still above the pubic limit, although the average radiation of the 35 patients was below the pubic limit; under 0.5 mmPb shielding, all patients’ radiation was nearly equivalent to the background at 0 meter. The results showed that among the time, distance and shielded protection, the individual radiological protection was especially important. The 0.25 mmPb lead cushion was the most commonly used shield. The 0.5 mmPb lead cushion also should be used in case of the large number of radioiodine seeds implantation and/or more superficial implant site, so as to ensure the individualization and optimization in radiological protection.

  10. Repeated local emergence of carbapenem-resistant Acinetobacter baumannii in a single hospital ward

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    Pham Thanh, Duy; Tran Do Hoan, Nhu; Wick, Ryan R.; Ingle, Danielle J.; Hawkey, Jane; Edwards, David J.; Kenyon, Johanna J.; Phu Huong Lan, Nguyen; Campbell, James I.; Thwaites, Guy; Thi Khanh Nhu, Nguyen; Hall, Ruth M.; Fournier-Level, Alexandre; Baker, Stephen; Holt, Kathryn E.

    2016-01-01

    We recently reported a dramatic increase in the prevalence of carbapenem-resistant Acinetobacter baumannii infections in the intensive care unit (ICU) of a Vietnamese hospital. This upsurge was associated with a specific oxa23-positive clone that was identified by multilocus VNTR analysis. Here, we used whole-genome sequence analysis to dissect the emergence of carbapenem-resistant A. baumannii causing ventilator-associated pneumonia (VAP) in the ICU during 2009–2012. To provide historical context and distinguish microevolution from strain introduction, we compared these genomes with those of A. baumannii asymptomatic carriage and VAP isolates from this same ICU collected during 2003–2007. We identified diverse lineages co-circulating over many years. Carbapenem resistance was associated with the presence of oxa23, oxa40, oxa58 and ndm1 genes in multiple lineages. The majority of resistant isolates were oxa23-positive global clone GC2; fine-scale phylogenomic analysis revealed five distinct GC2 sublineages within the ICU that had evolved locally via independent chromosomal insertions of oxa23 transposons. The increase in infections caused by carbapenem-resistant A. baumannii was associated with transposon-mediated transmission of a carbapenemase gene, rather than clonal expansion or spread of a carbapenemase-harbouring plasmid. Additionally, we found evidence of homologous recombination creating diversity within the local GC2 population, including several events resulting in replacement of the capsule locus. We identified likely donors of the imported capsule locus sequences amongst the A. baumannii isolated on the same ward, suggesting that diversification was largely facilitated via reassortment and sharing of genetic material within the localized A. baumannii population.

  11. A work-based learning approach for clinical support workers on mental health inpatient wards.

    Science.gov (United States)

    Kemp, Philip; Gilding, Moorene; Seewooruttun, Khooseal; Walsh, Hannah

    2016-09-14

    Background With a rise in the number of unqualified staff providing health and social care, and reports raising concerns about the quality of care provided, there is a need to address the learning needs of clinical support workers. This article describes a qualitative evaluation of a service improvement project that involved a work-based learning approach for clinical support workers on mental health inpatient wards. Aim To investigate and identify insights in relation to the content and process of learning using a work-based learning approach for clinical support workers. Method This was a qualitative evaluation of a service improvement project involving 25 clinical support workers at the seven mental health inpatient units in South London and Maudsley NHS Foundation Trust. Three clinical skills tutors were appointed to develop, implement and evaluate the work-based learning approach. Four sources of data were used to evaluate this approach, including reflective journals, qualitative responses to questionnaires, three focus groups involving the clinical support workers and a group interview involving the clinical skills tutors. Data were analysed using thematic analysis. Findings The work-based learning approach was highly valued by the clinical support workers and enhanced learning in practice. Face-to-face learning in practice helped the clinical support workers to develop practice skills and reflective learning skills. Insights relating to the role of clinical support workers were also identified, including the benefits of face-to-face supervision in practice, particularly in relation to the interpersonal aspects of care. Conclusion A work-based learning approach has the potential to enhance care delivery by meeting the learning needs of clinical support workers and enabling them to apply learning to practice. Care providers should consider how the work-based learning approach can be used on a systematic, organisation-wide basis in the context of budgetary

  12. A preliminary study of Patient Dignity Inventory validation among patients hospitalized in an acute psychiatric ward

    Science.gov (United States)

    Di Lorenzo, Rosaria; Cabri, Giulio; Carretti, Eleonora; Galli, Giacomo; Giambalvo, Nina; Rioli, Giulia; Saraceni, Serena; Spiga, Giulia; Del Giovane, Cinzia; Ferri, Paola

    2017-01-01

    Purpose To investigate the perception of dignity among patients hospitalized in a psychiatric setting using the Patient Dignity Inventory (PDI), which had been first validated in oncologic field among terminally ill patients. Patients and methods After having modified two items, we administered the Italian version of PDI to all patients hospitalized in a public psychiatric ward (Service of Psychiatric Diagnosis and Treatment of a northern Italian town), who provided their consent and completed it at discharge, from October 21, 2015 to May 31, 2016. We excluded minors and patients with moderate/severe dementia, with poor knowledge of Italian language, who completed PDI in previous hospitalizations and/or were hospitalized for Depression and Anxiety, Global Assessment of Functioning and Health of the Nation Outcome Scales) to analyze the PDI concurrent validity. Results With a response rate of 93%, we obtained a mean PDI score of 48.27 (±19.59 SD) with excellent internal consistency (Cronbach’s alpha coefficient =0.93). The factorial analysis showed the following three factors with eigenvalue >1 (Kaiser’s criterion), which explained >80% of total variance with good internal consistency: 1) “Loss of self-identity and social role”, 2) “Anxiety and uncertainty for future” and 3) “Loss of personal autonomy”. The PDI and the three-factor scores were statistically significantly positively correlated with the Hamilton Scales for Depression and Anxiety but not with other scale scores. Conclusion Our preliminary research suggests that PDI can be a reliable tool to assess patients’ dignity perception in a psychiatric setting, until now little investigated, helping professionals to improve quality of care and patients to accept treatments. PMID:28182110

  13. The Effect on mortality of fluconazole or echinocandins treatment in candidemia in internal medicine wards [corrected].

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    Francesco G De Rosa

    Full Text Available The incidence of candidemia has increased over the past two decades, with an increased number of cases in Internal Medicine and a prevalence ranging from 24% to 57%. This single-center retrospective study was performed to evaluate the epidemiology and the risk factors associated with mortality of candidemia in patients admitted to Internal Medicine wards (IMWs of the City of Health and Sciences, Molinette Hospital, Turin, from January 2004 to December 2012. For each patient, demographic, clinical and microbiological data were collected. A case of candidemia was defined as a patient with at least one blood culture positive for Candida spp. Amongst 670 episodes of candidemia, 274 (41% episodes occurred in IMWs. The mortality was 39% and was associated at multivariate analysis with sepsis, cirrhosis and neurologic diseases, whilst removal of central venous catheter ≤48h was significantly associated with survival. In the 77 patients treated with early antifungal therapy the mortality was 29% and was not significantly different with caspofungin or fluconazole, whilst in patients with definitive therapy the mortality was significantly lower with echinocandins compared to fluconazole (11.7% Vs. 39%; p=0.0289, a finding confirmed by multivariate analysis. The mortality was significantly associated with sepsis, cirrhosis and neurologic diseases, whilst CVC removal ≤48h was associated with survival. In patients with early therapy, fluconazole or caspofungin were equally effective. However, echinocandins were significantly more effective as definitive treatment, a finding not explained by differences in treatment delays. Further studies are needed to understand the full potential of these different therapeutic strategies in IMWs.

  14. Narcissism in patients admitted to psychiatric acute wards: its relation to violence, suicidality and other psychopathology

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    Wallin Juliska

    2008-02-01

    Full Text Available Abstract Background The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM. Methods This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS and the Global Assessment of Functioning (GAF. The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21, The Hospital Anxiety and Depression Scale (HADS and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM. Results Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales. Conclusion Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination.

  15. Quality Control of Air Disinfection Cleanliness in Burn Ward%烧伤病房空气消毒洁净度的质量控制

    Institute of Scientific and Technical Information of China (English)

    周树仁; 彭幼林; 王建莉; 程永佳

    2011-01-01

    目的:研究烧伤病房空气净化消毒洁净度的质量控制.方法:选择层流、静电和紫外线消毒烧伤病房各一间,分别在开机前、消毒后进行采样做空气培养和微粒检测.结果:层流烧伤病房细菌数明显少于静电和紫外线消毒烧伤病房.结论:烧伤病房层流净化消毒是一种理想的空气净化消毒方式,是实现烧伤病房现代化管理目标的重要设施之一.%Objective To study the quality control of air purification disinfection cleanliness in burn ward. Methods Three bum wards are selected including laminar flow, electrostatic and ultraviolet disinfection respectively. Sampling, air cultivation and particle detection were performed before starting and after disinfection. Results The number of bacteria in laminar flow bum wards is obviously less than wards with electrostatic and ultraviolet disinfection. Conclusion Laminar purification disinfection of bum ward is an ideal air disinfection way, which is is one of the important facilities to realize the modernization management target in bum ward.

  16. Quantification of the diversity among common bean accessions using Ward-MLM strategy Quantificação da diversidade entre acessos de feijoeiro-comum com uso da estratégia Ward-MLM

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    Pablo Diego Silva Cabral

    2010-10-01

    Full Text Available The present work aimed at evaluating the divergence among common bean accessions by their agronomic, morphological and molecular traits, based on the Ward-MLM procedure. A collection of 57 accessions from the gene bank of Universidade Federal do Espírito Santo was used in this study, from which: 31 were landraces belonging to the community Fortaleza, in the municipality of Muqui, ES, Brazil; 20 accessions were provided by Embrapa Trigo; and 6 were commercial cultivars. Five agronomic traits (plant cycle, number of seeds per pod, number of pods per plant, weight of 100 seeds, and grain yield, five morphological traits (growth habit, plant size, seed shape, seed color, and commercial group and 16 microsatellite primers were evaluated. High genetic variability was detected considering morphological, agronomic and molecular traits in the 57 common bean accessions studied. The Ward-MLM procedure showed that the ideal number of groups was five, according to the pseudo F and pseudo t² criteria. The accessions from Andean origin had heavier seeds than others and formed a cluster. The Ward-MLM statistical procedure is a useful technique to detect genetic divergence and to cluster genotypes by simultaneously using morphological, agronomic and molecular data.O objetivo deste trabalho foi avaliar a divergência de acessos de feijoeiro-comum por suas características agronômicas, morfológicas e moleculares, com base no procedimento Ward-MLM. Uma coleção de 57 acessos do banco de germoplasma da Universidade Federal do Espírito Santo foi utilizada neste estudo, dos quais: 31 acessos locais, pertencentes à comunidade Fortaleza, no Município de Muqui, ES; 20 acessos fornecidos pela Embrapa Trigo; e 6 cultivares comerciais. Foram avaliados cinco caracteres agronômicos (ciclo da planta, número de sementes por vagem, número de vagens por planta, peso de 100 grãos e produtividade de grãos, cinco caracteres morfológicos (hábito de crescimento, porte

  17. Drug Utilization on Neonatal Wards: A Systematic Review of Observational Studies

    Science.gov (United States)

    Rosli, Rosliana; Dali, Ahmad Fauzi; Abd Aziz, Noorizan; Abdullah, Amir Heberd; Ming, Long Chiau; Manan, Mohamed Mansor

    2017-01-01

    Despite limited evidence on safety and efficacy of drug use in neonates, drugs are extensively used in this age group. However, the availability of information on drug consumption in neonates, especially inpatient neonates, is limited. This paper systematically reviews published studies on drug utilization in hospitalized neonates. A systematic literature review was carried out to identify observational studies published from inception of databases used till August 2016. Four search engines, namely Medline, CINAHL, Embase, and PubMed, were used. Publications written in English that described drug utilization in neonatal wards were selected. Assessment of the data was based on the category of the study design, the objective of study and the method used in reporting drug consumption. A total of 20 drug utilization studies were identified, 12 of which focused on all drug classes, while the other eight evaluated antimicrobials. Studies were reported in Europe (n = 7), the United States (n = 6), India (n = 5), Brazil (n = 1), and Iran (n = 1). Substantial variance with regard to study types (study design and methods), data source, and sample size were found among the selected studies. Of the studies included, 45% were cross-sectional or retrospective, 40% were prospective studies, and the remaining 15% were point prevalence surveys. More than 70% of the studies were descriptive studies, describing drug consumption patterns. Fifteen per cent of the descriptive studies evaluated changes in drug utilization patterns in neonates. Volume of units was the most prevalent method used for reporting all drug categories. The ATC/DDD system for reporting drug use was only seen in studies evaluating antimicrobials. The most commonly reported drugs across all studies are anti-infectives for systemic use, followed by drugs for the cardiovascular system, the nervous system and the respiratory system. Ampicillin and gentamicin were the most prescribed antimicrobials in hospitalized

  18. An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy

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    Margari Francesco

    2007-01-01

    Full Text Available Abstract Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs. Information was focused on diagnosis (DSM-IV, reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS, the Modified Overt Aggression Scale (MOAS and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30. Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs completed both admission and discharge visits. A severe psychotic episode with (19.1% or without (47.7% aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge and depression (12.9% at admission and 14.7% at discharge were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0% patients had episodes of aggressiveness at admission and 8 (1.7% at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%, 686 (94.2% and 676 (92.9%. The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%, typical anti-psychotics (48.3%, 57.0%, 49.6%, atypical anti-psychotics (35.6%, 41.8%, 39.8% and antidepressants (40.9%, 48.8%, 43.2%. Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20

  19. Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian university hospital

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    Somers A

    2013-06-01

    Full Text Available Annemie Somers,1 Hugo Robays,1 Peter De Paepe,2 Georges Van Maele,3 Katrina Perehudoff,4 Mirko Petrovic41Department of Pharmacy, Ghent University Hospital, Ghent, Belgium; 2Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium; 3Department of Medical Statistics, Ghent University Hospital, Ghent, Belgium; 4Department of Geriatrics, Ghent University Hospital, Ghent, BelgiumObjective: To evaluate the type, acceptance rate, and clinical relevance of clinical pharmacist recommendations at the geriatric ward of the Ghent university hospital.Methods: The clinical pharmacist evaluated drug use during a weekly 2-hour visit for a period of 4 months and, if needed, made recommendations to the prescribing physician. The recommendations were classified according to type, acceptance by the physician, prescribed medication, and underlying drug-related problem. Appropriateness of prescribing was assessed using the Medication Appropriateness Index (MAI before and after the recommendations were made. Two clinical pharmacologists and two clinical pharmacists independently and retrospectively evaluated the clinical relevance of the recommendations and rated their own acceptance of them.Results: The clinical pharmacist recommended 304 drug therapy changes for 100 patients taking a total of 1137 drugs. The most common underlying drug-related problems concerned incorrect dose, drug–drug interaction, and adverse drug reaction, which appeared most frequently for cardiovascular drugs, drugs for the central nervous system, and drugs for the gastrointestinal tract. The most common type of recommendation concerned adapting the dose, and stopping or changing a drug. In total, 59.7% of the recommendations were accepted by the treating physician. The acceptance rate by the evaluators ranged between 92.4% and 97.0%. The mean clinical relevance of the recommendations was assessed as possibly important (53.4%, possibly low relevance (38.1%, and possibly

  20. "Driving the devil away": qualitative insights into miraculous cures for AIDS in a rural Tanzanian ward

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    Urassa Mark

    2010-07-01

    Full Text Available Abstract Background The role of religious beliefs in the prevention of HIV and attitudes towards the infected has received considerable attention. However, little research has been conducted on Faith Leaders' (FLs perceptions of antiretroviral therapy (ART in the developing world. This study investigated FLs' attitudes towards different HIV treatment options (traditional, medical and spiritual available in a rural Tanzanian ward. Methods Qualitative interviews were conducted with 25 FLs purposively selected to account for all the denominations present in the area. Data was organised into themes using the software package NVIVO-7. The field work guidelines were tailored as new topics emerged and additional codes progressively added to the coding frame. Results Traditional healers (THs and FLs were often reported as antagonists but duality prevailed and many FLs simultaneously believed in traditional healing. Inter-denomination mobility was high and guided by pragmatism. Praying for the sick was a common practice and over one third of respondents said that prayer could cure HIV. Being HIV-positive was often seen as "a punishment from God" and a consequence of sin. As sinning could result from "the work of Satan", forgiveness was possible, and a "reconciliation with God" deemed as essential for a favourable remission of the disease. Several FLs believed that "evil spirits" inflicted through witchcraft could cause the disease and claimed that they could cast "demons" away. While prayers could potentially cure HIV "completely", ART use was generally not discouraged because God had "only a part to play". The perceived potential superiority of spiritual options could however lead some users to interrupt treatment. Conclusions The roll-out of ART is taking place in a context in which the new drugs are competing with a diversity of existing options. As long as the complementarities of prayers and ART are not clearly and explicitly stated by FLs

  1. Factors Influencing Participation of Rural Women in Zimbabwes 2013 Constitution Referendum A Case Study Of Ward 22 Gutu District

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    Barbra Ncube

    2015-08-01

    Full Text Available Abstract Participation is the cornerstone of citizen engagement. In constitution making and other public policy formulation processes public participation typically involves preparing the public to participate through civic education and public information campaigns as well as consulting the public on issues such as how the process should take place and the contents of the constitution itself. This study sought to examine the factors that influence womens participation in constitution making processes specifically relating to voting in the constitution referendum in the case of rural women residing in ward 22 of Gutu district of Zimbabwe. Gutu District is the third largest district in Masvingo province. Ward 22 is located in the communal region of Gutu central. The people of ward 22 largely depend on subsistence farming and market gardening for their livelihoods. The objectives of the study were to ascertain to what extent media campaign and publicity efforts by womens civic groups and public interaction through public meetings and hearings were able to influence the participation of Zimbabwean women in the 2013 referendum in ward 22 Gutu district. Over and above these objectives the study sought to document the experiences and views of rural Zimbabwean women on the constitution making process. This study adopted a descriptive case study research design. Samples of 108 women from Ward 22 Gutu District were conveniently selected to participate in this study. Data was collected using a structured interview guide and questionnaires which were administered to the respondents. A focused group discussion was also carried out to verify the information gathered through these instruments. Findings and conclusions were derived by means of detailed comparative and inductive analysis of data. Descriptive statistics were employed in the presentation of the findings. Amongst the major findings are that rural women in ward 22 in Gutu district were in actual

  2. The relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.

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    Angela Sweeney

    Full Text Available BACKGROUND: Poor service user experiences are often reported on mental health inpatient wards. Crisis houses are an alternative, but evidence is limited. This paper investigates therapeutic alliances in acute wards and crisis houses, exploring how far stronger therapeutic alliance may underlie greater client satisfaction in crisis houses. METHODS AND FINDINGS: Mixed methods were used. In the quantitative component, 108 crisis house and 247 acute ward service users responded to measures of satisfaction, therapeutic relationships, informal peer support, recovery and negative events experienced during the admission. Linear regressions were conducted to estimate the association between service setting and measures, and to model the factors associated with satisfaction. Qualitative interviews exploring therapeutic alliances were conducted with service users and staff in each setting and analysed thematically. RESULTS: We found that therapeutic alliances, service user satisfaction and informal peer support were greater in crisis houses than on acute wards, whilst self-rated recovery and numbers of negative events were lower. Adjusted multivariable analyses suggest that therapeutic relationships, informal peer support and negative experiences related to staff may be important factors in accounting for greater satisfaction in crisis houses. Qualitative results suggest factors that influence therapeutic alliances include service user perceptions of basic human qualities such as kindness and empathy in staff and, at service level, the extent of loss of liberty and autonomy. CONCLUSIONS AND IMPLICATIONS: We found that service users experience better therapeutic relationships and higher satisfaction in crisis houses compared to acute wards, although we cannot exclude the possibility that differences in service user characteristics contribute to this. This finding provides some support for the expansion of crisis house provision. Further research is needed

  3. A comparative study of epidural catheter colonization and infection in Intensive Care Unit and wards in a Tertiary Care Public Hospital

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    Harde, Minal; Bhadade, Rakesh; Iyer, Hemlata; Jatale, Amol; Tiwatne, Sagar

    2016-01-01

    Infection is a potentially serious complication of epidural analgesia and with an increase in its use in wards there is a necessity to demonstrate its safety. We aimed to compare the incidence of colonization of epidural catheters retained for short duration (for 48 h) postoperative analgesia in postanesthesia care unit and wards. It was a prospective observational study done in a tertiary care teaching public hospital over a period of 2 years and included 400 patients with 200 each belonged to two groups PACU and ward. We also studied epidural tip culture pattern, skin swab culture at the entry point of the catheter, their relation to each other and whether colonization is equivalent to infection. Data were analyzed using statistical software GraphPad. Overall positive tip culture was 6% (24), of them 7% (14) were from PACU and 5% (10) were from ward (P = 0.5285). Positive skin swab culture was 38% (150), of them 20% (80) were from PACU and 18% (70) were from ward (P = 0.3526). The relation between positive tip culture and positive skin swab culture in same patients is extremely significant showing a strong linear relationship (95% confidence interval = 0.1053–0.2289). The most common microorganism isolated was Staphylococcus epidermidis. No patient had signs of local or epidural infection. There is no difference in the incidence of epidural catheter tip culture and skin swab culture of patients from the general ward and PACU. Epidural analgesia can be administered safely for 48 h in general wards without added risk of infection. The presence of positive tip culture is not a predictor of epidural space infection, and colonization is not equivalent to infection; hence, routine culture is not needed. Bacterial migration from the skin along the epidural track is the most common mode of bacterial colonization; hence, strict asepsis is necessary. PMID:27076712

  4. A comparative study of epidural catheter colonization and infection in Intensive Care Unit and wards in a Tertiary Care Public Hospital

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    Minal Harde

    2016-01-01

    Full Text Available Infection is a potentially serious complication of epidural analgesia and with an increase in its use in wards there is a necessity to demonstrate its safety. We aimed to compare the incidence of colonization of epidural catheters retained for short duration (for 48 h postoperative analgesia in postanesthesia care unit and wards. It was a prospective observational study done in a tertiary care teaching public hospital over a period of 2 years and included 400 patients with 200 each belonged to two groups PACU and ward. We also studied epidural tip culture pattern, skin swab culture at the entry point of the catheter, their relation to each other and whether colonization is equivalent to infection. Data were analyzed using statistical software GraphPad. Overall positive tip culture was 6% (24, of them 7% (14 were from PACU and 5% (10 were from ward (P = 0.5285. Positive skin swab culture was 38% (150, of them 20% (80 were from PACU and 18% (70 were from ward (P = 0.3526. The relation between positive tip culture and positive skin swab culture in same patients is extremely significant showing a strong linear relationship (95% confidence interval = 0.1053–0.2289. The most common microorganism isolated was Staphylococcus epidermidis. No patient had signs of local or epidural infection. There is no difference in the incidence of epidural catheter tip culture and skin swab culture of patients from the general ward and PACU. Epidural analgesia can be administered safely for 48 h in general wards without added risk of infection. The presence of positive tip culture is not a predictor of epidural space infection, and colonization is not equivalent to infection; hence, routine culture is not needed. Bacterial migration from the skin along the epidural track is the most common mode of bacterial colonization; hence, strict asepsis is necessary.

  5. Enacting 'team' and 'teamwork': using Goffman's theory of impression management to illuminate interprofessional practice on hospital wards.

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    Lewin, Simon; Reeves, Scott

    2011-05-01

    Interprofessional teamwork is widely advocated in health and social care policies. However, the theoretical literature is rarely employed to help understand the nature of collaborative relations in action or to critique normative discourses of teamworking. This paper draws upon Goffman's (1963) theory of impression management, modified by Sinclair (1997), to explore how professionals 'present' themselves when interacting on hospital wards and also how they employ front stage and backstage settings in their collaborative work. The study was undertaken in the general medicine directorate of a large NHS teaching hospital in England. An ethnographic approach was used, including interviews with 49 different health and social care staff and participant observation of ward-based work. These observations focused on both verbal and non-verbal interprofessional interactions. Thematic analysis of the data was undertaken. The study findings suggest that doctor-nurse relationships were characterised by 'parallel working', with limited information sharing or effective joint working. Interprofessional working was based less on planned, 'front stage' activities, such as wards rounds, than on ad hoc backstage opportunistic strategies. These backstage interactions, including corridor conversations, allowed the appearance of collaborative 'teamwork' to be maintained as a form of impression management. These interactions also helped to overcome the limitations of planned front stage work. Our data also highlight the shifting 'ownership' of space by different professional groups and the ways in which front and backstage activities are structured by physical space. We argue that the use of Sinclair's model helps to illuminate the nature of collaborative interprofessional relations within an acute care setting. In such settings, the notion of teamwork, as a form of regular interaction and with a shared team identity, appears to have little relevance. This suggests that interventions to

  6. Evaluation of the effect of music on anxiety level of patients hospitalized in cardiac wards before angiography

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    Pourmovahed Zahra

    2016-08-01

    Full Text Available Background and Objective: Patients experience high levels of anxiety before angiography, which is mostly associated with irreparable effects on health status of such individuals. Use of alternative medicine to reduce stress and anxiety is of paramount importance. Therefore, this study aimed to evaluate the effect of music on anxiety level of patients hospitalized in cardiac wards before angiography. Materials and Method: This clinical trial was conducted on 70 patients admitted to cardiac wards before angiography in three selected hospitals of Shiraz, Iran in 2015. Samples were randomized convenience sampling and divided into two groups of control (n=35 and intervention (n=35. In this study, the intervention group received one hour of music before angiography for 20 minutes, whereas the usual care of ward was provided for the control group. Data was collected using the state-trait anxiety inventory (STAI by Spielberger one hour before angiography (immediately before the intervention and 20 minutes after angiography (immediately after the intervention through interviews with all the participants. Data analysis was performed in SPSS version 22 using descriptive statistics, Chi-square, as well as paired and independent-tests. Results: In this study, mean anxiety scores of patients in the intervention and control groups before the intervention were 48.45±6.63 and 48.25±6.63, respectively. After the intervention, these scores were changed to 44.28±5.21 and 49.02±7.74 in the intervention (P=0.004 and control (P=0.90 groups, respectively. Therefore, a significant difference was observed between the groups after the intervention (P=0.008. Conclusion: According to the results of this study, music before angiography could lead to a significant decrease in anxiety level of patients. Therefore, this approach could be used as an effective method to alleviate anxiety in patients.

  7. Evaluation of the effect of music on anxiety level of patients hospitalized in cardiac wards before angiography

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    Zahra Pourmovahed

    2016-02-01

    Full Text Available Background: Patients experience high levels of anxiety before angiography, which is mostly associated with irreparable effects on health status of such individuals. Use of alternative medicine to reduce stress and anxiety is of paramount importance. Therefore, this study aimed to evaluate the effect of music on anxiety level of patients hospitalized in cardiac wards before angiography. Methods: This clinical trial was conducted on 70 patients admitted to cardiac wards before angiography in three selected hospitals of Shiraz, Iran in 2015. Samples were selected through randomized and available sampling and divided into two groups of control (n=35 and intervention (n=35. In this study, the intervention group received one hour of music before angiography for 20 minutes, whereas the usual care of ward was provided for the control group. Data was collected using the state-trait anxiety inventory (STAI by Spielberger one hour before angiography (immediately before the intervention and 20 minutes after angiography (immediately after the intervention through interviews with all the participants. Data analysis was performed in SPSS version 22 using descriptive statistics, Chi-square, as well as paired and independent-tests. Results: In this study, mean anxiety scores of patients in the intervention and control groups before the intervention were 48.45±6.63 and 48.25±6.63, respectively. After the intervention, these scores were changed to 44.28±5.21 and 49.02±7.74 in the intervention (P=0.004 and control (P=0.90 groups, respectively. Therefore, a significant difference was observed between the groups after the intervention (P=0.008. Conclusion: According to the results of this study, music before angiography could lead to a significant decrease in anxiety level of patients. Therefore, this approach could be used as an effective method to alleviate anxiety in patients.

  8. Acquired CNS Demyelinating Syndrome in Children Referred to Shiraz Pediatric Neurology Ward

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    Soroor INALOO*

    2014-04-01

    Full Text Available How to Cite This Article: Inaloo S, Haghbin S, Moradi M, Dashti H, Safari N. Acquired CNS Demyelinating Syndrome in Children Referred to Shiraz Pediatric Neurology Ward. Iran J Child Neurol. 2014 Spring; 8(2:18-23.ObjectiveIncidence of CNS acquired demyelinating syndrome (ADS, especially multiple sclerosis (MS in children, appears to be on the rise worldwide. The objective of this study was to determine prevalence, clinical presentation, neuroimagingfeatures, and prognosis of different types of ADS in Iranian children.Materials & MethodsDuring the period 2002-2012, all the patients (aged 1-18 years with ADS, such as MS, acute disseminated encephalomyelitis (ADEM, optic neurotic (ON, Devic disease, and transverse myelitis (TM, referred to the pediatric neurology ward, Nemazee Hospital, Shiraz University of Medical Sciences, were includedin this study. Demographic data, clinical signs and symptoms, past and family history, preclinical findings, clinical course, and outcome were obtained.ResultsWe identified 88 patients with ADS in our center. The most prevalent disease was MS with 36.5% (n=32, followed by AEDM 26.1% (n=31, ON 17% (n=13, TM 15.9% (n=14, and Devic disease 4.5% (n=4. MS, ON, TM were morecommon among females while ADEM was more common in males. Children with ADEM were significantly younger than those with other types of ADS.Family history was positive in 10% of patients with MS.Previous history of recent infection was considerably seen in cases with ADEM.Clinical presentation and prognosis in this study was in accordance with those in previous studies on children.ConclusionIn this study, the most common type of ADS was MS, which was more common in female and older age cases. ADEM was more common in male and younger children. ADEM and ON had the best and Devic disease had the worst prognosis.References1. Longer-Gould A, Zhaug JL, Chung J, Yeung Y, Wanbant E, Yao J. Incidence of acquired CNS demyelinating syndrome in a

  9. An unusual outbreak of nontuberculous mycobacteria in hospital respiratory wards: Association with nontuberculous mycobacterial colonization of hospital water supply network.

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    D'Antonio, Salvatore; Rogliani, Paola; Paone, Gregorino; Altieri, Alfonso; Alma, Mario Giuseppe; Cazzola, Mario; Puxeddu, Ermanno

    2016-06-01

    The incidence and prevalence of pulmonary nontuberculous mycobacterial (NTM) infection is increasing worldwide arousing concerns that NTM infection may become a serious health challenge. We recently observed a significant increase of NTM-positive sputa samples from patients referred to respiratory disease wards of a large tertiary hospital in Rome. A survey to identify possible NTM contamination revealed a massive presence of NTM in the hospital water supply network. After decontamination procedures, NTM presence dropped both in water pipelines and sputa samples. We believe that this observation should encourage water network surveys for NTM contamination and prompt decontamination procedures should be considered to reduce this potential source of infection.

  10. Evaluation of the decision support system for antimicrobial treatment, TREAT, in an acute medical ward of a university hospital

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    Arboe, Bente; Laub, Rasmus Rude; Kronborg, Gitte;

    2014-01-01

    of hospital stay, or hospital or 30-day mortality. Direct costs were significantly higher for TREAT advice than for local guidelines or the physician prescriptions (pcosts were lower for TREAT advice than for both local guidelines (p....247). The coverage of TREAT advice for the bacteraemia patients was non-inferior to the physicians (p=1.00). CONCLUSIONS: TREAT can potentially improve the ecological costs of empirical antimicrobial therapy for patients in acute medical wards, but provided lower coverage than local guidelines....... coverage rates were 65%, 51%, and 79%, respectively, and in the prospective part, 68%, 62%, and 77%, respectively. TREAT provided lower coverage than local guidelines (plength...

  11. Measuring multidisciplinary team effectiveness in a ward-based healthcare setting: development of the team functioning assessment tool.

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    Sutton, Gigi; Liao, Jenny; Jimmieson, Nerina L; Restubog, Simon Lloyd D

    2011-01-01

    Nontechnical skills relating to team functioning are vital to the effective delivery of patient care and safety. In this study, we develop a reliable behavioral marker tool for assessing nontechnical skills that are critical to the success of ward-based multidisciplinary healthcare teams. The Team Functioning Assessment Tool (TFAT) was developed and refined using a literature review, focus groups, card-sorting exercise, field observations, and final questionnaire evaluation and refinement process. Results demonstrated that Clinical Planning, Executive Tasks, and Team Relations are important facets of effective multidisciplinary healthcare team functioning. The TFAT was also shown to yield acceptable inter-rater agreement.

  12. Comparison of 2D fingerprint types and hierarchy level selection methods for structural grouping using Ward's clustering

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    Wild; Blankley

    2000-01-01

    Four different two-dimensional fingerprint types (MACCS, Unity, BCI, and Daylight) and nine methods of selecting optimal cluster levels from the output of a hierarchical clustering algorithm were evaluated for their ability to select clusters that represent chemical series present in some typical examples of chemical compound data sets. The methods were evaluated using a Ward's clustering algorithm on subsets of the publicly available National Cancer Institute HIV data set, as well as with compounds from our corporate data set. We make a number of observations and recommendations about the choice of fingerprint type and cluster level selection methods for use in this type of clustering

  13. Poverty and Its Association with Child Labor in Njombe District in Tanzania: The Case of Igima Ward

    OpenAIRE

    Akarro, Rocky R.J.; Nathan Anthon Mtweve

    2011-01-01

    The main aim of the study is to present the state of child labour and factors behind this citing one of the most prevalent areas for child labour in Tanzania known as Njombe. Njombe district which is predominantly a rural area is one of the most prevalent areas of child labour in Tanzania. A survey of 300 household heads that were randomly selected from accessible four villages in Igima ward in Njombe district confirmed this phenomenon. Chi-square statistic analysis on the relationship betwee...

  14. Randomized multicentre feasibility trial of intermediate care versus standard ward care after emergency abdominal surgery (InCare trial)

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    Vester-Andersen, M; Waldau, T; Wetterslev, J;

    2015-01-01

    BACKGROUND: Emergency abdominal surgery carries a considerable risk of death and postoperative complications. Early detection and timely management of complications may reduce mortality. The aim was to evaluate the effect and feasibility of intermediate care compared with standard ward care...... no statistically significant effect on 30-day mortality after emergency abdominal surgery, nor any effect on secondary outcomes. The trial was stopped prematurely owing to slow recruitment and a much lower than expected mortality rate among the enrolled patients. REGISTRATION NUMBER: NCT01209663 (http://www.clinicaltrials.gov)....

  15. Cost-effectiveness of ward-based pharmacy care in surgical patients: protocol of the SUREPILL (Surgery & Pharmacy In Liaison study

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    Kuks Paul F

    2011-03-01

    Full Text Available Abstract Background Preventable adverse drug events (pADEs are widely known to be a health care issue for hospitalized patients. Surgical patients are especially at risk, but prevention of pADEs in this population is not demonstrated before. Ward-based pharmacy interventions seem effective in reducing pADEs in medical patients. The cost-effectiveness of these preventive efforts still needs to be assessed in a comparative study of high methodological standard and also in the surgical population. For these aims the SUREPILL (Surgery & Pharmacy in Liaison study is initiated. Methods/Design A multi-centre controlled trial, with randomisation at ward-level and preceding baseline assessments is designed. Patients admitted to the surgical study wards for elective surgery with an expected length of stay of more than 48 hours will be included. Patients admitted to the intervention ward, will receive ward-based pharmacy care from the clinical pharmacy team, i.e. pharmacy practitioners and hospital pharmacists. This ward-based pharmacy intervention includes medication reconciliation in consultation with the patient at admission, daily medication review with face-to-face contact with the ward doctor, and patient counselling at discharge. Patients admitted in the control ward, will receive standard pharmaceutical care. The primary clinical outcome measure is the number of pADEs per 100 elective admissions. These pADEs will be measured by systematic patient record evaluation using a trigger tool. Patient records positive for a trigger will be evaluated on causality, severity and preventability by an independent expert panel. In addition, an economic evaluation will be performed from a societal perspective with the costs per preventable ADE as the primary economic outcome. Other outcomes of this study are: severity of pADEs, number of patients with pADEs per total number of admissions, direct (non-medical costs and indirect non-medical costs, extra costs per

  16. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study.

    Science.gov (United States)

    Gorski, Stanislaw; Piotrowicz, Karolina; Rewiuk, Krzysztof; Halicka, Monika; Kalwak, Weronika; Rybak, Paulina; Grodzicki, Tomasz

    2017-01-01

    Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy internal medicine ward.

  17. The Good Pain Management (GPM) Ward Program in China and its impact on Chinese cancer patients:the SYSUCC experience

    Institute of Scientific and Technical Information of China (English)

    Yun-Peng Yang; Yu-Xiang Ma; Yan Huang; Yuan-Yuan Zhao; Fei Xu; Ying Tian; Ben-Yan Zou; Rui-Zhen Gao; Li Zhang

    2014-01-01

    To improve cancer pain management, the Medical Oncology Department of Sun Yat-sen University Cancer Center (SYSUCC) launched the Good Pain Management (GPM) Ward Program, which has been recognized by the Chinese Ministry of Health and promoted throughout the nation. This retrospective case-control study was designed to evaluate the effectiveness of the program. Patients diagnosed with malignant solid tumors with bone metastasis were eligible. Patients who were admitted 6 months before the initiation of the GPM program were used as the control group, and patients admitted 6 months after the initiation of the program were used as the GPM group. The pain-reporting rate and pain management index (PMI) were calculated. The pain levels before and after pain management were compared. A total of 475 patients (244 in the control group and 231 in the GPM group) were analyzed. The pain-reporting rate of the GPM group was significantly higher than that of the control group (62.8% vs. 37.7%,P< 0.001). The PMI of the GPM group was significantly higher than that of the control group (0.083 vs. -0.261,P< 0.001). Therefore, the GPM Ward Program improved the pain management of cancer patients and provided experience for improving cancer pain management in the future.

  18. BACTERIAL EPIDEMIOLOGY AND ANTIMICROBIAL RESISTANCE IN THE SURGERY WARDS OF A LARGE TEACHING HOSPITAL IN SOUTHERN ITALY

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    Silvano Esposito

    2015-05-01

    Full Text Available Objectives: Surgical infections represent an increasingly important problem for the National Health System. In this study we retrospectively evaluated the bacterial epidemiology and antimicrobial susceptibility of the microorganisms concerned as well as the utilization of antibiotics in the General and Emergency Surgery wards of a large teaching hospital in southern Italy in the period 2011-2013. Methods: Data concerning bacterial isolates and antimicrobial susceptibility were retrieved from the Vitek II database. The pharmacy provided data about the consumption of antibiotics in the above reported wards. Chi-square or Fisher’s exact test were used to analyze categorical variables. Results: In all, 94 Gram-negative were isolated in 2011, 77 in 2012, and 125 in 2013, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa always being the most frequently isolated microorganisms. In the same years, there were respectively 105, 93, and 165 Gram-positive isolated, Enterococcus faecalis, Staphylococcus epidermidis and Staphylococcus aureus being the most commonly found. No significant variation in the antibiotic susceptibility pattern was observed, either among Gram-negative or among Gram-positive pathogens; carbapenems (especially meropenem consumption remained stable over time. Conclusions: Our results show no significant increase in antimicrobial resistance over the period in question, and a higher rate of both MRSA isolates and resistance to carbapenems in A. baumannii compared with other European data.

  19. Prospective pilot study on the incidence of infections caused by peripheral venous catheters at a general surgical ward

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    Heinrich, Ines

    2013-04-01

    Full Text Available [english] Device-associated infections comprise a significant proportion of all nosocomial infections. In this prospective, observational pilot study the incidence of infections in 89 peripheral venous catheters (PVCs was documented on a general surgical ward employing an infection data sheet developed by the Institute of Hygiene and Environmental Medicine, Greifswald in adherence to CDC standards for infections. 16 of 20 infections were documented during a four-week time period when medical students in the first four months of their practical year performed their compulsory rotation on the general surgical ward. Insufficient knowledge of adequate hygienic measures as well as non-compliance to aseptical procedural measures prior to and following insertion of a peripheral venous catheter are the assumed instigators of these infections. In order to ensure a uniform hygienic standard in the performance of applied procedures, it is essential that medical students during this practical year receive not only theoretical, but also hands-on schooling prior to initiation of their subsequent official residency.

  20. [The home palliative care transition manual for the regional cooperation from the general ward at Shizuoka Red Cross Hospital].

    Science.gov (United States)

    Shiraishi, Ko

    2007-12-01

    Recently, a home palliative care has been recommended for terminal stage cancer patients. However, a few clinics are available providing a home palliative care. As a result of that, there have been many cases of the terminal stage cancer patients who could not receive a peace of mind care and die peacefully at home. Home palliative care has been promoted in Shizuoka City by starting Shizuoka city regional cooperation conference of cancer management with a help from Shizuoka city medical association and the general hospital. It is important to have the knowledge and technique put into practice by clinics and home visiting nurses for a further improvement of the palliative care. In order to transfer patient smoothly, the palliative care team conference is held in the general ward and the homecare transition manual is used at the hospital. An application of homecare insurance, the visiting doctor and nurse are arranged in parallel to management of physical and psychological symptoms of the patient, the visiting doctor and nurse are arranged. Before a patient is discharged from the hospital, the meeting will be held among the ward staff, visiting nurse and the patient's family. We intervened 8 cases from April to July 2007. Six out of 8 cases were transferred to home, and 2 patients were died at home. The home care transition manual will be shared with other hospitals from now on.

  1. Prevalence of delirium among patients at a cancer ward: Clinical risk factors and prediction by bedside cognitive tests.

    Science.gov (United States)

    Grandahl, Mia Gall; Nielsen, Svend Erik; Koerner, Ejnar Alex; Schultz, Helga Holm; Arnfred, Sidse Marie

    2016-08-01

    Background Delirium is a frequent psychiatric complication to cancer, but rarely recognized by oncologists. Aims 1. To estimate the prevalence of delirium among inpatients admitted at an oncological cancer ward 2. To investigate whether simple clinical factors predict delirium 3. To examine the value of cognitive testing in the assessment of delirium. Methods On five different days, we interviewed and assessed patients admitted to a Danish cancer ward. The World Health Organization International Classification of Diseases Version 10, WHO ICD-10 Diagnostic System and the Confusion Assessment Method (CAM) were used for diagnostic categorization. Clinical information was gathered from medical records and all patients were tested with Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test. Results 81 cancer patients were assessed and 33% were diagnosed with delirium. All delirious participants were CAM positive. Poor performance on the cognitive tests was associated with delirium. Medical records describing CNS metastases, benzodiazepine or morphine treatment were associated with delirium. Conclusions Delirium is prevalent among cancer inpatients. The Mini Cognitive Test, The Clock Drawing Test, and the Digit Span Test can be used as screening tools for delirium among inpatients with cancer, but even in synergy, they lack specificity. Combining cognitive testing and attention to nurses' records might improve detection, yet further studies are needed to create a more detailed patient profile for the detection of delirium.

  2. The impact of facility relocation on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care.

    Science.gov (United States)

    Alexiou, Eirini; Degl' Innocenti, Alessio; Kullgren, Anette; Wijk, Helle

    2016-08-01

    In recent years, large groups of forensic psychiatric patients have been relocated into new medium- and maximum-security forensic psychiatric facilities in Sweden, where a psychosocial care approach is embedded. From this perspective and on the assumption that physical structures affect the therapeutic environment, a prospective longitudinal study was designed to investigate the impact of the facility relocation of three forensic psychiatric hospitals on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care. Participants were patients over 18 years of age sentenced to compulsory forensic psychiatric treatment. Data were obtained by validated questionnaires. Overall, 58 patients (78%) answered the questionnaires at baseline with a total of 25 patients (34%) completing follow-up 1 at six months and 11 patients (15%) completing follow-up 2, one year after relocation. Approximately two-thirds of the participants at all time-points were men and their age range varied from 18 to 69. The results of this study showed that poor physical environment features can have a severe impact on care quality and can reduce the possibilities for person-centered care. Furthermore, the study provides evidence that the patients' perceptions of person-centered care in forensic psychiatric clinics are highly susceptible to factors in the physical and psychosocial environment. Future work will explore the staff's perception of ward atmosphere and the possibilities to adapt a person-centered approach in forensic psychiatric care after facility relocation.

  3. The A-test: Reliability of functional recovery assessment during early rehabilitation of patients in an orthopedic ward

    Directory of Open Access Journals (Sweden)

    Vukomanović Aleksandra

    2014-01-01

    Full Text Available Background/Aim. There are few tests for evaluation of functional abilities of patients surgically treated for hip fractures or osteoarthritis during early rehabilition period. The aim of this study was to investigate reliability (interobserver reproducibility and internal consistency of the A-test, an original test for functional recovery evaluation during early rehabilitation of patients in an orthopedic ward. Methods. The investigation included 105 patients (55 patients with hip osteoarthritis that underwent arthroplasty and 50 surgically treated patients with hip fracture. It was conducted in an orthopedic ward during early inpatient rehabilitation (from 1st to 5th day. For their functional recovery evaluation during early rehabilitation we used the A-test, a performance-based test with 10 items for assessing basic activities by six level ordinal scale (0-5. For internal consistency of the test the Cronbach coefficient alpha was calculated for the A-test results collected during early rehabilitation for all patients (105 patients x 5 days = 525 measures and separately for the results of patients with hip osteoarthritis (275 measures and hip fracture (250 measures. Values of this coefficient > 0.7 imply good internal consistency of the test. Interobserver reproducibility was estimated as follows: two physiotherapists together conducted physical therapy with the patients, and then, separately, rated the performance of each activity from the test (78 measures. The agreement between their estimations was expressed by the linear weighted kappa coefficient (for very good agreement values of kappa coefficient have to be in the range 0.81-1. Results. The Cronbach coefficient alpha was 0.98 (the results of all the patients and the results of the patients with hip osteoarthritis and 0.97 (the results of the patients with hip fracture. The values of kappa coefficient were in the range 0.81-0.92 for all items. Conclusion. The A-test is a reliable

  4. Implications of Shared Interactive Displays for Work at a Surgery Ward: Coordination, Articulation Work and Context-awareness

    DEFF Research Database (Denmark)

    Bossen, Claus; Jensen, Lis Witte Kjær

    2008-01-01

    appropriate meaning to new clues by clinicians and learning new ways of cooperating. Trade-offs had to be made, since work and benefits were differentially redistributed. We propose that computer support for medical work should support flexible appropriation and learning.......We report on experiences gained from the use at a surgery ward of shared interactive displays to support coordination and communication.  The displays merge large displays, video feed, RFID tag, chat and mobile phones to facilitate better coordination and articulation of work tasks and enhance...... context-awareness of collaborating physicians, nurses and surgery technicians. We focus on the implication of the systems for work and describe the changes in coordination, articulation work and context-awareness that occurred. This implied creating a fit between technology and work, attributing...

  5. [Dealing with parents facing imminent death of their neonate: introducing palliative care in maternity wards and neonatal intensive care units].

    Science.gov (United States)

    Storme, Laurent; de Mézerac, Isabelle

    2010-06-01

    Following antenatal diagnosis of a lethal disorder, some parents are so overwhelmed by grief that therapeutic abortion is seen as the least traumatic option. However, the impending death and anticipated mourning create a particularly complex emotional situation. When faced with such dramatic circumstances, some parents seek to restore meaning to their parenthood by accompanying their baby through to the end of its life. Methods derived from hospice care may be appropriate in such situations, considering the unborn child as "a living being among the living ", pregnancy as the first chapter of every life, and death as a natural process. This approach, which may be adopted in maternity wards and neonatal intensive care units, requires the medical team to provide consistent information to the parents and to ensure their close involvement. These new parental demands must be clearly understood if they are to be met as effectively as possible.

  6. Experiences of patients with acute abdominal pain in the ED or acute surgical ward --a qualitative comparative study

    DEFF Research Database (Denmark)

    Schultz, Helen; Qvist, Niels; Backer Mogensen, Christian

    2013-01-01

    was that the ED included a multidisciplinary team with nurses, who mainly had interactions with the patients before surgical assessment. In all, it resulted in fragmentation of care and a patient experience of repetition. In ASW, focus was on assessment by a senior physician, only, and the nurses' interaction......The Danish health care system is currently establishing emergency departments (EDs) with an observation unit nationwide. The aim of the study was to investigate patients with acute abdominal pain and their experiences upon arrival and stay in an acute surgical ward (ASW) versus an ED...... with the patients took place after surgical assessment. In all, patients experienced long waiting times. The study shows a need to define the roles of the professionals in units receiving patients with acute abdominal pain in order to fulfil the medical as well as the experienced needs of the acute patient....

  7. Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: a qualitative study

    DEFF Research Database (Denmark)

    Lindhardt, Tommi Bo; Hallberg, I.R.; Poulsen, Ingrid

    2008-01-01

    . OBJECTIVE: To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. DESIGN AND SETTING: The design was descriptive. Three acute units in a large Danish university hospital participated....... PARTICIPANTS: Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. METHOD: Open interviews using an interview guide. Manifest and latent content analysis was applied. RESULT: The main theme Encountering relatives-to be caught between ideals and practice...... reflected the nurses' two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter-the collaboration and Relatives...

  8. Nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards: A qualitative study

    DEFF Research Database (Denmark)

    Tove, Lindhardt; Hallberg, Ingalill Rahm; Poulsen, Ingrid

    2008-01-01

    . OBJECTIVE: To illuminate nurses' experience of collaboration with relatives of frail elderly patients in acute hospital wards, and of the barriers and promoters for collaboration. DESIGN AND SETTING: The design was descriptive. Three acute units in a large Danish university hospital participated....... PARTICIPANTS: Six registered nurses and two auxiliary nurses in charge of discharge planning for the patients were included. METHOD: Open interviews using an interview guide. Manifest and latent content analysis was applied. RESULT: The main theme Encountering relatives-to be caught between ideals and practice...... reflected the nurses' two sets of conflicting attitudes towards collaboration with relatives, one in accordance with professional nursing values, the other reflecting the values of every day practice. The dual attitudes were reflected in two themes The coincidental encounter-the collaboration and Relatives...

  9. PS-022 Complex automated medication systems reduce medication administration error rates in an acute medical ward

    DEFF Research Database (Denmark)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    2017-01-01

    Background Medication errors have received extensive attention in recent decades and are of significant concern to healthcare organisations globally. Medication errors occur frequently, and adverse events associated with medications are one of the largest causes of harm to hospitalised patients....... Reviews have suggested that up to 50% of the adverse events in the medication process may be preventable. Thus the medication process is an important means to improve safety. Purpose The objective of this study was to evaluate the effectiveness of two automated medication systems in reducing...... the medication administration error rate in comparison with current practice. Material and methods This was a controlled before and after study with follow-up after 7 and 14 months. The study was conducted in two acute medical hospital wards. Two automated medication systems were tested: (1) automated dispensing...

  10. HEALTH RISK FOR CHILDREN RESULTING FROM LEGIONELLA OCCURRENCE IN WATER NETWORK OF CHILDREN’S WARDS IN HOSPITALS

    Directory of Open Access Journals (Sweden)

    Renata Matuszewska

    2011-06-01

    Full Text Available Legionnaires’ disease is an established and frequent cause of hospital-acquired pneumonia in adults. However, it can also affect children, particularly with immunodeficiencies. Hot water supply systems and any equipment generating water-air aerosol are the main sources of Legionella infection in healthcare facilities. The aim of our study was to determine the frequency of Legionella colonization of water supply systems in children’s wards in hospitals. In 5 hospitals water samples were collected from water network (29 samples, air conditioning device (1 sample and from medical ventilator (1 sample. The samples were examined using the NIPH-NIH membrane filtration method and PN-ISO 11731-2:2006 method.Legionella was isolated from water samples taken in 3 of 5 hospitals (60% of studied healthcare facilities, in 25 water samples (80% of tested samples. Among 353 isolated strains, 230 were identified as L. pneumophila sg 2-14. The most hazardous L. pneumophila sg 1 was not isolated. In 74% of positive samples the number of bacteria exceeded 100 cfu in 100 ml. The results of our study indicate relatively high frequency of Legionella colonization of water systems in children’s wards in hospitals. In order to reduce/minimize the health risk, measures to prevent Legionella colonization in healthcare facilities are necessary, including the proper design of water system and its maintenance in accordance with appropriate standards. There is also the necessity to sample hospital water routinely to detect Legionella and prevent the outbreaks, not only from water supply systems, but also air conditioning systems and medical equipment.

  11. The Effect of Stress Management on Occupational Stress and Satisfaction among Midwives in Obstetrics and Gynecology Hospital Wards in Iran

    Science.gov (United States)

    Jahromi, Mahdi Karimyar; Minaei, Shahnaz; Abdollahifard, Sareh; Maddahfar, Majid

    2016-01-01

    Introduction: Occupational stress is one of the major problems of health care staff, substantially affecting their professional and personal performance. This research has been conducted with the aim of determining the effect of stress management on occupational stress and satisfaction among the Midwives in Obstetrics and Gynecology Hospital wards at Motahari Hospital in Jahrom, Iran 2013-2014. Methods: This is a Quasi-experimental study of the pre- and post-clinical trials type. The study population included midwives employed in the Obstetrics and Gynecology Hospital wards selected trough census. The samples were categorized into two groups randomly. The intervention group participated in the short-term training workshop of stress management. The studied samples were measured in terms of occupational stress and satisfaction before, right after, and one month after the workshop. Occupational stress measurement was measured by Toft-Anderson occupational stress questionnaire (1981). Similarly, the occupational satisfaction was measured by JDI checklist developed by Stephen Robins (1994). In order to analyze the information, SPSS 16 together with descriptive statistics tests (frequency, percentile, mean, and standard deviation), independent sample t-tests, iterative measurement and Spearman correlation coefficient were used. Results: A total of 70 people (two 35-person groups) of midwives participated in this study. The findings revealed that there was a significant difference between the mean of scores of occupational stress between the two groups before and after the workshop (p=0.001). There was, however, no significant difference between the scores of satisfactions across the two groups. Discussion: Training of skills of coping with stress including stress management can be effective in diminishing level of occupational stress. Mitigation of stress without catering for professional, occupational, organizational, and environmental factors would not lead to

  12. Close encounters in a pediatric ward: measuring face-to-face proximity and mixing patterns with wearable sensors.

    Directory of Open Access Journals (Sweden)

    Lorenzo Isella

    Full Text Available BACKGROUND: Nosocomial infections place a substantial burden on health care systems and represent one of the major issues in current public health, requiring notable efforts for its prevention. Understanding the dynamics of infection transmission in a hospital setting is essential for tailoring interventions and predicting the spread among individuals. Mathematical models need to be informed with accurate data on contacts among individuals. METHODS AND FINDINGS: We used wearable active Radio-Frequency Identification Devices (RFID to detect face-to-face contacts among individuals with a spatial resolution of about 1.5 meters, and a time resolution of 20 seconds. The study was conducted in a general pediatrics hospital ward, during a one-week period, and included 119 participants, with 51 health care workers, 37 patients, and 31 caregivers. Nearly 16,000 contacts were recorded during the study period, with a median of approximately 20 contacts per participants per day. Overall, 25% of the contacts involved a ward assistant, 23% a nurse, 22% a patient, 22% a caregiver, and 8% a physician. The majority of contacts were of brief duration, but long and frequent contacts especially between patients and caregivers were also found. In the setting under study, caregivers do not represent a significant potential for infection spread to a large number of individuals, as their interactions mainly involve the corresponding patient. Nurses would deserve priority in prevention strategies due to their central role in the potential propagation paths of infections. CONCLUSIONS: Our study shows the feasibility of accurate and reproducible measures of the pattern of contacts in a hospital setting. The obtained results are particularly useful for the study of the spread of respiratory infections, for monitoring critical patterns, and for setting up tailored prevention strategies. Proximity-sensing technology should be considered as a valuable tool for measuring such

  13. The Function of Warding off Evil of Folk Dress%民间服饰的辟邪功能

    Institute of Scientific and Technical Information of China (English)

    许平山; 郭小文; 宿伟

    2015-01-01

    The psychological orientation of warding off evil has a far- reaching influence on Chinese people’s clothing outlook,which embodied not only in the choice of clothing color,such as taking red as auspicious,taking black and white as fierce;it is also reflected in the choice of clothing materials,such as taking hemp clothing to avoid fierce,with thick texture clothing access to auspicious.Moreover,it is also re-flected in the selection of morphological diversity of jewelry and clothing,such as jade,tattoos,chisel teeth to ward off evil.The function of special evil with the folk dress is the specific national culture,social psy-chology and aesthetic taste.%趋吉避凶的心理取向,对中国人的服饰观,产生了深远的影响。这不仅体现于服装色彩的选择上,如以红色为吉,以黑、白色为凶;也体现于服装材质的选择上,如以麻服避凶,以质地粗厚服装趋吉;还体现在多样形态的服装饰物的选取与佩戴上,如佩玉、文身、凿齿等以辟邪。民间服饰所承载的特定的辟邪功能,是特定的民族文化、社会心理与审美情趣的外现。

  14. Respect for privacy by nurses from the perspective of the elderly hospitalized in internal and surgical wards

    Directory of Open Access Journals (Sweden)

    Marzieh Zihaghi

    2016-03-01

    Full Text Available Background: Respect for privacy is the right of all patients, including the elderly, and lack of respect for patients could be associated with increased anxiety, stress, lack of confidence in hospital personnel, refusal of physical examination, and impaired recovery. This study aimed to evaluate respect for privacy by nurses from the perspective of the elderly hospitalized in internal and surgical wards. Methods: This cross-sectional study was conducted on the elderly hospitalized in internal and surgical wards of hospitals affiliated to Zahedan University of Medical Sciences, Zahedan, Iran, in 2015. In total, 132 patients were selected through convenience sampling. Data was collected using the researcher-made questionnaire of respect for privacy, reliability and validity of which were confirmed. Data analysis was performed in SPSS, version 16, using descriptive statistics, Mann-Whitney U tests, and Spearman’s correlation coefficient. Results: In this study, mean score of respect for privacy of patients by nurses was favorable in 70.4% of the cases. In terms of physical and psycho-social dimensions of privacy, 81.1% and 73.4% of the cases were at an acceptable level, respectively. Regarding information dimension of privacy, 84.8% of the cases were at a moderate level. A higher level of respect for privacy was reported by elderly female patients (104.24±13.7, compared to male elderlies (109.13±60.62; P=0.013. Moreover, a negative significant correlation was observed between age of the elderly and respect for privacy by nurses (P<0.001, r=-0.37. Conclusion: According to the results of this study, respect for the elderly was reported to be at a favorable level for physical and psycho-social dimensions. Nevertheless, information dimension of privacy was not acceptable. Therefore, it is recommended that necessary educational programs be performed for nurses.

  15. Sensory signals and neuronal groups involved in guiding the sea-ward motor behavior in turtle hatchlings of Chelonia agassizi

    Science.gov (United States)

    Fuentes, A. L.; Camarena, V.; Ochoa, G.; Urrutia, J.; Gutierrez, G.

    2007-05-01

    Turtle hatchlings orient display sea-ward oriented movements as soon as they emerge from the nest. Although most studies have emphasized the role of the visual information in this process, less attention has been paid to other sensory modalities. Here, we evaluated the nature of sensory cues used by turtle hatchlings of Chelonia agassizi to orient their movements towards the ocean. We recorded the time they took to crawl from the nest to the beach front (120m long) in control conditions and in visually, olfactory and magnetically deprived circumstances. Visually-deprived hatchlings displayed a high degree of disorientation. Olfactory deprivation and magnetic field distortion impaired, but not abolished, sea-ward oriented movements. With regard to the neuronal mapping experiments, visual deprivation reduced dramatically c-fos expression in the whole brain. Hatchlings with their nares blocked revealed neurons with c-fos expression above control levels principally in the c and d areas, while those subjected to magnetic field distortion had a wide spread activation of neurons throughout the brain predominantly in the dorsal ventricular ridge The present results support that Chelonia agassizi hatchlings use predominantly visual cues to orient their movements towards the sea. Olfactory and magnetic cues may also be use but their influence on hatchlings oriented motor behavior is not as clear as it is for vision. This conclusion is supported by the fact that in the absence of olfactory and magnetic cues, the brain turns on the expression of c- fos in neuronal groups that, in the intact hatchling, are not normally involved in accomplishing the task.

  16. Impact of a Local Low-Cost Ward-Based Response System in a Canadian Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Andrea Blotsky

    2016-01-01

    Full Text Available Background. Medical emergency teams (METs or rapid response teams (RRTs facilitate early intervention for clinically deteriorating hospitalized patients. In healthcare systems where financial resources and intensivist availability are limited, the establishment of such teams can prove challenging. Objectives. A low-cost, ward-based response system was implemented on a medical clinical teaching unit in a Montreal tertiary care hospital. A prospective before/after study was undertaken to examine the system’s impact on time to intervention, code blue rates, and ICU transfer rates. Results. Ninety-five calls were placed for 82 patients. Median time from patient decompensation to intervention was 5 min (IQR 1–10, compared to 3.4 hours (IQR 0.6–12.4 before system implementation (p<0.001. Total number of ICU admissions from the CTU was reduced from 4.8/1000 patient days (±2.2 before intervention to 3.3/1000 patient days (±1.4 after intervention (IRR: 0.82, p=0.04 (CI 95%: 0.69–0.99. CTU code blue rates decreased from 2.2/1000 patient days (±1.6 before intervention to 1.2/1000 patient days (±1.3 after intervention (IRR: 0.51, p=0.02 (CI 95%: 0.30–0.89. Conclusion. Our local ward-based response system achieved a significant reduction in the time of patient decompensation to initial intervention, in CTU code blue rates, and in CTU to ICU transfers without necessitating additional usage of financial or human resources.

  17. Prevalence and Antibiogram of Microbial Agents Causing Nosocomial Urinary Tract Infection in Surgical Ward of Dhaka Medical College Hospital

    Directory of Open Access Journals (Sweden)

    Tashmin Afroz Binte Islam

    2016-05-01

    Full Text Available Background: Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Bangladesh, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints and lack of awareness regarding nosocomial infections. Objective: We carried out this study to determine the prevalence of different microorganisms from urine in surgery ward and antimicrobial susceptibility pattern against various antibiotics. Materials and Methods: This cross sectional study was carried out in Department of Microbiology, Dhaka Medical College, Dhaka over a period of 12 months from July 2011 to June 2012. A total of 52 urine specimens were collected from catheterized patients admitted in general surgery ward of Dhaka Medical College Hospital (DMCH and incubated in blood agar, MacConkey agar media and the isolates were identified by different biochemical tests – oxidase test and reaction in MIU (motility indole urease and Simmon’s citrate and TSI (triple sugar iron media. ESBL producers were detected by double-disk synergy test (DDST. Results: Bacteria were isolated from 35 specimens and Escherichia coli was the commonest isolate (23, 65.71% followed by Pseudomonas aeruginosa 6 (17.14%, Klebsiella pneumoniae 3 (8.57%, Acinetobacter baumannii 2 (5.72% and Proteus vulgaris 1 (2.86% respectively. Among the isolates, 10 (28.57% ESBL producers were detected and the highest ESBL production was observed in Escherichia coli (8, 22.85% followed by Klebsiella pneumoniae 1 (2.86% and Pseudomonas aeruginosa 1 (2.86%. The isolates were resistant to most of the commonly used antimicrobial agents. Conclusion: The emergence of multi-drug resistant (MDR bacteria poses a difficult task for physicians who have limited therapeutic options. However, the high rate of nosocomial infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.

  18. Treatable factors associated with severe anaemia in adults admitted to medical wards in Blantyre, Malawi, an area of high HIV seroprevalence.

    NARCIS (Netherlands)

    Lewis, D.K.; Whitty, C.J.; Walsh, A.L.; Epino, H.; Broek, N.R.; Letsky, E.A.; Munthali, C.; Mukiibi, J.M.; Boeree, M.J.

    2005-01-01

    Severe anaemia is a common presentation in non-pregnant adults admitted to hospital in southern Africa. Standard syndromic treatment based on data from the pre-HIV era is for iron deficiency, worms and malaria. We prospectively investigated 105 adults admitted consecutively to medical wards with hae

  19. A quality improvement project using a problem based post take ward round proforma based on the SOAP acronym to improve documentation in acute surgical receiving

    Directory of Open Access Journals (Sweden)

    R. Dolan

    2016-02-01

    Conclusions: Standardised proformas improve the documentation of post-take ward round notes. This helps to clarify the onward management plan for all aspects of a patient's care and will help avoid adverse events and litigation. This should improve the quality and safety of Patient Care.

  20. A model of environmental variable in warding in electric power generation; Um modelo de internalizacao da variavel ambiental na geracao de energia eletrica

    Energy Technology Data Exchange (ETDEWEB)

    Maciel, Dulce Maria Holanda; Selig, Paulo Mauricio; Camargo, C. Celso de Brasil [Santa Catarina Univ., Florianopolis, SC (Brazil)

    2002-07-01

    Considering that the sustainable development became a unanimous objective to be attained by Brazil and rest of the world as well, this work presents a conception and a model for in warding of the environmental variable in the implantation of electric power generation, based on the project feasibility analysis by using the well established methodologies of the BIRD and Project Finance.

  1. 伦理查房的研究进展综述%Review on the Research Prowess on Ethical Ward- Round

    Institute of Scientific and Technical Information of China (English)

    刘雪莲; 嵇承栋

    2011-01-01

    In the process of medical service, the ethical ward - rounds which begin at 2002 reflect the important content of medical ethics. This paper summarize the concept, methods, content, effect, and the problem in the process of the ethical ward - rounds. Besides, feasible suggestions are also provided, such as the personnel constitution of ethical ward - rounds, promotion of ethics education, objective demonstration of ethical ward - rounds, concern for patients'psychological health, and ethical principle for out -patient clinic, in order to provide theoretical basis of further study.%在医疗服务的进程中,体现医学伦理重要内容的就是伦理查房.通过对伦理查房的概念、查房方式、查房内容、由此在实践中产生的成效,提出伦理查房目前还存在的问题及其思考,如伦理查房的人员构成、继续加强伦理教育、伦理查房客观论证、关注患者心理健康、门诊的伦理原则等,从而为进一步对伦理查房的研究提供理论基础.

  2. Do “trainee-centered ward rounds” help overcome barriers to learning and improve the learning satisfaction of junior doctors in the workplace?

    Directory of Open Access Journals (Sweden)

    Acharya V

    2015-10-01

    Full Text Available Vikas Acharya,1Amir Reyahi,2 Samuel M Amis,3 Sami Mansour2 1Department of Neurosurgery, University Hospitals Coventry and Warwickshire, Coventry, 2Luton and Dunstable University Hospital, Luton, 3Warwick Medical School, University of Warwick, Coventry, UK Abstract: Ward rounds are widely considered an underutilized resource with regard to medical education, and therefore, a project was undertaken to assess if the initiation of “trainee-centered ward rounds” would help improve the confidence, knowledge acquisition, and workplace satisfaction of junior doctors in the clinical environment. Data were collated from junior doctors, registrar grade doctors, and consultants working in the delivery suite at Luton and Dunstable University Hospital in Luton over a 4-week period in March–April 2013. A review of the relevant literature was also undertaken. This pilot study found that despite the reservations around time constraints held by both junior and senior clinicians alike, feedback following the intervention was largely positive. The junior doctors enjoyed having a defined role and responsibility during the ward round and felt they benefited from their senior colleagues’ feedback. Both seniors and junior colleagues agreed that discussing learning objectives prior to commencing the round was beneficial and made the round more learner-orientated; this enabled maximal learner-focused outcomes to be addressed and met. The juniors were generally encouraged to participate more during the round and the consultants endeavored to narrate their decision-making, both were measures that led to greater satisfaction of both parties. This was in keeping with the concept of “Legitimate peripheral participation” as described by Lave and Wenger. Overall, trainee-centered ward rounds did appear to be effective in overcoming some of the traditional barriers to teaching in the ward environment, although further work to formalize and quantify these findings

  3. Design and Development of Ward-Call Information System%病区呼叫信息系统的设计与开发

    Institute of Scientific and Technical Information of China (English)

    王建强; 仲晓伟

    2011-01-01

    Objective To develop and implement the ward-call management system. Methods According to the network mode and single mode, the state of patient in the ward bed and the call response were stored using SQL Server and Access database, and the client program was developed using Delphi7. Results The management system achieved the automatic and graphic management of ward beds, which made the management and statistical inquiries could be achieved by the management department. Conclusion The informationization of ward -call management is a part of informationization and digitalization management of hospital. It achieves the effective management of ward -call and improves satisfaction of patient.[Chinese Medical Equipment Journal, 201 1 , 32 ( 4) : 49-51 . 54]%目的:开发实现对病区呼叫可管理的系统.方法:按照网络模式和单机模式,分别采用SQL Server和Access的数据库分别存储病区床位患者情况及呼叫响应,客户端程序采用Delphi7开发.结果:管理系统实现了对病区床位的自动化图形化管理,医院护理管理部门可以实现查询和统计.结论:护理呼叫管理信息化是医院信息化、数字化管理的一部分,能实现对床位呼叫的有效管理,提高患者的满意度.

  4. The effect of additional training on motor outcomes at discharge from recovery phase rehabilitation wards: a survey from multi-center stroke data bank in Japan.

    Directory of Open Access Journals (Sweden)

    Nariaki Shiraishi

    Full Text Available The purpose of the present study was to examine the potential benefits of additional training in patients admitted to recovery phase rehabilitation ward using the data bank of post-stroke patient registry.Subjects were 2507 inpatients admitted to recovery phase rehabilitation wards between November 2004 and November 2010. Participants were retrospectively divided into four groups based upon chart review; patients who received no additional rehabilitation, patients who were added with self-initiated off hours training, patients who were added with off hours training by ward staff, patients who received both self-initiated training and training by ward staff. Parameters for assessing outcomes included length of stay, motor/cognitive subscales of functional independent measures (FIM and motor benefit of FIM calculated by subtracting the score at admission from that at discharge.Participants were stratified into three groups depending on the motor FIM at admission (≦28, 29∼56, 57≦ for comparison. Regarding outcome variables, significant inter-group differences were observed in all items examined within the subgroup who scored 28 or less and between 29 and 56. Meanwhile no such trends were observed in the group who scored 57 or more compared with those who scored less. In a decision tree created based upon Exhaustive Chi-squared Automatic Interaction Detection method, variables chosen were the motor FIM at admission (the first node additional training (the second node, the cognitive FIM at admission(the third node.Overall the results suggest that additional training can compensate for the shortage of regular rehabilitation implemented in recovery phase rehabilitation ward, thus may contribute to improved outcomes assessed by motor FIM at discharge.

  5. Application of visual management in medication management in the ward%目视管理在病区备用药物管理中的应用

    Institute of Scientific and Technical Information of China (English)

    苏琴; 何桂娟; 金瑛

    2014-01-01

    Objective:To investigate the effects of visual management in standby medication management in the ward. Methods:Using visual management method including color, logo, regional lines, and signboard to perform the standardized management of standby medication in the ward. Results:After implementation of visual management, the adverse events of ward standby medication reduced signiifcantly (P<0.05). Conclusion:Using visual management model in standby medication management in the ward is beneifcial for nurses to be familiar with the environment, enhance the safety awareness on standby medication management, reduce medication errors, ensure patient safety, and promote the standardized management of the ward standby medication.%目的:探讨目视管理在病区备用药物管理中的应用效果。方法:采用颜色、标识、区域线、看板等目视管理方法对病区备用药物进行规范化管理。结果:实施目视管理后,病区备用药物相关的不良事件发生率较前明显降低,差异有统计学意义(P<0.05)。结论:目视管理应用于病区备用药物管理,可方便护士熟悉环境,增强护士对药物管理的安全意识,降低病区备用药物不良事件发生率,保证患者用药安全,实现病区备用药物的规范化管理。

  6. Microbial Contamination on Used Surgical Masks among Hospital Personnel and Microbial Air Quality in their Working Wards: A Hospital in Bangkok

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    Pipat Luksamijarulkul

    2014-09-01

    Full Text Available Objective: To assess the relationship of bacterial and fungal contamination on used surgical masks worn by the hospital personnel and microbial air quality in their working wards. Methods: This is a cross-sectional study of 230 used surgical masks collected from 214 hospital personnel, and 215 indoor air samples collected from their working wards to culture for bacterial and fungal counts. This study was carried out at the hospital in Bangkok. Group or genus of isolated bacteria and fungi were preliminarily identified by Gram’s stain and lacto-phenol cotton blue. Data were analyzed using paired t-test and Pearson’s correlation coefficient at the significant level of p<0.050. Results: Means and standard deviation of bacterial and fungal contamination on inside area of the used masks were 47 ± 56 and 15 ± 9 cfu/ml/piece, and on outside area were 166 ± 199 and 34 ± 18 cfu/ml/piece, respectively, p<0.001. The bacterial and fungal contamination on used masks from hospital personnel working in the male and female medical wards and out-patient department, as well as the bacterial and fungal counts of the indoor air sample collected from the same area were relatively higher than the other wards. The predominant isolated bacteria and fungi contaminated on inside and outside areas of the used masks and air samples were similar (Staphylococcus spp. and Aspergillus spp.; respectively. For its relationship, results found that bacterial and fungal counts in air samples showed significantly positive correlation with the bacterial contamination load on outside area of the used masks, r=0.16, p=0.018 and r=0.21, p=0.003, respectively. Conclusion: High bacterial contamination on outside area of the used masks was demonstrated, and it showed a significant correlation with microbial air quality of working wards.

  7. Inpatient Opioid Withdrawal Management of Street Children and Adolescents Admitted to Child and Adolescent Psychiatric Ward: A Preliminary Case Series

    Directory of Open Access Journals (Sweden)

    Mahboubeh Firouzkouhi Moghadam

    2016-07-01

    Full Text Available Background About 10 million children worldwide live or work on the street. International reports estimate the prevalence of substance use among street children to be between 25% - 90%, which is who were referredntal disorders and high-risk behaviors. Objectives The objective of this study was to report the outcomes of assisted withdrawal of opioid-dependent vulnerable children and adolescents who were referred to child and adolescent psychiatric ward of Ali Ebne Abitaleb hospital, an academic hospital in Zahedan city. Methods Clinical chart abstractions were performed on a convenience sample of 40 serial opioid-dependent street children and adolescents (mean age: 11.14 ± 3.6 years who were referred to child and adolescent psychiatric ward of Ali Ebne Abitaleb treatment and research center from November 2014 to May 2015. The demographic data, drug use history, comorbid physical and psychiatric conditions, symptomatology of opioid withdrawal syndrome, pharmacotherapies and psychosocial services, length of hospital stay, and any adverse events were extracted from the patients’ files using a checklist developed by the authors. Results Twenty-four (60% patients were male, and 16 (40% were female. The main drug used by all patients was opioids. Heroin Kerack (which has a street name of crystal in southeast Iran was the most common (75% drug of use, followed by opium (10% and opium residue (7.5%. None of the participants self-reported using injected drugs. The high rate of a lack of eligibility for guardianship was documented among parents (87.5% mainly due to their use of illegal drugs. Musculoskeletal pain and diarrhea were the most common withdrawal symptoms of the patients upon admission. The mean length of stay was 10.8 (± 7.30 days, and no significant adverse events were reported during the symptomatic treatment of opioid withdrawal syndrome. Conclusions To our knowledge, this is the first study to report on the safety and feasibility of

  8. Potential drug-drug interactions in pediatric wards of Gondar University Hospital, Ethiopia:A cross sectional study

    Institute of Scientific and Technical Information of China (English)

    Henok Getachew; Mohammed Assen; Feser Dula; Akshaya Srikanth Bhagavathula

    2016-01-01

    Objective: To determine the prevalence, level of severity of potential drug–drug in-teractions (PDDIs) and the associated factors for PDDIs in hospitalized pediatric patients of Gondar University Hospital. Methods: A retrospective cross-sectional study was conducted for a period of 3 months from March to May 2014 in pediatric wards of Gondar University Hospital. Systematic random sampling technique was used to select charts from all pediatric patients' charts with every 7th interval to get sample size of 384. Univariate and multivariate analysis were performed to compute crude odds ratio and adjusted odds ratio respectively. Sta-tistical significance was set at P value Results: A total of 176 (45.8%) patients had at least one PDDI. A total of 393 PDDIs, which were comprised of 283 types of interacting combinations, were identified. Of the total of 393 PDDIs, most were of moderate severity [201 (51%)] followed by minor [152 (39%)] and major severity [40 (10%)]. The most common interacting pairs of major severity were gentamicin + furosemide (6), cotrimoxazole + methotrexate (4) and phenytoin + artemether (4). The occurrence of PDDIs was significantly associated with age and polypharmacy. Conclusions: The study showed that most of the interactions had moderate severity followed by minor severity. Age and polypharmacy were found to show statistically significant association with the occurrence of PDDIs. Due to sensitive nature of pediatrics population, close monitoring is recommended for the detection and management of PDDIs to prevent its negative consequences.

  9. The Revolving Door Phenomenon in an Italian Acute Psychiatric Ward: A 5-Year Retrospective Analysis of the Potential Risk Factors.

    Science.gov (United States)

    Di Lorenzo, Rosaria; Sagona, Marco; Landi, Giulia; Martire, Lisa; Piemonte, Chiara; Del Giovane, Cinzia

    2016-09-01

    To highlight the revolving door (RD) phenomenon in an acute psychiatric ward, we retrospectively identified the patients hospitalized three or more times in a calendar year from 1/1/2009 to 31/12/2013 as RD patients (RDP). We collected sociodemographic and clinical variables of RDP and statistically analyzed the potential RD risk factors. We divided RDP into "high" and "extremely high" utilizers and evaluated the variables related to more frequent readmissions. RDP represented 5.68% of all patients and their hospitalizations (RDH) 25% of all admissions. The statistically significant risk factors for all RDH were "disability pension," "substance abuse/dependence," "mild/severe aggressiveness," and "psychiatric and social rehabilitative programs". The comparison between "high" and "extremely high" utilizers showed that "manic episodes" and "personality disorders," among the diagnoses, "familial relational conflicts" and "violence/suicidality", among the hospitalization reasons, were statistically significant risk factors for more frequent readmissions. RD phenomenon was greatly affected by severe clinical conditions with social disability.

  10. An IBCLC in the Maternity Ward of a Mother and Child Hospital: A Pre- and Post-Intervention Study

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    Antonella Chiurco

    2015-08-01

    Full Text Available Published evidence on the impact of the integration of International Board Certified Lactation Consultants (IBCLCs for breastfeeding promotion is growing, but still relatively limited. Our study aims at evaluating the effects of adding an IBCLC for breastfeeding support in a mother and child hospital environment. We conducted a prospective study in the maternity ward of our maternal and child health Institute, recruiting 402 mothers of healthy term newborns soon after birth. The 18-month intervention of the IBCLC (Phase II was preceded (Phase I by data collection on breastfeeding rates and factors related to breastfeeding, both at hospital discharge and two weeks later. Data collection was replicated just before the end of the intervention (Phase III. In Phase III, a significantly higher percentage of mothers: (a received help to breastfeed, and also received correct information on breastfeeding and community support, (b started breastfeeding within two hours from delivery, (c reported a good experience with the hospital staff. Moreover, the frequency of sore and/or cracked nipples was significantly lower in Phase III. However, no difference was found in exclusive breastfeeding rates at hospital discharge or at two weeks after birth.

  11. The use of typing methods and infection prevention measures to control a bullous impetigo outbreak on a neonatal ward

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    Koningstein Maike

    2012-11-01

    Full Text Available Abstract Background We describe an outbreak of Bullous Impetigo (BI, caused by a (methicillin susceptible, fusidic acid resistant Staphylococcus aureus (SA strain, spa-type t408, at the neonatal and gynaecology ward of the Jeroen Bosch hospital in the Netherlands, from March-November 2011. Methods We performed an outbreak investigation with revision of the hygienic protocols, MSSA colonization surveillance and environmental sampling for MSSA including detailed typing of SA isolates. Spa typing was performed to discriminate between the SA isolates. In addition, Raman-typing was performed on all t408 isolates. Results Nineteen cases of BI were confirmed by SA positive cultures. A cluster of nine neonates and three health care workers (HCW with SA t408 was detected. These strains were MecA-, PVL-, Exfoliative Toxin (ETA-, ETB+, ETAD-, fusidic acid-resistant and methicillin susceptible. Eight out of nine neonates and two out of three HCW t408 strains yielded a similar Raman type. Positive t408 HCW were treated and infection control procedures were reinforced. These measures stopped the outbreak. Conclusions We conclude that treatment of patients and HCW carrying a predominant SA t408, and re-implementing and emphasising hygienic measures were effective to control the outbreak of SA t408 among neonates.

  12. Effect of handrubbing using locally-manufactured alcohol-based handrubs in paediatric wards in Harare, Zimbabwe

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    Muchaneta Gudza-Mugabe

    2017-01-01

    Full Text Available Abstract We assessed bacterial contamination of hands of adults present in paediatric wards in two tertiary-care hospitals in Harare, Zimbabwe and the microbiologic efficacy of locally-manufactured alcohol-based hand rub (ABHR. During unannounced visits, samples were collected using hand-print and hand-rinse methods. Samples were collected from 152 individuals (16 nurses, 10 doctors, 28 students, 86 parents/guardians, 12 others. Contamination of hands with Gram-negative bacteria was found in 91% of adults tested with a mean of 14.6 CFU (hand-rinse method; IQR 3–65, representing a high risk for transmission of pathogens potentially leading to nosocomial infections. A single application of ABHR under controlled conditions achieved an average of 82% (or 0.72 log reduction in detectable counts. Amongst 49 Enterobacteriaceae isolates from hands, 53% were resistant to gentamicin and 63% were resistant to cefpodoxime. Use of ABHR represents an attractive intervention for reducing nosocomial infections in this setting.

  13. Poverty and Its Association with Child Labor in Njombe District in Tanzania: The Case of Igima Ward

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    Rocky R.J. Akarro

    2011-05-01

    Full Text Available The main aim of the study is to present the state of child labour and factors behind this citing one of the most prevalent areas for child labour in Tanzania known as Njombe. Njombe district which is predominantly a rural area is one of the most prevalent areas of child labour in Tanzania. A survey of 300 household heads that were randomly selected from accessible four villages in Igima ward in Njombe district confirmed this phenomenon. Chi-square statistic analysis on the relationship between household poverty and child labour showed that household poverty was the factor which forced children to engage in economic activities. Major finding emanating from this study is that child labour is a reflection of poverty and therefore tackling poverty will have a positive impact on child labour. This suggests that policies such as a ban on child labour in rural areas could have an adverse effect as child labour decisions are more likely a response to poverty and subsistence requirements.

  14. Epidemiology, species distribution, antifungal susceptibility and outcome of candidemia among Internal Medicine Wards of community hospitals of Udine province, Italy

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    Federico Silvestri

    2014-09-01

    Full Text Available Candidemia is an emerging problem among patients hospitalized in Internal Medicine Wards (IMW. We performed a retrospective study to assess the epidemiology, species distribution, antifungal susceptibility and outcome of candidaemia recorded over a 3-year period (2010-2012 among IMW of community hospitals of Udine province in Italy: forty-eight patients were identified, with an overall incidence of 1.44 cases/1000 hospital admissions/year. Candida albicans was the most frequent species, followed by Candida parapsilosis that accounted for 42.9% of Tolmezzo cases. All isolates were susceptible to amphotericin and caspofungin, while 11.4% of strains were not-susceptible to voriconazole and 14.3% to fluconazole. Crude mortality was 41.7%. In conclusion, in community hospitals overall incidence of candidemia is similar to tertiary care hospitals, but 80% of cases are detected in IMW. Candida species distribution is overlapping, but differences in local epidemiology were found and should be taken into consideration. No resistance to amphotericin and caspofungin was found while resistance to azoles was observed. Knowledge of this data might be useful when planning the best therapeutic strategy.

  15. Characteristics of patients frequently subjected to pharmacological and mechanical restraint--a register study in three Norwegian acute psychiatric wards.

    Science.gov (United States)

    Knutzen, Maria; Bjørkly, Stål; Eidhammer, Gunnar; Lorentzen, Steinar; Mjøsund, Nina Helen; Opjordsmoen, Stein; Sandvik, Leiv; Friis, Svein

    2014-01-30

    This retrospective study from three catchment-area-based acute psychiatric wards showed that of all the pharmacologically and mechanically restrained patients (n=373) 34 (9.1%) had been frequently restrained (6 or more times). These patients accounted for 39.2% of all restraint episodes during the two-year study period. Adjusted binary logistic regression analyses showed that the odds for being frequently restrained were 91% lower among patients above 50 years compared to those aged 18-29 years; a threefold increase (OR=3.1) for those admitted 3 times or more compared to patients with only one stay; and, finally, a threefold increase (OR=3.1) if the length of stay was 16 days or more compared to those admitted for 0-4 days. Among frequently restrained patients, males (n=15) had significantly longer stays than women (n=19), and 8 of the females had a diagnosis of personality disorder, compared to none among males. Our study showed that being frequently restrained was associated with long inpatient stay, many admissions and young age. Teasing out patient characteristics associated with the risk of being frequently restraint may contribute to reduce use of restraint by developing alternative interventions for these patients.

  16. Feed back of the parents and / or relatives witnessing a squint surgery of their ward in the operation theater

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    Mihir Kothari

    2011-01-01

    Full Text Available The aim of the study was to know the response of the relatives attending the squint surgery of their ward. A trained secretary administered an eight item questionnaire by live / telephonic interview. Of the 44 attendees, two left the Operation Theater before completion of the surgery. Mean age of the patients was 7.2 years ± 7.8 and that of the attendees was 36.1 years ± 8.5. Forty patients had a surgery under general anesthesia and four under local anesthesia. Eleven (25% attendees experienced an increase in anxiety. Thirty-six (82% attendees reported increased transparency, 38 (86% reported increased confidence, and 43 (98% reported increased awareness. None found any disadvantage. Twenty-seven (61% recommended this practice for all and 16 (36% recommended the practice selectively. The internal validity of the questionnaire was fair (Cronbach′s Alpha = 0.6. It was concluded that the presence of relatives in the Operation Theater during the surgery could bring in more transparency, accountability, confidence, awareness, and trust.

  17. 医院病房楼雷击风险评估%Lightning Risk Evaluation on Hospital Ward

    Institute of Scientific and Technical Information of China (English)

    金雯晴

    2012-01-01

    针对医院病房楼的特殊结构,用IEC62305-2《雷电灾害风险评估》的评估方法对其进行雷击风险评估。风险评估的结果显示,雷击风险主要来自雷击建筑物及相连线路造成的内部系统失效所引起的,需要采取三级浪涌保护,使人员伤亡损失R1风险值降低到容限值以下,并通过对经济损失R4的计算。得出该方案是经济合理的。%Aiming at the special structure of the hospital ward, and its lightning risk was assessed using the method from IEC 62305-2 risk assessment for lightning disaster. The results showed that the lightning risk is mainly caused by system failure of the buildings and their connection lines when they are struck by lightning. It need to use 3 level SPD to decrease the casualties loss (R1 ) to an acceptable range, and calculate the economical rationality of the program by counting the economic loss (R4).

  18. Developing an holistic assessment protocol on a hospice inpatient ward: staff engagement and my role as a practice development facilitator

    Directory of Open Access Journals (Sweden)

    John Lansdell

    2016-05-01

    Full Text Available Background: In 2014 I received the Richard Tompkins Nurse Development Scholarship, granted through the Foundation of Nursing Studies and including attendance at a five-day International Practice Development Collaborative practice development school, followed by a year’s mentorship. The scholarship aims to foster the delivery of person-centred care, which I hoped to achieve by enhancing holistic nursing assessment on a hospice inpatient ward. Aims: This article is a critical reflection on my learning through the scholarship, specifically related to staff engagement and my role as a practice development facilitator. Conclusions: While the project has not yet reached its conclusion, the learning has been invaluable. I have deepened my understanding of the need for collaboration, inclusion and participation to foster engagement and cultural change. More fundamentally, understanding how different aspects of my role enable change has proved both challenging and constructive, resulting in greater self-awareness and confidence. I remain committed to refining holistic nursing assessment to allow a greater degree of person-centred care in the hospice. Implications for practice: Practice development combines a variety of approaches to realise a shared vision; collaboration, inclusion and participation are central to fostering engagement Balancing different elements of a role (for instance, leader-manager-facilitator has the potential to be confusing and contradictory; awareness of how these elements interrelate promotes effectiveness when introducing change Individuals in a practice development role must ensure they have good sources of support

  19. Characteristics of immigrant and non-immigrant patients in a dual-diagnosis psychiatric ward and treatment implications.

    Science.gov (United States)

    Walsh, Sophie D; Blass, David; Bensimon-Braverman, Meital; Barak, Lee Topaz; Delayahu, Yael

    2014-12-01

    Two studies were conducted among patients in a male dual diagnosis (severe mental illness [SMI] with substance use) ward. The research examined the following questions: (1) Do immigrant and non-immigrant dual diagnosis patients exhibit similar or different socio-demographic, clinical and criminological characteristics? (2) What are the implications for treatment of immigrant (and non-immigrant) patients? Study one analyzed computerized hospital records of 413 male patients; Study two examined patient files of a subgroup of 141 (70 immigrant) male patients. Alongside similarities, non-immigrant patients reported higher numbers of repeat and involuntary hospitalizations and more drug use while immigrants showed longer hospitalizations, more suicide attempts, more violent suicide attempts, more violent offenses and more alcohol use. Among non-immigrants significant relationships were found between severity of SMI and crime/violence while among immigrants a significant relationship was found between suicidality and crime/violence. Implications for treatment include need for awareness of suicide risk among immigrant dual-diagnosis patients and an understanding of the differential relationship with crime/violence for the two populations.

  20. Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general ward - a questionnaire study

    DEFF Research Database (Denmark)

    Sølver, Lisbeth; Østergaard, Birte; Rydahl Hansen, Susan;

    2012-01-01

    SOELVER L., OESTERGAARD B., RYDAHL-HANSEN S. & WAGNER L. (2012) European Journal of Cancer Care21, 667-676 Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general wards - a questionnaire study Most cancer patients receiving life......-prolonging or palliative treatment are offered non-specialist palliative services. There is a lack of knowledge about their problem profile. The aim of this article is to describe the incidence of patient-reported physical and emotional problems on admission and discharge from general hospital wards and health staff......-reported problems and reported intervention for physical function, pain, constipation and loss of appetite. Palliative cancer patients' self-reported problem profile on admission and discharge from hospital has not previously been described and the results indicate a need to focus on improvements to palliative...

  1. The Norwegian version of Mini-International Neuropsychiatric Interview (M.I.N.I.): Feasibility, patient acceptability and test-retest reliability in an acute psychiatric ward.

    OpenAIRE

    Gundersen, Øystein

    2007-01-01

    ABSTRACT Background: Mini-International Neuropsychiatric Interview (MINI) is a structured psychiatric diagnostic interview. Feasibility, patient acceptability, reliability and validity of MINI have been tested in other countries, but not yet in Norway. Objective: The aim of the present study was to test the feasibility, patient acceptability and test-retest reliability of the Norwegian MINI version in an acute psychiatric ward. Methods: From August 2006 to February 2007 3...

  2. Nurse Managers' Perceptions Related to Their Leadership Styles, Knowledge, and Skills in These Areas—A Viewpoint: Case of Health Centre Wards in Finland

    OpenAIRE

    Soili Vesterinen; Marjo Suhonen; Arja Isola; Leena Paasivaara; Helena Laukkala

    2013-01-01

    The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles—visionary, coaching, affiliate, democratic, commanding, and isolating—were reflected on. Almost all respondents in every age group considered four...

  3. Characteristics of Potassium-Enriched, Flue-Cured Tobacco Genotype in Potassium Absorption,Accumulation,and In-Ward Potassium Currents of Root Cortex

    Institute of Scientific and Technical Information of China (English)

    YNAG Tie-zhao; LU Li-ming; XIA Wei; FAN Jin-hua

    2007-01-01

    This study was to investigate the main traits of potassium-enriched,flue-cured tobacco genotypes related to potassium absorption,accumulation,and in-ward potassium currents of the root cortex.Hydroponic methods,K+-depletion methods,and patch-clamp,whole-cell recordings were conducted to study the accumulation of dry matter and potassium in different organs,and to measure potassium absorption and dynamic and in-ward potassium currents in potassium-enriched,fluecured tobacco genotypes.The average dry weights of leaves and whole plant of potassium-enriched,flue-cured tobacco genotype ND202 were 10.20,and 14.85g,respectively,higher than JYH(8.50 and 13.11g,respectively)and NC2326(8.39 and 12.72g,respectively),when potassium concentration in the solution ranged from 0.1 to 50mmol L-1.Potassium accumulation in the leaves of ND202 was 18.6% higher than JYH and 34% higher than NC2326 when potassium concentration in the solution was superior to 0.5mmol L-1.The Vmax(the maximum velocity)of ND202 was 118.11μmol FW g-1h-1,obviously higher than that of JYH(58.87 μmol FW g-1 h-1)and NC2326(64.40μmol FW g-1 h-1).In the in-ward potassium currents,the absolute value of current density(pA/pF)of ND202 was 60,higher than that of JYH(50)and NC2326(40).Potassium concentration in leaves,Vmax and in-ward potassium currents,could be used to screen potassium-enriched,flue-cured tobacco genotypes.

  4. Epidemiology and resistance features of Acinetobacter baumannii isolates from the ward environment and patients in the burn ICU of a Chinese hospital.

    Science.gov (United States)

    Gong, Yali; Shen, Xiaodong; Huang, Guangtao; Zhang, Cheng; Luo, Xiaoqiang; Yin, Supeng; Wang, Jing; Hu, Fuquan; Peng, Yizhi; Li, Ming

    2016-08-01

    Acinetobacter baumannii is an important opportunistic pathogen that causes severe nosocomial infections, especially in intensive care units (ICUs). Over the past decades, an everincreasing number of hospital outbreaks caused by A. baumannii have been reported worldwide. However, little attention has been directed toward the relationship between A. baumannii isolates from the ward environment and patients in the burn ICU. In this study, 88 A. baumannii isolates (26 from the ward environment and 62 from patients) were collected from the burn ICU of the Southwest Hospital in Chongqing, China, from July through December 2013. Antimicrobial susceptibility testing results showed that drug resistance was more severe in isolates from patients than from the ward environment, with all of the patient isolates being fully resistant to 10 out of 19 antimicrobials tested. Isolations from both the ward environment and patients possessed the β-lactamase genes bla OXA-51, bla OXA-23, bla AmpC, bla VIM, and bla PER. Using pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST), these isolates could be clustered into 4 major PFGE types and 4 main sequence types (ST368, ST369, ST195, and ST191) among which, ST368 was the dominant genotype. Epidemiologic and molecular typing data also revealed that a small-scale outbreak of A. baumannii infection was underway in the burn ICU of our hospital during the sampling period. These results suggest that dissemination of β-lactamase genes in the burn ICU might be closely associated with the high-level resistance of A. baumannii, and the ICU environment places these patients at a high risk for nosocomial infection. Cross-contamination should be an important concern in clinical activities to reduce hospitalacquired infections caused by A. baumannii.

  5. A Study to Identify Functions Which Inhibit or Facilitate the Health Care Delivery Process on Ward 51 at Walter Reed Army Medical Center, Washington, D.C.

    Science.gov (United States)

    1980-08-01

    system for distribution of supplies and linen on mobile supply carts has become a manual system because of design flaws in the monorail which was desigred...point have malfunctioned, creating the need for manual transport systems. 5. The move into the new facility coincided with fu]l implementation of the...of logistics technicians 3. Helpfulness of ward desk personnel - 29 - Administrativo Personnel 1. Information presented on nursing organization 2

  6. Implementing Electronic Patient Record and VIPS in medical hospital wards: Evaluating change in quantity and quality of nursing documentation by using the audit instrument Cat-ch-Ing

    OpenAIRE

    Rykkje, Linda

    2009-01-01

    Aim: The study examines the effectiveness of implementation of electronic nursing documentation and the nursing documentation system VIPS at the Department of Medicine, and also aims to improve our understanding of content and quality in nursing documentation. Background: After introducing Electronic Patient Record (EPR) and VIPS to medical wards, change in the quantity and quality of nursing documentation was evaluated by using the audit instrument Cat-ch-Ing. Method: Cat-ch-Ing ...

  7. A quality improvement project using a problem based post take ward round proforma based on the SOAP acronym to improve documentation in acute surgical receiving

    Science.gov (United States)

    Dolan, R.; Broadbent, P.

    2015-01-01

    Objectives Ward round documentation provides one of the most important means of communication between healthcare professionals. We aimed to establish if the use of a problem based standardised proforma can improve documentation in acute surgical receiving. Methods Gold standards were established using the RCSE record keeping guidelines. We audited documentation for seven days using the following headings: patient name/identification number, subjective findings, objective findings, clinical impression/diagnosis, plan, diet status, discharge decision, discharge planning, signature, and grade. After the initial audit cycle, a ward round proforma was introduced using the above headings and re-audited over a seven day period. Results The pre-intervention arm contained 50 patients and the post intervention arm contained 47. The following headings showed an improvement in documentation compliance to 100%: patient name/identification number vs 96%, subjective findings vs 84%, objective findings vs 48%, plan vs 98%, signature vs 96%, and grade vs 62%. Documentation of the clinical impression/diagnosis improved to 98% vs 30%, diet status rose to 83% vs 16%, discharge decision to 66% vs 16%, and discharge planning to 40% vs 20%. Conclusions Standardised proformas improve the documentation of post-take ward round notes. This helps to clarify the onward management plan for all aspects of a patient's care and will help avoid adverse events and litigation. This should improve the quality and safety of Patient Care. PMID:26858834

  8. The Changing Pattern of Hospital Admission to Medical Wards; Burden of non-communicable diseases at a hospital in a developing country

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    Sufian K. Noor

    2015-11-01

    Full Text Available Objectives: This study aimed to determine the pattern of hospital admissions and patient outcomes in medical wards at Atbara Teaching Hospital in River Nile State, Sudan. Methods: This retrospective cross-sectional study was conducted from August 2013 to July 2014 and included all patients admitted to medical wards at the Atbara Teaching Hospital during the study period. Morbidity and mortality data was obtained from medical records. Diseases were categorised using the World Health Organization’s International Classification of Diseases (ICD coding system. Results: A total of 2,614 patient records were analysed. The age group with the highest admissions was the 56‒65-year-old age group (19.4% and the majority of patients were admitted for one week or less (86.4%. Non-communicable diseases constituted 71.8% of all cases. According to ICD classifications, patients were admitted most frequently due to infectious or parasitic diseases (19.7%, followed by diseases of the circulatory (16.4%, digestive (16.4% and genito-urinary (13.8% systems. The most common diseases were cardiovascular disease (16.4%, malaria (11.3%, gastritis/peptic ulcer disease (9.8%, urinary tract infections (7.2% and diabetes mellitus (6.9%. The mortality rate was 4.7%. Conclusion: The burden of non-communicable diseases was found to exceed that of communicable diseases among patients admitted to medical wards at the Atbara Teaching Hospital.

  9. [Clinical psychopathological research on late-onset schizophrenia--mainly patients with schizophrenia from a hospital psychiatric ward].

    Science.gov (United States)

    Yasuda, Manabu; Kato, Satoshi

    2009-01-01

    In the field of clinical psychiatry, cases of late-onset schizophrenia are often observed in the population of 40 years or older. Female patients seem to significantly predominate those diagnosed with late-onset schizophrenia. Generally, paranoid delusions of reference with family members, neighbors, and friends are observed as clinical features of such late-onset schizophrenia conditions. Medical treatment for such a condition is often effective and considered to improve the prognosis. The authors conducted clinical research at Jichi Medical University Hospital psychiatric ward involving 38 late-onset schizophrenia patients (7 males; 31 females) diagnosed over the age of 40 using DSM-IV-TR diagnostic criteria. Subjects were selected from 316 schizophrenia patients (164 males; 152 females) admitted to the hospital for schizophrenia treatment at some time during the 13 years from April 1, 1993 to March 31, 2006. Also, another 14 late-onset schizophrenia patients diagnosed over the age of 40 (1 male; 13 females), with additional investigation, were selected from 130 cases (50 males; 80 females) treated in related facilities at some time during the 2 years from April 1, 2004 to March 31, 2006. The investigation revealed the following results: (1) Cases showing an onset after the age of 40 comprised 12% of the total population. Female cases comprised 20.4%, being significantly higher than that of male cases (4.3%). Within the psychiatric ward, cases showing an onset after 40 made up 10.8% of the total population. Female cases comprised 16.3%, being significantly higher than that of male cases (2.0%). (2) The paranoid type comprised 55.3% of the total population of late-onset cases, being significantly higher than in early-onset cases younger than 40 years old. A total of 55.3% of late-onset cases also showed depressive symptoms, being significantly higher than in early-onset cases. (3) For late-onset, 55.3% of patients showed an introverted premorbid character, while

  10. Cost - utility analysis of parenteral antibiotics prescribed in medical wards in a tertiary care health facility in southern province of Sri Lanka

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    Lukshmy Menik Hettihewa

    2012-10-01

    Full Text Available Introduction: Parenteral antibiotic (PA prescription pattern in a hospital will directly influence the annual budget allocation, development of bacterial resistance and occurrence of unnecessary adverse drug reactions if it is done with poor adherence to the standard guidelines of prescription. As specialist in the field we understand the need of conducting economic studies in relation to the cost and utility of PA prescription pattern. It will be helpful to predict the drug procurement plan for the next year and also to prevent unnecessary complications mentioned above. Objective: Our main objective was to analyze the cost/utility relationship of PA drugs which were used in medical wards in this hospital according to the top ten of the cost (TTTC and the top ten of the consumption (TTCS. Materials and method : Aggregate data from the pharmacy record books were collected for year 2010 from indoor pharmacy. Unit prize was obtained from medical supplies division. Total quantity consumed by each medical ward was considered for analysis of the cost /utility relationship. Two top ten lists were prepared according to the cost and the consumption respectively for medical wards and the correlation was analyzed using non parametric testing with spearman test. Results: Regarding PA drugs used in this hospital, 7/10 PA drugs in TTTC are not included in the TTCS. Out of the total cost for TTTC, 82.6% of the cost had been spent for the PA drugs which are not in the TTCS and 17.5% of the cost of TTTC was used to purchase only three drugs from the TTCS. But these three drugs had contributed only 28% of top ten consumption. 72% of the PA drugs in TTCS were not costly drugs and highly consumed in medical wards. Correlation was significantly positive between cost and utility of PA drugs. ( r=-0.91,p<0.001 Conclusion: Majority of the consumed PA drugs are non-costly and it indicates the prescriptions had been done according to the rational guidelines including

  11. Epidemiologic Evaluation of Ocular Trauma in Patients Admitted to Ophthalmology Ward of Farshchian Hospital in Hamadan in 2012

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    N. Bazzazi

    2014-04-01

    Full Text Available Introduction & Objective: Ocular trauma is one of the important reasons of visual loss which can cause multiple damages to eyelid, eyeball and adenexal tissues. Furthermore, ocular trauma is one of the major causes of unilateral blindness and the third leading cause of hospi-talization in ophthalmology wards. The aim of this study is to determine the prevalence and characteristics of eye trauma at Farshchian hospital in Hamadan in 2012. Material & Methods: In this cross-sectional descriptive study, 70 patients with ocular trauma, admitted to Farshchian hospital, were studied. We assessed the age, sex, job , educational level, location, cause of trauma, its type and site of injury. The data was analyzed by SPSS 16 software and t, ?2 statistical tests. Results: The mean age of patients in this study was 24.01 years (SD= 16.04. Among 70 pa-tients, 58 people (82.1% were males and 12 patients (17.1% were females. The most com-mon cause of trauma was observed in 19 patients (27.1%. The most common location of the trauma in this study was homing, seen in 28 patients (40%. Among the 70 patients, 29 peo-ple (41.4% had open globe injuries, 25 people had (35.7% closed globe injuries, 5 patients (7.1% had burning and 11 patients (15.7% had adenexal injury. Conclusions: The results showed that most ocular traumas occur in the early ages and in males. The most common type of them is open globe injury and the most common cause is a sharp object. (Sci J Hamadan Univ Med Sci 2014; 21 (1:25-31

  12. About to Lose all the Soil in Zaka’s Ward 5, Zimbabwe: Rewards of Unsustainable Land Use

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    E.C. Makwara

    2014-04-01

    Full Text Available Soil erosion which manifests itself in the form of gullies, rills and sheet wash is animmensely complicated process involving the interaction of many biological, social,economic, environmental and political factors. It varies in its occurrence bothspatially and temporally. The ultimate result of soil erosion is that it reduces cropyields and ruins agriculture, though the exact extent of soil erosion and landdegradation is not known.The study was carried out in Masvingo Province, ZakaDistrict, Ward 5 with 4502 households using the questionnaire survey, interviewand field observations as research methods. The study established that populationpressure ( people and livestock, as evidenced by, cultivation of steep slopes,stream bank cultivation, deforestation and overstocking are major problems .Fromthe results, it emerged that people continue to compound the problem by settlingand extending farmlands on steep slopes, stream banks, grazing land and dambos/veils. Therefore, there is need to educate people on conservation, proper tillage,proper or correct stocking rates, develop a proper land tenure system and avoidingland degradation. There are patches of abandoned land on account of failure tosupport crops or grazing. This means that there is need for soil conservationmeasures to be instituted so as to save the soil from further deterioration. This isnot to say nothing has been done before, rather it is the enormity of the problemthat dictates that form and decisive action needs be taken sooner rather than latter.Measures which have been implemented are fragmented and seem to have metwith very limited, if at all any, success so there might be need to revisit both theapproach ,methods, techniques and strategies which have been tried hitherto witha view to blend them with the yet untried and untested methods.

  13. Nutritional status influences the length of stay and clinical outcomes in hospitalized patients in internal medicine wards

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    Ana Manuela Ordoñez

    2013-08-01

    Full Text Available Objective: The aim of this study was to investigate the relationship between the nutritional status (NS and clinical outcome and length of stay (LOS among patients admitted to the internal medicine ward. Methods: This is a retrospective observational study performed with the data of clinical patients collected during a one year period. The NS was assessed using: subjective global assessment (SGA, body mass index (BMI, triceps skinfold thickness (TST, muscle arm circumference (MAC and combined tools. Statistical analysis was performed with a confidence interval of 95% (p < 0.05. For categories comparison the chi-square test was used. To examine the association between length of stay and variables related to the NS Mann-Whitney and Kruskal-Wallis tests was used with multiple comparisons. Results: 396 patients were included in the study, 42.2% were over 60 years of age, what was associated with the presence of hypertension (p < 0.001, diabetes mellitus (p = 0.003 and required diet with modifications consistency (p = 0.003. According to combined diagnostic tools, 45.7% of patients were malnourished. Decreased food intake (p = 0.01, malnutrition according to SGA (p = 0.02 and MAC (p = 0.03 were associated with increased mortality. Patients with tertiary level of care (p = 0.01, decreased food intake (p = 0.001, who died (p = 0.004 and diagnosed with malnutrition by SGA (p = 0.001 and by the combined tools (p = 0.001 had a longer LOS. Conclusions: Patients who were malnourished by SGA and who presented decrease food intake at admission had longer LOS and poorer clinical outcomes (highest number of deaths. The diagnosis of malnutrition by MAC was also related to higher mortality.

  14. What aspects of intentional rounding work in hospital wards, for whom and in what circumstances? A realist evaluation protocol

    Science.gov (United States)

    Harris, Ruth; Sims, Sarah; Levenson, Ros; Gourlay, Stephen; Ross CBE, Fiona; Davies, Nigel; Brearley, Sally; Favato, Giampiero; Grant, Robert

    2017-01-01

    Introduction Intentional rounding (IR) is a structured process whereby nurses in hospitals carry out regular checks, usually hourly, with individual patients using a standardised protocol to address issues of positioning, pain, personal needs and placement of items. The widespread implementation of IR across the UK has been driven by the recommendations of the Francis Inquiry although empirical evidence of its effectiveness is poor. This paper presents a protocol of a multimethod study using a realist evaluation approach to investigate the impact and effectiveness of IR in hospital wards on the organisation, delivery and experience of care from the perspective of patients, their family members and staff. Methods and analysis The study will be conducted in four phases. Phase 1: theory development using realist synthesis to generate hypotheses about what the mechanisms of IR may be, what particular groups may benefit most or least and what contextual factors might be important to its success or failure which will be tested in subsequent phases of the study. Phase 2: a national survey of all NHS acute trusts to explore how IR is implemented and supported across England. Phase 3: case studies to explore how IR is implemented ‘on the ground’, including individual interviews with patients, family members and staff, non-participant observation, retrieval of routinely collected patient outcomes and cost analysis. Phase 4: accumulative data analysis across the phases to scrutinise data for patterns of congruence and discordance and develop an overall evaluation of what aspects of IR work, for whom and in what circumstances. Ethics and dissemination The study has been approved by NHS South East Coast—Surrey Research Ethics Committee. Findings will be published in a wide range of outputs targeted at key audiences, including patient and carer organisations, nursing staff and healthcare managers. PMID:28069627

  15. Assessment of drug-drug interactions among renal failure patients of nephrology ward in a south Indian tertiary care hospital

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    Mylapuram Rama

    2012-01-01

    Full Text Available Polypharmacy is common in drug prescriptions of chronic kidney disease patients. A study of the prescription patterns of drugs with potential interactions would be of interest to prevent drug related adverse events. A prospective observational study of six months (Dec 2009-May 2010 was carried out among the chronic kidney disease patients admitted to the nephrology ward of a South Indian tertiary care hospital. The pattern and rates of drug-drug interactions seen in the prescriptions of these patients was studied. Among the 205 prescriptions included, a total of 474 interactions were reported, making 2.7 interactions per prescription with incidence rates of 76.09%. Around 19.62% of interactions were of major severity. Most common interactions were found between ascorbic acid and cyanocobalamine (12.45%, clonidine and metoprolol (3.80% respectively. Hypo or hypertension (31.65%, decreased drug efficacy (29.11% and hypo or hyperglycemia (14.14%, were the most commonly reported clinical outcomes of the drug interactions. Cardiovascular drugs (calcium channel blockers and beta blockers; 52% constitute the major class of drugs involved in interactions. As most of the interactions had a delayed onset, long term follow-up is essential to predict the clinically significant outcomes of these interactions. Hence, drug interactions are commonly seen in the prescriptions of chronic kidney disease patients which can lead to serious adverse events if not detected early. Need for collaboration with a clinical pharmacist and electronic surveillance, which are absent in developing countries like India, is emphatic.

  16. Substance abuse in patients admitted voluntarily and involuntarily to acute psychiatric wards: a national cross-sectional study

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    Anne Opsal

    2011-12-01

    Full Text Available Background: Substance abuse and mental disorder comorbidity is high among patients admitted to acute psychiatric wards. The aim of the study was to identify this co-occurrence as a reason for involuntary admission and if specific substance use-related diagnoses were associated with such admissions.Methods: The study was a part of a multicentre, cross-sectional national study carried out during 2005-2006 within a research network of acute mental health services. Seventy-five percent of Norwegian hospitals providing acute in-patient treatment participated. Substance use was measured using the Clinician Rating Scale and the ICD-10 diagnoses F10-19. Diagnostic assessments were performed by the clinicians during hospital stay.Results: Overall, 33.2% (n=1,187 of the total patient population (3,506 were abusing alcohol or drugs prior to admission according to the Clinician Rating Scale. No difference in the overall prevalence of substance abuserelated diagnoses between the two groups was found. Overall, 310 (26% of the admissions, 216 voluntarily and 94 involuntarily admitted patients received a double diagnosis. Frequent comorbid combinations among voluntarily admitted patients were; a combination of alcohol and either mood disorder (40% or multiple mental disorders (29%. Among involuntarily admitted patients, a combination of poly drug use and schizophrenia was most frequent (47%. Substance abusing patients diagnosed with mental and behavioral disorders due to the use of psychoactive stimulant substances had a significantly higher risk of involuntary hospitalization (OR 2.3.Conclusion: Nearly one third of substance abusing patients are involuntarily admitted to mental hospitals, in particular stimulant drug use was associated with involuntarily admissions.

  17. Flow situations during everyday practice in a medical hospital ward. Results from a study based on experience sampling method

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    Ejlertsson Göran

    2011-02-01

    Full Text Available Abstract Background Nursing is a constant balance between strain and stimulation and work and health research with a positive reference point has been recommended. A health-promoting circumstance for subjective experience is flow, which is a psychological state, when individuals concurrently experience happiness, motivation and cognitive efficiency. Flow situations can be identified through individuals' estimates of perceived challenge and skills. There is, to the best of our knowledge, no published study of flow among health care staff. The aim of this study was to identify flow-situations and study work-related activities and individual factors associated with flow situations, during everyday practice at a medical emergency ward in Sweden, in order to increase the knowledge on salutogenic health-promoting factors. Methods The respondents consisted of 17 assistant nurses and 14 registered nurses, who randomly and repeatedly answered a small questionnaire, through an experience sampling method, during everyday nursing practice. The study resulted in 497 observations. Flow situations were defined as an exact match between a high challenge and skill estimation and logistic regression models were used to study different variables association to flow situations. Results The health care staff spent most of its working time in individual nursing care and administrative and communicative duties. The assistant nurses were more often occupied in individual nursing care, while the registered nurses were more involved in medical care and administrative and communicative duties. The study resulted in 11.5% observations of flow situations but the relative number of flow situations varied between none to 55% among the participants. Flow situations were positively related to medical care activities and individual cognitive resources. Taking a break was also positively associated with flow situations among the assistant nurses. Conclusions The result showed

  18. Aggression in Psychiatric Wards

    DEFF Research Database (Denmark)

    Hvidhjelm, Jacob; Sestoft, Dorte; Skovgaard, Lene Theil

    2016-01-01

    Health care workers are often exposed to violence and aggression in psychiatric settings. Short-term risk assessments, such as the Brøset Violence Checklist (BVC), are strong predictors of such aggression and may enable staff to take preventive measures against aggression. This study evaluated...

  19. Experience of ward nurses on division of labor and management of ward work under the responsibility ;management model:a qualitative research%责任制管理模式下病区护士对分工管理体验的质性研究

    Institute of Scientific and Technical Information of China (English)

    李敏; 王玉梅; 胡翠红; 李晶; 李佳; 夏漫

    2016-01-01

    Objective To understand the real experience of ward nurses on division of labor and management of ward work.Methods A total of 13 ward nurses were interviewed in depth with the phenomenology method in qualitative research to understand the experience of ward nurses on division of labor and management of ward work. And then, we sorted out the data, refined theme and analyzed the data. Results A total of three positive themes were refined including a high degree of recognition, a heavy sense of responsibility, a great benefit in division of labor and management. Another three negative themes were also refined involving the uneven content, a lack of team strength, different difficulties in implementation in division of labor and management. Conclusions Division of labor and management can ensure that the ward work is operated effectively and improve personal ability. However, there also exist shortcomings. Therefore, nursing managers should attach importance to the malpractices so as to improve and perfect them.%目的:了解病区护士对病房工作分工管理的真实体验。方法采用质性研究中的现象学方法对13名病区护士进行深入访谈,了解病区护士对病房工作分工管理的感受,整理资料提炼主题并进行分析。结果提炼出分工管理认可度高、分工管理责任感重、分工管理获益性强3个正性主题;分工管理内容参差不齐、分工管理团队力量欠缺、分工管理实施难点各异3个负性主题。结论分工管理能保障病房工作有效运转及促进个人能力的提升,但也存在不足之处,护理管理者应重视其弊端,加以改进完善。

  20. Appropriateness of admission and stay in obstetrics wards: a new tool assessing unnecessary days of hospital care

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    Giuseppina Poppa

    2009-12-01

    Full Text Available

    Introduction: The Appropriateness Evaluation Protocol (AEP is a widely used assessment tool that identifies and measures the inappropriateness variables of hospital healthcare related to unjustified admission and/or length of stay, however it does not apply specifically to gynaecology or obstetrics wards. Objectives of the study: The main objectives of the present study were to develop a new tool for the evaluation of the appropriateness of admission and hospital stay in obstetric settings; as well as to analyze the main determinants of inappropriate admission and days of hospital stay within all the units of the Pediatric Hospital “Regina Margherita” and the Obstetrics and Gynaecology Teaching Hospital “S.Anna” in Turin.

    Methods: A multidisciplinary team of reviewers, composed of gynaecologists, paediatricians and obstetricians, was established and the appropriateness evaluation criteria, the operational handbook and the plan were all defined. Data were collected during the period between September and December 2005 and then put in an ad hoc database. Data analysis and evaluation were performed by univariate analysis (chisquare test and multivariate analysis using a multiple logistic regression model. The level of significance was set at p<0.05.

    Results: Out of 734 clinical records, 598 were considered for the study. The prevalence of inappropriateness of admission was 3.34%. The total number of examined days was 2888, 801 of which (27.74% were considered to be inappropriate. The variables “place of residence” (÷²=6.272; p=0.0435 and “type of admission” (÷²=14.223; p<0.001 were significantly associated with the inappropriateness of the admission. Between the 2nd and the 8th day of hospital stay the percentage of inappropriate days exponentially increased (up to 56%. With regards to the quality of the clinical records almost all of them were characterized by

  1. Efficacy of a low-cost bubble CPAP system in treatment of respiratory distress in a neonatal ward in Malawi.

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    Kondwani Kawaza

    Full Text Available BACKGROUND: Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care. METHODS: We conducted a non-randomized convenience sample study to test the efficacy of a low-cost bCPAP system treating newborns with severe respiratory distress in the neonatal ward of Queen Elizabeth Central Hospital, in Blantyre, Malawi. Neonates weighing >1,000 g and presenting with severe respiratory distress who fulfilled inclusion criteria received nasal bCPAP if a device was available; if not, they received standard care. Clinical assessments were made during treatment and outcomes compared for the two groups. FINDINGS: 87 neonates (62 bCPAP, 25 controls were recruited. Survival rate for neonates receiving bCPAP was 71.0% (44/62 compared with 44.0% (11/25 for controls. 65.5% (19/29 of very low birth weight neonates receiving bCPAP survived to discharge compared to 15.4% (1/13 of controls. 64.6% (31/48 of neonates with respiratory distress syndrome (RDS receiving bCPAP survived to discharge, compared to 23.5% (4/17 of controls. 61.5% (16/26 of neonates with sepsis receiving bCPAP survived to discharge, while none of the seven neonates with sepsis in the control group survived. INTERPRETATION: Use of a low-cost bCPAP system to treat neonatal respiratory distress resulted in 27% absolute improvement in survival. The beneficial effect was greater for neonates with very low birth weight, RDS, or sepsis. Implementing appropriate bCPAP devices could reduce neonatal mortality in developing countries.

  2. Impact of ALSO training on the management of prolonged labor and neonatal care at Kagera Regional Hospital, Tanzania

    DEFF Research Database (Denmark)

    Sorensen, Bjarke Lund; Rasch, Vibeke; Massawe, Siriel

    2010-01-01

    . During prolonged labor, action was delayed for more than 3hours in half of the cases. The stillbirth rate, Apgar scores, and frequency of neonatal resuscitation did not change significantly. After the intervention, there was a significant increase in newborns given to their mothers within 10minutes, from...... 5.6% to 71.5% (RR 12.71; 95% CI, 9.04-17.88). There was a significant decrease from 6 to 0 neonatal deaths before discharge among those born with an Apgar score after 1minute of 4 or more (P=0.03). CONCLUSION: ALSO training had no effect on the management of prolonged labor. Early contact between...

  3. Medically unexplained illness and the diagnosis of hysterical conversion reaction (HCR in women’s medicine wards of Bangladeshi hospitals: a record review and qualitative study

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    Kendall Emily A

    2012-10-01

    Full Text Available Abstract Background Frequent reporting of cases of hysterical conversion reaction (HCR among hospitalized female medical patients in Bangladesh’s public hospital system led us to explore the prevalence of “HCR” diagnoses within hospitals and the manner in which physicians identify, manage, and perceive patients whom they diagnose with HCR. Methods We reviewed admission records from women’s general medicine wards in two public hospitals to determine how often and at what point during hospitalization patients received diagnoses of HCR. We also interviewed 13 physicians about their practices and perceptions related to HCR. Results Of 2520 women admitted to the selected wards in 2008, 6% received diagnoses of HCR. HCR patients had wide-ranging symptoms including respiratory distress, headaches, chest pain, convulsions, and abdominal complaints. Most doctors diagnosed HCR in patients who had any medically-unexplained physical symptom. According to physician reports, women admitted to medical wards for HCR received brief diagnostic evaluations and initial treatment with short-acting tranquilizers or placebo agents. Some were referred to outpatient psychiatric treatment. Physicians reported that repeated admissions for HCR were common. Physicians noted various social factors associated with HCR, and they described failures of the current system to meet psychosocial needs of HCR patients. Conclusions In these hospital settings, physicians assign HCR diagnoses frequently and based on vague criteria. We recommend providing education to increase general physicians’ awareness, skill, and comfort level when encountering somatization and other common psychiatric issues. Given limited diagnostic capacity for all patients, we raise concern that when HCR is used as a "wastebasket" diagnosis for unexplained symptoms, patients with treatable medical conditions may go unrecognized. We also advocate introducing non-physician hospital personnel to address

  4. Application of IPAD in Wireless Ward Rounds in Hospitals%iPad在医院无线移动查房中的应用

    Institute of Scientific and Technical Information of China (English)

    陈小荣; 杨建民

    2012-01-01

    目的:采用国际先进的、流行的苹果IPAD实现无线移动查房.方法:应用VMware vSphereTM整合服务器虚拟、工作站虚拟化、应用虚拟化技术,通过安装在iPad上的View Client,可以高效安全地接入到数据中心内的虚拟桌面.结果:通过VMware服务器虚拟化技术创建单独的桌面,并依托VMware高效的传输协议PCoIP带来与传统PC机一致的用户体验.结论:最大程度的提升医生查房的工作效率,减少患者的等待时间,同时充分体现了IPAD的便携性、优异的操作性、多点触摸技术以及待机时间长的特点.%Objective: the international advanced IPAD is adopted in mobile wireless ward rounds. Method: VMware vSphereTM is adopted to integrate server virtualization, work station virtualization and application virtualization, and with View Client built in IPAD, it can efficiently and safely access virtual desktop inside data center. Results: independent desktop was created by VMware server virtualization technology, and with the help of PCoIP, high efficient VMware transport protocols, it led to experience same as traditional PC. Conclusions: it maximally improved the efficiency of doctor ward round and reduced the waiting of patients, and besides, it also reflected the advantages of IPAD, such as portability, operability, multipoint touch technology and long stand-by time. Keywords wireless ward round, IPAD, VMware, virtual server

  5. 医院移动查房系统的设计与应用%Design and Application of Hospital Mobile Ward-Round System

    Institute of Scientific and Technical Information of China (English)

    蔡燕; 卞松

    2015-01-01

    随着移动互联网技术的发展,移动医疗成为现代化医院信息化建设的重要组成部分之一。为了提高医师查房的效率,优化医师工作流程,对医院移动查房系统进行了设计,包括系统架构设计、业务流程设计和系统安全性设计,将游离于医院各信息系统间的患者信息整合并在移动终端统一呈现,并阐述了系统的实施与应用场景。系统的应用能够为医师工作提供便利,提高医疗服务质量,为医院的移动办公时代提供了有效的支撑平台。%With the development of mobile internet technology,mobile medical has become an important part of the information construction of modern hospital. In order to improve the efficiency of warding round and optimize the work flow for the doctor, this paper carried out the design of hospital mobile ward round system, including system architecture design, work process design and system security design. The ward round system integrate the information among various information system and present the integrated information in mobile terminal. Then the paper expounds the application and implementation of the system. The application of the system can provide convenience for doctors’work, can improve the quality of medical service, and provide an effective supporting platform for mobile office of hospital.

  6. Antibiotic stewardship ward rounds and a dedicated prescription chart reduce antibiotic consumption and pharmacy costs without affecting inpatient mortality or re-admission rates.

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    Tom H Boyles

    Full Text Available BACKGROUND: Antibiotic consumption is a major driver of bacterial resistance. To address the increasing burden of multi-drug resistant bacterial infections, antibiotic stewardship programmes are promoted worldwide to rationalize antibiotic prescribing and conserve remaining antibiotics. Few studies have been reported from developing countries and none from Africa that report on an intervention based approach with outcomes that include morbidity and mortality. METHODS: An antibiotic prescription chart and weekly antibiotic stewardship ward round was introduced into two medical wards of an academic teaching hospital in South Africa between January-December 2012. Electronic pharmacy records were used to collect the volume and cost of antibiotics used, the patient database was analysed to determine inpatient mortality and 30-day re-admission rates, and laboratory records to determine use of infection-related tests. Outcomes were compared to a control period, January-December 2011. RESULTS: During the intervention period, 475.8 defined daily doses were prescribed per 1000 inpatient days compared to 592.0 defined daily doses/1000 inpatient days during the control period. This represents a 19.6% decrease in volume with a cost reduction of 35% of the pharmacy's antibiotic budget. There was a concomitant increase in laboratory tests driven by requests for procalcitonin. There was no difference in inpatient mortality or 30-day readmission rate during the control and intervention periods. CONCLUSIONS: Introduction of antibiotic stewardship ward rounds and a dedicated prescription chart in a developing country setting can achieve reduction in antibiotic consumption without harm to patients. Increased laboratory costs should be anticipated when introducing an antibiotic stewardship program.

  7. Child-Parent Wellbeing in a Paediatric Ward: The Role of Music Therapy in Supporting Children and Their Parents Facing the Challenge of Hospitalisation

    Directory of Open Access Journals (Sweden)

    Carolyn Ayson

    2008-03-01

    Full Text Available This report, based on clinical practice on a children’s ward in New Zealand, examines the role of short-term music therapy in supporting children and their parents[1] facing the difficulties of hospitalisation. It endeavours to explore three questions. How might music therapy support hospitalised children? How can it support parents of hospitalised children? Is it important/valuable for music therapists working in a paediatric ward to involve parent(s in music therapy sessions? Three hospitalised children (aged 11 months, 5 and 7 years, who were accompanied by a parent, participated in a single individual music therapy session. From the clinical notes, semi-structured interviews with the children’s parents and a staff member, and my own reflective journal it was indicated that music therapy supported the psychosocial needs of the paediatric patients and their parents in many ways. For the children music therapy: 1 promoted normalisation; and 2 provided emotional/psychological support. For parents, it: 1 elicited positive changes in mood; 2 reduced anxiety; and 3 supported parental learning/parenting. Furthermore, the findings suggested that the wellbeing of the parent-child relationship can be supported during music therapy. The importance of parental involvement varied for each case, and highlighted different views between therapist, staff member and parents regarding this. Factors that may determine parental involvement and the benefits of both parental presence and absence during sessions were elicited. The report suggests that music therapy has the potential positively to support paediatric wards in New Zealand to provide an environment that is responsive to the psychosocial needs of hospitalised children and their parents

  8. The Teamwork Assessment Scale: A Novel Instrument to Assess Quality of Undergraduate Medical Students' Teamwork Using the Example of Simulation-based Ward-Rounds

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    Kiesewetter, Jan

    2015-05-01

    Full Text Available Background: Simulation-based teamwork trainings are considered a powerful training method to advance teamwork, which becomes more relevant in medical education. The measurement of teamwork is of high importance and several instruments have been developed for various medical domains to meet this need. To our knowledge, no theoretically-based and easy-to-use measurement instrument has been published nor developed specifically for simulation-based teamwork trainings of medical students. Internist ward-rounds function as an important example of teamwork in medicine.Purposes: The purpose of this study was to provide a validated, theoretically-based instrument that is easy-to-use. Furthermore, this study aimed to identify if and when rater scores relate to performance.Methods: Based on a theoretical framework for teamwork behaviour, items regarding four teamwork components ( were developed. In study one, three ward-round scenarios, simulated by 69 students, were videotaped and rated independently by four trained raters. The instrument was tested for the embedded psychometric properties and factorial structure. In study two, the instrument was tested for construct validity with an external criterion with a second set of 100 students and four raters. Results: In study one, the factorial structure matched the theoretical components but was unable to separate Information Exchange and Team Cooperation. The preliminary version showed adequate psychometric properties (Cronbach’s α=.75. In study two, the instrument showed physician rater scores were more reliable in measurement than those of student raters. Furthermore, a close correlation between the scale and clinical performance as an external criteria was shown (r=.64 and the sufficient psychometric properties were replicated (Cronbach’s α=.78.Conclusions: The validation allows for use of the simulated teamwork assessment scale in undergraduate medical ward-round trainings to reliably measure

  9. Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone

    Directory of Open Access Journals (Sweden)

    Alexander Blacklock

    2015-01-01

    Full Text Available Background and objectives: In 2012, Sierra Leone suffered a nationwide cholera epidemic which affected the capital Freetown and also the provinces. This study aims to describe the characteristics and clinical management of patients admitted to cholera isolation wards of the main referral hospital in the Northern Province and compare management with standard guidelines. Design: All available clinical records of patients from the cholera isolation wards were reviewed retrospectively. There was no active case finding. The following data were collected from the clinical records after patients had left the ward: date of admission, demographics, symptoms, dehydration status, diagnoses, tests and treatments given, length of stay, and outcomes. Results: A total of 798 patients were admitted, of whom 443 (55.5% were female. There were 18 deaths (2.3%. Assessment of dehydration status was recorded in 517 (64.8% of clinical records. An alternative or additional diagnosis was made for 214 patients (26.8%. Intravenous (IV fluids were prescribed to 767 patients (96.1%, including 95% of 141 patients who had documentation of being not severely dehydrated. A history of vomiting was documented in 92.1% of all patients. Oral rehydration solution (ORS was given to 629 (78.8% patients. Doxycycline was given to 380 (47.6% patients, erythromycin to 34 (4.3%, and other antibiotics were used on 247 occasions. Zinc was given to 209 (26.2%. Discussion: This retrospective study highlights the need for efforts to improve the quality of triage, adherence to clinical guidance, and record keeping. Conclusions: Data collection and analysis of clinical practices during an epidemic situation would enable faster identification of those areas requiring intervention and improvement.

  10. Child-Parent Wellbeing in a Paediatric Ward: The Role of Music Therapy in Supporting Children and Their Parents Facing the Challenge of Hospitalisation

    Directory of Open Access Journals (Sweden)

    Carolyn Ayson

    2008-03-01

    Full Text Available This report, based on clinical practice on a children’s ward in New Zealand, examines the role of short-term music therapy in supporting children and their parents[1] facing the difficulties of hospitalisation. It endeavours to explore three questions. How might music therapy support hospitalised children? How can it support parents of hospitalised children? Is it important/valuable for music therapists working in a paediatric ward to involve parent(s in music therapy sessions? Three hospitalised children (aged 11 months, 5 and 7 years, who were accompanied by a parent, participated in a single individual music therapy session. From the clinical notes, semi-structured interviews with the children’s parents and a staff member, and my own reflective journal it was indicated that music therapy supported the psychosocial needs of the paediatric patients and their parents in many ways. For the children music therapy: 1 promoted normalisation; and 2 provided emotional/psychological support. For parents, it: 1 elicited positive changes in mood; 2 reduced anxiety; and 3 supported parental learning/parenting. Furthermore, the findings suggested that the wellbeing of the parent-child relationship can be supported during music therapy. The importance of parental involvement varied for each case, and highlighted different views between therapist, staff member and parents regarding this. Factors that may determine parental involvement and the benefits of both parental presence and absence during sessions were elicited. The report suggests that music therapy has the potential positively to support paediatric wards in New Zealand to provide an environment that is responsive to the psychosocial needs of hospitalised children and their parents.

  11. 高效能病区护士长才能的质性研究%A qualitative research exploring the competence of effective ward head nurses

    Institute of Scientific and Technical Information of China (English)

    王思琛; 朱明霞; 陆亮; 尹一桥; 胡笑霞; 霍惠兰; 陈婉华

    2012-01-01

    Objectives: To explore the competence of effective ward head nurses, and to provide reference for constructing training content for ward head nurses. Methods: In-depth interview was carried out among 9 nursing supervisors from 2 Three Grade Class A hospitals in Guangzhou. Qualitative content analysis was used to analyze the data. Results: The themes included positive attitude with commitment, fair and impartial characteristics, self administrative ability with rational analysis and stress coping, good communication skill and instructing subordinates, prospective and creative thinking, favorable executive ability, and sensitive awareness of crisis and risk. Conclusions: The competence of effective ward head nurse is multi-dimensions and multi-angles. The results can provide reference for selection, evaluation and training of ward head nurses.%目的:探讨研究高效能病区护士长需具备的才能,为今后构建病区护士长培训内容体系提供依据.方法:采用质性研究中的内容分析法,对广州市两家三级甲等医院的9名科护士长进行深度访谈.访谈结束后,对照记录及录音材料形成文字文件,对所获得的资料进行归纳整理和分析.结果:高效能病区护士长需具备的才能包括勇于承担、全情投入的积极态度;公平公正的正面素质;善于自我管理,能理性分析、适应压力;良好的人际沟通能力,善导下属;有前瞻性、创新的思维及很好的执行力,同时具备危机管理、风险管理的意识.结论:高效能病区护士长所具备的才能是多方面、多角度的,研究的结果有利于临床病区护士长的选拔、绩效考核及作为制订培训内容的依据.

  12. Accelerated HIV testing for PMTCT in maternity and labour wards is vital to capture mothers at a critical point in the programme at district level in Malawi.

    Science.gov (United States)

    Beltman, J J; Fitzgerald, M; Buhendwa, L; Moens, M; Massaquoi, M; Kazima, J; Alide, N; van Roosmalen, J

    2010-11-01

    Round the clock (24 hours×7 days) HIV testing is vital to maintain a high prevention of mother to child transmission (PMTCT) coverage for women delivering in district health facilities. PMTCT coverage increases when most of the pregnant women will have their HIV status tested. Therefore routine offering of HIV testing should be integrated and seen as a part of comprehensive antenatal care. For women who miss antenatal care and deliver in a health facility without having had their HIV status tested, the labour and maternity ward could still serve as other entry points.

  13. Ward Nurse Role in Quality Management%病区护士长在质量管理中的作用

    Institute of Scientific and Technical Information of China (English)

    曹萍

    2014-01-01

    The quality of care is an important indicator of the quality of medical services,nurse plays an important role in improving the quality of care management level and create harmony in the ward.%护理质量是衡量医疗服务质量的重要指标,护士长在提高护理质量管理水平及创建和谐病区中起着重要的作用。

  14. 伦理查房在临床工作中的应用%The Application of Ethical Ward Round in Clinical Practice

    Institute of Scientific and Technical Information of China (English)

    廖绮霞; 贺小伶; 刘俊荣; 吴晓东

    2011-01-01

    Requirements for the ethical ward round in clinical practice include feasible systemic regulations, specific countermeasures, and emphasis on practical effects. Concrete measures are raised such as strengthening medical ethics education and improving the evaluation mechanism of ethical ward round, thus to promote and facilitate the medical services from an ethical angle. This article also put forward suggestions including implementation of the privacy protection, performance of informed consent, and improvement of environment and facilities in medical institutions in order to harmonize the relationship between doctors and patients.%医疗机构进行伦理查房工作,需构建可行的医学伦理查房体系;落实医学伦理查房措施;注重医学伦理查房实效.采取加强医学伦理学教育、完善伦理查房评价机制等途径,从伦理学的角度去促进、完善医疗服务,并提出构建和谐医患关系应切实做好隐私保护操作、履行知情告知及完善环境布局设施等建议.

  15. Clinical documentation and data transfer from Ebola and Marburg virus disease wards in outbreak settings: health care workers' experiences and preferences.

    Science.gov (United States)

    Bühler, Silja; Roddy, Paul; Nolte, Ellen; Borchert, Matthias

    2014-02-19

    Understanding human filovirus hemorrhagic fever (FHF) clinical manifestations and evaluating treatment strategies require the collection of clinical data in outbreak settings, where clinical documentation has been limited. Currently, no consensus among filovirus outbreak-response organisations guides best practice for clinical documentation and data transfer. Semi-structured interviews were conducted with health care workers (HCWs) involved in FHF outbreaks in sub-Saharan Africa, and with HCWs experienced in documenting and transferring data from high-risk areas (isolation wards or biosafety level 4 laboratories). Methods for data documentation and transfer were identified, described in detail and categorised by requirement for electricity and ranked by interviewee preference. Some methods involve removing paperwork and other objects from the filovirus disease ward without disinfection. We believe that if done properly, these methods are reasonably safe for certain settings. However, alternative methods avoiding the removal of objects, or involving the removal of paperwork or objects after non-damaging disinfection, are available. These methods are not only safer, they are also perceived as safer and likely more acceptable to health workers and members of the community. The use of standardised clinical forms is overdue. Experiments with by sunlight disinfection should continue, and non-damaging disinfection of impregnated paper, suitable tablet computers and underwater cameras should be evaluated under field conditions.

  16. Pattern of Hepatitis A Virus Epidemiology in Nursing Students and Adherence to Preventive Measures at Two Training Wards of a University Hospital

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    Campagna

    2016-02-01

    Full Text Available Background Nursing students can be exposed to patients with hepatitis A virus (HAV and can represent a vehicle of transmission both for health personnel, patients and relatives. Objectives The aim of this study was to assess the risk of HAV infection in nursing students during their internship. Patients and Methods A seroprevalence survey on HAV infection was performed on nursing students at the Cagliari university-hospital, together with the assessment of the compliance to preventive measures to decrease the risk of infection during their internship. Blood specimens were obtained from 253 students. All serum samples were tested for anti-HAV antibodies (IgG by the enzyme-linked immunosorbent assay (ELISA. Compliance to preventive measures was recorded by trained personnel. Results Overall HAV seropositivity in nursing students (mean age 24, range 17 - 45 years was 3%. Compliance to preventive measures was not uniform (6% - 76% and extremely low in some specific measures targeted to decrease the oral-fecal transmission. Conclusions The high proportion of susceptible nursing students can contribute to an increase in the risk of nosocomial transmission, especially when specific preventive measures are not completely applied. Nursing education packages, before starting medical internship, should be implemented in order to increase their compliance to preventive measures, especially in wards at higher risk. Vaccination should be considered in wards at higher risk.

  17. Risk assessment of the Manual Handling of Patients in remedial wards of Qazvin hospitals and its relationship with incidence of musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Kalantari Reza

    2014-10-01

    Full Text Available Background & Objectives : Approximately one third of all reported work-related incidents are triggered by manual handling. The proportion of incidents associated with manual handling in health and social care is 38%. Lifting and transferring patients is the task that is most often cited as a cause of manual handling incidents and of back injury in the healthcare sector. The aim of this study is to determine the MAPO index for remedial hospital wards of Qazvin and considering its relationship with incidence and intensity of musculoskeletal disorders among servers whose main task is manual handling of patients . Methods : In this cross sectional study, 54 cases of servers from 23 wards of 4 Hospitals was considered. The data was collected using the demographic characteristic questionnaire, the Verbal pain intensity scale, the Nordic questionnaire and the MAPO checklist. Statistical Analysis of collected data was performed with SPSS 22. Results : One year prevalence of musculoskeletal disorders was 75.9% and this amount during performing this study was reported 53.7%. Regarding to different levels of MAPO score, just 5.5% of surveyed personnel were in safe zone. 18.5% of them exposed to moderate risk of musculoskeletal disorders and 76 % were at high risk. Also prevalence of musculoskeletal disorders incidents and pain intensity had significantly associated with the MAPO index score. Conclusion : Regarding to association between MAPO index score and prevalence of musculoskeletal disorders, to reducing incidences risk, improvement of MAPO index parameters to reducing its amount will be effective.

  18. Application effect of open nursing information website in ward%病区开放式护理信息网站应用效果探讨

    Institute of Scientific and Technical Information of China (English)

    范萍; 孔秋菊; 李福红

    2012-01-01

    目的:探讨应用信息网络技术,提高病房护理管理水平.方法:在病区建立开放式护理信息网站,便于病人查询相关的护理信息.结果:390例病人对护理质量满意率达98.72%,未发生护理纠纷和差错.结论:病区建立开放式护理信息网站,使各项护理信息透明,护患关系良好互动,减少了护患纠纷,有效提高了护理质量,值得推广.%Objective: To explore the application of information network technology to improve nursing management method, improve the nurse - patient relationship, improve the quality of care. Methods:Established open nursing information website in ward,for patients with query related nursing treatment project. Results:390 patients received clinical therapy and careful nursing,got better recovery,the quality of nursing satisfaction rate was 98.72% .nursing disputes and errors did not occured. Conclusion;Established open nursing information website in ward,made the patients active participation of nursing treatment, reduced nurse - patient disputes, improved the quality of nursing.

  19. To Investigate the Quality Nursing Ward Neural Department of Internal Medicine%神经内科病房开展优质护理的探讨

    Institute of Scientific and Technical Information of China (English)

    谢霖

    2015-01-01

    Analysis of unfolding high quality of nursing in Department of internal medicine ward neural work pat ern, and car ies on the appraisal to the quality care carried out in neural Department of internal medicine work. To car y out the quality of nursing in Department of internal medicine ward nerve can obviously daily nursing work quality and improve the patients' satisfaction in nursing care for patients with various services, nursing staf unanimously gave praise, up the new image of good for hospital and nursing industry tree.%探讨分析在神经内科病房中开展优质护理的工作模式,并对在神经内科开展的优质护理工作进行评价。在神经内科病房中开展优质护理可以明显日常的护理工作的质量和提高患者对护理工作的满意度,患者对于护理人员的各项服务一致给予了好评,为医院及护理行业树起了良好的新形象。

  20. Clinical Documentation and Data Transfer from Ebola and Marburg Virus Disease Wards in Outbreak Settings: Health Care Workers’ Experiences and Preferences

    Directory of Open Access Journals (Sweden)

    Silja Bühler

    2014-02-01

    Full Text Available Understanding human filovirus hemorrhagic fever (FHF clinical manifestations and evaluating treatment strategies require the collection of clinical data in outbreak settings, where clinical documentation has been limited. Currently, no consensus among filovirus outbreak-response organisations guides best practice for clinical documentation and data transfer. Semi-structured interviews were conducted with health care workers (HCWs involved in FHF outbreaks in sub-Saharan Africa, and with HCWs experienced in documenting and transferring data from high-risk areas (isolation wards or biosafety level 4 laboratories. Methods for data documentation and transfer were identified, described in detail and categorised by requirement for electricity and ranked by interviewee preference. Some methods involve removing paperwork and other objects from the filovirus disease ward without disinfection. We believe that if done properly, these methods are reasonably safe for certain settings. However, alternative methods avoiding the removal of objects, or involving the removal of paperwork or objects after non-damaging disinfection, are available. These methods are not only safer, they are also perceived as safer and likely more acceptable to health workers and members of the community. The use of standardised clinical forms is overdue. Experiments with by sunlight disinfection should continue, and non-damaging disinfection of impregnated paper, suitable tablet computers and underwater cameras should be evaluated under field conditions.

  1. Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients).

    Science.gov (United States)

    Chiara, Mussi; Gianluigi, Galizia; Pasquale, Abete; Alessandro, Morrione; Alice, Maraviglia; Gabriele, Noro; Paolo, Cavagnaro; Loredana, Ghirelli; Giovanni, Tava; Franco, Rengo; Giulio, Masotti; Gianfranco, Salvioli; Niccolò, Marchionni; Andrea, Ungar

    2013-01-01

    To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82 ± 7 years, range 65-101). Falls were defined "accidental" (fall explained by a definite accidental cause), "medical" (fall caused directly by a specific medical disease), "dementia-related" (fall in patients affected by moderate-severe dementia), and "unexplained" (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause). According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury.

  2. Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients

    Directory of Open Access Journals (Sweden)

    Mussi Chiara

    2013-01-01

    Full Text Available To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82±7 years, range 65–101. Falls were defined “accidental” (fall explained by a definite accidental cause, “medical” (fall caused directly by a specific medical disease, “dementia-related” (fall in patients affected by moderate-severe dementia, and “unexplained” (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause. According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury.

  3. The Prevalence of Accidental Needle Stick Injury and their Reporting among Healthcare Workers in Orthopaedic Wards in General Hospital Melaka, Malaysia

    Directory of Open Access Journals (Sweden)

    Bhardwaj A

    2014-07-01

    Full Text Available Accidental needle-stick injuries (NSIs are a hazard for health-care workers and general public health. Orthopaedic surgeons may be more prone to NSIs due to the prevalence of bone spikes in the operative field and the use of sharp orthopaedic instruments such as drills, saws and wires. A hospital-based cross sectional study was conducted in the orthopedic wards of Melaka General Hospital. The prevalence of NSIs was 32 (20.9% and majority of it occurred during assisting in operation theatre 13(37.4%. Among them six (18.8% were specialist, 12(37.5% medical officer, 10 (31.2% house officer and four staff nurses (12.5%. Among the respondents 142 (92.8% had been immunized against Hepatitis B and 148 (96.7% participants had knowledge regarding universal precaution. The incidence of NSI among health care workers at orthopaedics ward was not any higher in comparison with the similar studies and it was found out that the prevalence was more in junior doctors compared with specialist and staff nurses and it was statistically significant.

  4. Clinical-Homeopathic Profile in the Pediatric Ward at the University Hospital – Brazil

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    Debora Alves dos Santos Fernandes

    2011-09-01

    Full Text Available Background: In 2004, the deployment of Homeopathy in the pediatric ward at the University Hospital of Gaffrée Guinle – UNIRIO (HUGG at the Federal University of the State of Rio de Janeiro was initiated in conjunction with both the Pediatric and Homeopathy Service. A research project approved by the HUGG Ethics and Research Committee was prepared to survey the most prevalent diseases. A team composed of medical students and doctors participating in the homeopathy course was formed and underwent training, enabling them to use the established protocols of action. A partnership was established with the Fluminense Federal University(Universidade Federal Fluminense – UFF, for the supply of drugs. In early 2009, the research project started, followed by homeopathic treatment in the pediatric ward. Aim: To demonstrate the diseases and treatment using homeopathic therapy on patients in the pediatric ward at the HUGG-UNIRIO-Brazil. Methodology: A sectional clinical study was carried out on patients participating in a research approved and registered by the Brazilian Research Ethics Committee, named,"The study of the effect of Homeopathic Treatment as an Adjunct Therapy on patients Hospitalized in the Pediatric Ward of HUGG". Criteria of Inclusion: Newborns up to the age of 16 of both sexes were admitted to the pediatric ward of HUGG, from May to October 2009. The diagnosis for admission being: respiratory, gastrointestinal and/or dermatologic diseases. A consent form had to be accepted and signed by the person responsible. Inclusion depended on the availability of having the appropriate homeopathic medicine in stock. Criteria of Exclusion: Cases of discontinuation of the homeopathic treatment or medical records not completed correctly. The medical records were analyzed individually. Microsoft Office Excel 2007 was used for data collection and analysis. Results: 32 patients admitted: 80% treated with

  5. Ⅰ期临床试验病房规范化管理的探讨%Study of Standardized Management of Phase Ⅰ Clinical Trial Ward

    Institute of Scientific and Technical Information of China (English)

    李楠; 黄海涛; 王蓝天; 黄娟; 雍小兰

    2012-01-01

    目的:规范药物Ⅰ期临床试验病房的各项管理标准.方法:分析、总结Ⅰ期临床试验研究人员、受试者、试验药物、病房监护等方面的管理经验和体会.其中受试者管理包括受试者的招募、知情同意、筛选、入住、饮食、用药、观察及采血、出组,试验药物的管理包括试验药物的验收、存放、领用、使用和回收处理.结果:通过分析、总结Ⅰ期临床试验病房的各个管理环节中可能存在的问题,提出规范化、系统化的管理要求.Ⅰ期临床试验研究人员应经过系统化的GCP培训,严格按照试验方案执行;受试者应在全面知情同意后参加试验,并遵守病房各项规章制度;试验药物应按照要求妥善保管,在各个环节监控和记录试验药物的流向;病房监护应做到抢救设备定期维护,抢救药品定期更换,专人负责保管.结论:通过规范化流程和系统管理,能够有效地降低Ⅰ期临床试验存在的风险.%Objective: To standardize the management of phase I clinical trial ward. Methods: The experiences of management of phase I clinical trial ward were analyzed and summarized from the researchers, subjects, experimental drugs and guardianship of ward. The management of subjects included recruitment, informed consent, screening, check-in, diet, medications, observation and blood collection and removal. The management of experimental drugs included acceptance, deposit, receiving, use and reclamation. Results: Standardized and systematic management requirements were proposed by means of the analysis and summary of the problems of management of phase I clinical trial ward. Researchers should be trained with GCP systematically, and should implement the trial strictly according to study protocol. Subjects should take part in the trial after understanding the informed consent comprehensively, and comply with the rules of the trial. Experimental drugs should be kept as required

  6. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students), Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    Science.gov (United States)

    Piotrowicz, Karolina; Rewiuk, Krzysztof; Halicka, Monika; Kalwak, Weronika; Rybak, Paulina

    2017-01-01

    Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students), targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males) participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward. PMID:28164113

  7. 规范化护理查房在护理质量管理中的作用%Effect of standardized nursing ward round in the nursing quality management

    Institute of Scientific and Technical Information of China (English)

    吴建芳

    2015-01-01

    Objective:To explore the effect of standardized nursing ward round in the nursing quality management.Methods:20 patients were given standardized nursing ward round.Results:After nursing ward round,19 cases(95% ) patients grasped the disease knowledge.19 patients were satisfied,the satisfaction was 95% .After the implementation of standardized nursing ward round,the emergency ability,doctor-patient communication ability,professional skill master degree,team cooperation ability and nursing documents writing standards degree of nursing staff were significantly higher than those before standardized nursing ward round(P<0.05).Conclusion:The implementation of standardized nursing ward round obviously improves the disease cognition and satisfaction of patients,and improves the comprehensive quality of nursing staff.%目的:探讨规范化护理查房在护理质量管理中的作用。方法:20例患者给予规范化护理查房。结果:经过护理查房,掌握疾病知识19例(95.0%),满意19例,满意度95.0%。实施规范化护理查房后,护理人员应急能力、医患沟通能力、专业技术熟练掌握程度、团队合作能力和护理文书书写规范程度明显高于规范化护理查房前(P<0.05)。结论:实施规范化护理查房明显提高了患者对疾病的认知程度和满意度,提高了护理人员的综合素质。

  8. 无菌层流病房护理人员倦怠调查及对策%Investigation in job burnout of nursing staff in sterile laminar flow wards and countermeasures

    Institute of Scientific and Technical Information of China (English)

    李文娟; 丁小萍

    2012-01-01

    Objective To evaluate the job burnout of the nurses in sterile laminar flow wards and offer proposals for improvements.Methods Forty nurses in sterile laminar flow wards were surveyed with MBI-GS.Results The scores of emotional exhaustion,cynicism,job inefficiency were higher after working in sterile laminar flow wards for 3 months than those working in general wards for 3 months.Conclusions The nurses in laminar flow wards are prone to have job burnout.Standardized training,humanized management and positive psvchological intervention can improve the job burnout of the nurses in laminar flow wards.%目的 分析、评价层流病房护理人员工作倦怠的状态,并提出相应的改善对策.方法 选取血液科和器官移植科层流病房护理人员40名,采用Maslach工作倦怠量表(MBI-GS)对其工作倦怠状况进行评价.结果 40名护理人员在层流病房工作3个月后,情绪耗竭、消极怠慢、专业低效能感的得分均高于普通病房连续工作3个月后的测评状态.结论 层流病房护理人员更易产生工作倦怠状态;通过加强层流病房护理规范培训、人性化管理及积极的心理干预可以舒缓工作倦怠状态.

  9. A Wearable Wireless Monitoring System for Ward Based on Zigbee%基于ZigBee的可穿戴式病房无线监护系统

    Institute of Scientific and Technical Information of China (English)

    王世平; 王志武; 颜国正

    2015-01-01

    To cover traditional ward monitoring system's shortage of complex structure and inconvenience,this pa-per proposes the design method of a kind of wireless physiological parameters monitoring system for hospital ward. A multifunctional wrist-type collector which integrates the function of blood pressure,oxyhemoglobin saturation, pulse rate and body temperature measurement was designed with noteworthy advantages of small volume,portable and easy to wear;a wireless sensors network based on ZigBee mesh topology was built meanwhile multiple-gateway communication mode was adopted between WSN and serverto improve the network performance;corresponding cen-tral monitoring station was established to fulfill real-time view of measured parameters,centralized management of patients'information,distant alarm and control,etc. a certainnumber of prototypeswerefabricated and the feasibility applying to hospital ward is verified in local area.%针对传统病房监护系统结构复杂,操作不便的不足,给出了一种新型可穿戴式多生理参数无线监护系统设计方案.设计了集血压、血氧、脉率及体温于一体的多功能腕式测量终端,其具有体积小,便携及易于佩戴等诸多优点;搭建了采用Zig?Bee网状拓扑结构的无线传感网络,通过实现服务器与无线传感网络之间的多网关通信提高了网络性能;建立了相应的中心监护软件以实现测量数据的实时显示,病人信息的集中管理以及远程报警与控制等功能;制作了一定数量的原理样机并在局部范围内验证了该系统应用于医院病房监护的可行性.

  10. Characteristics associated with falls among the elderly within aged care wards in a tertiary hospital: a retrospective case-control study

    Institute of Scientific and Technical Information of China (English)

    CHEN Xue-li; LIU Yun-hu; Daniel KY Chan; SHEN Qing; Huong Van Nguyen

    2010-01-01

    Background Falls are the most frequently reported adverse events in inpatient settings. We conducted a retrospective case-control study of inpatient falls within aged care wards in a tertiary hospital to investigate the associated characteristics of elderly patients suffering from falls and fall-related characteristics.Methods Consecutive retrospective cross-sectional design spanned July 2006 to December 2008. Patient group: Information on all aged care inpatients who suffered from 1 or more falls was extracted from Incident information Management System (IIMS). Further details about the particular admission(s) were obtained from patients' medical records, e.g., patients' characteristics and circumstances surrounding the falls. Randomly selected aged care patients who did not suffer from a fall and who were discharged from the hospital in the same period served control group. Characteristics among patients with single fall and recurrent falls, as well as non-fallers were compared. Results Of the 438 falls evaluated, 71.9% occurred in patients' room and 18.9% in patients' bathroom/toilet. The common activities were moving/transferring and taking shower/toileting, respectively, 70.3%, 12.1% while occurring falls; and time of falls had a high peak during 9:00-11:00 a.m. Many were unassisted while falling. The common contributing factors for fall were intrinsic factors. Patients with recurrent falls were more likely to have lower Mini-Mental State Examination (MMSE) score. Logistic regression analysis showed length of stay longer than five weeks, dementia and stroke were independent risk factors for recurrent falls; and living in hostel/nursing home preadmission, needing assistance with mobility, cognitive impairment, stroke, incontinence and arthritis/osteoporosis were independent risk factors for fall.Conclusions In an aged care ward, falls are independently associated with recurrent factors. Cognitive impairment/dementia was a strong risk factor for falls, and main

  11. 不同阶段心理干预对层流病房患者的影响%The influence of patients in different stage of psychological intervention in laminar ward.

    Institute of Scientific and Technical Information of China (English)

    吴玉梅

    2011-01-01

    目的:通过对入住层流病房患者在不同时期恐惧、焦虑、睡眠等心理状况分析并开展针对性的心理干预,以达到早日康复的目的.方法:对27例入住层流病房患者分别于入住前、入住后3 d和出层流病房前应用自制恐惧自评量表、焦虑自评量表、睡眠自评量表评估患者心理状况并针对性进行心理干预.结果:恐惧量表评分中,患者出层流病房前评分明显低于入住层流病房前、入住层流病房后3 d,同时入住层流病房后3日低于入住层流病房前.焦虑量表评分中,患者于出层流病房前评分明显低于入住层流病房前、入住层流病房后3 d,但入住层流病房前与入住层流病房后3 d之间无明显统计学差异.睡眠量表评分,患者入住层流病房后3 d评分明显高于入住层流病房前及出层流病房前,存在统计学差异,而入住层流病房前评分高于出层流病房前,存在统计学差异.结论:不同时期层流病房患者有不同的心理特征及心理变化,开展针对性心理干预是促进康复的重要手段之一.%Objective:Through the check - in laminar ward in different periods of patients with fear, anxiety, and sleeping psychological condition analysis and carrying out the pertinence psychological intervention,to achieve the purpose of recover at an early date. Methods:Apply the scale of fear, anxiety, and sleeping to assess the 27 patients' psychological condition and carrying out the pertinence psychological intervention before check in, in 3 days and out of the laminar ward before. Results:In fear rating scale,patients in the ward score was significantly lower than the laminar before check - in laminar ward and stay in 3 days,significant differences exist. In anxiety rating scale,patients out of the laminar ward before score was significantly lower than the laminar before check - in laminar ward and stay in 3 days,but there was no significant differences between before check

  12. Does a post-take ward round proforma have a positive effect on completeness of documentation and efficiency of information management?

    Science.gov (United States)

    Wright, Daniel N

    2009-06-01

    The post-take ward round (PTWR) involves the assessment of the latest intake of patients into the hospital. At a busy 400-bed city hospital it had been noted that PTWR notes had, in some cases, become overly brief and uninformative. Previous research had shown that proformas can improve the completeness of the records. So a new proforma was designed and introduced. Its impact on completeness of information was assessed by carrying out an audit of PTWR notes both with and without the proforma. The results showed statistically significant improvements in documentation when the proforma was used. They also showed an improvement in areas of efficiency of record management: for example, the proforma reduced the time taken to retrieve information from the notes, and most users said it saved them time recording in the notes and assimilating information and helped them to speed up patient transfers.

  13. 母婴病房护理在产科病房中的效果观察%Efficacy of Maternal and Child Care in the Maternity Ward

    Institute of Scientific and Technical Information of China (English)

    徐玉霞; 周伟秀

    2016-01-01

    目的:观察母婴病房护理在产科病房的效果。方法选取108例产妇作为研究对象,随机进行分组;对照组54例,采取常规护理;观察组54例,采取母婴病房护理,包括产妇护理、新生儿护理、床旁宣教、出院指导;对比两组产妇的新生儿护理知识问卷评分、育儿自我效能量表评分。结果护理前,对照组和观察组产妇自我保健、新生儿护理及母乳喂养评分差异均无统计学意义(P>0.05);护理后,观察组产妇自我保健、新生儿护理及母乳喂养评分均高于对照组,差异具有统计学意义(P<0.05);护理前,对照组和观察组促进发育、健康照顾、安全、喂养评分差异均无统计学意义(P>0.05);护理后,观察组促进发育、健康照顾、安全、喂养评分均高于对照组,差异具有统计学意义(P<0.05)。结论在产科病房中加强母婴病房护理,有助于提高产妇对新生儿护理知识的认知水平,改善育儿自我效能,对于促进产后恢复、掌握育儿技能均具有积极作用。%Objective Maternal and child care in maternity wards observed effect.Method Select 108 cases of women as research subjects were randomly grouped;the control group 54 cases take routine care; the observation group, 54 patients taking maternal ward care, including maternal care, neonatal care, bedside missionary, discharge instructions; comparing the two groups maternal newborn care knowledge questionnaire ratings, parental self-efficacy scale score.Result Former nursing, the observation group and the control group, maternal self-care, newborn care and breastfeeding rates were not significantly different (P>0.05); after treatment, the observation group maternal self-care, newborn care and breastfeeding rates were higher than control group, the difference was statistically significant (P0.05); after treatment, the observation group to promote development, health

  14. Effects of Two Kinds of Air Purification in NICU Ward%两种不同空气净化方式对NICU病房的影响

    Institute of Scientific and Technical Information of China (English)

    洪素蜜; 黄跃兴

    2014-01-01

    目的比较不同空气净化方式对病房医院感染的影响,探讨更适合NICU病房空气质量的管理办法。方法在同个季度的不同月份采用两种不同的空气净化方式,平板自然沉降法检测病房内空气净化后的细菌总数,监测各个月份医院感染发生情况,应用SPSS 10.0统计分析。结果采用自然通风换气与空气消毒机消毒后病房的细菌总数比较没有显著性差异(﹥0.05),两种方法而发生医院感染率同样没有显著性差异(﹥0.05)。与空气消毒机净化室内空气方式比,采用自然通风方式时病房患儿平均住院日数更短,平均少0.93d。结论在自然通风良好的状态下,做好通风时间对患儿的保暖,在NICU病房采用合理的自然通风可能对患儿的康复更有利。%Objective To compare the influence of dif erent air purification way about hospital infection, explore more suitable measures for the administration of NICU ward air quality. Methods In the same quarter of dif erent months using two dif erent ways of air purification, use the method of flat natural sedimentation to monitoring the ward air after purification, the total number of bacteria, hospital infection occurred in monitoring the situation, application of spss10.0 statistical analysis.Results After using natural ventilation and Air disinfection machine to disinfection ward of the total number of bacteria is no significant dif erence ( ﹥0.05), two methods and the hospital infection rate is also no significant dif erence( ﹥0.05). compare with air purifying indoor using air disinfection machine, natural ventilation mode can shorter average hospital stay, an average of 0.93 days.Conclusion Under the conditions of natural ventilation, keep children warm when ventilated time , employing reasonable natural ventilation in the NICU ward might be more beneficial to the patient's recovery.

  15. The Leader of the Band: A Case Story of Community Music Therapy on a Hospital Ward for People Who Have Dementia

    Directory of Open Access Journals (Sweden)

    Patrice Dennis

    2014-03-01

    Full Text Available This case story was undertaken as part of a research project investigating music therapy to aid relationships between people with dementia and their family members. Involving family members in the music therapy process was found to be valuable in fostering a sense of community between residents, family members, and care staff (Dennis, 2012. However, a sense of community was also fostered by the interactions of the residents themselves as they participated in music therapy over a ten month period. Music making became a natural part of the environment, an important medium for individual expression, shared communication, enhancing social events, and demonstrating mutual care and love. We demonstrate this through our case story of Jack whose music making permeated the dementia ward to invite the active participation of others, and led to the development of caring relationships.

  16. Prolonged clonal spreading and dynamic changes in antimicrobial resistance of Escherichia coli ST68 among patients who stayed in a respiratory care ward.

    Science.gov (United States)

    Chen, Chih-Ming; Ke, Se-Chin; Li, Chia-Ru; Chiou, Chien-Shun; Chang, Chao-Chin

    2014-11-01

    From 2007 to 2009, we collected a total of 83 bacteraemic isolates of Escherichia coli with reduced susceptibility or resistance to third-generation cephalosporins (TGCs). Isolates were genotyped by PFGE and multilocus sequence typing (MLST). The PFGE patterns revealed two highly correlated clusters (cluster E: nine isolates; cluster G: 22 isolates) associated with this prolonged clonal spreading. Compared with cluster E isolates, cluster G isolates were significantly more likely to harbour aac(6')-Ib-cr (Pcoli cases caused by cluster E and G isolates were significantly associated with having stayed in our hospital's respiratory care ward (Pcoli ST68 associated with a stay in a long-term care facility. Using epidemiological investigations and PFGE and MLST analyses, we have identified long-term clonal spreading caused by E. coli ST68, with extra antimicrobial-resistance genes possibly acquired during the prolonged spreading period.

  17. mu-Squared Dependent Deviation of the Non Perturbative ZA,MOM from the True Axial Renormalisation Constant, Implied by Ward Identity

    CERN Document Server

    Boucaud, Ph; Yaouanc, A Le; Micheli, J; Pène, O; Rodriguez-Quintero, J

    2015-01-01

    It is recalled why, as already stated in a previous paper, there seems to be an inconsistency in identifying the non perturbative ZA,MOM as the renormalisation of the axial current, or equivalently, in setting as normalisation condition that the renormalised vertex=1 at p^2 = mu^2 at some renormalisation scale mu, where p is the momentum in the legs. Indeed, unlike the vector case, the Ward-Takahashi (WT) identity for the axial current is shown to imply both the renormalisation scale independence of ZA and a mu2 dependence of ZA,MOM. This mu^2 dependence is simply related to certain invariants in the pseudoscalar vertex and can persist in the chiral limit due to the spontaneous breaking of chiral symmetry (pion pole). It is seen clearly in the mu^2 dependence of some lattice calculations of ZA,MOM/ZV,MOM near the chiral limit.

  18. Cholestasis sepsis at neonatology ward and neonatal Intensive Care Unit Cipto Mangunkusumo Hospital 2007 : incidence, mortality rate and associated risk factors

    Directory of Open Access Journals (Sweden)

    Kadim S. Bachtiar

    2008-06-01

    Full Text Available Cholestatic jaundice represents serious pathological condition. Septic-cholestasis is a kind of hepato-cellular cholestasis that occured during or after sepsis caused by biliary flow obstruction. This is a cohort study from February to June 2007 on neonatal sepsis patients at Neonatology ward Department of Child Health Faculty of Medicine University of Indonesia-Cipto Mangunkusumo General National Hospital. Aim of this study is to find out the incidence of intrahepatic cholestasis in neonatal sepsis, associated risk factors, and mortality rate in neonatal cholestasis-sepsis. From 138 neonatal sepsis patients, the incidence of intrahepatic cholestasis is 65.9%. None of the risk factors tested in this study showed statistically significant result. Mortality rate of neonatal cholestasis-sepsis is 52.8%. (Med J Indones 2008; 17: 107-13Keywords: cholestasis intrahepatic, neonatal sepsis, cholestasis sepsis, conjugated hyperbilirubinemia

  19. 实施三级护理查房促进护理质量提高%Application of three-grade nursing ward in improving nursing quality

    Institute of Scientific and Technical Information of China (English)

    梁美明

    2015-01-01

    Objective To analyze the effect of three-grade nursing ward on the quality of nursing. Methods 200 patients were randomly divided into two groups:the experiment group and the control group, and the former took the model of three-grade nursing ward, however, the latter took the model of traditional conventional ward.The qualified rate of daily nursing records, percent of pass of nurse'quality, patient's satisfaction of two groups would be compared.Results There was statistically significant difference between two groups at the side of qualified rate of daily nursing records (P<0.05), and the experiment group was better than the control group;Percent of pass of nurse'quality of the experiment group was higher than that of the control group, and its difference was statistically significant ( P <0.05 ); Patient's satisfaction of the experiment was superior to the control group, and its difference was statistically significant ( P <0.05 ) .Conclusions Application of three-grade nursing ward can improve nurse'quality and provide patients with more satisfactory service and make the quality of clinical nursing have a large extent improvement.%目的 分析实施三级护理查房护理质量的效果. 方法 选取我院200例患者,随机分为对照组和实验组,实验组采取三级护理查房模式,而对照组采取传统常规查房模式,比较两组日常护理记录的合格率、护理人员护理素养的合格率、患者的满意度. 结果 实验组和对照组在日常护理记录的合格率上有统计学差异(P<0.05),实验组明显优于对照组;实验组的护理人员护理素养的合格率是明显高于对照组,差异具有统计学意义(P<0.05);实验组的患者满意度要高于对照组,差异具有统计学意义(P<0.05).结论 实施三级护理查房可以提高护理人员的综合素质,给予患者更加满意的服务,对临床上的护理质量有很大的提高.

  20. Study of the outcome of suicide attempts: characteristics of hospitalization in a psychiatric ward group, critical care center group, and non-hospitalized group

    Directory of Open Access Journals (Sweden)

    Kemuyama Nobuo

    2010-01-01

    Full Text Available Abstract Background The allocation of outcome of suicide attempters is extremely important in emergency situations. Following categorization of suicidal attempters who visited the emergency room by outcome, we aimed to identify the characteristics and potential needs of each group. Methods The outcomes of 1348 individuals who attempted suicide and visited the critical care center or the psychiatry emergency department of the hospital were categorized into 3 groups, "hospitalization in the critical care center (HICCC", "hospitalization in the psychiatry ward (HIPW", or "non-hospitalization (NH", and the physical, mental, and social characteristics of these groups were compared. In addition, multiple logistic analysis was used to extract factors related to outcome. Results The male-to-female ratio was 1:2. The hospitalized groups, particularly the HICCC group, were found to have biopsychosocially serious findings with regard to disturbance of consciousness (JCS, general health performance (GAS, psychiatric symptoms (BPRS, and life events (LCU, while most subjects in the NH group were women who tended to repeat suicide-related behaviors induced by relatively light stress. The HIPW group had the highest number of cases, and their symptoms were psychologically serious but physically mild. On multiple logistic analysis, outcome was found to be closely correlated with physical severity, risk factor of suicide, assessment of emergent medical intervention, and overall care. Conclusion There are different potential needs for each group. The HICCC group needs psychiatrists on a full-time basis and also social workers and clinical psychotherapists to immediately initiate comprehensive care by a medical team composed of multiple professionals. The HIPW group needs psychological education to prevent repetition of suicide attempts, and high-quality physical treatment and management skill of the staff in the psychiatric ward. The NH group subjects need a

  1. A three level supervision system for pressure ulcer management in geriatric ward%老年病房压疮管理的三级监控

    Institute of Scientific and Technical Information of China (English)

    王勤; 孙丽; 冯军; 王瑛

    2012-01-01

    目的 提高压疮防护效果.方法 在病房建立以护士长宏观监控、监管护士中间管理及责任护士微观监控的病房压疮三级监控管理模式.比较实施三级监控前(2007年)、后(2008~2010年)压疮发生情况.结果 实施三级监控前、后压疮发生率分别为8.51%、3.34%,实施前后比较,差异有统计学意义(P<0.01).结论 病房压疮三级监控有利于降低压疮发生率.%Objective To improve preventive effect of pressure ulcers. Methods We designed a three level supervision system for managing pressure ulcers in geriatric ward: head nurse monitored at the top level, inspection nurses were in charge of pressure ulcer management control at the second level and primary nurses supervised pressure ulcers at the base level. Incidence of pressure ulcer before (in the year of 2007) and after (from 2008 to 2010) the implement of the system was compared. Results The incidence rate of pressure ulcer decreased from 8. 51 % to 3. 34% after implement of the system, with significant difference between them (P< 0. 01). Conclusion Three level supervision system can reduce pressure ulcer in geriatric ward.

  2. Quality Evaluation of Attending Physician Ward Rounds Appraisal%高年资主治医师查房考核的质量评价

    Institute of Scientific and Technical Information of China (English)

    张珊红; 王冠英; 朱镕; 田妮娜

    2013-01-01

    目的 通过查房考核,评价主治医师业务综合能力.方法 对117名拟晋副主任医师职称的高年资主治医师查房考核结果进行回顾性统计分析.结果 3年来考核成绩呈逐年上升趋势,内科系统成绩优于外科、专科系统.正式在编人员与聘用人员存在不同优势.结论 通过查房考核,主治医师临床能力、带教意识等明显提高.但也存在人力资源、查房质量等方面的问题,提出改进建议.%Objective To evaluate the comprehensive medical ability of attending physician through the ward rounds appraisal. Method Retrospectively analyzed the ward rounds appraisal of 117 attending physicians who was ready to be promoted to deputy director of the physician. Result The performance appraisal results showed an upward trend yearly in three years, department of internal medicine system scored better than surgery, specialist system. Formal permanent staff and employed staff performance appraisal had different advantages. Conclusion Through the rounds appraisal, attending physicians'clinical competence, teaching awareness improved. It also reflected some problems on human resources and rounds quality, and recommendations were suggested for improvement.

  3. Transmission of endemic ST22-MRSA-IV on four acute hospital wards investigated using a combination of spa, dru and pulsed-field gel electrophoresis typing.

    LENUS (Irish Health Repository)

    Creamer, E

    2012-11-01

    The transmission of meticillin-resistant Staphylococcus aureus (MRSA) between individual patients is difficult to track in institutions where MRSA is endemic. We investigated the transmission of MRSA where ST22-MRSA-IV is endemic on four wards using demographic data, patient and environmental screening, and molecular typing of isolates. A total of 939 patients were screened, 636 within 72 h of admission (on admission) and 303 >72 h after admission, and 1,252 environmental samples were obtained. Isolates were typed by spa, dru and pulsed-field gel electrophoresis (PFGE) typing. A composite dendrogram generated from the three sets of typing data was used to divide isolates into \\'dendrogram groups\\' (DGs). Ten percent of patients (92\\/939) were MRSA-positive; 7 % (44\\/636) on admission and 16 % (48\\/303) >72 h after admission (p = 0.0007). MRSA was recovered from 5 % of environmental specimens (65\\/1,252). Most isolates from patients (97 %, 85\\/88) and the environment (97 %, 63\\/65) exhibited the ST22-MRSA-IV genotype. Four DGs (DG1, DG4, DG16 and DG17) accounted for 58 % of ST22-MRSA-IV isolates from patients. Epidemiological evidence suggested cross-transmission among 44\\/92 patients (48 %) but molecular typing confirmed probable cross-transmission in only 11 instances (13 %, 11\\/88), with the majority of cross-transmission (64 %; 7\\/11) occurring on one ward. In the setting of highly clonal endemic MRSA, the combination of local epidemiology, PFGE, spa and dru typing provided valuable insights into MRSA transmission.

  4. SDS-PAGE Analysis of the Outer Membrane Proteins of Uropathogenic Escherichia coli Isolated from Patients in Different Wards of Nemazee Hospital, Shiraz, Iran

    Directory of Open Access Journals (Sweden)

    Behzad Dehghani

    2016-09-01

    Full Text Available Background: Outer membrane proteins (OMPs constitute the main structure and about half of the cell wall of Gram-negative bacteria. The OMPs of Escherichia coli (E. coli play an important role in its drug resistance. Previous studies have shown that the OMPs of E. coli enhance its pathogenic effects by helping the bacterium to evade the immune defense and promote its adsorption to host cells. We sought to compare E. coli isolates collected from different hospital wards and to perform a primary investigation of the association between the serotypes and profiles of their OMPs. We also aimed to detect the diversity of the E. coli isolates from the hospitalized patients. Methods: A total of 115 isolates of E. coli were collected from patients hospitalized in Nemazee Hospital, Shiraz, Iran. After biochemical and serological tests, OMPs were extracted by using glass beads and N-Lauroylsarcosine sodium. OMP typing was done by 10% SDS-PAGE and Coomassie brilliant blue staining. In terms of the number of protein bands, OMP-I was detected with 2 bands, OMP-α with 3 bands, and OMP-β with1 band. Results: Of the 115 isolates, 103 were OMP-I and 12 were OMP-α; none of the isolates belonged to OMP-β. Our statistical analyses showed a relationship between OMP patterns and other factors, including hospital wards and source of samples. Serotyping showed that the majority of the isolates were O128. Conclusion: Our results demonstrated some similarities between the OMP band patterns of the analyzed groups of E. coli. Of all the OMPs in the isolates from the hospitalized and outpatient department patients, OmpA and OmpC were the most prevalent proteins in the outer membrane of the studied uropathogenic E. coli.

  5. Prevalence and risk factors of metallo β-lactamase producing Pseudomonas aeruginosa and Acinetobacter species in burns and surgical wards in a tertiary care hospital

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    Simit H Kumar

    2012-01-01

    Full Text Available Introduction: The production of Metallo-β-lactamases (MBLs is one of the resistance mechanisms of Pseudomonas aeruginosa and Acinetobacter species. There is not much Indian data on the prevalence of MBLs in burns and surgical wards. Materials and Methods: A total of 145 non-duplicate isolates of carbapenem-resistant Pseudomonas aeruginosa and Acinetobacter species, isolated from pus/wound swabs and endotracheal secretions from burns and surgical wards, were tested for MBL production by modified ethylene diamine tetra acetic acid (EDTA disc synergy and double disc synergy tests. Results: Prevalence of MBLs was 26.9% by both the above tests. All MBL-positive isolates were multidrug resistant. Only 6.06% (2/33 P.aeruginosa and 16.67% (1/06 Acinetobacter species were susceptible to piperacillin-tazobactam and netilmycin, respectively. These patients had multiple risk factors like >8 days hospital stay, catheterization, IV lines, previous antibiotic use, mechanical ventilation, etc. Graft application and surgical intervention were significant risk factors in MBL-positive patients. Overall mortality in MBL-positive patients was 34.21%. Conclusion: Emergence of MBL-producing Pseudomonas aeruginosa and Acinetobacter species in this hospital is alarming, which reflect excessive use of carbapenems and at the same time, pose a therapeutic challenge to clinicians as well as to microbiologists. Therefore, a strict antibiotic policy and implementation of proper infection control practices will go a long way to prevent further spread of MBLs. Detection of MBLs should also become mandatory in all hospitals.

  6. Assessment of the MSF triage system, separating patients into different wards pending Ebola virus laboratory confirmation, Kailahun, Sierra Leone, July to September 2014.

    Science.gov (United States)

    Vogt, Florian; Fitzpatrick, Gabriel; Patten, Gabriela; van den Bergh, Rafael; Stinson, Kathryn; Pandolfi, Luigi; Squire, James; Decroo, Tom; Declerck, Hilde; Van Herp, Michel

    2015-01-01

    Prevention of nosocomial Ebola virus (EBOV) infection among patients admitted to an Ebola management centre (EMC) is paramount. Current Médecins Sans Frontières (MSF) guidelines recommend classifying admitted patients at triage into suspect and highly-suspect categories pending laboratory confirmation. We investigated the performance of the MSF triage system to separate patients with subsequent EBOV-positive laboratory test (true-positive admissions) from patients who were initially admitted on clinical grounds but subsequently tested EBOV-negative (false-positive admissions). We calculated standard diagnostic test statistics for triage allocation into suspect or highly-suspect wards (index test) and subsequent positive or negative laboratory results (reference test) among 433 patients admitted into the MSF EMC Kailahun, Sierra Leone, between 1 July and 30 September 2014. 254 (59%) of admissions were classified as highly-suspect, the remaining 179 (41%) as suspect. 276 (64%) were true-positive admissions, leaving 157 (36.3%) false-positive admissions exposed to the risk of nosocomial EBOV infection. The positive predictive value for receiving a positive laboratory result after being allocated to the highly-suspect ward was 76%. The corresponding negative predictive value was 54%. Sensitivity and specificity were 70% and 61%, respectively. Results for accurate patient classification were unconvincing. The current triage system should be changed. Whenever possible, patients should be accommodated in single compartments pending laboratory confirmation. Furthermore, the initial triage step on whether or not to admit a patient in the first place must be improved. What is ultimately needed is a point-of-care EBOV diagnostic test that is reliable, accurate, robust, mobile, affordable, easy to use outside strict biosafety protocols, providing results with quick turnaround time.

  7. Experience in the form of night nursing ward round%夜间护理查房形式的体会

    Institute of Scientific and Technical Information of China (English)

    陈菊英

    2016-01-01

    夜间护理查房是保证护理质量的重要措施之一,也是医院护理管理中不可缺少的一个环节,在省、市各大医院广泛重视。我院是一所二级甲等中医院,在执行过程中,通过夜间查房,提高护理质量,提高护士长管理水平,不断改革,不断创新,逐步形成了目前执行的一套“计划检查、填写表格、奖优罚劣”的查房形式。这对于促进护理规范化,提高护士长的管理水平,促进岗位责任制的落实具有积极作用。%Night nursing ward round is one of the important measures to ensure the quality of nursing, is an indispensable link in hospital nursing management, wide attention in the province, city hospitals. Our hospital is a level 2 grade a hospital, in the process of execution, through the night ward inspection, improve the quality of nursing, improve the level of head nurse management, continuous reform and innovation, gradually formed the currently executing a set of \\"planning inspection, fill out the form, retiring\\" form of patient rounds. This to promote nursing standardization, improve the management level of the head nurse, plays a positive role to promote job responsibility to carry out the.

  8. Comparison of PCR/Electron Spray Ionization-Time-of-Flight-Mass Spectrometry versus Traditional Clinical Microbiology for Active Surveillance of Organisms Contaminating High-Use Surfaces in a Burn Intensive Care Unit, an Orthopedic Ward and Healthcare Workers

    Science.gov (United States)

    2012-10-10

    Enterobacter spp., Streptococcus spp. (68% viridans group), Pseudomonas aeruginosa, and Acinetobacter baumannii -calcoaceticus complex; the proportions of these...Staphylococcus aureus and Acinetobacter baumannii on computer interface surfaces of hospital wards and association with clinical isolates. BMC Infect Dis 2009, 9...Cursino MR, Sinto S: Environmental contamination by multidrug resistant Acinetobacter baumannii in an intensive care unit. Infect Control Hosp Epidemiol

  9. Notes on the inherently safe core design meeting with the DOE-RRT, AI, GE, W-ARD, EPRI, and ETEC (at AI, Canoga Park, California, November 7-8, 1978). [LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Jackola, A.S.; Paschall, R.K.

    1978-11-09

    The primary purpose of the meeting was to familiarize large LMFBR design managers with the capabilities of the Inherent Secondary Shutdown Systems (articulated rod and absorber balls) and to obtain inputs from them. The other purpose of the meeting was for the ISSS designers (AI, GE, and WARD) to present current work status, future plans, and schedules for their respective ISSS tasks.

  10. Nonpharmacological Interventions Targeted at Delirium Risk Factors, Delivered by Trained Volunteers (Medical and Psychology Students, Reduced Need for Antipsychotic Medications and the Length of Hospital Stay in Aged Patients Admitted to an Acute Internal Medicine Ward: Pilot Study

    Directory of Open Access Journals (Sweden)

    Stanislaw Gorski

    2017-01-01

    Full Text Available Purpose. Effectiveness of nonpharmacological multicomponent prevention delivered by trained volunteers (medical and psychology students, targeted at delirium risk factors in geriatric inpatients, was assessed at an internal medicine ward in Poland. Patients and Methods. Participants were recruited to intervention and control groups at the internal medicine ward (inclusion criteria: age ≥ 75, acute medical condition, basic orientation, and logical contact on admission; exclusion criteria: life expectancy < 24 hours, surgical hospitalization, isolation due to infectious disease, and discharge to other medical wards. Every day trained volunteers delivered a multicomponent standardized intervention targeted at risk factors of in-hospital complications to the intervention group. The control group, selected using a retrospective individual matching strategy (1 : 1 ratio, regarding age, gender, and time of hospitalization, received standard care. Outcome Measures. Hospitalization time, deaths, falls, delirium episodes, and antipsychotic prescriptions were assessed retrospectively from medical documentation. Results. 130 patients (38.4% males participated in the study, with 65 in the intervention group. Antipsychotic medications were initiated less frequently in the intervention group compared to the control group. There was a trend towards a shorter hospitalization time and a not statistically significant decrease in deaths in the intervention group. Conclusion. Nonpharmacological multicomponent intervention targeted at delirium risk factors effectively reduced length of hospitalization and need for initiating antipsychotic treatment in elderly patients at the internal medicine ward.

  11. 基于病例学习模式查房对住院医师培养的实践%Application of Case-based Learning in Ward-round for Residents Training

    Institute of Scientific and Technical Information of China (English)

    马欣; 王玉平; 樊洁

    2015-01-01

    目的:观察基于病例学习(CBL)模式查房对住院医师培养的效果。方法对神经内科轮转期间参加常规式查房和CBL查房的33名住院医师进行问卷调查。结果共回收有效问卷30份。认为CBL查房在促进临床思维培养、专业知识掌握、自主学习兴趣和能力以及加强与患者及其家属沟通能力方面显著有效的人数均多于常规查房(P<0.05)。结论 CBL查房对住院医师综合专业能力的培养具有明显优势。%Objective To observe the effect of case-based learning (CBL) applied in ward-round on residents training. Methods A total of 33 residents trained with routine ward-round and CBL ward-round in the neurological department were investigated with questionnaire. Results 30 effective answers were recalled. More of them reported that CBL ward-round was very significant in improving clinical thinking, mastering the specialized knowledge, developing autonomous learning and improving the communication with patients and their family members (P<0.05). Conclusion CBL ward-round is effective on improving the comprehensive professional abilities of residents.

  12. Applying the Integrated Practice Unit Concept to a Modified Virtual Ward Model of Care for Patients at Highest Risk of Readmission: A Randomized Controlled Trial

    Science.gov (United States)

    Ng, Matthew Joo Ming; Balasubramaniam, Kanchana; Towle, Rachel Marie

    2017-01-01

    Background Emerging evidence from the virtual ward care model showed that multidisciplinary case management are inadequate to reduce readmissions or death for high risk patients. There is consensus that interventions should encompass both pre-hospital discharge and post-discharge transitional care to be effective. Integrated practice units (IPU) had been proposed as an approach of restructuring the organization and work processes of multidisciplinary teams to achieve value in healthcare. Our primary objective is to evaluate if the novel application of the IPU concept to organize a modified virtual ward model incorporating pre-hospital discharge transitional care can reduce readmissions of patients at highest risk for readmission. Methods We conducted an open label, assessor blinded randomized controlled trial on patients with one or more unscheduled readmissions in the prior 90 days and LACE score ≥ 10. 840 patients were randomized in 1:1 ratio and blocks of 6 to the intervention program (n = 420) or control (n = 420). Allocation concealment was effected via an off-site telephone service maintained by a hospital administrator. Intervention patients received discharge planning, medication reconciliation, coaching on self-management of chronic diseases using standardized action plans and an individualized care plan complete with written discharge instructions, appointments schedule, medication changes and the contact information of the outpatient VW nurse before discharge. At discharge, care is handed over to the outpatient VW team. Patients were closely monitored in the VW for three months that included a telephone review within 72 hours of discharge, home assessment, regular telephone reviews to identify early complications and early review clinics for patients who destabilize. The VW meet daily to discuss new patients and review care plans for patients. Control patients received standard hospital care that included a standardized patient copy of the hospital

  13. The A-test: Assessment of functional recovery during early rehabilitation of patients in an orthopedic ward - content, criterion and construct validity

    Directory of Open Access Journals (Sweden)

    Vukomanović Aleksandra

    2014-01-01

    Full Text Available Background/Aim. The A-test was designed for assessment of functional recovery during early rehabilitation of patients in an orthopedic ward. This performance-based test consists of 10 items for assessing basic activities by a six level ordinal scale (0-5. Total scores can range from 0 to 50, i.e. from inability to perform any activity despite the help of therapists to complete independence and safety in performing all activities. The aim of this study was to examine the A-test validity. Methods. This prospective study was conducted in an orthopedic ward and included 120 patients [60 patients with hip osteoarthritis that underwent arthroplasty and 60 surgically treated patients with hip fracture (HF] during early inpatient rehabilitation (1st-5th day. Validity was examined through 3 aspects: content validity - floor and ceiling effect, range, skewness; criterion validity - concurrent validity [correlation with the University of Iowa Level of Assistance Scale (ILAS for patients with hip osteoarthritis, and with the Cumulated Ambulation Score (CAS for patients with HF, Spearman rank correlation] and predictive validity [the New Mobility Score (NMS 4 weeks after surgery, Mann-Whitney U test]; construct validity - 4 hypotheses: 1 on the fifth day of rehabilitation in patients underwent arthroplasty due to hip osteoarthritis, the A-test results will strongly correlate with those of ILAS, while the correlation with the Harris hip score will be less strong; 2 in patients with HF, the A-test results will be significantly better in those with allowed weight bearing as compared to patients whom weight bearing is not allowed while walking; 3 results of the A-test will be significantly better in patients with hip osetoarthritis than in those with HF; 4 the A-test results will be significantly better in patients younger than 65 years than in those aged 65 years and older. Results. The obtained results were: low floor (1% and ceiling (2% effect, range 0

  14. ANALYSIS OF MULTIDRUG -RESISTANT BACTERIA INFECTIONS IN THE GERIATRIC WARD%老年病房患者多重耐药菌感染的调查

    Institute of Scientific and Technical Information of China (English)

    陈英; 杨军; 张剑江

    2014-01-01

    目的:了解医院老年病房住院患者多重耐药菌感染特点,探讨有效防控措施。方法采用回顾性调查方法,对某医院老年病房住院患者多重耐药菌感染特征、病原菌分布以及危险因素进行调查。结果该医院老年病房在2年内共调查老年患者957例,发生多重耐药菌感染30例,感染率为3.14%,病死率70%。老年患者多重耐药菌感染以下呼吸道感染为主,其构成比达到66.67%。分离出的多重耐药菌主要是产超广谱β-内酰胺酶( ES-BLs)肺炎克雷伯菌、大肠埃希菌及耐碳青酶烯铜绿假单菌。病人的年龄、基础疾病、住院时间、侵入性操作、激素使用等构成感染的主要危险因素。结论该医院老年患者多重耐药菌感染率较高,以下呼吸道感染最多见,免疫力的改善、无菌技术保障和合理使用抗菌药物为主要防控措施。%Objective To study the clinical features of multidrug-resistant bacteria infection in the geriatric wards,so as to explore the effective measures for prevention and control. Methods The retrospective investigation was used to ana-lyze multi-resistant bacteria infection characteristics,pathogen distribution and risk factors of the inpatients in geriatric ward of a hospital. Results 957 elderly patients in the hospital geriatric ward were investigated in 2 years. 30 cases oc-curred multidrug-resistant bacteria infection and the infection rate was 3. 14%,the mortality was 70%. Most of them were lower respiratory tract infections and the constituent ratio was 66. 67%. The main pathogens included ESBLs -produing Escherichia coli,Klebsiella pneumoniae and Carbapenems-resistant Pseudomonas aeruginosa. The risk factors of multidrug-resistant bacteria infection were age,disease kind and extent,hospitalization,invasive operation and glucocorticoid u-sing,et al. Conclusion The infection rate of the elderly patients with multiple drug-resistant bacteria is

  15. PCA在“无痛病房”创建中的应用研究%Application of Patient-controlled Analgesia in the Establishment of "Painless Ward"

    Institute of Scientific and Technical Information of China (English)

    赖红燕; 李军; 徐武敏

    2016-01-01

    Objective To explore the application of Patient-controlled Analgesia (PCA) in the establishment of "painless ward" in the department of orthopedics.Methods A total of 400 patients with limb fractures meeting the criteria were selected and randomly divided into experimental group and control group. The control group adopted the traditional pain care model, and the experimental group adopted PCA and intervention of painless ward philosophy. Numeric rating scale (NRS) was used to evaluate postoperative resting NRS score and postoperative exercise NRS score. Sleep rate and cases of sleep disruption caused by pain were recorded. In addition, satisfaction level of pain control were recorded.Results Compared with the control group, the experimental group had lower resting NRS scores at each measuring point except 2h after surgery; Exercise NRS scores of the experimental group at each measuring point were lower than that of the control group. At the first postoperative night, patients of the experimental group had higher sleep disruption rate and lower sleep rate than patients of the control group. The satisfaction level of the experimental group was significantly higher than that of the control group, the differences were statistically significant.Conclusions Establishment of painless ward with PCA is a feasible, effective and safe way to help reduce the pain level, carry out rehabilitation exercises and improve quality of life, which is worth to be further applied.%目的探讨自控镇痛泵(PCA)在创伤骨科“无痛病房”创建中的应用效果。方法选择符合条件的肢体骨折患者400例,并随机分为实验组和对照组,对照组采用传统疼痛护理模式,实验组给予PCA及无痛病房理念干预。采用疼痛数字评分量表(NRS)进行术后静息NRS评分、运动NRS评分。记录患者有无因疼痛而致夜间睡眠中断和睡眠率,并记录患者对疼痛控制的满意程度。结果与对照组相比,

  16. 新生儿数字化查房系统的实现%Realization of the Digital Ward Round System for Newborns

    Institute of Scientific and Technical Information of China (English)

    汤福南; 敦煌俊秋; 张可; 刘宾; 朱松盛; 吴小玲

    2016-01-01

    The research adopted the RFID technology and Bluetooth technology to improve the ward round system for neonatal patients. The coin-shaped inductive and intelligent IC card was chosen to use as the system identiifcation card. The portable card reader equipment adopted the RC522 radio frequency card reader module; data transmission adopted the CC2530 single chip microcomputer and the Bluetooth module BLK-MD-BC04-B; based on the current development smartphones and tablet computers, data exchange can be conducted between intelligent terminals and card-reading equipment in hospital information system by using the RFID and Bluetooth technology. The system can exchange data with the hospital information systemvia the network interface. Through simulation experiments, the feasibility of and stability of the system was conifrmed. The system can help with the realization of the digitalization and intellectualization of the ward round system for neonatal patients, also can improve the efifciency of the medical staff and hospital service quality.%本研究采用RFID技术和蓝牙技术对我院原新生儿查房系统做了改进。系统身份识别卡片选用圆币式的感应式智能IC卡,读卡设备采用RC522射频读卡模块;数据传输采用CC2530单片机和蓝牙BLK-MD-BC04-B模块;智能终端基于现有的智能手机或者平板电脑开发,与读卡设备通过蓝牙协议进行数据传输。系统通过网络接口与医院信息系统(HIS)进行数据交流。通过模拟实验证实了系统的可行性和稳定性,实现了对新生儿查房数字化、智能化。

  17. 老年病房真菌分布及耐药性分析%Clinical distribution and drug resistance of fungi from geriatric wards

    Institute of Scientific and Technical Information of China (English)

    龚美亮; 周玉; 李玉茹; 白洁; 蔡力力; 徐雅萍; 李晓霞

    2011-01-01

    OBJECTIVE To explore the clinical distribution and drug resistance characteristics of pathogens from eldly fungal infection patients to provide the gist for clinical therapy. METHODS The clinical isolates gathered from inpatients in geriatric ward during Jun 2010 to Jun 2011 were identified and tested for drug resistance: RESULTS Among 2 290 strains of fungi, 1322 strains were Candida albicans(57. 7%) , 336 strains were C. Trop-icalisdi. 7%)and.328 strains were C. Glabrata (14. 3%). The clinical departments with highest infective rate was department of Respiratory; The highest detection rate of 78. 3% was in sputum specimens, followed by 10. 1% in the urine. Susceptibility results showed that amphotericin B was the most sensitive drug with the sensitivity rate of 99.0%. CONCLUSION In geriatric wards, the majority isolated fungal strain is C. Albicans. The fungal infection is severe. It should pay attention to the fungi detection and rational use of antifungal agents.%目的 探讨老年患者真菌感染的分布及耐药性,为临床合理用药提供依据.方法 收集医院老年病房2010年6月-2011年6月临床送检标本,进行真菌分离、鉴定和药敏试验.结果 2290株真菌中,白色假丝酵母菌占57.7%,光滑假丝酵母菌占14.3%;真菌分离率较高的科室为呼吸科;检出真菌标本痰液占78.6%,尿液标本占10.1%;真菌对两性霉素B和5-氟胞嘧啶敏感率分别为99.0%和98.4%.结论 老年病房真菌感染以白色假丝酵母菌为主,真菌感染率较高,应重视真菌病原学检查及药敏检测,为临床合理用药提供依据.

  18. Influence of Attending Physician Ward Round to Medical Quality%主治医师查房对医疗质量的影响

    Institute of Scientific and Technical Information of China (English)

    张红宇; 李小莹; 王力红; 赵国光

    2013-01-01

    Objective To strengthen the medical work management ,improve the inpatient medical quality by attending ward round examination . Methods Checking the ward round quality of the 81 attending physicians in 22 clinical departments in our hospital ,and summarizing the problems . Results 47 .6% of the attending physicians ignored physical examination .33 .3% of the attending physicians did not review medical record and lack of the consciousness of teaching .28 .5% of them did not present the next treatment measures .23 .8% of them did not ask critical history .23 .8% of them did not analyze special examination and treatment .19% of them did not ful y analyze diagnosis and distinguishing diagnosis .14 .3% of them did not analyze laboratory results .Conclusion We should strengthen the attending physicians training ,establish the relevant examination system to improve the inpatient medical quality .%  目的通过主治医师查房考核,加强对病房医疗工作的管理,提高住院患者医疗质量。方法对我院22个临床科室的81名主治医师进行查房考核,并总结分析。结果主治医师查房时忽视体格检查占47.6%;没有修改病历和缺乏教学意识均占33.3%;没有提出患者下一步诊疗措施占28.5%;没有重点询问关键病史占23.8%;特殊检查与治疗分析不全面占23.8%;诊断及鉴别诊断分析不充分占19.0%;未对检查结果进行分析占14.3%。结论加强对主治医师的培训,建立主治医师查房考核制度,提高住院患者的医疗质量。

  19. Can patients with moderate to severe acute respiratory failure from COPD be treated safely with noninvasive mechanical ventilation on the ward?

    Directory of Open Access Journals (Sweden)

    Yalcinsoy M

    2016-05-01

    Full Text Available Murat Yalcinsoy,1 Cuneyt Salturk,2 Selahattin Oztas,2 Sinem Gungor,2 Ipek Ozmen,2 Feyyaz Kabadayi,2 Aysem Askim Oztim,2 Emine Aksoy,2 Nalan Adıguzel,2 Ozlem Oruc,2 Zuhal Karakurt2 1Department of Pulmonary Medicine, Inonu University Medical Faculty, Turgut Ozal Medical Center, Malatya, 2Department of Pulmonary Medicine, Sureyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey Purpose: Noninvasive mechanical ventilation (NIMV usage outside of intensive care unit is not recommended in patients with COPD for severe acute respiratory failure (ARF. We assessed the factors associated with failure of NIMV in patients with ARF and severe acidosis admitted to the emergency department and followed on respiratory ward.Patients and methods: This is a retrospective observational cohort study conducted in a tertiary teaching hospital specialized in chest diseases and thoracic surgery between June 1, 2013 and May 31, 2014. COPD patients who were admitted to our emergency department due to ARF were included. Patients were grouped according to the severity of acidosis into two groups: group 1 (pH=7.20–7.25 and group 2 (pH=7.26–7.30.Results: Group 1 included 59 patients (mean age: 70±10 years, 30.5% female and group 2 included 171 patients (mean age: 67±11 years, 28.7% female. On multivariable analysis, partial arterial oxygen pressure to the inspired fractionated oxygen (PaO2/FiO2 ratio <200, delta pH value <0.30, and pH value <7.31 on control arterial blood gas after NIMV in the emergency room and peak C-reactive protein were found to be the risk factors for NIMV failure in COPD patients with ARF in the ward.Conclusion: NIMV is effective not only in mild respiratory failure but also with severe forms of COPD patients presenting with severe exacerbation. The determination of the failure criteria of NIMV and the expertise of the team is critical for treatment success. Keywords: noninvasive mechanical ventilation

  20. Application of infrared ear thermometer in cancer ward%红外耳温仪在肿瘤病区的应用探讨

    Institute of Scientific and Technical Information of China (English)

    沙海萍

    2012-01-01

    Objective To explore the feasibility and advantages of using infrared ear thermometer in cancer chemotherapy ward. Methods A total of 200 hospitalized patients randomly in cancer chemotherapy ward were selected randomly. Their ear temperature, mouth temperature, axillary temperature, and rectal temperature were measured and compared. Results Infrared ear thermometer was used to measure the temperatures of the patients. At the same time, a mercury thermometer was used to measure the temperatures of all patients again. The rectal temperature measured by the mercury thermometer was slightly lower, and the mouth temperature measured by the mercury thermometer was slightly higher. The differences had no statistical significance. However, the ear temperature was significantly higher than axillary temperature and the difference was statistically significant (P<0. 01). The temperature difference between the left ear and right ear had no statistical significance. Conclusion Infrared ear thermometer is as precise and stable as the mercury thermometer. But it is simpler, safer, time-saving and more convenient. It is worthy of clinical application.%目的 探讨红外耳温仪测温方法在肿瘤化疗病区应用的可行性和优点.方法 随机选择肿瘤化疗病区200例住院患者分别进行耳温(左耳和右耳)与口温、腋温及肛温的测量,并进行测量结果的比对.结果 红外耳温仪所测得的耳温比同时、同一患者用水银体温计测得的肛温略低,比口温稍高,两者差异无统计学意义;耳温明显高于腋温,差异有统计学意义(P<0.01);左、右耳温度差异无统计学意义.结论 红外线耳温仪和水银体温计测温一样准确、稳定,但红外线耳温仪还具备操作简单、使用安全、省时省力的优点,值得在临床推广应用.

  1. SWOT分析法在特需病房护理管理中的应用%Application of SWOT analysis method in nursing management in special wards

    Institute of Scientific and Technical Information of China (English)

    曹何琼; 郑春霞; 吴丽英; 魏燕旋

    2012-01-01

    目的 探讨在特需病房护理管理中如何运用SWOT分析法进行分析,制订个性化措施,评价临床护理质量.方法 运用SWOT分析法对特需病房护理管理的内部优势因素(strenths)、弱点因素(weaknesses)和外部机会因素(opportunities)、威胁因素(threats)进行调查并按一定的次序排列成矩阵形式,运用系统分析的方法把各因素相互匹配加以分析,从中得出相应的结论,制订相应对策.于SWOT分析法应用到特需病房的护理管理前选择30例患者,应用后选择40例患者,进行应用前后的效果比较.结果 实施SWOT分析法后基础护理、Ⅰ级护理、健康教育质量、患者满意度及病房管理等评分明显优于实施前.结论 SWOT分析法直观,使用简单,具有平衡性和系统性,适用于特需病房的临床护理管理.%Objective To explore how to apply SWOT analysis method for analysis in nursing management in special wards,to develop individualized measures,and to evaluate the clinical quality of care. Methods Using SWOT analysis method to investigate the internal strengths factors,internal weaknesses factors,external opportunities factors,and external threats factors and arranged as a matrix in accordance with a certain order,and used systems analysis methods to analyze the factors matching each other,to dr aw the appropriate conclusions,and to develop appropriate countermeasures.30 patients before and 40 patients after the application of SWOT analysis method were selected for effect comparison. Results After the implementation of SWOT analysis method primary care,I-level care,health education quality,satisfaction degree of patients and ward management score were better than those before the implementation. Conclusions SWOT analysis method was intuitive and simple to use.It possesses balance and systematieness,which is suitable for clinical care management.

  2. Encontro com Ciborgues no hospital: cartografias de um campo cirúrgico Meeting with Cyborgs in the hospital: cartographies of a surgical ward

    Directory of Open Access Journals (Sweden)

    Tonantzin Ribeiro Gonçalves

    2005-04-01

    Full Text Available O presente trabalho é fruto da consultoria em psicologia do trabalho realizado com trabalhadores da unidade de bloco cirúrgico de um hospital geral em Porto Alegre. Pretendeu-se discutir a relação constitutiva entre trabalho e subjetividade no contexto da enfermagem cirúrgica, buscando mapear modos particulares de fazer, sentir, sofrer e subjetivar, além de descrever e problematizar a organização do trabalho e as relações desejantes entre trabalhadores e hospital. Por fim, debate-se atravessamentos da contemporaneidade na atividade cirúrgica, tais como, a ciborguização, a biotecnologia, a engenharia genética, o questionamento do "eu" e a reconstrução da noção de corpo.The present work is the result of the consultancy in psychology related to a work accomplished with workers in a unit of a surgical ward at a General Hospital in the city of Porto Alegre. The work intended to discuss the constitutive relation between work and subjectivity in the context of the surgical nursing, looking for the outline of peculiar manners of doing, feeling, suffering and making subjective. Moreover, the article describes and problemizes the organization of the work and the desirable relationships among the workers and the hospital. Finally, it discusses contemporary issues which permeate the surgical activity, such as, robotization, biotechnology, genetic engineering, the questioning of "me" and the reconstruction of the body notion.

  3. A reflection on choosing practice development as a framework to explore music as a therapeutic method to reduce anxiety in patients living with dementia in a ward setting

    Directory of Open Access Journals (Sweden)

    Alasdair Pithie

    2016-05-01

    Full Text Available Background: As a student nurse I chose to write my fourth year dissertation on the use of music as a therapeutic method to reduce anxiety in patients living with dementia. Music has been shown to have a positive effect on patients’ anxiety levels and improve their quality of life. A music therapy intervention could be beneficial but I realised I would need a framework that would enable me to implement the intervention in a ward setting, while offering practitioners and other participants a reasonable level of control and ownership. Discussion: Practice development was chosen because it is a person-centred framework, encouraging the learning of all those involved as well as those facilitating. It is inclusive and allows staff to adapt to the way new practices are introduced in a project. Change management theory was also considered as a framework but lacked many of the person-centred qualities required. Conclusions and implications for practice: Practice development provides the required characteristics for a project to introduce music into a care setting. Given that the methods of the project rely heavily on the involvement of staff and patients’ families, it is important to offer them a sense of ownership and control as an encouragement to take an interest and pride in its success. Furthermore, student nurses can benefit from being introduced to practice development because it will offer them a change theory that is person centred and inclusive.

  4. Ward Edwards: Father of Behavioral Decision Theory%行为决策理论之父:纪念Edwards教授2周年忌辰

    Institute of Scientific and Technical Information of China (English)

    李纾; 谢晓非

    2007-01-01

    著名心理学家Ward Edwards对行为决策的学科形成与理论发展作出了巨大贡献.文章简要介绍了Edwards的生平,以主观期望效用模型和贝叶斯决策为核心回顾了Edwards的决策理论、主要成就及其对行为决策研究的学术贡献.文章并从行为决策领域的研究、科普、应用及人才培养等方面总结了中国行为决策研究的发展历程,以及Edwards的学术思想对中国行为决策研究的主要影响.文章展望了行为决策研究的前景,并呼吁更多的中国心理学工作者投身于行为决策研究.

  5. Nurse managers' perceptions related to their leadership styles, knowledge, and skills in these areas-a viewpoint: case of health centre wards in Finland.

    Science.gov (United States)

    Vesterinen, Soili; Suhonen, Marjo; Isola, Arja; Paasivaara, Leena; Laukkala, Helena

    2013-01-01

    The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles-visionary, coaching, affiliate, democratic, commanding, and isolating-were reflected on. Almost all respondents in every age group considered four leadership styles-visionary, coaching, affiliate, and democratic-to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing.

  6. Anammox moving bed biofilm reactor pilot at the 26th Ward wastewater treatment plants in Brooklyn, New York: start-up, biofilm population diversity and performance optimization.

    Science.gov (United States)

    Mehrdad, M; Park, H; Ramalingam, K; Fillos, J; Beckmann, K; Deur, A; Chandran, K

    2014-01-01

    New York City Environmental Protection in conjunction with City College of New York assessed the application of the anammox process in the reject water treatment using a moving bed biofilm reactor (MBBR) located at the 26th Ward wastewater treatment plant, in Brooklyn, NY. The single-stage nitritation/anammox MBBR was seeded with activated sludge and consequently was enriched with its own 'homegrown' anammox bacteria (AMX). Objectives of this study included collection of additional process kinetic and operating data and assessment of the effect of nitrogen loading rates on process performance. The initial target total inorganic nitrogen removal of 70% was limited by the low alkalinity concentration available in the influent reject water. Higher removals were achieved after supplementing the alkalinity by adding sodium hydroxide. Throughout startup and process optimization, quantitative real-time polymerase chain reaction (qPCR) analyses were used for monitoring the relevant species enriched in the biofilm and in the suspension. Maximum nitrogen removal rate was achieved by stimulating the growth of a thick biofilm on the carriers, and controlling the concentration of dissolved oxygen in the bulk flow and the nitrogen loading rates per surface area; all three appear to have contributed in suppressing nitrite-oxidizing bacteria activity while enriching AMX density within the biofilm.

  7. Effects of Civic Education on Women’s Political Participation in Gatanga Ward in Gatanga Constituency, Murang’a County- Kenya

    Directory of Open Access Journals (Sweden)

    Anthony Kamau Wainana

    2013-10-01

    Full Text Available Kenyan women comprise 52 percent of the population (according to 2009 national census and 60 percent of the country's registered voters but are represented in very limited numbers as elected officials. The dominance of patriarchic structures in Kenyan politics and society is well illustrated by the low number of women among the members of parliament. This paper examines the effects of civic education (CE on women’s political participation in Gatanga Ward in Gatanga Constituency in Murang’a county-Kenya mainly political knowledge. Results of the study reveals that the majority of respondents support women’s political participation in public life in the society. Also, women’s supports the right of women to have equal educational opportunities, as well as equal participation in civil societies, volunteer societies, and political participation. Finally, empirical results are that civic education is associated with women’s political participation. The study recommends that civic education should be carried out to sensitize women on their role in politics and participation in other leadership positions. It further recommends that women should be considered for political appointment at the County and National level to facilitate gender balance.

  8. Impact of Infection Control Measures to Control an Outbreak of Multidrug-Resistant Tuberculosis in a Human Immunodeficiency Virus Ward, Peru

    Science.gov (United States)

    Ticona, Eduardo; Huaroto, Luz; Kirwan, Daniela E.; Chumpitaz, Milagros; Munayco, César V.; Maguiña, Mónica; Tovar, Marco A.; Evans, Carlton A.; Escombe, Roderick; Gilman, Robert H.

    2016-01-01

    Multidrug-resistant tuberculosis (MDRTB) rates in a human immunodeficiency virus (HIV) care facility increased by the year 2000—56% of TB cases, eight times the national MDRTB rate. We reported the effect of tuberculosis infection control measures that were introduced in 2001 and that consisted of 1) building a respiratory isolation ward with mechanical ventilation, 2) triage segregation of patients, 3) relocation of waiting room to outdoors, 4) rapid sputum smear microscopy, and 5) culture/drug–susceptibility testing with the microscopic-observation drug-susceptibility assay. Records pertaining to patients attending the study site between 1997 and 2004 were reviewed. Six hundred and fifty five HIV/TB–coinfected patients (mean age 33 years, 79% male) who attended the service during the study period were included. After the intervention, MDRTB rates declined to 20% of TB cases by the year 2004 (P = 0.01). Extremely limited access to antiretroviral therapy and specific MDRTB therapy did not change during this period, and concurrently, national MDRTB prevalence increased, implying that the infection control measures caused the fall in MDRTB rates. The infection control measures were estimated to have cost US$91,031 while preventing 97 MDRTB cases, potentially saving US$1,430,026. Thus, this intervention significantly reduced MDRTB within an HIV care facility in this resource-constrained setting and should be cost-effective. PMID:27621303

  9. How to simplify and improve incident and near miss reporting in wards:I.R.G.E. (Incident Reporting with Gravity Effect system

    Directory of Open Access Journals (Sweden)

    Francesco De Caro

    2011-09-01

    Full Text Available

    In this paper, an improved system that allows a simplified reporting of errors and near misses in wards, and permits operators to accurately manage all data recorded, is presented. IRGE (Incident Reporting with Gravity Effect System is based on the use of a paper form for reporting accidents and near misses. The severity of an error can be evidenced through the choice of a color similar to the well-known method used in the emergency medicine triage, thus leading to the most evident and immediate understanding of the magnitude of error. In addition, the system is provided with a report form for its users to be compiled with the highest completeness of information.


    A dedicated software for the storage of records and data analysis has been created, which gives one the possibility of alerting key figures within the health facility promptly. The system allows us to store and share records among different care units and also among different hospitals, thus providing a basis for a national database. Moreover, through this system, it is possible to assess the “risk attitude” of the health facility monitored.

  10. Survey and analysis on supportive level of inpatients towards no accompanying relative ward%住院患者对无陪护病房支持度的调查分析

    Institute of Scientific and Technical Information of China (English)

    高凤; 国秀娣; 李益民; 陆骏

    2011-01-01

    目的 了解住院患者对无陪护病房的支持度.方法 自行设计调查问卷,内容包括患者的社会学特征、家庭年收入、住院天数、住院频率以及对无陪护病房的支持度.对98例内、外科住院患者进行调查,调查结果行描述性统计分析.结果 47例患者支持开展无陪护病房(支持率48.0%),51例反对,与年龄、文化程度、家庭收入、住院时间、住院次数等有关.结论 由于多种因素影响,住院患者对无陪护病房的支持度不高.%Objective To study the supportive level of inpatients towards no accompanying relative ward. Method Investigate 98 medical and surgical inpatients by self-designed questionnaire on patients' sociological characteristic, annual income of family, hospitalization days, frequency of hospitalization and supportive level towards no accompanying relative ward. Take descriptive statistical analysis on the result. Result 47 (48. 0%) patients are in support of no accompanying relative ward, while 51 oppose. It is related to their age, education level, family income, hospitalization days and frequency of hospitalization. Conclusion The supportive level of inpatients towards no accompanying relative ward is not high because of various factors.

  11. An Investigation into Reliability of Knee Extension Muscle Strength Measurements, and into the Relationship between Muscle Strength and Means of Independent Mobility in the Ward: Examinations of Patients Who Underwent Femoral Neck Fracture Surgery

    OpenAIRE

    Katoh, Munenori; Kaneko, Yoshihiro

    2014-01-01

    [Purpose] The purpose of the present study was to investigate the reliability of isometric knee extension muscle strength measurement of patients who underwent femoral neck fracture surgery, as well as the relationship between independent mobility in the ward and knee muscle strength. [Subjects] The subjects were 75 patients who underwent femoral neck fracture surgery. [Methods] We used a hand-held dynamometer and a belt to measure isometric knee extension muscle strength three times, and use...

  12. Investigation on awareness of pulmonary infection prevention among nursing staff in geriatric wards%老年病区护理人员对预防肺部感染相关知识调查分析

    Institute of Scientific and Technical Information of China (English)

    牛娜; 董喆; 黄颖; 丁志平

    2012-01-01

    OBJECTIVE To evaluate the knowledge of nursing staff in geriatric wards related to pneumonia prevention in order to improve the quality of clinical care. METHODS A total of 90 nursing staffs of different levels in geriatric wards were investigated by questionnaires designed for pulmonary care knowledge. RESULTS Since there were many elderly patients with long-term bed rest in geriatric wards, standing up, buckling back and suction operation were highly used in daily nursing, and scores for those items were higher than inhalation and vibration meter expectoration in both terms of basic knowledge and clinical skills. CONCLUSION The pulmonary infection prevention associated knowledge need to be strengthened among the nursing staff and it will help the nursing personnels in geriatric wards to grasp and apply in the nursing work.%目的 了解老年病区护理人员对预防肺部感染相关知识的掌握,以提高临床护理质量.方法 采用自行设计的肺部护理知识问卷调查表,对医院老年病房90名不同层次的护理人员进行调查.结果 老年病房中高龄长期卧床患者较多,翻身、扣背、吸痰在日常护理中操作率较高,在调查问卷中得分显著高于雾化吸人和振动排痰仪得分.结论 需要加强预防肺部感染相关知识的宣教,使高龄老年病房护理人员掌握其相关知识,并应用于护理工作中.

  13. 眼科病房课堂在青年医师综合能力培训中的应用%Application of eye ward class in young doctors' comprehensive ability training

    Institute of Scientific and Technical Information of China (English)

    王艳玲; 罗丽华; 西村哲哉

    2012-01-01

    为培养眼科青年医师扎实的临床基本功,可通过对其进行眼底检查培训、医患沟通能力培训,让其参与教学查房、病房小讲课、给患者讲课,鼓励其参加科研会议,为其提供便利的学习场所等;全面促进其知识及能力的提升.病房作为眼科青年医师最早的课堂有其得天独厚的优势,尽早对眼科青年医师进行病房综合能力培训,能更有利于其成长.%To develop the basic skills of young ophthalmic doctors,The following means can be used:the fundus examination training,doctor-patient communication ability training,teaching ward round,ward small lectures,giving patients lectures,encouraging young doctors to participate in scientific research conference and providing convenient learning places etc.for them to actively implementing knowledge and promote their ability.Ward as the earliest classroom for ophthalmic young doctor has its unique advantages,which is advantageous to the quick and good growth of young ophthalmologists.

  14. Application of quality control circle activity in reducing the ward noise%品管圈活动在降低血液内科病区噪音中的应用

    Institute of Scientific and Technical Information of China (English)

    林莉; 阮文珍; 丁桂芳

    2014-01-01

    目的:探讨品管圈活动对降低血液内科病区噪音的应用效果。方法成立品管圈活动小组,对病区噪音因素进行分析,制定并采取相应措施。结果病区各种噪声下降率均达80%以上,其中各类车轮产生的噪音下降率达92.31%,家属大声谈话噪音与各仪器报警噪音也分别达88.24%和88.10%。结论品管圈方法的应用降低了病区噪音,患者满意度提高,护理质量提升。%Objective To investigate the QCC activities to reduce the effect of noise on the ward. Methods Formulate and adopt the measures by setting up QQC team to analyze the factors of the ward noise. Results Ward noise reduction rate was more than 80%, including all types of wheel noise reduction rate was up to 92.31%, the family talking loudly and the eachinstrument noise were respectively 88.24% and 88.10%. Conclusion The application of QQC reduces the ward’s noise, improves patient’s satisfaction and nursing quality.

  15. Application of PDCA circulation in the quality management of nursing document writing in the ward%PDCA循环在病区护理文件书写质量管理中的应用

    Institute of Scientific and Technical Information of China (English)

    孙霞

    2014-01-01

    目的:探讨PDCA循环在护理文件书写质量管理中的应用效果。方法:应用PDCA循环对病区护理文件书写质量进行管理。结果:通过运用PDCA循环管理,护理文件书写质量得到了显著提高。结论:PDCA循环管理在护理文件书写管理中运用的效果满意,值得推广应用。%Objective:To explore the application effect of PDCA circulation in the quality management of nursing document writing in the ward.Methods:The PDCA circulation was used to manage the quality of nursing document writing in the ward. Results:Through the application of PDCA cycle management,nursing document writing quality had been improved significantly. Conclusion:The application effect of PDCA circulation in the quality management of nursing document writing in the ward is satisfied.It is worthy of popularization and application.

  16. The Effect of Early Clinical Exposure Program on Attitude Change of Undergraduate Medical Students toward their preparation for Attending Clinical Setting in Internal Medicine, Surgery and Pediatrics Wards during 2013-2014

    Directory of Open Access Journals (Sweden)

    M.A. Seifrabei

    2016-01-01

    Full Text Available Introduction & Objective: This study was conducted to evaluate the effect of early clinical exposure on medical students’ attitude toward their preparation for attending clinical setting. Material & Methods: In an interventional before -after study, 52 fourth semester medical students studying at Hamadan University of medical sciences were enrolled in the study. The participants filled out a self-structured questionnaire before and after taking part in a 4 month course in three different wards including: surgery, pediatric and internal wards . The staff’s opinions about the program were also gathered. Result: Mean attitude score increased significantly after taking part in the course in these areas: satisfaction about basic science lessons (P=0.019, understanding social determinants of health (P= 0.03 and understanding clinical thinking and simple clinical skills (P= 0.01. Passing the course did not have any significant effect in communication skills and current semester scores (P.0.05 in both issues. Forty one percent of the academic staff in the mentioned wards believed in the necessity of early clinical exposure in basic science stage, 29.5% denied it's necessity and 29.5% did not express their opinions. Conclusion: It seems that despite the mean score increase of some items, early clinical exposure program doesn’t have any positive effect on the measured items. Therefore, it is recommended to change the medical education program. Sci J Hamadan Univ Med Sci . 2016; 22 (4 :323-330

  17. Administración de la alimentación enteral en salas generales de internación Nutrition delivery in general wards

    Directory of Open Access Journals (Sweden)

    MV Bertona

    2009-12-01

    associated with more complications, increased duration of hospital stay, and greater associated costs. The objective of this study is to establish the rate of inadequate delivery of prescribed enteral feedings by nasogastric tube and the reasons for inadequate delivery in hospitalized patients. A descriptive observational cross-sectional prospective study was performed from July 2008 through February 2009. The study included 43 patients hospitalized at Argerich Hospital in the Clinical Medicine, General Surgery and Neurosurgery wards, who were receiving enteral nutrition by nasogastric tube as the only route of feeding. Overall delivery of enteral nutrition by nasogastric tube was found inadequate in 79.10% of cases (CI 95%: 64-90%. Nursing staffand patient-related causes were the most common reasons for discontinuing enteral feeding (35.85% and 30.19%, respectively. Patient-related causes included gastrointestinal intolerance and nasogastric tube removal. According to the results of this research, we conclude that the implementation of specific protocols should be promoted in every ward since they are a simple and effective approach and their use is clearly associated with an improvement in enteral nutrition delivery in hospitalized patients.

  18. 我院开展病区用药医嘱点评模式探讨%Exploration of Evaluation Mode on Medication Orders in Hospital Wards

    Institute of Scientific and Technical Information of China (English)

    黄秋萍; 郑淑敏

    2014-01-01

    目的:探索适合我院病区用药医嘱点评的模式,促进临床合理用药。方法:根据我院用药与临床药师水平实际情况,初步制定医嘱点评模式及干预措施,并对我院2012年3月-2013年10月月使用金额排序前十位且异常增长的药品选两种随机抽取一时间段架上病历进行点评。结果:共点评病区用药医嘱单487份,涉及药品30种,39品次,平均不合理医嘱率为30.0%,其中,不合理医嘱主要为超说明书适应证用药(54.1%),不良反应预防及监测不当(20.6%),品种选择不当(11.6%),用法用量不适宜(11.0%),超禁忌证使用(2.7%),医务科每月将不合理结果纳入医疗质量整改通知书发至各科室,要求各科室进行整改回复,各个科室将整改情况于规定时间内反馈至内网专栏。结论:该模式可有效评价不合理医嘱,丰富临床药师用药经验,借以引起临床医生警惕,减少不合理医嘱的产生。%Objective:To explore the review mode of medication orders in hospital wards and to promote the rational drug use in clinical practice.Methods:According to the actual situation of medication and the level of clinical pharmacist in our hospital,a review mode of medical orders and intervention measures were worked out, and two medication orders were reviewed which were randomly selected from the drugs of top ten in both usage and dosage and with abnormal increase of use in our hospital from March 2012 to October 2013.Results:About 487 ward medication orders were reviewed,including 30 kinds of medicines and 39 variety/times,about 30.0% or-ders was unreasonable averagely, the main problems of unreasonable orders including medication beyond drug indi-cations(54.1%),improper prevention and monitoring of adverse reactions(20.6%),inappropriate selection of medicines(11.6%),unsuitable usage and dosage(11.0%),and medication beyond contraindications(2.7%). The medical

  19. Application effects of quality circle control on ward oral medication preparation%品管圈在病区口服药准备中的应用效果

    Institute of Scientific and Technical Information of China (English)

    李小娜; 潘岁月; 崔茜

    2015-01-01

    目的 探讨品管圈( QCC )活动在提高病区口服药准备中的应用效果. 方法 2013 年9月—2014年3月,成立品管圈活动小组,通过主题选定、现状把握、目标设定、要因分析、对策拟定及实施和效果确认等流程进行QCC活动,对我科口服药准备的现况进行调查分析,制定相应的对策并组织实施,将活动前后病区口服药准备的正确率进行对比分析. 结果 实施品管圈前病房口服药准备的正确率为73. 66%,活动后正确率为94. 54%,活动前后比较差异有统计学意义(χ2 =29. 938,P<0. 01). 结论 品管圈活动对提高病区口服药准备的正确率效果显著,值得推广.%Objective To explore the application effect of quality control circle ( QCC) on improving the accuracy of preparing oral drugs in ward. Methods The QCC group was established and organized activities from September 2013 to March 2014. QCC activities were conducted by selecting topics, grasping current status, setting goals, analyzing major factors, forming and implementing countermeasures, and confirming effect. The current status of preparing oral drugs in our ward was analyzed from September 2013 to March 2014, then countermeasures were formed and implemented. At last, the accuracy of preparing oral drugs in ward was analyzed before and after QCC activities. Results The accuracy of preparing oral drugs in ward before QCC activities was 73. 66%, and after QCC activities 94. 54% (χ2 =29. 938,P <0. 01). Conclusions QCC activities can improve the accuracy of preparing oral drugs in ward and should be popularized.

  20. Prescribing patterns of antibiotics and sensitivity patterns of common microorganisms in the Internal Medicine ward of a teaching hospital in Western Nepal: a prospective study

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    Easow Joshy

    2003-07-01

    Full Text Available Abstract Background Information about antibiotic use and resistance patterns of common microorganisms are lacking in hospitals in Western Nepal. Excessive and inappropriate use of antibiotics contributes to the development of bacterial resistance. The parameter: Defined daily dose/100 bed-days, provides an estimate of consumption of drugs among hospital in-patients. This study was carried out to collect relevant demographic information, antibiotic prescribing patterns and the common organisms isolated including their antibiotic sensitivity patterns. Methods The study was carried out over a 3-month period (01.04.2002 to 30.06.2002 at the Manipal Teaching Hospital, Western Nepal. The median number of days of hospitalization and mean ± SD cost of antibiotics prescribed during hospital stay were calculated. The use of antibiotics was classified for prophylaxis, bacteriologically proven infection or non-bacteriologically proven infection. Sensitivity patterns of the common organisms were determined. Defined daily dose/100 bed-days of the ten most commonly prescribed antibiotics were calculated. Results 203 patients were prescribed antibiotics; 112 were male. Median duration of hospitalization was 5 days. 347 antibiotics were prescribed. The most common were ampicillin, amoxicillin, metronidazole, ciprofloxacin and benzylpenicillin. Mean ± SD cost of antibiotics was 16.5 ± 13.4 US$. Culture and sensitivity testing was carried out in 141 patients. The common organisms isolated were H. influenzae, E. coli, K. pneumoniae and S. aureus. Conclusions Antibiotic resistance is becoming a problem in the Internal Medicine ward. Formulation of a policy for hospital antibiotic use and an educational programme especially for junior doctors is required.

  1. Evaluation of Prescriptions and Use of Intravenous Pantoprazole in General Wards and Intensive Care Unit of Shahid Sadoughi Hospital in Yazd

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    Seyed-Mojtaba Sohrevardi

    2016-05-01

    Full Text Available Background: Proton pump inhibitors (PPIs are currently the most effective agents for acid related disorders. However, studies show that 25-75% of patients receiving intravenous Pantoprazole had no appropriate justification, indicating high rate of inappropriate prescribing in hospitals. The aim of this study is to examine the appropriate use of intravenous Pantoprazole in accordance with guidelines at Shahid Sadoughi hospital.Methods: From January to April 2015, sample of 100 prescriptions who received Intravenous (IV Pantoprazole were collected with observational and sectional model in Intensive care unit (ICU and general wards of “Shahid Sadoughi” Hospital of Yazd, Iran. Clinical data from patient records are obtained and these data were mapped to establish clinical criteria and appropriate use of Intravenous Pantoprazole.Results: The majority (63% of Intravenous Pantoprazole prescriptions were deemed inappropriate in terms of either indication for use, dose or duration of therapy. 51.5% of the patients were above 55 years old. Endoscopy did not performed in most of the Non UGIB (Non upper gastrointestinal bleeding cases. Most Intravenous Pantoprazole prescriptions were ordered by junior doctors (Intern, and again this group were significantly less likely to prescribe the drug for appropriate reasons when compared with more experienced clinicians.Conclusion: This study suggests that the majority of IV PPI prescriptions in our hospital are inappropriate. Awareness of the result of this article through medical staff could result in more judicious use of intravenous pantoprazole and dose optimization. Physicians and pharmacists can work together to create solutions to inappropriate drug use.

  2. THE INFLUENCE OF STRESS CONNECTED WITH PROFESSIONAL WORK ON THE OCCURRENCE OF BURNOUT SYNDROME IN NURSES WORKING IN SURGICAL AND MEDICAL TREATMENT WARDS

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    Grażyna Nowak-Starz

    2013-11-01

    Full Text Available Nursing is one of the professions where chronic stress is an inseparable characteristic and stems from the very nature of the profession itself. The job of a nurse involves particular mental burdens. The source of these is another person, one who has most often found themselves in an extreme situation. A nurse carries out her/his duties in a state of strong and long-lasting emotional strain. Inappropriate coping with stress and a lack of support from others in difficult situations leads to the development of burnout syndrome. This syndrome not only lowers, to a great extent, the quality of performed work but also prevents nurses from further professional development. Aims : The aim of the following paper is to evaluate the influence of stress connected with the professional work of a nurse on the occurrence of burnout syndrome. Material and methodology : Research was conducted on a group of 103 nurses working at eight hospital wards (surgical and medical treatment at the District Hospital in Lipsko. The research tool was a questionnaire of the author’s own devise, which contained 34 questions. Results : Among the examined nurses, 90% concluded that their professional work has a negative impact on their family life and they pointed to their own occupational burnout. Nurses who carried negative emotions over from work to their homes significantly more often showed a lack of satisfaction from their job and signs of occupational burnout. A substantial percentage of the participants considered shift-work and the professional position held to be a detrimental factor in the process of occupational burnout. Conclusion : The nurses were to a large extent exposed to mental burdens having a negative impact on their work. The vast majority of the respondents felt satisfaction from their job but a significant percentage of the respondents admitted to suffering from symptoms of chronic stress and exhaustion, which may indicate a lack of any support from co

  3. Profile of antimicrobial susceptibility isolated microorganisms from hospitalized patients in PICU ward and detection of Methicillin-resistant Staphylococcus aureus and ESBL-producing bacteria by phenotypic methods

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    Shahla Abbas Poor

    2014-10-01

    Full Text Available Background: Hospital-acquired infections are a major challenge to patient. A range of gram-negative organisms are responsible for hospital-acquired infections, the Enterobacteriaceae family being the most commonly identified group overall. Infections by ESBL producers are associated with severe adverse clinical outcomes that have led to increased mortality, prolonged hospitalization, and rising medical costs. The aim of this study was to survey profile of antimicrobial susceptibility isolated microorganisms from hospitalized patients in PICU ward and detection of methicillin-resistant Staphylococcus aureus and ESBL-producing bacteria by phenotypic methods. Material and Methods: In this study participants were patients hospitalized in PICU part of Bahrami Hospital, Tehran, with attention to involved organ. For isolation of bacteria from patient’s samples, culture performed on different selective and differential media. After confirmation of bacteria by biochemical tests, susceptibility testing was performed by disc diffusion method. Phenotypic detection of MRSA strains was performed using cefoxcitin disc. ESBL producing strains were detected by ceftazidime (CAZ and ceftazidime/clavulanic acid (CAZ/CLA discs. Results: Among all isolated organisms from clinical samples, the most common isolated organisms were Escherichia coli (24 cases, Pseudomonas areoginosa (9 cases and Staphylococcus aureus (8 cases, respectively. Among eight MRSA isolated strains from different clinical samples, six strains (75% were MRSA. Among 52 isolated gram negative organisms, 5 strains (9/6% were ESBL. Conclusion: Standard interventions to prevent the transmission of antimicrobial resistance in health care facilities include hand hygiene, using barrier precautions in the care of colonized and infected patients, using dedicated instruments and equipment for these patients. The colonized or infected patients should be isolated in single rooms, multibed rooms or areas

  4. Identification of a novel KCNQ1 mutation associated with both Jervell and Lange-Nielsen and Romano-Ward forms of long QT syndrome in a Chinese family

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    Liu Jing

    2008-04-01

    Full Text Available Abstract Background Long QT syndrome (LQTS is a cardiac disorder characterized by prolonged QT intervals on electrocardiograms (ECG, ventricular arrhythmias, and sudden death. Clinically, two inherited forms of LQTS have been defined: autosomal dominant LQTS or Romano-Ward syndrome (RWS not associated with deafness and autosomal recessive LQTS or Jervell and Lange-Nielsen syndrome (JLNS associated with deafness. Methods A Chinese family with both RWS and JLNS was identified. Family members were diagnosed based on the presence of a prolonged QT interval as seen on a 12-lead ECG and a medical history of syncope, palpitation, and deafness. Mutational studies in the KCNQ1 potassium channel gene were performed using direct DNA sequence analysis and restriction length polymorphism analysis. Results The proband in the Chinese family and her brother had previously been diagnosed with JLNS, and two other members were affected with RWS. The proband was also affected with atrial fibrillation. A single nucleotide substitution of C to T at nucleotide 965 of KCNQ1 was identified, and the mutation resulted in the substitution of a threonine residue at codon 322 by a methionine residue (T322M. The novel heterozygous T322M mutation was identified in two patients with RWS, one member with borderline QTc, and two normal family members. The two JLNS patients in the family carried the homozygous T322M mutation. The T322M mutation was not found in 200 Chinese normal controls. Conclusion Our results suggest that T322M is a novel mutation that caused RWS with high intrafamilial variability in the heterozygous carriers and typical JLNS in the homozygous carriers within this Chinese family. The T322M mutation is the first mutation identified for JLNS in the Chinese population.

  5. Molecular characterization of the bla(KPC-2) gene in clinical isolates of carbapenem-resistant Klebsiella pneumoniae from the pediatric wards of a Chinese hospital.

    Science.gov (United States)

    Liu, Yang; Li, Xiang-Yang; Wan, La-Gen; Jiang, Wei-Yan; Li, Fang-Qu; Yang, Jing-Hong

    2012-10-01

    The present study was conducted to confirm the presence of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae associated with a nosocomial outbreak in a Chinese pediatric hospital. From July 2009 to January 2011, 124 nonduplicated K. pneumoniae isolates were collected from specimens from patients of pediatric units in the hospital. Twelve of the 124 isolates possessed the bla(KPC-2) gene and showed 7 different pulsed-field gel electrophoresis (PFGE) patterns. Meanwhile, 16S rRNA methylase, acc(6')-Ib-cr, and several types of β-lactamases were also produced by the majority of the KPC-producing isolates. Class 1 integron-encoded intI1 integrase gene was subsequently found in all strains, and amplification, sequencing, and comparison of DNA between 5' conserved segment and 3' conserved segment region showed the presence of several known antibiotic resistance gene cassettes of various sizes. The conjugation and plasmid-curing experiments indicated some KPC-2-encoding genes were transmissible. In addition, conjugal cotransfer of multidrug-resistant phenotypes with KPC-positive phenotypes was observed in KPC-producing strains. Restriction endonuclease analysis and DNA hybridization with a KPC-specific probe showed that the bla(KPC-2) gene was carried by plasmid DNA from K. pneumoniae of PFGE pattern B. The overall results indicate that the emergence and outbreak of KPC-producing K. pneumoniae in our pediatric wards occurred in conjunction with plasmids coharboring 16S rRNA methylase and extended-spectrum β-lactamases.

  6. Experience of Quality Care Ward to Implement APN Scheduling%在优质护理病房实行APN排班的体会

    Institute of Scientific and Technical Information of China (English)

    刘颖

    2014-01-01

    目的探讨在优质护理病房实行APN排班模式的可行性。方法改革传统排班,根据学历、职称、工作能力的不同,将科室护理人员合理搭配后实施APN排班模式,为患者提供连续的整体服务。结果APN排班模式减少了交接班次数,实现了护士双班制值班,保障了护理安全,做到让患者满意、护士满意、医生满意。结论APN排班模式是可行的,使护理人力资源使用更加合理,而且实现了科室护士的分层级管理,有助于优质护理服务工作的推进。%Objective To investigate the feasibility of the implementation of quality care ward APN scheduling model. Methods Reform the traditional scheduling methods, depending on education, job title, ability to work, the department wil implement APN scheduling nurses with a reasonable model for the patient to provide continuous service as a whole. Results APN scheduling mode reduces shift times to achieve a double-shift nurse on duty to ensure the safety of care, so that patient satisfaction, nurse satisfaction, physician satisfaction. Conclusion APN scheduling model is feasible to make nursing a more rational use of human resources, but also to achieve a hierarchical management department nurses to help promote quality care work.

  7. 无陪护病房护士人文关怀能力现状调查分析%Survey on humanistic caring ability of nurses working in only-nurse-attending wards

    Institute of Scientific and Technical Information of China (English)

    褚梁梁; 许翠萍; 杨雪莹; 葛洪霞; 刘凯

    2011-01-01

    Objective To comprehend humanistic caring ability of nurses working in only-nurse-attending wards, to analyze the factors influencing the humanistic caring ability of them,and to provide basis to improve their humanistic caring ability. Methods A total of 288 nurses working in only-nurse-attending wards and 304 nurses working in general wards from 6 topnotch hospitals in Shandong province were recruited to fill out nursing humanistic caring ability questionnaire designed by researchers themselves. Results There was no statistical difference in humanistic caring ability between nurses working in general wards and those working in only-nurse-attending wards (P>0. 05). For nurses working in only-nurse-attending wards, levels of humanistic caring ability had significant disparities among those with varied professional titles or those with different hiring forms (P<0. 05.P<0. 01). Conclusion The humanistic caring ability of nurses working in only-nurse-attending wards needs further improvement. Measures should be taken to upgrade the level of humanistic caring ability of them. Nurses with higher professional titles and higher educational levels should have their advantages expressed at work.%目的 了解无陪护病房护士的临床护理人文关怀能力,分析影响无陪护病房护士临床护理人文关怀能力的因素,为提高无陪护病房护士的人文关怀能力提供依据。方法抽取山东省6所三级综合性医院的无陪护病房288名护士与普通病房304名护士为研究对象,采用自制临床护理人文关怀能力量表进行问卷调查。结果无陪护病房与普通病房护士的人文关怀能力得分比较,差异无统计学意义(P>0.05)。无陪护病房不同职称、聘用形式护士的人文关怀能力比较,差异有统计学意义(P<0. 05,P<0.01)。结论无陪护病房护士的人文关怀能力仍有待提高,应采取措施提高护士的人文关怀能力,并体现其职称、学历优势。

  8. Life on the British Ward

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    Sreedhar Krishna

    2009-07-01

    Full Text Available Literally invalid/We sit for hours/The day passes/Daily purposes/ -He phones his wife/She mixes cake/ -Cannot be yours/A small, dumb place/Lacking context/White with a blind contradiction of connection/The sitting room/Hums with boredom/A crippled euphemistic kingdom/Of pills or 'medication'/Meals cooked and crockery washed'/Neighbours': drama mimics life/Has Max left Steph?/Is Skye expecting?/A concept forms unbidden:/This is what 'care' means/ Talk to me!/It doesn't matter what you say -/What are the children doing?/Have they opened the new Arcade?/How did Hillary Clinton do in the primaries?/Is Tescos cheaper than Waitrose?/I will wear a pair of reliable shoes to the wedding/Let's play charades/I will finish the crossword, then play chess/Will you come with me to Bravissimo?/Do you remember The Rolling Stones at Knebworth?/Did you prefer Paul McCartney or John Lennon?/I will tell you off-by-heart my favourite poem;/I haven't always been a lemon./The doctor's care ends this nightmare.

  9. Mobility at a medical ward

    DEFF Research Database (Denmark)

    Kanstrup, Anne Marie; Christiansen, Ellen

    2006-01-01

    The paper reports from the MINI-project in which the authors are currently designing a mobile e-learning service for physicians in clinical training. The paper presents results from the analysis trying to grasp what mobility means in this specific context and which design challenges and decisions...

  10. Comparing the predictive accuracy of frailty, comorbidity, and disability for mortality: a 1-year follow-up in patients hospitalized in geriatric wards

    Science.gov (United States)

    Ritt, Martin; Ritt, Julia Isabel; Sieber, Cornel Christian; Gaßmann, Karl-Günter

    2017-01-01

    Background Studies evaluating and comparing the power of frailty, comorbidity, and disability instruments, together and in parallel, for predicting mortality are limited. Objective This study aimed to evaluate and compare the measures of frailty, comorbidity, and disability in predicting 1-year mortality in geriatric inpatients. Design Prospective cohort study. Patients and setting A total of 307 inpatients aged ≥65 years in geriatric wards of a general hospital participated in the study. Measurements The patients were evaluated in relation to different frailty, comorbidity, and disability instruments during their hospital stays. These included three frailty (the seven-category Clinical Frailty Scale [CFS-7], a 41-item frailty index [FI], and the FRAIL scale), two comorbidity (the Cumulative Illness Rating Scale for Geriatrics [CIRS-G] and the comorbidity domain of the FI [Comorbidity-D-FI]), and two disability instruments (disability in basic activities of daily living [ADL-Katz] and the instrumental and basic activities of daily living domains of the FI [IADL/ADL-D-FI]). The patients were followed-up over 1 year. Results Using FI, CIRS-G, Comorbidity-D-FI, and ADL-Katz, this study identified a patient group with a high (≥50%) 1-year mortality rate in all of the patients and the two patient subgroups (ie, patients aged 65–82 years and ≥83 years). The CFS-7, FI, FRAIL scale, CIRS-G, Comorbidity-D-FI, and IADL/ADL-D-FI (analyzed as full scales) revealed useful discriminative accuracy for 1-year mortality (ie, an area under the curve >0.7) in all the patients and the two patient subgroups (all P<0.001). Thereby, CFS-7 (in all patients and the two patient subgroups) and FI (in the subgroup of patients aged ≥83 years) showed greater discriminative accuracy for 1-year mortality compared to other instruments (all P<0.05). Conclusion All the different instruments emerged as suitable tools for risk stratification in geriatric inpatients. Among them, CFS-7, and in

  11. Increasing the frequency of hand washing by healthcare workers does not lead to commensurate reductions in staphylococcal infection in a hospital ward

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    Kerr Kevin G

    2008-09-01

    Full Text Available Abstract Background Hand hygiene is generally considered to be the most important measure that can be applied to prevent the spread of healthcare-associated infection (HAI. Continuous emphasis on this intervention has lead to the widespread opinion that HAI rates can be greatly reduced by increased hand hygiene compliance alone. However, this assumes that the effectiveness of hand hygiene is not constrained by other factors and that improved compliance in excess of a given level, in itself, will result in a commensurate reduction in the incidence of HAI. However, several researchers have found the law of diminishing returns to apply to hand hygiene, with the greatest benefits occurring in the first 20% or so of compliance, and others have demonstrated that poor cohorting of nursing staff profoundly influences the effectiveness of hand hygiene measures. Collectively, these findings raise intriguing questions about the extent to which increasing compliance alone can further reduce rates of HAI. Methods In order to investigate these issues further, we constructed a deterministic Ross-Macdonald model and applied it to a hypothetical general medical ward. In this model the transmission of staphylococcal infection was assumed to occur after contact with the transiently colonized hands of HCWs, who, in turn, acquire contamination only by touching colonized patients. The aim of the study was to evaluate the impact of imperfect hand cleansing on the transmission of staphylococcal infection and to identify, whether there is a limit, above which further hand hygiene compliance is unlikely to be of benefit. Results The model demonstrated that if transmission is solely via the hands of HCWs, it should, under most circumstances, be possible to prevent outbreaks of staphylococcal infection from occurring at a hand cleansing frequencies Conclusion Although our study confirmed hand hygiene to be an effective control measure, it demonstrated that the law of

  12. The Impact of Cannabis Use on the Dosage of Antipsychotic Drugs in Patients Admitted on the Psychiatric Ward at the University Hospital of the West Indies

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    P Thomas

    2015-03-01

    Full Text Available Objective: To assess the impact of cannabis use on the efficacy of antipsychotic drugs in male subjects presenting to the University Hospital of the West Indies (UHWI with psychotic episodes. Methods: Male subjects, 18–40 years old, admitted to the psychiatric ward of the UHWI between February 2013 and May 2013, diagnosed with schizophrenia, schizophreniform disorder and who tested positive for ∆9-tetrahydrocannabinol were recruited for the study. On day one, consenting subjects were assessed using the Brief Psychiatric Rating Scale (BPRS. Patients were prescribed seven days of an oral antipsychotic medication (haloperidol, chlorpromazine, risperidone, quetiapine, olanzapine. Medicated subjects were then reassessed using the BPRS on days three and seven. Statistical analysis involved the use of Student’s t-test and repeated measure analysis of variance. Results: In total, 20 subjects were recruited (mean age = 26.00 ± 5.96 years. Subjects were grouped based on the daily chlorpromazine equivalent (CPZE dose given on day one into CPZE1 (CPZE dose of 100–300mg; n = 8 and CPZE2 (CPZE dose of 400–1250 mg; n = 12. There was no significant difference in the total BPRS score between the groups on day one (CPZE1 = 41.38 ± 16.47 versus CPZE2 = 49.42 ± 25.58; p = 0.44; similar findings were obtained for the positive (26.75 ± 9.27 versus 31.83 ± 17.30; p = 0.46 and negative (14.63 ± 7.73 versus 17.58 ± 9.74; p = 0.48 symptom component on the BPRS. For subjects in CPZE1, there was no significant decrease in total BPRS score [F(2,21 = 0.07, p = 0.93] over the study period. For CPZE2, significant reduction in total BPRS scores was achieved [F(2,33 =7.12, p = 0.01], contributed by significant decrease in the positive [F(2,33 = 5.64, p = 0.02 and negative [F(2,33 = 7.53, p = 0.01 symptom components of the BPRS. Conclusion: The findings of this study purport that male cannabis users presenting with psychotic disorders may not achieve optimal

  13. Application of pressure ulcers wound record form in geriatric wards%压疮伤口记录表在压疮患者中的应用

    Institute of Scientific and Technical Information of China (English)

    张元; 张雪梅; 陈茜; 刘红琼

    2016-01-01

    目的 探讨压疮伤口记录表在压疮患者中的应用效果.方法 将本科室2014年1~6月收治的压疮患者28例,设为对照组,采用压疮评估与护理措施表格进行压疮记录,将本科室2014年7~12月收治的压疮患者30例,设为试验组,采用压疮记录表进行压疮记录.比较两组护士使用压疮伤口记录表前后对压疮护理记录时间、护士满意度及对压疮伤口记录存在问题情况.结果 两组护士记录时间、满意度及压疮伤口记录存在问题情况比较,均P<0.05,差异具有统计学意义,试验组护士记录时间明显短于对照组,满意度明显高于对照组,压疮伤口记录存在问题明显少于对照组.结论 应用压疮伤口记录表可提高压疮伤口记录质量,缩短护士书写时间,提高护士满意度.%Objective To investigate the effect of pressure ulcers wound record form on the quality of nursing records in geriatric wards . Methods Twenty-eight patients with pressure ulcers hospitalized from January to June 2014 were assigned as control group , where the pressure ulcers assessment and nursing form was used for recording pressure ulcers . Another 30 patients during July to December 2014 were assigned as the trial group , where the pressure ulcers wound record form was used . The two groups were compared in terms of time for writing nursing records , satisfaction of nurses and problems in recording the pressure ulcers . Result Compared with the control group, the time for writing nursing records was much shorter, the satisfaction degree was significantly higher and the problems in recording wounds were significantly fewer as well. Conclusion The pressure ulcers wound record form can enhance the quality of pressure ulcers wound records, shorten the time for writing the records and increase the nurses′satisfaction.

  14. Les oiseaux de l’archipel de Nosy Hara, au nord nord - ouest de Madagascar et la nouvelle distribution connue du Gobe mouche de Ward (Pseudobias wardi

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    Marie Jeanne Raherilalao

    2010-06-01

    Full Text Available Peu d’informations ornithologiques étaient disponibles sur l’archipel de Nosy Hara, au nord nord - ouest de Madagascar. Afin de constituer une base de données scientifique, nous avons entrepris un inventaire du peuplement aviaire de cet archipel entre fin septembre et début octobre 2005. Pour la collecte des données, deux méthodes complémentaires ont été utilisées sur l’île de Nosy Hara, à savoir le taux de rencontre et les observations générales mais la présence des espèces dans certains îlots de l’archipel a été notée par la deuxième de ces techniques. Un total de 31 espèces d’oiseaux a été rencontré aucours de cet inventaire. Outre les espèces inféodées au milieu marin et celles des zones littorales, 18 espèces terrestres ont été trouvées sur l’île et une sur l’île d’Andalatsara. Bien que l’archipel présente un appauvrissement en espèces d’oiseaux par rapport aux autres écosystèmes forestiers de la grande terre, son importance ornithologique n’est pas à négliger. Le Gobe mouche de Ward Pseudobias wardi a été découvert au cours de cet inventaire dans un type d’habitat duquel il n’était pas encore connu et dans une nouvelle localité qui étend sensiblement sa distribution connue. La préservation de cet archipel est justifiée pour préserver ses richesses biologiques face aux diverses pressions anthropiques.

  15. Application of Quality Control Circle in Reducing the Decibel Rate of Ward Noise%应用品管圈降低病房噪音的分贝率

    Institute of Scientific and Technical Information of China (English)

    李双; 吴琼; 薄艳云

    2016-01-01

    目的:探讨应用品管圈活动降低病房噪音的应用效果。方法成立品管圈活动小组,通过对住院病人满意度调查表,确定解决的主要问题为降低病房噪音”。对病区噪音因素进行分析,根据主题选定理由、制定活动计划表、数由原来最高的据目标设定、原因分析、对策制定、运用PDCA方法,再进行检讨和采取相应措施,解决问题。结果2014年5月7-14日通过住院病人满意度调查表中患者对病房安静度问卷调查,病房噪音的分贝数患由原来最高的83.9分贝,降低到2014年10月1-10日59.7 dB。在提高出院病人满意度的同时,也为护士提供展示自我为才能的平台,极大的体现了个人价值、提升全体圈员的沟通能力和解决问题的能力。结论通过品质管理,有效降低了病房噪音,使环境安静有序,提高工作质量,患者满意度提高,从而使护理服务质量大大提升。%Objective To study the application effect of the quality control circle in reducing the ward noise. Methods The quality control circle activity groups were established, that the main issue was reducing the ward noise was determined by the satisfactory degree survey scale in inpatients, and the ward noise factors were analyzed, and the reasons were selected according to the theme and the activity plan table was made and the review and corresponding measures were adopted by PDCA method. Results The ward quiet degree questionnaire of inpatients from May 7, 2014 to May 14, 2015 showed that the decibel number of ward noise was from 83.9 db that was the originally highest decreased to 59.7 db from October 1, 2014 to October 10, 2014, and it improves the satisfactory degree of discharged patients, at the same time, it provides the platform of showing self-talent, greatly reflects the individual value and improves the community ability and problem-solv-ing ability of the whole circle staff. Conclusion The

  16. Occurrence Causes and Preventive Measures of Disputes in the Nursing Pro-cess in the Obstetrical Ward%产科病房护理过程中纠纷发生原因及预防措施

    Institute of Scientific and Technical Information of China (English)

    马爱玲; 侯玲军; 高媛

    2016-01-01

    Objective To survey the occurrence causes and preventive measures of disputes in the nursing process in the obstetrical ward. Methods The occurrence causes of disputes in the nursing process in the obstetrical ward were analyzed and evaluated, and the corresponding preventive measures were put forwards and implemented. Results The implementation of preventive measures can improve the nursing satisfactory degree, reduce the occurrence of clinical complications of de-livery women, and reduce the incidence rate of adverse events in the obstetrical ward. Conclusion The obstetrical nursing staff should enhance the doctor-patient communication, improve the professional level, enhance the nursing responsibility, intensify law awareness and comprehensively improve the nursing quality, which can effectively reduce the occurrence of disputes.%目的:调查产科病房护理过程中纠纷发生的原因并探究其预防措施。方法通过对产科病房护理过程中纠纷发生的原因进行分析和评估,并提出和实施相应的预防措施。结果预防措施的实施可提高护理满意度,减少产妇临床并发症的发生,降低产科病房的不良事件发生率。结论产科护理人员加强护患沟通的同时,提高专业技术水平,增强护理责任心,强化法律意识,全面提高护理质量,可有效减少纠纷的发生。

  17. The qualitative research on the nurse psychological status under violence experience in AIDS ward%艾滋病区护士经历工作场所暴力后心理状况的质性研究

    Institute of Scientific and Technical Information of China (English)

    鲁桂兰; 张立

    2013-01-01

    Objective: To investigate the nurse psychological status under violence experience in AIDS ward and get the method comforting the nurse' physical and mental. Methods: Using qualitative research method of the phenomenology, the material on 9 nurse violence experiences which got through depth interview were analysis and sorted. Results: Under violence experience, all nurses in AIDS ward could appear bad stress emotional reaction and bad behavior. Conclusion: Nursing managers should pay attention to having continuous humanistic care, and take measures to prevent and intervention violence and psychological damage in AIDS ward.%目的:深入了解经历工作场所暴力后艾滋病区护士的心理状况,为促进受暴后的护士身心健康提供依据和方法.方法:运用质性研究中的现象学方法,对在艾滋病区经历过工作场所暴力的9名护士进行深入访谈,将获得的资料进行分析、整理,提出主题.结果:经历工作场所暴力后,艾滋病区护士可出现不良的应激情绪反应和不良的机体行为反应.结论:管理者应注意后期的具有连续性的人文关怀,并采取措施预防和干预工作场所暴力和心理伤害的发生.

  18. ICU病人转到康复过渡病房家属心理状况变化调查分析%Investigation on the psychological change of ICU patients' family after the patients transported to rehabilitation ward

    Institute of Scientific and Technical Information of China (English)

    沈锡珊; 吴爱霞; 钱孝言

    2012-01-01

    Objective To analyze the psychological change of ICU patients'family after the patients were transported to rehabilitation ward. Methods 76 cases of ICU patients'family were selected and divided into observation group,these patients were transported to rehabilitation ward.73 families without the patients being transported selected and divided into control group.Their psychological changes were observed.Results The scores of subjective well - being and life quality in observation group were significantly higher than those in control group ( P < 0.05 ) ; the scores of HAMD and HAMA of observation group were lower than those of control group ( P < 0.05 ).Conclusions The psychological status of ICU patients' family was improved significantly after the patients were transported to the rehabilitation ward.%目的 分析ICU病人转到康复过渡病房家属心理状况的变化.方法 取2008至2012年76例转入康复过渡病房的患者家属作为观察组,同期未转入康复过渡病房的73例患者家属作为对照组,观察两组心理状态变化.结果 观察组对象的主观幸福感及生活质量评分明显高于对照组(P<0.05);转运后,观察组的HAMD评分(25.21±3.32)、HAMA评分(19.45 ±2.23)明显低于对照组(P<0.05).结论 ICU患者转入康复过渡病房后其家属的心理状态明显改善.

  19. Application of kindred-like nursing on demonstration ward during creating the high quality care services%亲情护理在创建优质护理服务示范病房中的应用

    Institute of Scientific and Technical Information of China (English)

    黄晓清; 杨叶香; 黄先荣; 罗冰梅

    2012-01-01

    目的探讨亲情护理在创建优质护理服务示范病房中的应用效果,提高护理质量。方法以人的健康为中心,视病人如亲人,为病人提供全方位服务的护理工作方法。结果亲情护理具有较强的人性化服务理念,是创建优质护理服务的保障,在临床护理工作中体现出绝对的优势。结论亲情护理体现了人性化的关怀与服务,使优质护理服务得到了实现,病房被评为创优示范病房。护理工作基本达到了病人满意、家属满意、领导满意及社会满意的总体目标。%Objective To investigate the application effects of kindred-like nursing on demonstration ward during creating the high quality care services, with the purpose of improving the quality of nursing. Methods We use the nursing methods which take human health as center, regard the patients as relatives, provide comprehensive services for the patients. Result Kindred-like nursing possesses strong humanity service concept, and it is the guarantee of establishing superior quality care services, reflecting absolutely superiority in clinical care.Conclusion Kindred-like nursing reflects humanity care and services, making superior quality nursing into reality, and our ward has been classified as merit demonstration ward. Our nursing care fundamentally achieve the goal of satisfaction from the patients, their family members , leaders and the society.

  20. Construction and Management of Day-care Ward for Tumor in Prefecture-level Hospitals%地市级医院肿瘤日间病房的建设与管理

    Institute of Scientific and Technical Information of China (English)

    蒋春梅

    2015-01-01

    Objective:To discuss the construction and management of day-care ward for tumor in prefecture-level hospitals,and summarize the experience. Method:The author analyzes the results of construction,management and opera-tion of the day-care ward for tumor from Sept,2014 to June,2015. Result:The average stays in hospital decreases 44. 12%compared with that of ordinary hospitalization,the average hospitalization expenses lowers 46. 98% with 5 087 527. 2 yuan savings in medical insurance. Conclusion:The construction of day-care ward for tumor can shorten the days of hospitaliza-tion,decrease expenses, reduce the payment from medical insurance and benefit the rational distribution of hospital re-sources.%目的 探讨地市级医院肿瘤日间病房的建设与管理,总结经验. 方法 分析2014年9月至2015年6月肿瘤日间病房建立、管理及运营的效果. 结果 平均住院日较普通住院降低44. 12%,平均住院费用降低46. 98%,医保节约5 087 527. 2元. 结论 肿瘤日间病房的建设在缩短病人住院天数、降低费用的同时减轻医保支付压力,有利于医院资源的合理配置.