WorldWideScience

Sample records for general hospital doctors

  1. The attitudes of general hospital doctors toward patients with comorbid mental illness.

    Science.gov (United States)

    Noblett, Joanne E; Lawrence, Robert; Smith, Jared G

    2015-01-01

    What are the attitudes of general hospital doctors toward patients with comorbid mental illness? Do certain characteristics of the health professional related to attitude valence to patients with comorbid mental illness? An anonymous questionnaire was sent out to a cohort of doctors working in three General Hospitals in South West London. The questionnaire included vignettes to assess the respondents' attitudes toward eight patients presenting with a physical compliant with different clinical histories, including depression, schizophrenia, personality disorder, diabetes, and criminal behavior. A total of 52 participants completed the questionnaire; 40 females and 12 males. Across all domains, the most positive attitudes were held toward patients without a diagnosis of mental illness. The least positive attitudes were toward patients with schizophrenia, personality disorder, and those classified as "criminals," and negative attitudes relating to the unpredictability of patients was identified in these categories. There was no statistically significant difference in attitudes depending on age or level of training. However, female participants tended to endorse more positive attitudinal responses, most clearly toward patients with depression and heroin addiction. Negative attitudes of doctors were identified toward certain mental illness diagnoses and are likely to contribute the physical health disparity between patients with and without a comorbid mental illness. This raises the question as to how these attitudes can be changed in order to improve the parity of physical health care between patient with and without mental illness. © The Author(s) 2015.

  2. Nosological Inaccuracies in death certification in Northern Ireland. A comparative study between hospital doctors and general practitioners.

    OpenAIRE

    Armour, A.; Bharucha, H.

    1997-01-01

    We aimed to audit nosological inaccuracies in death certification in Northern Ireland and to compare performance of hospital doctors and general practitioners. Nosology is the branch of medicine which treats of the classification of disease. 1138 deaths were registered in Northern Ireland in a 4-week period commencing 3/10/94. 195 of these were either registered by HM Coroners (HMC) or required further investigation by their staff; these cases were excluded from the study. The remaining 943 w...

  3. Experiences of Public Doctors on Managing Work Difficulties and Maintaining Professional Enthusiasm in Acute General Hospitals: A Qualitative Study.

    Science.gov (United States)

    Luk, Andrew Leung; Yau, Adrian Fai To

    2018-01-01

    Overseas studies suggest that 10-20% of doctors are depressed, 30-45% have burnout, and many report dissatisfaction with work-life balance. A local study on public doctors showed that 31.4% of the respondents satisfied the criteria for high burnout. Young, but moderately experienced doctors who need to work shifts appeared most vulnerable. This study aims to explore the experiences of those public doctors who have managed their work difficulties and maintained professional enthusiasm for references in medical education and continuing professional training. Ten public doctors with reputation were invited respectively from three acute general hospitals for an in-depth interview. Interviews were audio recorded and transcribed. Content analysis was carried out to identify major themes in relation to the research questions. Three themes emerging from difficulties encountered were (1) managing people, mostly are patients, followed by colleagues and then patients' relatives; (2) constraints at work, include time and resources; and (3) managing self with decision-making within a short time. Three themes generating from managing work difficulties included (1) self-adjustment with practicing problem solving and learning good communication appeared more frequently, followed by maintaining a professional attitude and accumulating clinical experiences; (2) seeking help from others; and (3) organizational support is also a theme though it is the least mentioned. Four themes emerging from maintaining work enthusiasm were (1) personal conviction and discipline: believing that they are helping the needy, having the sense of vocation and support from religion; disciplining oneself by continuing education, maintaining harmonious family relationship and volunteer work. (2) Challenging work: different challenging natures of their job. (3) Positive feedback from patients: positive encounters with patients keep a connectedness with their clients. (4) Organization support: working with

  4. General self-efficacy and the effect of hospital workplace violence on doctors' stress and job satisfaction in China.

    Science.gov (United States)

    Yao, Yongcheng; Wang, Wei; Wang, Faxuan; Yao, Wu

    2014-06-01

    This study aims at exploring associations of general self-efficacy (GSE), workplace violence and doctors' work-related attitudes. In this study a cross-sectional survey design was applied. Questionnaires were administrated to 758 doctors working in 9 hospitals of Zhengzhou, Henan province, China, between June and October 2010. General information on age, gender, and years of working was collected, and the doctors' experience and witnessing workplace violence, job satisfaction, job initiative, occupational stress as well as GSE were measured. General linear regression analysis was performed in association analyses. Both experiencing and witnessing workplace violence were significantly positively correlated with the level of occupational stress but significantly negatively correlated with job satisfaction, job initiative, and GSE. General self-efficacy significantly modified relationships between both experiencing and witnessing workplace violence with occupational stress (β = 0.49 for experiencing violence; β = 0.43 for witnessing violence; p violence with job initiative (p > 0.05). The levels of occupational stress declined significantly with the increase of GSE, while job satisfaction increased significantly along with its increase. The effects of GSE on occupational stress and job satisfaction weakened as the frequency of violence increased. The findings suggest that GSE can modify effects of workplace violence on health care workers' stress and job satisfaction. Enhancing GSE in combination with stress reduction may lead to facilitating health care workers' recovery from workplace violence, and thereby improving their work-related attitudes.

  5. Experiences of Public Doctors on Managing Work Difficulties and Maintaining Professional Enthusiasm in Acute General Hospitals: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Andrew Leung Luk

    2018-03-01

    Full Text Available BackgroundOverseas studies suggest that 10–20% of doctors are depressed, 30–45% have burnout, and many report dissatisfaction with work-life balance. A local study on public doctors showed that 31.4% of the respondents satisfied the criteria for high burnout. Young, but moderately experienced doctors who need to work shifts appeared most vulnerable. This study aims to explore the experiences of those public doctors who have managed their work difficulties and maintained professional enthusiasm for references in medical education and continuing professional training.MethodTen public doctors with reputation were invited respectively from three acute general hospitals for an in-depth interview. Interviews were audio recorded and transcribed. Content analysis was carried out to identify major themes in relation to the research questions.ResultsThree themes emerging from difficulties encountered were (1 managing people, mostly are patients, followed by colleagues and then patients’ relatives; (2 constraints at work, include time and resources; and (3 managing self with decision-making within a short time. Three themes generating from managing work difficulties included (1 self-adjustment with practicing problem solving and learning good communication appeared more frequently, followed by maintaining a professional attitude and accumulating clinical experiences; (2 seeking help from others; and (3 organizational support is also a theme though it is the least mentioned. Four themes emerging from maintaining work enthusiasm were (1 personal conviction and discipline: believing that they are helping the needy, having the sense of vocation and support from religion; disciplining oneself by continuing education, maintaining harmonious family relationship and volunteer work. (2 Challenging work: different challenging natures of their job. (3 Positive feedback from patients: positive encounters with patients keep a connectedness with their clients. (4

  6. Locum tenens consultant doctors in a rural general hospital - an essential part of the medical workforce or an expensive stopgap?

    Science.gov (United States)

    Sim, Andrew Jw

    2011-01-01

    Maintaining hospital consultant staffing levels often requires the employment of locum tenens to meet service needs. This is particularly so in hospitals where core clinical services are run by a small number of permanently appointed consultants. The problems associated with locum employment are underestimated and little attention has been directed towards addressing the issue in the rural general hospitals of Scotland. This study looked at the permanent and short- and long-term locum consultant usage over an 8 year period in one Scottish rural general hospital, the Western Isles Hospital in Stornoway. Data were extracted from the Human Resources Department of NHS Western Isles' list of locum consultants for most weeks from the beginning of January 2002 to the end of December 2009. The Western Isles Hospital in Stornoway has an establishment of 17 permanent consultants. During the 8 year study period 239 different consultants were employed, 20 held substantive permanent positions, 31 were long-term locums (employed >3 months) and 188 were short-term locums. The short-term locums worked for 535 different locum episodes. The pattern of usage varied according to service configuration. Study data revealed the alarming scope of the locum tenens issue, which will increase unless action is taken. For sustainable medical services to continue in the rural general hospitals of Scotland, staffing models must minimise the need to employ locum consultants.

  7. Acute referral of patients from general practitioners: should the hospital doctor or a nurse receive the call?

    Directory of Open Access Journals (Sweden)

    Mortensen Anne Mette M

    2011-08-01

    Full Text Available Abstract Background Surprisingly little is known about the most efficient organization of admissions to an emergency hospital. It is important to know, who should be in front when the GP requests an acute admission. The aim of the study was to analyse how experienced ED nurses perform when assessing requests for admissions, compared with hospital physicians. Methods Before- and after ED nurse assessment study, in which two cohorts of patients were followed from the time of request for admission until one month later. The first cohort of patients was included by the physicians on duty in October 2008. The admitting physicians were employed in the one of the specialized departments and only received request for admission within their speciality. The second cohort of patients was included by the ED in May 2009. They received all request from the GPs for admission, independent of the speciality in question. Results A total of 944 requests for admission were recorded. There was a non-significant trend towards the nurses admitting a smaller fraction of patients than the physicians (68 versus 74%. While the nurses almost never rejected an admission, the physicians did this in 7% of the requests. The nurses redirected 8% of the patients to another hospital, significantly more than the physicians with only 1%. (p Conclusions We found no differences in the frequency of admitted patients or unnecessary admissions, but the nurses redirected significantly more patients to the right hospital according to the catchment area, and used only half the time for the assessment. We find, that nurses, trained for the assignment, are able to handle referrals for emergency admissions, but also advise the subject to be explored in further studies including other assessment models and GP satisfaction.

  8. Home care, hospitalizations and doctor visits

    OpenAIRE

    Gonçalves Judite; Weaver France

    2014-01-01

    This study estimates the effects of formal home care on hospitalizations and doctor visits. We compare the effects of medically- and non-medically-related home care and investigate heterogeneous effects by age group and informal care availability. Two-part models are estimated, using data from Switzerland. In this federal country, home care policy is decentralized into cantons (i.e. states). The endogeneity of home care is addressed by using instrumental variables, canton and time fixed effec...

  9. Smoking trends amongst young doctors of a tertiary care hospital - Mayo Hospital, Lahore - Pakistan

    International Nuclear Information System (INIS)

    Chudhary, M.K.; Younis, M.; Bukhari, M.H.

    2011-01-01

    The World Health Organization cites tobacco use as one of the biggest public health threats the world has ever faced. Tobacco is the number one preventable cause of disability and death. Tobacco has many negative health effects which many of the smokers know them well. In Pakistan tobacco use is common in general public and the health professionals don't lack behind this habit. To study the smoking trends amongst young doctors of Mayo Hospital. Questionnaire based descriptive study. This study was conducted at the Institute of Chest Medicine, Mayo Hospital - A tertiary care hospital affiliated with King Edward Medical University, Lahore. Out of 250 doctors, 180 (72%) were males and 70 (28%) were female. Amongst 180 male doctors 97 (53.88%) were smokers and 83 (46.21%) were non smokers. Amongst 70 female doctors 8 (11.43%) were smokers and 62 (88.57%) were non smokers. Smoking is common among male young doctors but it is less common in female doctors. (author)

  10. GENERAL PRACTITIONERS AND HOSPITALS

    African Journals Online (AJOL)

    In recent years in South Africa the position of the general practi- tioner in hospitals has ... ments, and it is in these hospitals that difficulties have arisen. On the other hand, ... great extent deprived of contact with his colleagues. He comes to ... eventually lose interest in the results of treatment and advances in medicine. In fact ...

  11. Choosing a doctor and hospital for your cancer treatment

    Science.gov (United States)

    ... htm Choosing a doctor and hospital for your cancer treatment To use the sharing features on this page, please enable JavaScript. When you seek cancer treatment, you want to find the best care possible. ...

  12. A National Study of Wellbeing of Hospital Doctors in Ireland

    OpenAIRE

    Hayes, Blanaid

    2016-01-01

    The working environment for hospital doctors in Ireland has undergone radical change in recent years with hospital posts becoming unattractive to doctors in training and to consultants. For young medical graduates, the tensions between training requirements and service demands have contributed to a ‘brain drain’ with over half leaving to work abroad after graduation. Many consultant posts are vacant or are filled on a temporary basis, impacting on the quality of patient care. This study se...

  13. Patient opinion of the doctor-patient relationship in a public hospital in Qatar.

    Science.gov (United States)

    Weber, Alan S; Verjee, Mohamud A; Musson, David; Iqbal, Navid A; Mosleh, Tayseer M; Zainel, Abdulwahed A; Al-Salamy, Yassir

    2011-03-01

    To analyze the factors associated with the level of satisfaction of outpatients in their relationship with their doctor at the largest public hospital in Qatar. This study was a cross-sectional survey of attitudes. Researchers surveyed 626 outpatients at Hamad General Hospital in Doha, Qatar from September 2009 to January 2010 using a novel questionnaire assessing satisfaction with patients' interaction(s) with their doctor (spent time with patient, took case seriously, maintained confidentiality, and the overall quality of visit). Mean responses on 4 Likert scale items (one to 5) were as follows: "spent enough time with patient" = 4.39; "doctor took case seriously" = 4.57; "satisfaction with doctor-patient confidentiality" = 4.71; "overall quality of visit" = 4.46. Age, gender, citizenship, level of education, and number of visits did not significantly impact the level of satisfaction. For 73.1% of patients, the physician's qualification was the most important factor in choosing a doctor. Of those surveyed, 40.7% of men and 28.1% of women preferred to see a doctor of their own gender. A positive correlation between perceived communication and satisfaction with the doctor-patient encounter was established. This study found that patients in the Out-Patient Department at Hamad Hospital were highly satisfied with their relationships with their doctors, and physician qualification was the most significant factor in choosing a doctor. A significant number of males and females preferred a physician of their own gender. Communication difficulty correlated with lower satisfaction.

  14. Through doctors' eyes: A qualitative study of hospital doctor perspectives on their working conditions.

    LENUS (Irish Health Repository)

    McGowan, Yvonne

    2013-03-11

    BACKGROUND: Hospital doctors face significant challenges in the current health care environment, working with staff shortages and cutbacks to health care expenditure, alongside increased demand for health care and increased public expectations. OBJECTIVE: This article analyses challenges faced by junior hospital doctors, providing insight into the experiences of these frontline staff in delivering health services in recessionary times. DESIGN: A qualitative methodology was chosen. METHODS: Semi-structured in-depth interviews were conducted with 20 doctors from urban Irish hospitals. Interviews were recorded via note taking. Full transcripts were analysed thematically using NVivo software. RESULTS: Dominant themes included the following: (1) unrealistic workloads: characterised by staff shortages, extended working hours, irregular and frequently interrupted breaks; (2) fatigue and its impact: the quality of care provided to patients while doctors were sleep-deprived was questioned; however, little reflection was given to any impact this may have had on junior doctors own health; (3) undervalued and disillusioned: insufficient training, intensive workloads and a perceived lack of power to influence change resulted in a sense of detachment among junior doctors. They appeared immune to their surroundings. CONCLUSION: Respondents ascribed little importance to the impact of current working conditions on their own health. They felt their roles were underappreciated and undervalued by policy makers and hospital management. Respondents were concerned with the lack of time and opportunity for training. This study highlighted several \\'red flags\\

  15. [Psychosomatic basic care in the general hospital - an empirical investigation of the bio-psycho-social stress, treatment procedures and treatment outcomes from the vantage point of medical doctors].

    Science.gov (United States)

    Fritzsche, Kurt; Schäfer, Inna; Wirsching, Michael; Leonhart, Rainer

    2012-01-01

    The present study investigates the psycho-social stress, the treatment procedures and the treatment outcomes of stressed patients in the hospital from the perspective of the hospital doctors. Physicians from all disciplines who had completed the course "Psychosomatic Basic Care" as part of their specialist training documented selected treatment cases. 2,028 documented treatment cases of 367 physicians were evaluated. Anxiety, depression and family problems were the most common causes of psychosocial stress. In over 40 % of the cases no information was found on the medical history. Diagnostic and therapeutic conversations took place with almost half the patients (45%). From the vantage point of the physicians patients receiving diagnostic and therapeutic conversations achieved significantly more positive scores with respect to outcome variables than patients without these measures. Collegial counseling was desired for more than half of the patients and took place mainly among the ward team. There were few significant differences in the views of surgical and nonsurgical physicians. Psychosomatic basic care in general hospitals is possible, albeit with some limitations. Patients undergoing psychosocial interventions have better treatment outcomes. Therefore, extending training to 80 hours for all medical disciplines seems reasonable.

  16. Anaphylaxis: lack of hospital doctors' knowledge of adrenaline (epinephrine) administration in adults could endanger patients' safety.

    Science.gov (United States)

    Droste, J; Narayan, N

    2012-06-01

    Adrenaline (epinephrine) is the first line drug to be given in anaphylaxis and can save patients' lives. Conversely, incorrect administration of adrenaline in anaphylaxis has caused patients serious harm, including death. We compared the survey results of doctors' knowledge of adrenaline administration in adults of two District General Hospitals Trusts in England and found, that from 284 Hospital Doctors, 14.4% (n = 41) would administer adrenaline as recommended by published anaphylaxis guidelines. This survey comparison shows that a significant number of hospital doctors, regardless of seniority and specialty, have an educational deficit regarding correct administration of adrenaline (epinephrine) administration in adults with anaphylaxis. Multilevel strategies to educate doctors and prevent patient harm are needed. We propose a mnemonic for remembering the recommended treatment for anaphylaxis in the adult: "A Thigh 500" forAdrenaline into the antero-lateral thigh, 500 micrograms.

  17. Questionnaire survey of working relationships between nurses and doctors in University Teaching Hospitals in Southern Nigeria

    Directory of Open Access Journals (Sweden)

    Adebamowo Clement A

    2006-02-01

    Full Text Available Abstract Background Smooth working relationships between nurses and doctors are necessary for efficient health care delivery. However, previous studies have shown that this is often absent with negative impact on the quality of health care delivery. In 2002, we studied factors that affect nurse-doctor working relationships in University Teaching Hospitals (UTH in Southern Nigeria in order to characterize it and identify managerial and training needs that might be used to improve it. Method Questionnaire survey of doctors and nurses working in four UTH in Southern Nigeria was done in 2002. The setting and subjects were selected by random sampling procedures. Information on factors in domains of work, union activities, personnel and hospital management were studied using closed and open-ended questionnaires. Results Nurse-doctor working relationships were statistically significantly affected by poor after-work social interaction, staff shortages, activist unionism, disregard for one's profession, and hospital management and government policies. In general, nurses had better opinion of doctors' work than doctors had about nurses' work. Conclusion Working relationships between doctors and nurses need to be improved through improved training and better working conditions, creation of better working environment, use of alternative methods of conflict resolution and balanced hospital management and government policies. This will improve the retention of staff, job satisfaction and efficiency of health care delivery in Nigeria.

  18. The hospital doctor of today - still continuously on duty.

    Science.gov (United States)

    Hertzberg, Tuva Kolstad; Skirbekk, Helge; Tyssen, Reidar; Aasland, Olaf Gjerløw; Rø, Karin Isaksson

    2016-10-01

    Norwegian hospital doctors emphasise the value of working hard and efficiently and of a high degree of attendance in the workplace. This helps establish social norms that guide behaviour within the professional culture. It is important to examine what consequences these values may entail when the doctor also needs to cater to his or her own needs. We conducted eight focus-group interviews and three individual interviews among a total of 48 senior consultants and specialty registrars working in the areas of surgery, psychiatry and internal medicine. Total N = 48; 56  % women. The interviews were analysed with the aid of systematic text condensation. When Norwegian hospital doctors wish to appear as good doctors, they see that this entails consequences for the interrelationships with colleagues, the management and the work-life balance. Conflicts of interest arose between senior consultants and specialty registrars. Management initiatives to deal with absence, adaptation of the job to the life stage of each individual doctor and increased management involvement among doctors were among the measures proposed. Better mutual knowledge between doctors and management with regard to each other’s values and responsibilities could constitute key premises for structural changes, for example in terms of better planning of leaves of absence and opportunities for adaptation of work schedules to the life stage of the persons concerned.

  19. Doctors' service orientation in public, private, and foreign hospitals.

    Science.gov (United States)

    Andaleeb, Syed Saad; Siddiqui, Nazlee; Khandakar, Shahjahan

    2007-01-01

    The purpose of this study is to propose a doctors' service orientation (DSO) scale and uses it to compare the services received in public, private and foreign hospitals in a developing country from the patient's perspective. The scale was derived from the service quality literature and qualitative research. A questionnaire was designed next. Data were collected from patients who had used the services of doctors in a hospital. The scale demonstrated appropriate psychometric properties. Two clear patterns emerge from the study results: on 10 out of 12 measures of doctors' service orientation, there was no significant difference in their perceived behaviors between public and private hospitals and foreign doctors were "always" rated significantly higher. This study focused on one major city because of time and resource constraints. The findings are thus not generalizable to hospitals across the country. Also, because of translation and retranslation issues, the scale ought to be further tested for wider use. The scale may be used periodically in a comprehensive quality assurance program to exhort doctors to become more service oriented and to improve their performance over time.

  20. Job satisfaction among hospital doctors in Norway and Germany. A comparative study on national samples.

    Science.gov (United States)

    Rosta, Judith; Nylenna, Magne; Aasland, Olaf G

    2009-07-01

    To compare German and Norwegian hospital doctors on 10 different aspects of job satisfaction and general life satisfaction. The study population consisted of a representative sample of 1,448 German and 484 Norwegian hospital doctors aged 33-65 years (n = 1,932), selected from nationwide postal surveys in 2006. The questionnaires contained items on subjective life satisfaction and the validated 10-item Job Satisfaction Scale. Each item was scored on a seven-point Likert scale from 1 (very dissatisfied) to 7 (very satisfied). A mean sum score was calculated, ranging from 1 to 7. Regression analyses and generalized-linear-model-estimated means controlled for age and gender with 95% confidence intervals were used for comparison. Norwegian hospital doctors had significantly higher life satisfaction (mean 5.31 vs. 5.15) and job satisfaction (mean 5.09 vs. 4.55) than their German colleagues. Item by item, doctors in Norway were significantly more content with seven aspects of their work: "Freedom to choose your own methods of working'' (mean 5.00 vs. 4.72), "opportunities to use your skills'' (mean 5.49 vs. 5.01), "physical working conditions'' (mean 4.62 vs. 4.08), "recognition you get for good achievements'' (mean 4.83 vs. 4.26), "overall job situation'' (mean 5.57 vs. 4.64), "work hours'' (mean 4.39 vs. 3.39), "ate of pay'' (mean 4.70 vs. 3.70). General life satisfaction and age, but not gender, were positively associated with job satisfaction in both countries. Norwegian hospital doctors enjoy a higher level of life and job satisfaction than German hospital doctors. The most likely reasons for this are more acceptable work hours, salary and control over clinical work in Norway.

  1. Violence Against Doctors and Nurses in Hospitals in Turkey.

    Science.gov (United States)

    Kaya, Sidika; Bilgin Demir, İpek; Karsavuran, Seda; Ürek, Duygu; İlgün, Gülnur

    2016-01-01

    This study shows the rates of violence experienced by doctors and nurses and their ensuing responses including reporting rates and any effects experienced because of the violence. The Survey for Investigating the Violence on Medical Employees was administered to 254 doctors and nurses. Data were analyzed using chi-square and logistic regression analysis. Of the participants, 74.4% had been exposed to some form of violence. Most of the participants, 87.3%, experienced verbal violence; 12.2% experienced physical violence; and 0.5% experienced sexual violence. Logistic regression analysis indicated that married doctors and nurses are at risk of experiencing violence 0.5 times greater when compared with unmarried or widowed doctors and nurses (p = 0.026). The experience of violence differs by hospital type (p = 0.038) and years working in the healthcare industry (p = 0.042). Differences were also found regarding exposure to violence between doctors and nurses in terms of time of day (p = 0.031) and the work being performed (p violence (50.8%) was the healthcare system. Verbal response was the most frequent reaction to violence (24.4%), with loss of occupational performance (58.2%) being the most cited negative outcome. Approximately 9.3% of the victims reported the violence to judicial authorities. A lengthy judicial proceeding was chosen as the most significant hindrance to reporting the violence (45.8%). This study reveals the effects of violence and reporting rates at two hospitals in Turkey, and it implies that underreporting of violence is an important issue. Therefore, hospital management should take measures to increase reporting and take necessary actions when violence is reported.

  2. Hospitalized children's representations of their relationship with nurses and doctors.

    Science.gov (United States)

    Corsano, Paola; Majorano, Marinella; Vignola, Valentina; Cardinale, Elisa; Izzi, Giancarlo; Nuzzo, Maria Josè

    2013-09-01

    This article reports an explorative study which aims to investigate hospitalized children's views of their relationships with nurses and doctors. Twenty-seven school-aged children and adolescents from 6 to 15 years old in the paediatric haematology and oncology ward of an Italian hospital participated in the study. Each participant was asked to draw him or herself with a doctor or nurse from the ward while they were doing something. The drawings were analysed using Pictorial Assessment of Interpersonal Relationships (PAIR) and a qualitative analysis. The results showed that the participants viewed their relationships with health professionals positively, in particular with the nurses. This relationship was perceived as close, intimate, cohesive and without conflict. In some cases it became an emotional bond. Finally, this relationship helped the patients to cope with painful and uncomfortable medical procedures, which gradually became familiar and accepted. The clinical implications of this study are discussed.

  3. An educational conference in a general hospital.

    Science.gov (United States)

    Caldwell, Gordon

    2011-12-01

    Western Sussex Hospitals National Health Service (NHS) Trust comprises the District General Hospitals of Worthing and Chichester. Both hospitals have successful postgraduate medical education centres, providing training for junior doctors and continuing professional development for senior doctors. Until now, there have been limited multi-professional teaching and learning activities available. The two hospitals have recently merged. The education executive felt that workplace learning had become undervalued since the implementation of Modernising Medical Careers in the UK. The executive wanted to provide a multi-professional conference on Workplace Learning, both to support the merger and to promote the value of workplace and multi-professional learning. The conference topic covering the 'how' of workplace learning was innovative. Many educational conferences concentrate on the organisation and evaluation of classroom learning, rather than on how learning can be facilitated in the workplace during ordinary working practice. It was also innovative to ensure that the presenters were representative of the multi-professional workforce. The presentations were limited to 8 minutes each to promote high-impact short presentations. The talks were recorded for publishing on the trust's intranet and the internet. A committed team in a district general hospital can provide a high-quality educational conference with wide appeal. Local health care professionals can produce short high-impact presentations. The use of modern information technology and audio-visual systems can make the presentations available to both local and worldwide audiences. © Blackwell Publishing Ltd 2011.

  4. The interpretability of doctor identification badges in UK hospitals: a survey of nurses and patients.

    Science.gov (United States)

    Hickerton, Bethan C; Fitzgerald, Daniel John; Perry, Elizabeth; De Bolla, Alan R

    2014-07-01

    Hospital badges have multiple important purposes, but their essential role remains the clear identification of the bearer, including their professional status. The modernisation of medical careers in the National Health Service has changed terminology dramatically, resulting in a plethora of new job titles emerging among both doctors and nurses. To determine whether the new or old terminology allowed clearer identification of medical doctors by patients and nurses. We replicated 11 identification badges used in the Royal Cornwall Hospital and Wrexham Maelor Hospital, both current and before the introduction of new medical training terminology. Data were collected from 114 patients and 67 nurses, by asking them to (1) identify which name badges represented doctors and (2) rank them in order of seniority. Only 11% of patients and 60% of nurses identified a 'Foundation Year 1 Trainee' as a qualified medical doctor. Indeed, only 'General Practice Vocational Trainee' and 'Consultant' were both readily identifiable as qualified doctors to both patients and nurses. Ranking was also a problem, with only 19% of patients and 45% of nurses able to correctly grade medical doctors using the current terminology. The old terminology allowed more accurate identification by nurses, with over 80% successfully ranking and marking the title appropriately. Current terminology is a source of confusion to both patients and members of the immediate medical care team, with nurses unable to correctly identify medical doctors. Our study indicates that a review of terminology is necessary to ensure patients, and staff, are able to communicate effectively. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. [Job satisfaction of hospital doctors. Results of a study of a national sample of hospital doctors in Germany].

    Science.gov (United States)

    Rosta, J; Gerber, A

    2008-01-01

    This paper presents the findings on the level of job satisfaction among hospital physicians in Germany and puts the results into relation to demographic variables and employment status. Data were collected as part of the survey "Work Life, Lifestyle and Health among Hospital Doctors in Germany 2006" using anonymous self-reporting questionnaires. Job satisfaction was scored using the scale according to Warr et al. It consists of 10 items with a seven-point Likert scale (1=dissatisfaction; 7=satisfaction), so the sum score ranks between 10 and 70. The following variables were correlated to job satisfaction: demographic variables (gender, age), and employment status (specialty, geographical localisation of hospital, hospital type, level of seniority, working time pattern). The response rate was 58% (n=1917). Doctors reported an average job satisfaction of 44.3. Comparing different specialties, physicians in radiology had the highest (47.6) and in surgery (43.0) the lowest level of job satisfaction. Below-average job satisfaction could also be found in urology (43.5) and internal medicine (43.7). The regression analysis showed that the younger age group (B=-1.45; p=0.031) and those with a status as junior physician (B=-4.97; p=0.0001) were significantly dissatisfied. Out of the ten items assessed "working hours" (3.25), "payment" (3.59), "physical working conditions" (3.96) and "recognition for good work" (4.08) attained the lowest ratings. Hospital doctors in Germany are moderately satisfied with their jobs - less satisfied than their colleagues in England, New Zealand and Norway. Improvement of job satisfaction and working conditions should be achieved via effective regulation of working hours and improvement of recognition for medical work regarding monetary and non-monetary factors such as payment and positive feedback for good work.

  6. Medical emergencies facing general practitioners: Drugs for the doctor's bag

    OpenAIRE

    Janković Slobodan

    2014-01-01

    General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever), morphine (for severe pain), naloxone (for heroin poisoning), ceftriaxone (for meningococcal ...

  7. How do patients define "good" and "bad" doctors? - Qualitative approach to the representations of hospital patients

    NARCIS (Netherlands)

    Luthy, C; Cedraschi, C; Perrin, E; Allaz, AF

    2005-01-01

    Questions under study: Knowledge of hospital patients' perceptions of doctors' qualities is limited. The purpose of this study was to explore hospital patients' definitions of "good" and "bad" doctors. Methods: Semi-structured interviews conducted with 68 consecutive hospital patients. The questions

  8. [External workplace violence against doctors in hospital services in Lima Metropolitana, Peru 2014].

    Science.gov (United States)

    Tuya-Figueroa, Ximena; Mezones-Holguin, Edward; Monge, Eduardo; Arones, Ricardo; Mier, Milagros; Saravia, Mercedes; Torres, Jose; Mayta-Tristán, Percy

    2016-01-01

    . To calculate the frequency and factors associated with external workplace violence (EWV) against doctors in health inpatient services in the metropolitan area of Lima (Spanish: Lima Metropolitana), Peru. . A cross-sectional analytic study, which included doctors from the Ministry of Health (MINSA), Social Security (EsSalud), and the private subsector, was carried out. The frequency of EWV was measured throughout the entire professional practice during the previous 12 months and during the last month. Variables related to the doctor, assailant, and health service were measured. Raw and adjusted prevalence ratios (PR) were calculated by means of a Poisson-family generalized linear model with non-parametric bootstrapping. . A total of 406 doctors participated; 31.5% were victims of EWV at least once during their professional practice, with 19.9% over the past 12 months and 7.6% during the last month. The chances of being threatened in the last 12 months increased if the doctor was male (adjusted PR [aPR]: 1.7; 95% confidence interval [CI] = 1.1- 2.8), had graduated from a Peruvian university outside of the metropolitan area of Lima (aPR: 1.5; 95% CI = 1.1-2.4), worked at MINSA (aPR: 7.9; 95% CI = 2.24-50.73) or EsSalud (RR: 8.68; 95% CI = 2.26-56.17), and worked in the emergency (aPR: 1.9; 95% CI = 1.2-3.6) or operating room (aPR: 1.6; 95% CI = 1.1-2.3). Age, years of professional practice, or being a medical resident were not associated with EWV. . In the hospitals studied, a large number of doctors have been victims of EWV. Working in public services increases the possibility of violence. Implementation of support, identification, and primary prevention strategies in hospitals is recommended.

  9. Attitudes of newly qualified doctors towards a career in general practice: a qualitative focus group study.

    Science.gov (United States)

    Merrett, Alexandra; Jones, Daniel; Sein, Kim; Green, Trish; Macleod, Una

    2017-04-01

    A key element of the NHS is universal access to a GP. Recently, UK general practice has been described as being in crisis, with training places unfilled and multiple practices reporting vacancies or facing closure. The recruitment of GPs continues to be a key focus for both the Royal College of General Practitioners (RCGP) and the government. To understand the attitudes of newly qualified doctors towards a career in general practice, to appreciate potential reasons for the crisis in GP recruitment, and to recommend ways to improve recruitment. A qualitative study comprising five focus groups with 74 Foundation Year 1 (FY1) doctors from one Yorkshire deanery. Audio recordings were transcribed verbatim and thematic analysis undertaken. Foundation Year 1 doctors' thoughts towards a career in general practice were summarised in four themes: quality of life, job satisfaction, uncertainty surrounding the future of general practice, and the lack of respect for GPs among both doctors and the public. Participants felt that general practice could provide a good work-life balance, fair pay, and job stability. Job satisfaction, with the ability to provide care from the cradle to the grave, and to work within a community, was viewed positively. Uncertainties around future training, skill levels, pay, and workload, together with a perceived stigma experienced in medical schools and hospitals, were viewed as a deterrent to a career in general practice. This study has gathered the opinions of doctors at a critical point in their careers, before they choose a future specialty. Findings highlight areas of concern and potential deterrents to a career in general practice, together with recommendations to address these issues. © British Journal of General Practice 2017.

  10. Interference with the clinical independence of doctors in hospitals faced with a shortage of resources: what should doctors do?

    Science.gov (United States)

    McQuoid-Mason, D J

    2014-11-01

    In the face of interference with their clinical independence in hospitals with a shortage of resources, what should doctors do? The question can be answered by considering: (i) the constitutional right to healthcare and emergency treatment; (ii) the common-law position regarding unlawful homicide and the doctrine of 'superior orders'; (iii) the ethical rules of the Health Professions Council of South Africa; and (iv) whether there is any protection for doctors who refuse to carry out unprofessional, unethical or unlawful directives from their superiors. While this article focuses on the public sector, some of the legal principles, where relevant, apply equally to doctors in the private sector.

  11. Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital

    OpenAIRE

    Chen, Qiwei; Yang, Lan; Feng, Qiming; Tighe, Scott S.

    2017-01-01

    Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction o...

  12. Hospital doctors' Opinions regarding educational Utility, public Sentiment and career Effects of Medical television Dramas: the HOUSE MD study.

    Science.gov (United States)

    Haboubi, Hasan N; Morgan, Holly; Aldalati, Omar

    2015-12-14

    To evaluate the opinions of practicing clinicians on medical television dramas and the effects these series have on society as well as their own practice. Observational study using a structured questionnaire disseminated among doctors of all grades and specialties at one tertiary centre and two large secondary care district general hospitals in Wales, United Kingdom. Three hundred and seventy-two questionnaires were distributed over a 3-month period, with 200 completed questionnaires received (response rate, 54%). Frequency and reasons for watching these programs, and opinions regarding realism, educational value and public perception, evaluated by doctors' grades and specialties. Identification of work practice with any observed traits in fictional doctors was also analysed. 65% of doctors surveyed admitted to watching these programs on more than one occasion. Junior doctors (interns and resident medical officers) were more regular viewers. Most doctors who admitted to watching medical dramas did so for entertainment purposes (69%); 8% watched for educational purposes and, of these, 100% watched House MD, 82% felt that these dramas were unrepresentative of daily practice, and 10% thought that they accurately portrayed reality. Most of the positive responses were from junior doctors. 61% of doctors identified some aspect of their clinical practice with another doctor (fictional or non-fictional; most junior doctors identified with a fictional doctor, compared with non-fictional role models for more senior practicing clinicians. This survey shows that a large body of the medical workforce watches medical television dramas and that such programs exercise a growing influence on the practice of junior doctors, particularly those in physicianly specialties. The reasons for certain role model selections remain unknown and may require further evaluation.

  13. Burnout among middle-grade doctors of tertiary care hospital in Saudi Arabia.

    Science.gov (United States)

    Agha, Adnan; Mordy, Ayedh; Anwar, Eram; Saleh, Noha; Rashid, Imran; Saeed, Mona

    2015-01-01

    Burnout Syndrome is a mental condition caused by chronic exposure to work related stress and is identified by the presence of any of the three distinct elements of emotional exhaustion, depersonalization and lack of personal accomplishment. Middle grade doctors are the backbone of any tertiary care hospital / medical institution, partaking in unscheduled and inpatient care. The aim of this study was to assess the presence of burnout syndrome in the middle grade doctors in a tertiary care hospital in Saudi Arabia. The study was conducted at the Armed Forces Hospital Southern Region, Khamis Mushyt, from August to October 2012 in departments with at least fifty inpatient admissions per month and with at least five middle grade (Resident, Registrar and Senior Registrar) doctors. The departments were Obstetrics and Gynecology, Internal Medicine, Pediatrics, Emergency, General Surgery and Nephrology. This was a cross sectional descriptive and analytical study using the Maslach Burnout Inventory-Health Services Survey and a self-reported stressor-identifying questionnaire to ascertain possible precursors of, or contributing factors to, Burnout Syndrome. A total of 96 proformas/questionnaires were collected anonymously to maintain confidentiality and burnout syndrome was identified in as high as 88.5% of the respondents with high emotional exhaustion in 68.8%, high depersonalization in 63.6% and low personal accomplishment in 38.5%. The authors concluded that burnout syndrome is high among the middle-grade doctors in this medical facility and that urgent steps are needed to address this problem to ensure that these physicians remain physically and mentally healthy.

  14. Practise what you preach: health behaviours and stress among non-consultant hospital doctors.

    LENUS (Irish Health Repository)

    Feeney, Sinéad

    2016-02-01

    High rates of psychological distress, depression and suicide have been reported among doctors. Furthermore, many doctors do not access healthcare by conventional means. This study aimed to increase understanding regarding non-consultant hospital doctors\\' (NCHDs\\') response to stress and barriers to accessing supports, and identify possible solutions. Medical manpower departments in 58 hospitals distributed a 25-item questionnaire to 4,074 NCHDs; we received 707 responses (response rate, 17.4%). 60% of NCHDs were unable to take time off work when unwell; \\'letting teammates down\\' (90.8%) and \\'difficulty covering call\\' (85.9%) were the leading reasons. \\'Being too busy\\' (85%), \\'self-prescription\\' (66.6%) and \\'self-management\\' (53.1%) were ranked highest in deterring NCHDs from visiting a general practitioner (GP). 22.9% of NCHDs would not attend a GP with anxiety or depression until they began to feel hopeless, helpless or suicidal. 12.2% would not seek help at all. 55% of respondents (n = 330) had to move away from partners or dependants due to work, negatively affecting the social supports of 82.9%. Possible practical solutions were explored. NCHDS are a vulnerable population and have a particularly challenging lifestyle. Key recommendations include improved GP and counselling access for NCHDs, and addressing the culture of self-treatment and poor health behaviours through undergraduate and postgraduate education.

  15. Survey of the use of epinephrine (adrenaline) for anaphylaxis by junior hospital doctors.

    Science.gov (United States)

    Jose, Ricardo; Clesham, Gerald J

    2007-09-01

    Anaphylaxis is a life threatening reaction where prompt and appropriate management can save lives. Epinephrine (adrenaline) is the treatment of choice; however, the recommended dose and route of administration of epinephrine used in the management of anaphylaxis is different from that used in the management of cardiac arrest. To investigate how junior doctors would administer epinephrine in a case of anaphylactic shock in an adult patient. Junior medical staff in two district general hospitals were assessed with a short questionnaire. 95 junior hospital doctors were assessed. The majority (94%) would administer epinephrine as the life saving drug of choice, but only 16.8% would administer it as recommended by the UK Resuscitation Council Guidelines. Junior doctors may be called to make immediate management decisions in patients with anaphylaxis; however, widespread confusion exists regarding the dose and route of administration of epinephrine. Strategies to improve education and access to appropriate drugs are needed. A labelled "anaphylaxis box" on every resuscitation trolley, containing the dose of epinephrine with clear labelling for intramuscular use, may be one solution.

  16. Effectiveness of mask ventilation performed by hospital doctors in an Irish tertiary referral teaching hospital.

    LENUS (Irish Health Repository)

    Walsh, K

    2012-02-03

    The objective of this study was to assess the effectiveness of mask ventilation performed by 112 doctors with clinical responsibilities at a tertiary referral teaching hospital. Participant doctors were asked to perform mask ventilation for three minutes on a Resusci Anne mannequin using a facemask and a two litre self inflating bag. The tidal volumes generated were quantified using a Laerdal skillmeter computer as grades 0-5, corresponding to 0, 334, 434, 561, 673 and > 800 ml respectively. The effectiveness of mask ventilation (i.e. the proportion of ventilation attempts which achieved a volume delivery of > 434 mls) was greater for anaesthetists [78.0 (29.5)%] than for non anaesthetists [54.6 (40.0)%] (P = 0.012). Doctors who had attended one or more resuscitation courses where no more effective at mask ventilation than their colleagues who had not undertaken such courses. It is likely that first responders to in-hospital cardiac arrests are commonly unable to perform adequate mask ventilation.

  17. General FAQs regarding the IDRC Doctoral Research Awards 2018 ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This award covers field research expenses for advanced doctoral students who intend ... serious security challenges, IDRC may ask you to delay your field research, .... Women candidates applying to IDRC Doctoral Research Awards calls in ...

  18. A Qualitative Study Investigating Gender Differences in Primary Work Stressors and Levels of Job Satisfaction in Greek Junior Hospital Doctors

    Science.gov (United States)

    Antoniou, Alexander-Stamatios; Cooper, Cary L.; Davidson, Marilyn J.

    2008-01-01

    Primary work stressors and job satisfaction/dissatisfaction in Greek Junior Hospital Doctors (JHDs) are investigated to identify similarities and differences in the reports obtained from male and female hospital doctors. Participants in the study included 32 male and 28 female Greek hospital doctors who provided information through…

  19. Management of chronic orofacial pain: a survey of general dentists in german university hospitals

    NARCIS (Netherlands)

    Wirz, Stefan; Ellerkmann, Richard K.; Buecheler, Marcus; Putensen, Christian; Nadstawek, Joachim; Wartenberg, Hans-Christian

    2010-01-01

    AIM: This survey assessed procedures performed by general dentists in German university hospitals treating patients with chronic orofacial pain (COP). METHODS: A standardized questionnaire was sent to dentists at all 42 German universities. Doctors were asked to describe demographics, diagnoses,

  20. Analysis of doctor-patient relationship status and its influencing factors of the tertiary hospital in Suzhou

    OpenAIRE

    Bing-yi WANG; Teng XIA; Xiao-tian YAN; Yi-cheng SHEN; Jia-ning WANG; Ya-na MA

    2014-01-01

    Objective: To investigate the relationship between doctors and patients in Suzhou, we focused on exploring the factors of doctor-patient communication, and strived to deepen the doctor-patient communication skills and knowledge. Method: Questionnaire survey was carried out in comprehensive tertiary-class hospitals in Suzhou , adopting the method of random sampling, respectively on patients and doctors. Results: 593 valid questionnaires were from both doctors and patients. The doctors thought ...

  1. Work hours and sleep/wake behavior of Australian hospital doctors.

    Science.gov (United States)

    Ferguson, Sally A; Thomas, Matthew J W; Dorrian, Jillian; Jay, Sarah M; Weissenfeld, Adrian; Dawson, Drew

    2010-07-01

    The objective of the study was to describe the work and sleep patterns of doctors working in Australian hospitals. Specifically, the aim was to examine the influence of work-related factors, such as hospital type, seniority, and specialty on work hours and their impact on sleep. A total of 635 work periods from 78 doctors were analyzed together with associated sleep history. Work and sleep diary information was validated against an objective measure of sleep/wake activity to provide the first comprehensive database linking work and sleep for individual hospital doctors in Australia. Doctors in large and small facilities had fewer days without work than those doctors working in medium-sized facilities. There were no significant differences in the total hours worked across these three categories of seniority; however, mid-career and senior doctors worked more overnight and weekend on-call periods than junior doctors. With respect to sleep, although higher work hours were related to less sleep, short sleeps (work) were observed at all levels of prior work history (including no work). In this population of Australian hospital doctors, total hours worked do impact sleep, but the pattern of work, together with other nonwork factors are also important mediators.

  2. CPR and the RCP (1). Training of doctors in NHS hospitals.

    Science.gov (United States)

    Wheatly, S; Redmond, A D

    1993-10-01

    Six years after the Royal College of Physicians published its report, most hospitals in the UK with acute coronary beds fail to train or test their doctors adequately in the skills of cardiopulmonary resuscitation. Doctors want more training, and consultants try to give it, but there is a lack of funds for this basic yet critical task.

  3. Medical emergencies facing general practitioners: Drugs for the doctor's bag

    Directory of Open Access Journals (Sweden)

    Janković Slobodan

    2014-01-01

    Full Text Available General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever, morphine (for severe pain, naloxone (for heroin poisoning, ceftriaxone (for meningococcal meningitis, albuterol (for bronchial asthma attack, hydrocortisone (for bronchial asthma attack, glucagon (for severe hypoglycemia, dextrose (for mild to moderate hypoglycemia, diazepam (for febrile convulsions or epileptic status, epinephrine (for anaphylaxis and cardiac arrest, atropine (for symptomatic bradicardia, chloropyramine (for acute allergy, aspirin (for acute myocardial infarction, nitroglycerine (for acute coronary syndrome, metoclopramide (for nausea and vomiting, haloperidol (for delirium, methylergometrine (for control of bleeding after delivery or abortion, furosemide (for acute pulmonary edema and flumazenil (for benzodiazepine poisoning. For each of the listed drugs a physician should well know the recommended doses, indications, contraindications and warnings. All of the listed drugs are either registered in Serbia or available through special import, so general practitioners may fill their bags with all necessary drugs and effectively and safely treat medical emergencies.

  4. Doctors' views of working conditions in rural hospitals in the Western ...

    African Journals Online (AJOL)

    management support impact negatively on doctors' views of working in district hospitals. Unless these ... and skills gap of district hospital practitioners in .... or tertiary hospitals, were highly regarded as a means of updating skills. Practical hands-on training was preferred to lectures. Lack of time, need for locums, remoteness.

  5. Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital.

    Science.gov (United States)

    Chen, Qiwei; Yang, Lan; Feng, Qiming; Tighe, Scott S

    2017-01-01

    Background . Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method . To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction of doctors and to make recommendations for improvements. Results . About 75% (28/39) of the doctors expressed negative attitudes related to their work conditions. Slightly more than half (22/39) mentioned they should receive greater compensation for their work and more than one were seriously considering other options. Many participants (35/39) showed their satisfaction about the achievement of serving as a doctor. Conclusion . Their main concerns related to job satisfaction included working conditions, financial rewards, and the doctor's relationships with patients. Increasing the incomes and fringe benefits of healthcare workers, improving their work conditions, and providing training and continuing education opportunities would help rural clinics retain doctors and eliminate the current unsatisfactory conditions. The findings also highlight the need for the government to increase financial support of township hospitals.

  6. Oral Cancer Awareness of Non-Consultant Hospital Doctors in Irish Hospitals

    LENUS (Irish Health Repository)

    Shanahan, D

    2018-01-01

    The incidence of oral cancer is rising in Ireland. The aim of this study is to assess the level of awareness of oral cancer amongst non-consultant hospital doctors (NCHDs) in Ireland, so any knowledge deficits can be identified and addressed. Data was collected by means of an anonymous online questionnaire, which was distributed via a private social media page for NCHDs in Ireland. It was completed by 221 participants, of which over 80% recorded that they do not regularly examine patients’ oral mucosa. Sixty percent were ‘unsure’, and 21%, ‘very unsure’, about diagnosing oral cancer based on clinical appearance. Nor were respondents able to identify confidently the various potential risk factors for oral cancer. Eighty-four percent of NCHDs requested further education on the topic. The response rate of the study was low, and further investigation is required to determine if the findings of this study are representative of the wider NCHD community. The chief recommendation of this paper is to provide more education about oral cancer, at both medical undergraduate and postgraduate levels, and to increase awareness of the condition amongst hospital doctors.

  7. Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital

    Directory of Open Access Journals (Sweden)

    Qiwei Chen

    2017-01-01

    Full Text Available Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction of doctors and to make recommendations for improvements. Results. About 75% (28/39 of the doctors expressed negative attitudes related to their work conditions. Slightly more than half (22/39 mentioned they should receive greater compensation for their work and more than one were seriously considering other options. Many participants (35/39 showed their satisfaction about the achievement of serving as a doctor. Conclusion. Their main concerns related to job satisfaction included working conditions, financial rewards, and the doctor’s relationships with patients. Increasing the incomes and fringe benefits of healthcare workers, improving their work conditions, and providing training and continuing education opportunities would help rural clinics retain doctors and eliminate the current unsatisfactory conditions. The findings also highlight the need for the government to increase financial support of township hospitals.

  8. Analysis of doctor-patient relationship status and its influencing factors of the tertiary hospital in Suzhou

    Directory of Open Access Journals (Sweden)

    Bing-yi WANG

    2014-09-01

    Full Text Available Objective: To investigate the relationship between doctors and patients in Suzhou, we focused on exploring the factors of doctor-patient communication, and strived to deepen the doctor-patient communication skills and knowledge. Method: Questionnaire survey was carried out in comprehensive tertiary-class hospitals in Suzhou , adopting the method of random sampling, respectively on patients and doctors. Results: 593 valid questionnaires were from both doctors and patients. The doctors thought that the current doctor-patient relationship  "good" and above accounted for 32% (31/98.At the meanwhile, in the patients, this proportion was 45% (223/495.There was statistically significance between the difference(P <0.05.Only 6% doctors thought that the communication between doctors and patients is not important; in the patients, the ratio was 10%. Among the doctors, the top three factors of doctor-patient communication were: lack of communication skills, too much tasks and not enough time and energy, not good attitude. Among patients, the top three factors were: incomprehension and distrust of the doctors, the poor understanding for medical knowledge and the low cultural level. Conclusion: In the first-class hospitals of Suzhou, the relationship between doctors and patients had a relatively good development trend. There were some problems in the communication between doctors and patients. We should enhance the doctor-patient communication, and build a harmonious doctor-patient relationship.

  9. Doctors on deck. ACOs led by doctors seek to manage costs, quality and hospital relationships.

    Science.gov (United States)

    Evans, Melanie

    2012-04-16

    Most of the first crop of ACOs in the Medicare Shared Savings Program are owned and operated by physicians without formal participation of a hospital in the efforts to improve quality and curb costs. "There were some people who feared that the only entities that would participate would be hospital-dominated systems," says Jonathan Blum, director of the Center for Medicare Management at the CMS, left. "That has not happened".

  10. What's up doc? A national cross-sectional study of psychological wellbeing of hospital doctors in Ireland.

    Science.gov (United States)

    Hayes, Blánaid; Prihodova, Lucia; Walsh, Gillian; Doyle, Frank; Doherty, Sally

    2017-10-16

    To measure levels of psychological distress, psychological wellbeing and self-stigma in hospital doctors in Ireland. National cross-sectional study of randomised sample of hospital doctors. Participants provided sociodemographic data (age, sex, marital status), work grade (consultant, higher/basic specialist trainee), specialty and work hours and completed well-being questionnaires (the Depression Anxiety Stress Scale, WHO Well-being Index, General Health Questionnaire) and single-item scales on self-rated health and self-stigma. Irish publicly funded hospitals and residential institutions. 1749 doctors (response rate of 55%). All hospital specialties were represented except radiology. Half of participants were men (50.5%). Mean hours worked per week were 57 hours. Over half (52%) rated their health as very good/excellent, while 50.5% reported positive subjective well-being (WHO-5). Over a third (35%) experienced psychological distress (General Health Questionnaire 12). Severe/extremely severe symptoms of depression, anxiety and stress were evident in 7.2%, 6.1% and 9.5% of participants (Depression, Anxiety, Stress Scale 21). Symptoms of distress, depression, anxiety and stress were significantly higher and levels of well-being were significantly lower in trainees compared with consultants, and this was not accounted for by differences in sociodemographic variables. Self-stigma was present in 68.4%. The work hours of doctors working in Irish hospitals were in excess of European Working Time Directive's requirements. Just over half of hospital doctors in Ireland had positive well-being. Compared with international evidence, they had higher levels of psychological distress but slightly lower symptoms of depression and anxiety. Two-thirds of respondents reported self-stigma, which is likely to be a barrier to accessing care. These findings have implications for the design of support services for doctors, for discussions on quality of patient care and for future

  11. Cost awareness among doctors in an Irish university-affiliated teaching hospital

    Directory of Open Access Journals (Sweden)

    William H.C. Tiong

    2011-11-01

    Full Text Available Previous studies in USA and Canada have found that physicians and physicians in training have a limited understanding of medical care costs. In this study, we set out to survey all grades of doctors in the surgical department, emergency department, and anaesthetic department in a university-affiliated, Irish teaching hospital. Open-ended questionnaires on cost of 25 routinely used items in the hospital were sent to each department. The aims of the study were to assess the present knowledge of cost among the various grades of doctors, and to evaluate the level of professional experience on cost awareness and their confidence in their estimates. We had an overall response rate of 56.8% with 68.5% of doctors admitted to have estimated more than 90% of their responses. Ninety three percent of doctors have no confidence in their estimates on cost of listed items. We found that the lack of cost awareness was universal among doctors of all grades (P = 0.236. The doctors in our study population showed a high level of inaccuracy on their estimates of cost of routinely used items with 84% of the items overestimated. Our results were discouraging and demonstrated that considerable educational activity will be necessary if doctors are to be more cost effective in meeting the national health care budget.

  12. THE PREVALENCE OF STRESS AND BURNOUT SYNDROME IN HOSPITAL DOCTORS AND FAMILY PHYSICIANS.

    Science.gov (United States)

    Stanetic, Kosana D; Savic, Suzana M; Racic, Maja

    2016-11-01

    Introducti on. Burnout syndrome is the result of chronic emotional stress. It is characterized by high levels of emotional exhaustion and depersonalization, and reduced level of personal accomplishment. The aim of this study was to determine the level of stress and risk ror burnout syndrome in doctors employed in health centers and hospitals, and to investigate the impact of socio-derrdgraphic characteristics on the level of stress and the o ccurrence of burnout syndrome. A cross-sectional study was conducted in the period from October I to December 31, 2015 in three health centers and in the University Clinical Center of the Republic of Srpska. The survey was anonymous. A socio-demographic questionnaire and a questionnaire for self-assessment of the level of stress and Maslach Burnout Inventory were used as research instruments. Out of 151 doctors included in the study, 49% were family physicians, and 51% were hospital doctors. The analysis of responses to questionnaires for self-assessment of stress level revealed that 51.7% of participants had high levels of stress (52.7% of family physicians, 50.6% of doctors working in hospital). A high degree of emotional exhaustion was found in 27.2% of participants (29.7% of fam ily physicians, 24.6% of doctors working in hospital), high depersonalization was found in 23.8% of participants (25.7% of family physicians, 22. 1% of doctors working in hospital), a low level of personal accomplishment was found in 39.7% of participants (37.8% of family physicians. 41.6% of doctors working in hospital). No statistically significant difference regarding stress degree, emotional exhaustion and depersonalizaion and personal accomplishment was found between hospital doctors and family physicians. The physicians aged over 45 years had a significantly (p = 0.030) higher level of emotional exhaustion than their younger colleagues. This study found that there was a high risk of burnout syndrome in physicians in the Republic of Srpska

  13. [The importance of master's degree and doctorate degree in general surgery].

    Science.gov (United States)

    Montalvo-Javé, Eduardo Esteban; Mendoza-Barrera, Germán Eduardo; Valderrama-Treviño, Alan Isaac; Alcántara-Medina, Stefany; Macías-Huerta, Nain Abraham; Tapia-Jurado, Jesús

    2016-01-01

    The Doctor of Philosophy is the highest academic degree that can be obtained in universities. Graduate Education Program in Medicine in Mexico is divided into 2 major categories: Medical Specialty and Master studies/Doctor of Philosophy. The objective of this study was to demonstrate the importance of master's degrees and Doctor of Philosophy in general surgery. A literature search in PubMed and Medline among others, from 1970 to 2015 with subsequent analysis of the literature reviews found. The physicians who conducted doctoral studies stand out as leaders in research, teaching and academic activities. Dual training with a doctorate medical specialty is a significant predictor for active participation in research projects within the best educational institutions. It is important to study a PhD in the education of doctors specialising in surgery, who show more training in teaching, research and development of academic activities. Currently, although there is a little proportion of students who do not finish the doctoral program, the ones who do are expected to play an important role in the future of medical scientific staff. It has been shown that most doctors with Doctor of Philosophy have wide range of career options. The importance of doctoral studies in the formation of general surgery is due to various reasons; the main one being comprehensively training physician scientists who can develop in clinical, teaching and research. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  14. Perceptions of hospital managers regarding the impact of doctors ...

    African Journals Online (AJOL)

    South African Family Practice ... In 1997, the South African government introduced compulsory community service (CS) to ... CS has improved health services delivery, alleviated work pressure, and improved the image of hospital managers.

  15. Primary prevention in psychiatry in general hospitals in South Asia

    Science.gov (United States)

    Sood, Mamta; Chadda, Rakesh Kumar; Kallivayalil, Roy Abraham

    2017-01-01

    The focus of primary prevention is on reducing the disease incidence. Primary prevention in mental health has been given minimal priority in low-resource settings with no significant investments. General hospitals are one of the main providers of mental health services in South Asia. This paper focuses on primary prevention activities, which can be undertaken in a general hospital in South Asia with abysmally low-mental health resources. For implementing primary prevention in psychiatry, a general hospital may be conceptualized as a population unit, located in a well-populated area with easy accessibility where different kinds of communities, for example, students and resident doctors, consultants, patients and their caregivers, and paramedical, nursing, administrative and other supportive staff, coexist and have varied functions. All the functional components of the general hospital psychiatric units (GHPUs) offer scope for introducing primary preventive psychiatry services. Psychiatrists in GHPUs can lead efforts for primary prevention in mental health in the hospital by employing strategies in the framework of universal, selective, and indicated prevention. The preventive strategies could be targeted at the patients visiting the hospital for various health services and their caregivers, employees, and the trainees. Similar principles can be employed in teaching and training. PMID:29497199

  16. The study of knowledge, attitude and practice of medical law and ethics among doctors in a tertiary care hospital

    International Nuclear Information System (INIS)

    Tahira, Q.U.A.; Lodhi, S.; Haider, S.T.; Abaidullah, S.

    2013-01-01

    Objective: To assess the knowledge, attitude and practice regarding medical law and ethics among doctors of a medical unit in a tertiary care teaching hospital in Lahore. Study Design: Descriptive cross sectional study. Methodology: A three part self - administered structured questionnaire designed to test the knowledge and practices regarding medical law and ethics was distributed among doctors in a medical unit in Mayo Hospital, Lahore during September - October, 2012. Results: The 52 respondent doctors included in the study comprised of 20 (38.5%) house officers, 22 (42.3%) postgraduate residents and 10 (19.2%) consultants. In keeping with the Pakistan Medical and Den-tal Council code of ethics, the correct responses of house officers, postgraduate residents and consultants regarding knowledge of medical law and ethics were respectively 50%, 27.3% and 10% for patient's autonomy, 40%, 36.4% and 10% for adhering to patient's wishes, 10%, 63.6% and 50% for breaching confidentiality, 35%, 36.4% and 0% for informed consent, 10%, 22.7% and 10% for doing best regardless of patient's opinion, 5%, 31.8% and 10% for informing patient's relatives, 15%, 4.5% and 0% for treating violent patients. The practical application part of the questionnaire was a general reflection of the knowledge and attitudes. Conclusion: Most of the doctors were poorly acquainted with PMDC code of ethics. (author)

  17. Bacteriological Evaluation of Kwale General Hospital Environment ...

    African Journals Online (AJOL)

    ... Pharmacy (40.7%) and Theatre (18.5%). This study showed that Kwale General Hospital environment is heavily contaminated and therefore underlies the necessity for regular evaluation of the hospital environment. Keywords: Bacteriological evaluation, hospital, environment. Journal of Medical Laboratory Sciences Vol.

  18. Workplace violence against resident doctors in a tertiary care hospital in Delhi.

    Science.gov (United States)

    Anand, Tanu; Grover, Shekhar; Kumar, Rajesh; Kumar, Madhan; Ingle, Gopal Krishna

    2016-01-01

    Healthcare workers particularly doctors are at high risk of being victims of verbal and physical violence perpetrated by patients or their relatives. There is a paucity of studies on work-related violence against doctors in India. We aimed to assess the exposure of workplace violence among doctors, its consequences among those who experienced it and its perceived risk factors. This study was done among doctors working in a tertiary care hospital in Delhi. Data were collected by using a self-administered questionnaire containing items for assessment of workplace violence against doctors, its consequences among those who were assaulted, reporting mechanisms and perceived risk factors. Of the 169 respondents, 104 (61.4%) were men. The mean (SD) age of the study group was 28.6 (4.2) years. Sixty-nine doctors (40.8%) reported being exposed to violence at their workplace in the past 12 months. However, there was no gender-wise difference in the exposure to violence (p=0.86). The point of delivery of emergency services was reported as the most common place for experiencing violence. Verbal abuse was the most common form of violence reported (n=52; 75.4%). Anger, frustration and irritability were the most common symptoms experienced by the doctors who were subjected to violence at the workplace. Only 44.2% of doctors reported the event to the authorities. 'Poor communication skills' was considered to be the most common physician factor responsible for workplace violence against doctors. A large proportion of doctors are victims of violence by their patients or relatives. Violence is being under-reported. There is a need to encourage reporting of violence and prepare healthcare facilities to tackle this emerging issue for the safety of physicians.

  19. A Failure to Communicate? Doctors and Nurses in American Hospitals.

    Science.gov (United States)

    Michel, Lucie

    2017-08-01

    This article showcases the realities and challenges of teamwork in American hospitals based on the in situ comparison with France. Drawing on observation of nurse-physician interactions in hospitals in the two nations, this article highlights a troubling conflict between teamwork rhetoric and realities on the ward. Although the use of informatics systems such as electronic health records is supposed to increase cooperation, the observations presented here show that on the contrary, it inhibits communication that is becoming mainly virtual. While the nursing profession is more developed and provides stronger education in the United States, this story highlights the challenges in creating a shared environment of work and suggests the importance of balancing professional autonomy and effective teamwork. Copyright © 2017 by Duke University Press.

  20. A study of needle stick injuries among non-consultant hospital doctors in Ireland.

    LENUS (Irish Health Repository)

    O'Connor, M B

    2011-06-01

    NCHDs are exposed to a great number of blood-borne infections. Needle stick injuries are possibly the main route of acquiring such infections from a non-consultant hospital doctors (NCHDs) perspective. This study examines NCHDs experiences surrounding needle stick injuries.

  1. Assessment of hepatitis B vaccination status in doctors of Services hospital, Lahore

    International Nuclear Information System (INIS)

    Usmani, R.A.; Rana, M.S.; Sarwer, H.; Fazli, H.; Ali Pervaiz, M.A.; Tahir, I.; Sajjad, R.; Muhammad Saleem Wazir, M.S.

    2010-01-01

    Background: Hepatitis B is the most common serious infection of the liver and can lead to premature death from liver cancer or liver failure. Of the two billion people who have been infected with Hepatitis B virus, more than 350 million have chronic infection. The objectives of this study were to assess the Hepatitis B vaccination status, reasons for non-compliance and the risk of exposure to doctors at a tertiary care hospital. Methods: Three hundred and twenty-two doctors were selected from the various departments of the hospital by simple random sampling. They were given a self-administered questionnaire after taking verbal consent. Some doctors refused to fill-in the questionnaire while some others were on leave during the time of study and the remaining 215 doctors responded to the questionnaire. Results: A total of 215 doctors, (age range 22-59 years) responded to the questionnaire. Amongst them 11.6% had not received even a single dose of Hepatitis B vaccine while 14.4% had not completed the required course of vaccination. Most common reason cited by doctors for non immunisation was that they had not thought about it. Consultants were more likely of the other doctors to have received completed vaccination (83.9% versus 69.9%) (p<0.05). They were also significantly more likely to know their antibody titre after completing vaccination. Needle stick injuries were common. One hundred and forty-five doctors in the study admitted having received at least one needle prick/sharp injury. Of them, 51.6% had received a needle prick/sharp injury more than once. Conclusion: Despite the availability of an effective vaccine in the market doctors continue to remain non-vaccinated. It is the lack of awareness and carelessness on part of doctors coupled with the negligence of the risk that has led them being incompletely vaccinated. There is a need to ensure that every doctor is completely vaccinated against Hepatitis B before he/she enters professional practice. (author)

  2. Training doctors for primary care in China: Transformation of general practice education.

    Science.gov (United States)

    Li, Donald

    2016-01-01

    China is known for developing a cadre of "Barefoot Doctors" to address her rural healthcare needs in past. The tradition of barefoot doctors has inspired similar developments in several other countries across world. Recently China has embarked upon an ambitious new mission to create a primary care workforce consisting of trained general practitioners having international standard skillsets. This editorial provides an insight into the current status of policy deliberations with regards to training of primary care doctors and a new surge in general practice education in China.

  3. PREVALENCE AND CORRELATES OF JOB STRESS AMONG JUNIOR DOCTORS IN THE UNIVERSITY COLLEGE HOSPITAL, IBADAN.

    Science.gov (United States)

    Adeolu, J O; Yussuf, O B; Popoola, O A

    2016-12-01

    Doctors respond differently to their complex work environment, some find it stimulating while others find it stressful. This study aimed to assess the prevalence and correlates of stress among junior doctors in a teaching hospital in Southwest Nigeria. A descriptive cross sectional survey of all junior doctors employed at the University College Hospital, Ibadan was carried out. Information was collected with a structured pretested questionnaire from 253 doctors. Descriptive statistics were generated. T-test, chi square and logistic regression analyses were conducted using SPSS version 16. Statistical significance was set at 5%. Mean age of respondents was 29.9 (±4.1) years, 61.3% were males, 59% had spent less than 5 years in medical practice, and 34.8% were married. Majority (79.4%) were resident doctors. Prevalence of stress, job dissatisfaction and poor mental health were 31.6%, 15.4% and 9.9% respectively. Age, gender, years of medical practice, religion, ethnicity and marital status were not significantly associated with job stress (p>0.05). Doctors who were stressed were more likely to be dissatisfied with their jobs (OR=2.33; CI=1.08-4.04) and to have poor mental health (OR=3.82; CI=1.47-9.95) than those who were not stressed. The prevalence of stress in this study is high, and job dissatisfaction and poor mental health have been implicated as determinants of stress. As such, there should be an improvement in doctors' welfare, health care facilities and delivery.

  4. [Checklist Development for Women-Doctor-Friendly Working Conditions in a Hospital Setting].

    Science.gov (United States)

    Horie, Saki; Takeuchi, Masumi; Yamaoka, Kazue; Nohara, Michiko; Hasunuma, Naoko; Okinaga, Hiroko; Nomura, Kyoko

    2015-01-01

    This study aims to develop a scale of "women-doctor-friendly working conditions in a hospital setting". A task team consisting of relevant people including a medical doctor and a hospital personnel identified 36 items related to women-doctor-friendly working conditions. From December in 2012 to January in 2013, we sent a self-administered questionnaire to 807 full-time employees including faculty members and medical doctors who worked for a university-affiliated hospital. We asked them to score the extent to which they think it is necessary for women doctors to balance between work and gender role responsibilities on the basis of the Likert scale. We carried out a factor analysis and computed Cronbach's alpha to develop a scale and investigated its construct validity and reliability. Of the 807 employees, 291 returned the questionnaires (response rate, 36.1%). The item-total correlation (between an individual item score and the total score) coefficient was in the range from 0.44 to 0.68. In factor analysis, we deleted six items, and five factors were extracted on the basis of the least likelihood method with the oblique Promax rotation. The factors were termed "gender equality action in an organization", "the compliance of care leave in both sexes and parental leave in men", "balance between life events and work", "childcare support at the workplace", and "flexible employment status". The Cronbach's alpha values of all the factors and the total items were 0.82-0.89 and 0.93, respectively, suggesting that the scale we developed has high reliability. The result indicated that the scale of women-doctor-friendly working conditions consisting of five factors with 30 items is highly validated and reliable.

  5. Does a self-referral counselling program reach doctors in need of help? A comparison with the general Norwegian doctor workforce

    Directory of Open Access Journals (Sweden)

    Gude Tore

    2007-03-01

    Full Text Available Abstract Background Doctors have a relatively high degree of emotional distress, but seek help to a lesser degree and at a later stage than other academic groups. This can be deleterious for themselves and for their patients. Prevention programs have therefore been developed but it is unclear to what extent they reach doctors in need of help. This study describes doctors who participated in a self-referrral, easily accessible, stress relieving, counselling program in Norway, and compares them with a nationwide sample of Norwegian doctors. Methods Two hundred and twenty seven (94% of the doctors, 117 women and 110 men, who came to the resort centre Villa Sana, Modum, Norway, between August 2003 and July 2005, agreed to participate in the study. Socio-demographic data, reasons for and ways of help-seeking, sick-leave, symptoms of depression and anxiety, job stress and burnout were assessed by self-reporting questionnaires. Results Forty-nine percent of the Sana doctors were emotionally exhausted (Maslach compared with 25% of all Norwegian doctors. However, they did not differ on empathy and working capacity, the other two dimensions in Maslach's burnout inventory. Seventy-three percent of the Sana doctors could be in need of treatment for depression or anxiety based on their symptom distress scores, compared with 14% of men and 18% of women doctors in Norway. Twenty-one percent of the Sana doctors had a history of suicidal thoughts, including how to commit the act, as compared to 10% of Norwegian doctors in general. Conclusion Sana doctors displayed a higher degree of emotional exhaustion, symptoms of depression and anxiety as well as job related stress, compared with all Norwegian doctors. This may indicate that the program at Villa Sana to a large extent reaches doctors in need of help. The counselling intervention can help doctors to evaluate their professional and private situation, and, when necessary, enhance motivation for seeking adequate

  6. General Practice Teaching--Within the Hospital

    Science.gov (United States)

    Drury, M.

    1976-01-01

    A program of integrated teaching by consultants and general practitioners is described. The teaching took place in the hospitals used for the purpose by the Medical Faculty of the University of Birmingham. (Author)

  7. Do you agree with the doctor's decision to continue treatment?: A scenario-based study of hospital nurses in Italy

    Directory of Open Access Journals (Sweden)

    Francesca Ingravallo

    2015-12-01

    Full Text Available INTRODUCTION: A lack of social consensus on the duty to comply with a patient's request to forgo treatment was reported in Italy, but little is known about the nurses' attitudes regarding this issue. MATERIALS AND METHODS: Questionnaire including two clinical scenarios regarding doctor's decision to not comply with a competent patient's request to forgo treatment was administered to all nurses (n = 487 of an Italian medium-sized hospital. RESULTS: Eighty-five percent of nurses completed the study. Although 83% of participants supported a general right to self-determination, around 40% of them agreed with the doctor's decision in both scenarios. The multivariate analyses adjusted for gender, age, length of professional experience, and care setting showed that the agreement with the doctor's decision was significantly associated with nurses' personal background beliefs about self-determination and quality of life. DISCUSSION AND CONCLUSIONS: Many nurses have difficulty in accepting a patient's request to forgo treatment. Increasing ethical reflection and discussion at both educational and professional level, and introducing ethical consultation services would be essential to develop a consistent approach to end-of-life decisions in Italian hospitals.

  8. Psychiatric referrals in two general hospitals.

    Directory of Open Access Journals (Sweden)

    Doongaji D

    1989-07-01

    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  9. Job Satisfaction among Doctors of a Government Medical College and Hospital of Eastern India.

    Science.gov (United States)

    Bhattacherjee, Sharmistha; Ray, Kuntala; Kumar Roy, Jayanta; Mukherjee, Abhijit; Roy, Hironmoy; Datta, Saikat

    2016-10-01

    Job satisfaction expresses the extent of congruence between an individual’s expectation of the job and the reward that the job provides.Job satisfaction among doctors is an issue that is of utmost importance because offactors like patient relationships and time pressures associated with managed care. The current study was done to determine the level of job satisfaction in doctors posted in a tertiary care hospital of eastern India and to find out the factors associated with it. A descriptive cross sectional study was conducted among 255 doctors posted in a tertiary care hospital of eastern India. Data werecollected using a self-reported questionnaire consisting of 49 items addressing the seven domains of job satisfaction, where higher values indicated higher level of satisfaction. The average scores of items were computed to construct factor scores for each individual. Two stage cluster analysis was performed to get the proportion of satisfied doctors and binary logistic regression was used for comparison of predictors of job satisfaction. The proportion of job satisfaction was found to be 59.6% and the most important factor was found to be working space. On adjustment, the odds of being satisfied were found to be higher in the older age groups, among males, doctors posted in preclinical or paraclinical departments and those staying in present setting for 5 years or more. More than half of the doctors were found to be satisfied with their job which can help the policy makers to make necessary strategies to increase the level of satisfaction of the employees. .

  10. Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

    Science.gov (United States)

    Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F

    2012-01-01

    To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.

  11. Junior doctor psychiatry placements in hospital and community settings: a phenomenological study.

    Science.gov (United States)

    Beattie, Sharon; Crampton, Paul E S; Schwarzlose, Cathleen; Kumar, Namita; Cornwall, Peter L

    2017-09-27

    The proportion of junior doctors required to complete psychiatry placements in the UK has increased, due in part to vacant training posts and psychiatry career workforce shortages, as can be seen across the world. The aim of this study was to understand the lived experience of a Foundation Year 1 junior doctor psychiatry placement and to understand how job components influence attitudes. The study was conducted using a cross-sectional qualitative phenomenological approach. Hospital and community psychiatry department settings in the North East of England, UK. In total, 14 Foundation Year 1 junior doctors were interviewed including seven men and seven women aged between 23 and 34 years. The majority had completed their medical degree in the UK and were White British. The lived experience of a junior doctor psychiatry placement was understood by three core themes: exposure to patient recovery, connectedness with others in the healthcare team and subjective interpretations of psychiatry. The experiences were moderated by instances of role definition, reaction to the specialty and the organisational fit of the junior doctor capacity in the specialty. The study reinforces and adds to the literature by identifying connectedness as being important for both job satisfaction and morale, which is currently damaged within the junior doctor population. The study provides in-depth insights into the lived experience of psychiatry placements and can be taken forward by educationalists to ensure the placements are meaningful experiences for junior doctors by developing role definition, belonging, structure and psychiatric care responsibility. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. An assessment of the quality of sleep among health professionals of the general hospital of Karpenissi

    OpenAIRE

    Ifanti Ε.; Zagkotsi Μ.; Gketsios Ι.; Armagos P.; Ifantis Α.; Charalampopoulou Ν.

    2011-01-01

    Introduction: Employees in cyclic or night shifts often complain of sleep disturbances. The latter are extremely frequent among health care workers. Aim: To evaluate sleep quality in health care workers of a Greek provincial general hospital Material and Methods: Seventy seven health professionals of General Hospital of Karpenisi took part in the study( doctors, nurses and paramedicals). 49 were women and 28 were men. Athens Insomnia Scale was used to evaluate sleep quality. The scale include...

  13. In a moment of mismatch: overseas doctors' adjustments in new hospital environments.

    Science.gov (United States)

    Harris, Anna

    2011-02-01

    This paper contributes to studies of healthcare worker migration and, more broadly, to the study of occupational adjustment, with an analysis of finely detailed sensorial data. It focuses upon doctors, who are increasingly on the move around the world, working in hospital environments different from those in which they have trained. A number of unexamined questions remain in relation to how medical practitioners shift their work across contexts, in particular the tactile nature of adjustment, which has been under-explored in health sociology. This paper examines a procedural skill; a skill in which tools have become almost natural extensions of the doctor's hands. It focuses upon what happens when doctors travel overseas and find unfamiliar equipment, and their habitual practice is interrupted. The paper argues that by studying overseas doctors' bodily adjustment during such moments of mismatch, we learn more about the environment of the doctors' past and present. It suggests that by looking at the rupture between habit and the unfamiliar, we also understand something about the ways in which we adjust to the unexpected. © 2011 The Author. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  14. Intergroup communication between hospital doctors: implications for quality of patient care.

    Science.gov (United States)

    Hewett, David G; Watson, Bernadette M; Gallois, Cindy; Ward, Michael; Leggett, Barbara A

    2009-12-01

    Hospitals involve a complex socio-technical health system, where communication failures influence the quality of patient care. Research indicates the importance of social identity and intergroup relationships articulated through power, control, status and competition. This study focused on interspecialty communication among doctors for patients requiring the involvement of multiple specialist departments. The paper reports on an interview study in Australia, framed by social identity and communication accommodation theories of doctors' experiences of managing such patients, to explore the impact of communication. Interviews were undertaken with 45 doctors working in a large metropolitan hospital, and were analysed using Leximancer (text mining software) and interpretation of major themes. Findings indicated that intergroup conflict is a central influence on communication. Contested responsibilities emerged from a model of care driven by single-specialty ownership of the patient, with doctors allowed to evade responsibility for patients over whom they had no sense of ownership. Counter-accommodative communication, particularly involving interpersonal control, appeared as important for reinforcing social identity and winning conflicts. Strategies to resolve intergroup conflict must address structural issues generating an intergroup climate and evoke interpersonal salience to moderate their effect.

  15. The efficiency of training for doctors of general practice — family medicine concerning to features work of teenagers at risk

    Directory of Open Access Journals (Sweden)

    Bobkova O.V.

    2016-05-01

    Full Text Available Medical personnel provide assistance to teenagers and young people because of understanding their problems and a common search for ways to resolve them to change risky behavior and health. A major problem for doctors of general practice — family medicine is the condition of adolescent morbidity diseases that are transmitted mainly through sexual contact, HIV infection, which requires the formation of the teenagers responsible attitude to their own health. Doctor of general practice — family medicine should actively influence on health status, including reproductive health specified target group of patients. The aim of the study was analysis of the effectiveness of educational training on( monitoring and evaluation M & E within the scientific support project «HIV prevention among young women of sex business, people who inject drugs and young people who live or work on the street» and development of an effective system of improving professional qualification of doctors of general practice — family medicine relative characteristics of health care among risk adolescents. During 2015 there were trainings for doctors, psychologists, social workers and nurses. Investigation of the effectiveness of the activities performed on a specially designed questionnaire monitoring and evaluation (M & E. 53 respondents were interviewed — doctors of general practice — family medicine of the Zaporozhye region and the city. Zaporozhye. Questioning was conducted before and after training exercises investigated by experts of department of medical care teenagers and youth KU «Zaporozhye Regional Children Clinical Hospital.» The rating was given on a 5-point scale. The study made the following findings: therapeutic and preventive work with teenagers and young people, is one of the major problems of medical and social work in Ukraine and practice of general practitioner — family medicine; training on the basis of a single M & E system is an effective means

  16. Evaluation of a radioisotope service in a general hospital

    International Nuclear Information System (INIS)

    Mateil, P.-Y.

    1978-12-01

    The value of radioisotopes in medicine has become increasingly apparent over the last few years. Nuclear medicine however recent, has nevertheless reached adult hood and doctors appreciate its substantial contribution in the field of diagnosis especially. So far nuclear medicine has been confined to University Hospital Centres, mainly for legal reasons. However the considerable help offered by this discipline is now taken for granted in the medical world and the wholly experimental stage is long past. While this aspect of nuclar medicine still exists, and is still dealt with by the services of University Hospital Centres, radioisotopes are now used to a large extend and on a day-to-day basis in pathology. Owing to pressure of work it is difficult for UH Centres to meet all request for examinations, so would the presence of nuclear medicine Service be justified in general Hospitals. The existence of one such service at the Bayonne HC might help to answer this question. For this reason the activity of the Bayonne HC Nuclear Medicine Service during its first year of practice is examined here. For a better understanding of the position this report first presents the Bayonne Hospital and the place occupied by a nuclear Medicine service in such an establishment. The activity of this service during its first year is then studied and the situation weighed up generally [fr

  17. The hospital doctor in legislation and medical deontology: tension between profession and institution.

    Science.gov (United States)

    Schutyser, K

    1998-01-01

    1. Every health policy should make clear the organization of its offer of care; also, more particularly, the role of the individual professionals and their groups, as well as the role of the services and institutions, all within the chosen private, public or mixed framework. 2. Both in public law and in private law as well as in deontology, clear rules will have to be formulated concerning the relationship of doctor-patient and institution-patient; therefore also concerning the relationship of hospital-doctor. 3. It is evident that the lack of clarity frequently encountered in the Belgian and many other national legal systems with respect to these matters is unfortunately also reflected in international health law. 4. The issue of the legal relationships in the patient-doctor-hospital triangle should no longer be delayed until the catastrophic moment when medical liability should be considered. 5. Can we indeed speak of integral quality of a hospital, when it is anything but clear whether it concerns a single integrated enterprise or a roof under which two or more enterprises or entrepreneurs organize their own separate services to the clients? 6. Although the decision is a societal matter, the organisations of institutions and professionals should (continue to) play an important role in the preparation of this debate, which must bring the necessary clarity to the present relations and preferably also about the future options with respect to these relations. 7. A fundamental question, which remains to be solved for the future health policy, appears to be whether hospitals can be integrated institutions and, in the affirmative, whether they should be so. 8. The law, with priority to deontology, should formulate basic rules to clarify all possibilities in the patient-hospital-doctor triangle relationship--which is evolving into a polygon through fusion and group practices--and especially to trace out the consequences of health policy options with regard to the

  18. Geographical distribution and profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa.

    Science.gov (United States)

    Ntuli, Samuel T; Maboya, Edwin

    2017-09-27

    The shortage and unequal distribution of medical doctors in low- and middle-income countries continues to be a public health concern. To establish the geographical distribution and demographic profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa. The PERSAL system was used to obtain information on the number of medical doctors employed in public sector hospitals of the Limpopo Province. Data were exported from PERSAL's database and then analysed using STATA version 9.0. The mean age of the 887 medical doctors was 40.1 ± 11.2 years (range 24-79 years). Sixty per cent of the doctors were male, 66% were aged ≤ 45 years and 84% were African. Most of the doctors (86%) were medical officers, of which 55% had < 5 years working experience. Overall, the doctor-to-population ratio for the five districts in the province was 16.4/100 000, with Capricorn (33.7/100 000) and Waterberg (20.2/100 000) recording the highest ratios. A large proportion (43%) of medical officers are employed in the Capricorn District, of which 71% were practising at the tertiary hospital. This study demonstrated a shortage and maldistribution of medical doctors in the public sector hospitals of the Limpopo Province. This has a potentially negative effect on the delivery of an appropriate and efficient healthcare service to the population and requires urgent attention.

  19. A Study of Power Relations in Doctor-Patient Interactions in Selected Hospitals in Lagos State, Nigeria

    Science.gov (United States)

    Adam, Qasim

    2014-01-01

    This paper explores power relations in clinical interactions in Nigeria. It seeks to investigate the use of power between doctors and patients during consultations on patient-centred approach to medicine in selected public and private hospitals in Lagos State, Nigeria. The objective is to establish how doctors' projection of power, using the…

  20. Hospital doctors behave differently, and only by respecting the fundamentals of professional organizations will managers be able to create common goals with professionals.

    Science.gov (United States)

    Van Dijck, H

    2014-08-01

    Hospital doctors behave differently from other hospital workers. The general and specific characteristics of the doctors' behavior are described. As professionals, doctors want to make autonomous decisions and more specifically, they negotiate differently. The best description of their negotiation style is one that features multi-actor, multi-issue characteristics. They behave as actors in a network in never-ending rounds of negotiations with variable issues up for discussion: one time you lose, the next you win. A doctor's career starts with a long residency period in which he or she absorbs professional habits. His or her knowledge and way of organizing are implicit. It is hard for him or her to explicitly describe what he or she is doing. This makes it difficult for managers to discuss quality issues with doctors. Dealing with disruptive behavior is not easy either. The difficult tasks of the chief medical officer, who acts as a go-between, are highlighted. Only when managers respect the fundamentals of the professional organization will they be able to create common goals with the professionals. Common goals bring about better care in hospitals.

  1. Doctor-pharmacist communication in hospitals: strategies, perceptions, limitations and opportunities.

    Science.gov (United States)

    Coomber, Peter; Clavarino, Alexandra; Ballard, Emma; Luetsch, Karen

    2018-04-01

    Background Effective communication between health professionals contributes to safe and efficient patient care, whereas communication breakdown can lead to adverse patient outcomes and increased healthcare expenditure. Information on how pharmacists and doctors communicate with each other in hospitals is limited. Objective To explore usage and perceptions of communication methods by doctors and pharmacists in hospital settings. Setting Four public hospitals in Australia. Method A mixed method study utilising a pilot questionnaire, semi-structured interviews, and electronic survey was designed. Frequentist statistics and logistic regression were used to analyse survey data. Thematic analysis was conducted to evaluate semi-structured interview data and free-text survey comments. Frequency of use of communication methods, perceptions of the convenience, time taken to use, accuracy and effectiveness of each method. Results More than 95% of doctors and pharmacists combined used face-to-face and phone calls to communicate with each other, 70% used a medication management plan, and 62% used progress notes. A preference for oral communication was confirmed with the expressed need for building professional rapport and receiving responses. Perceptions regarding effectiveness of oral communication methods were related to perceptions of their convenience and accuracy. Professional groups described differences in perceived ownership of various modes of communication. Conclusions Preferences for oral communication create potential issues with recall and comprehension. Integrating oral communication features into written communication methods, e.g. creating responses, conversations, building rapport, may change doctors' and pharmacists' perceptions of effectiveness. Communication receipt and response functionality in electronic medication and record management systems may improve communication.

  2. Awareness and attitude of doctors and nurses at a teaching hospital to skin donation and banking.

    Science.gov (United States)

    Michael, A I; Ademola, S A; Olawoye, O A; Iyun, A O; Oluwatosin, O M

    2014-12-01

    This study sought to determine the awareness and attitude of doctors and nurses in a teaching hospital to skin donation and banking, and to identify needs for personnel educational programmes. A cross sectional survey on doctors and nurses was carried out using a 44-item questionnaire that included a Likert scale on attitudes. Predictors of favourable attitudes were determined. Eighty (49.7%) doctors and 81 (50.3%) nurses participated in the study. Many participants, 126 (78.3%), knew that skin could be donated, but only 96 (59.6%) participants were aware of skin banking. The main source of information was during professional training (17.4%). Only 41 (25.5%) participants were willing to donate skin after death. Body disfigurement was the major reason (20.5%) against skin donation. Participants who were doctors, were aware of skin banking, and who were previous blood donors had higher attitudes scores (pbanking were predictors of favourable attitudes to skin donation and banking. Knowledge transfer during health professional training on the usefulness of banked skin in patients with major burns may lead to improved attitude of health professionals and acceptance of this modality of burn management. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  3. Can hospital-based doctors change their working hours? Evidence from Australia.

    Science.gov (United States)

    Norman, R; Hall, J

    2014-07-01

    To explore factors predicting hospital-based doctors' desire to work less, and then their success in making that change. Consecutive waves of an Australian longitudinal survey of doctors (Medicine in Australia-Balancing Employment and Life). There were 6285 and 6337 hospital-based completers in the two waves, consisting of specialists, hospital-based non-specialists and specialist registrars. Forty-eight per cent stated a preference to reduce hours. Predictive characteristics were being female and working more than 40 h/week (both P less likely to state the preference. Factors associated with not wanting to reduce working hours were being in excellent health and being satisfied with work (both P working hours, only 32% successfully managed to do so in the subsequent year (defined by a reduction of at least 5 h/week). Predictors of successfully reducing hours were being older, female and working more than 40 h/week (all P hours and then their subsequent success in doing so. Designing policies that seek to reduce attrition may alleviate some of the ongoing pressures in the Australian hospital system. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  4. Creativity in Medical Learning: A direction-finding study of junior hospital doctors

    Directory of Open Access Journals (Sweden)

    Martin Talbot

    2006-04-01

    Full Text Available In a questionnaire study of creativity, the author has assessed the teaching and clinical practice of medical teachers, as observed by their students. The study has taken some preliminary steps to assess the place of creativity in postgraduate medical learning in the United Kingdom. Junior doctors were asked to compare their ‘best’ teacher with their ‘worst’ utilising a semantic differential scale and questions derived from Torrance’s definitions of creativity. The response rate was 81 (56.25% of 144 junior hospital doctors, in whose view, ‘best’ teachers showed greater creative behaviour as evidenced by significantly higher creativity scores on the majority of parameters (p<0.0001.

  5. [Crisis unit at the general hospital: Determinants of further hospitalization].

    Science.gov (United States)

    Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M

    2017-10-01

    The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of

  6. Hospital Web site 'tops' in Louisiana. Hospital PR, marketing group cites East Jefferson General Hospital.

    Science.gov (United States)

    Rees, Tom

    2002-01-01

    East Jefferson General Hospital in Metairie, La., launched a new Web site in October 2001. Its user-friendly home page offers links to hospital services, medical staff, and employer information. Its jobline is a powerful tool for recruitment. The site was awarded the 2002 Pelican Award for Best Consumer Web site by the Louisiana Society for Hospital Public Relations & Marketing.

  7. Doctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: A qualitative study.

    LENUS (Irish Health Repository)

    Cullinan, S

    2014-11-18

    Older patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events and hospitalisations. However, little has been done to identify why PIP occurs. The objectives of this study were; (1) to identify hospital doctors\\' perceptions as to why PIP occurs, (2) to identify the barriers to addressing the issues identified, and (3) to determine which intervention types would be best suited to improving prescribing.

  8. What influences the job satisfaction of staff and associate specialist hospital doctors?

    Science.gov (United States)

    French, Fiona; Ikenwilo, Divine; Scott, Anthony

    2007-08-01

    Despite their rising numbers in the National Health Service (NHS), the recruitment, retention, morale and educational needs of staff and associate specialist hospital doctors have traditionally not been the focus of attention. A postal survey of all staff grades and associate specialists in NHS Scotland was conducted to investigate the determinants of their job satisfaction. Doctors in both grades were least satisfied with their pay. They were more satisfied if they were treated as equal members of the clinical team, but less satisfied if their workload adversely affected the quality of patient care. With the exception of female associate specialists, respondents who wished to become a consultant were less satisfied with all aspects of their jobs. Associate specialists who worked more sessions also had lower job satisfaction. Non-white staff grades were less satisfied with their job compared with their white counterparts. It is important that associate specialists and staff grades are promoted to consultant posts, where this is desired. It is also important that job satisfaction is enhanced for doctors who do not desire promotion, thereby improving retention. This could be achieved through improved pay, additional clinical training, more flexible working hours and improved status.

  9. Carotid Surgery in a District General Hospital

    Science.gov (United States)

    Fairgrieve, John

    1981-01-01

    The carotid surgical experience of Cheltenham General Hospital over a 13 year period (1968-81) is presented. This includes 42 operations for stenosis, and 12 further operations for carotid body tumour, carotid aneurysm, subclavian steal syndrome and trauma to the internal carotid artery. The operative techniques and complications are briefly discussed and reasons advanced for a more agressive approach to the problems of extra-cerebral carotid disease in this country. PMID:7185417

  10. GPs' job satisfaction: doctors who chose general practice early or late.

    Science.gov (United States)

    Lambert, Trevor; Smith, Fay; Goldacre, Michael

    2013-11-01

    In the UK many practising GPs did not choose general practice as their first choice of career when they originally graduated as doctors. To compare job satisfaction of GPs who chose general practice early or later in their career. Questionnaires were sent to all UK-trained doctors who graduated in selected years between 1993 and 2000. Questionnaires were sent to the doctors 1, 3, 7 and 10 years after graduation. Of all 3082 responders working in general practice in years 7 and 10, 38% had first specified general practice as their preferred career when responding 1 year after graduation, 19% by year 3, 21% by year 5, and 22% after year 5. Job satisfaction was high and, generally, there was little difference between the first three groups (although, when different, the most positive responses were from the earliest choosers); but there were slightly lower levels of job satisfaction in the 'more than 5 years' group. For example, in response to the statement 'I find enjoyment in my current post', the percentages agreeing in the four groups, respectively, were 91.5%, 91.1%, 91.0% and 88.2%. In response to 'I am doing interesting and challenging work' the respective percentages were 90.2%, 88.0%, 86.6% and 82.6%. Job satisfaction levels were generally high among the late choosers as well as the early choosers. On this evidence, most doctors who turn to general practice, after preferring another specialty in their early career, are likely to have a satisfying career.

  11. Perception, attitude and usage of complementary and alternative medicine among doctors and patients in a tertiary care hospital in India.

    Science.gov (United States)

    Roy, Vandana; Gupta, Monica; Ghosh, Raktim Kumar

    2015-01-01

    Complementary and alternative medicine (CAM) has been practiced in India for thousands of years. The aim of this study was to determine the extent of use, perception and attitude of doctors and patients utilizing the same healthcare facility. This study was conducted among 200 doctors working at a tertiary care teaching Hospital, India and 403 patients attending the same, to determine the extent of usage, attitude and perception toward CAM. The use of CAM was more among doctors (58%) when compared with the patients (28%). Among doctors, those who had utilized CAM themselves, recommended CAM as a therapy to their patients (52%) and enquired about its use from patients (37%) to a greater extent. CAM was used concomitantly with allopathic medicine by 60% patients. Very few patients (7%) were asked by their doctors about CAM use, and only 19% patients voluntarily informed their doctors about the CAM they were using. Most patients who used CAM felt it to be more effective, safer, less costly and easily available in comparison to allopathic medicines. CAM is used commonly by both doctors and patients. There is a lack of communication between doctors and patients regarding CAM, which may be improved by sensitization of doctors and inclusion of CAM in the medical curriculum.

  12. A study of needle stick injuries among non-consultant hospital doctors in Ireland.

    LENUS (Irish Health Repository)

    O'Connor, M B

    2012-02-01

    INTRODUCTION: NCHDs are exposed to a great number of blood-borne infections. Needle stick injuries are possibly the main route of acquiring such infections from a non-consultant hospital doctors (NCHDs) perspective. This study examines NCHDs experiences surrounding needle stick injuries. METHODS: A cross-sectional self-administered anonymous questionnaire survey was conducted on 185 NCHDs working in a clinical setting among seven teaching hospitals in Ireland. Implied consent was obtained. The data was analysed using Excel spreadsheets. Ethical approval was received. RESULTS: A response rate of 85.4% (158\\/185) was achieved. Findings of the study are shown in the manuscript table. CONCLUSIONS: A needle stick injury (NI) history is greater among surgical NCHDs than medical NCHDs. The level of disposable glove usage is worryingly poor. Training in sharps handling and dealing with a NI needs to be addressed. HIV is the blood-borne infection most fear of being contracting as a consequence of a NI.

  13. Why and when do Danish medical doctors choose to become a general practitioner?

    DEFF Research Database (Denmark)

    Lewandowska, Karolina; Kjær, Niels Kristian; Lillevang, Gunver

    of study is to examine why and when Danish junior doctors choose family medicine as their future specialty. Method: We carried out two focus group interviews with medical doctors from two regions. An academic employee from the Danish College of Family Medicine mediated the interviews assisted by a family......Background and Aim: Continued supply of qualified general practitioners is essential for the vitality of the primary health care sector. In Denmark however we have observed a decline in the number of applicants for our family medicine specialist training program, leaving some posts vacant. The aim......-graduate training the structure of the postgraduate educational program, working conditions, respect for general practice, uncertainty about the future for general practice as a profession, when did I decide to choose family medicine. Out of these themes we identified factors, which influenced the choice...

  14. The effect of performance-related pay of hospital doctors on hospital behaviour: a case study from Shandong, China

    Directory of Open Access Journals (Sweden)

    Mills Anne

    2005-10-01

    Full Text Available Abstract Background With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors – termed the "bonus" system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary. Methods The primary concerns of this study were to assess the effects of the bonus system on hospital revenue, cost recovery and productivity, and to explore whether various forms of bonus pay were associated with the provision of unnecessary care. The study drew on longitudinal data on revenue and productivity from six panel hospitals, and a detailed record review of 2303 tracer disease patients (1161 appendicitis patients and 1142 pneumonia patients was used to identify unnecessary care. Results The study found that bonus system change over time contributed significantly to the increase in hospital service revenue and hospital cost recovery. There was an increase in unnecessary care and in the probability of admission when the bonus system switched from one with a weaker incentive to increase services to one with a stronger incentive, suggesting that improvement in the financial health of public hospitals was achieved at least in part through the provision of more unnecessary care and drugs and through admitting more patients. Conclusion There was little evidence that the performance-related pay system as designed by the sample of Chinese public hospitals was socially desirable. Hospitals should be monitored more closely

  15. Quality of clinical supervision as perceived by attending doctors in university and district teaching hospitals.

    Science.gov (United States)

    Busari, Jamiu O; Koot, Bart G

    2007-10-01

    Attending doctors (ADs) play important roles in the supervision of specialist registrars. Little is known, however, about how they perceive the quality of their supervision in different teaching settings. We decided to investigate whether there is any difference in how ADs perceive the quality of their supervision in university teaching hospital (UTH) and district teaching hospital (DTH) settings. We used a standardised questionnaire to investigate the quality of supervision as perceived by ADs. Fifteen items reflecting good teaching ability were measured on a 5-point Likert scale (1-5: never-always). We investigated for factors that influenced the perceived quality of supervision using Likert scale items (1-5: totally disagree-totally agree) and open-ended questionnaires. A total of 83 ADs (UTH: 51; DTH: 32) were eligible to participate in the survey. Of these, 43 (52%) returned the questionnaire (UTH: 25; DTH: 18). There was no difference in the overall mean of the 15 items between the UTH (3.67, standard deviation [SD] 0.35) and DTH (3.73, SD 0.31) ADs. Attending doctors in the DTH group rated themselves better at 'teaching technical skills' (mean 3.50, SD 0.70), compared with their UTH counterparts (mean 3.0, SD 0.76) (P = 0.03). Analysis of variance of the overall means revealed no significant difference between the different hospital settings. The results suggest that teaching hospital environments do not influence how ADs perceive the quality of their supervision. Lack of time for teaching was perceived as responsible for poor supervision. Other factors found to influence AD perceptions of good supervision included effective teaching skills, communication skills and provision of feedback.

  16. A geriatric assessment in general practice: prevalence, location, impact and doctor-patient perceptions of pain.

    Science.gov (United States)

    Kruschinski, Carsten; Wiese, Birgitt; Dierks, Marie-Luise; Hummers-Pradier, Eva; Schneider, Nils; Junius-Walker, Ulrike

    2016-01-28

    To investigate what a geriatric assessment in general practice adds towards previous findings of prevalence, location, impact and the dyadic doctor-patient perception of pain in this age group. Cross-sectional study. Consecutive patients aged 70 and over underwent a comprehensive geriatric assessment in general practice that included a basic pain assessment (severity, sites and impact). Patients with pain and their doctors then independently rated its importance. Pain was correlated with further findings from the assessment, such as overall health, physical impairments, everyday function, falls, mood, health related lifestyle, social circumstances, using bivariate and multivariate statistics. Patient-doctor agreement on the importance of pain was calculated using kappa statistics. 219 out of 297 patients (73.7 %) reported pain at any location. Pain was generally located at multiple sites. It was most often present at the knee (33.9%), the lumbar spine (33.5%) as well as the hip (13.8%) and correlated with specific impairments such as restrictions of daily living (knee) or sleep problems (spine). Patients with pain and their physicians poorly agreed on the importance of the pain problem. A basic pain assessment can identify older patients with pain in general practice. It has resulted in a high prevalence exceeding that determined by encounters in consultations. It has been shown that a geriatric assessment provides an opportunity to address pain in a way that is adapted to older patients' needs - addressing all sites, its specific impact on life, and the patients' perceived importance of pain. Since there is little doctor-patient agreement, this seems a valuable strategy to optimize concrete treatment decisions and patient centered care. This study is registered in the German Clinical Trial Register ( DRKS00000792 ).

  17. Publications by doctoral candidates at Charité University Hospital, Berlin, from 1998-2008.

    Science.gov (United States)

    Ziemann, Esther; Oestmann, Jörg-Wilhelm

    2012-05-01

    One quality parameter of medical theses is the number of articles published by the doctoral candidates. Over the course of the past decade the Charité-Universitätsmedizin Berlin has taken steps to improve the quality of the theses completed by its doctoral students in medicine and increase their publication activity. This study was designed to verify the efficacy of these measures and to detect general trends. Medical theses completed in 1998, 2004 and 2008 (sample size >250 for each year) were retrospectively analyzed with regard to associated publications within a 7-year period (from 5 years before completion to 2 years thereafter). Quality and quantity were recorded. Publications found in the PubMed database were evaluated; the impact factor of the publishing journal was used as quality parameter. The sample sizes were 264 for 1998, 316 for 2004, and 316 for 2008. The number of publications per doctoral student increased from 0.78 to 1.39 over the course of the study period, and the average impact factor rose from 2.42 to 3.62. Analysis using the current impact factors of the publishing journals showed an increase from 3.13 to 3.85. The proportion of case reports fell from 12.7% to 8%. The proportion of first authorships remained about the same. The past decade has seen an increase in the number of publications by doctoral students at the Charité and a rise in the average impact factor of the journals concerned.

  18. Percutaneous injuries among healthcare workers at a general hospital

    Directory of Open Access Journals (Sweden)

    Ibak Gönen, Mehmet Faruk Geyik

    2011-06-01

    Full Text Available Objectives: Percutaneous injuries (PCIs remain a common incident among healthcare workers (HCWs despite the introductionof safety programs. The aim of this study was to assess the PCIs, required precautions, and applications after the injuries among healthcare workers in a small general hospital.Materials and methods: We assessed the occurrence of PCIs at a General Hospital (EGH from January 2007 to November2010. During this period, all injury cases among HCWs were reported to the Infection Control Committee (ICC using percutaneous injury notification form. The injury notification forms were evaluated retrospectively.Results: Totally 275 health personnel were working in our hospital, 36 healthy workers have been exposed to PCIs during this period. The incidence of PCIs was 2,9/10000 in 2007, 3,1/10000 in 2008, 3,8/10000 in 2009 and 3,9/10000 patient-days in 2010. Injured staff were recorded as, 16 nurses (44%, 12 cleaning staffs (34%, and eight (22% doctors. The device leading to damage was most frequently the needle-channel. Ten sources (27% were detected positive for hepatitis B virus (HBV, four (11% for hepatitis C virus (HCV, and two (5% for Crimean-Congo hemorrhagic fever virus (CCHFV. No case of seroconversion has been recognized for any of the above mentioned infections.Conclusions: Percutaneous injuries remain to occur among HCWs. Since some the sources were infected, the health personnel are endangered for infections due to PCIs. The health personnel should presume that all patients are infected,and thus should work following universal precautions to avoid complications about the PCIs. J Microbiol Infect Dis 2011;1(1:26-30.

  19. Creating opportunities for interdisciplinary collaboration and patient-centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting.

    Science.gov (United States)

    Liu, Wei; Gerdtz, Marie; Manias, Elizabeth

    2016-10-01

    This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. Patient-centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a direct influence on patient outcomes. There is a lack of research that adopts a multidisciplinary approach and involves critical in-depth analysis of medication interactions among nurses, doctors, pharmacists and patients. A critical ethnographic approach with video reflexivity was adopted to capture communication strategies during medication activities in two general medical wards of an acute care hospital in Melbourne, Australia. A mixed ethnographic approach combining participant observations, field interviews, video recordings and video reflexive focus groups and interviews was employed. Seventy-six nurses, 31 doctors, 1 pharmacist and 27 patients gave written consent to participate in the study. Data analysis was informed by Fairclough's critical discourse analytic framework. Clinicians' use of communication strategies was demonstrated in their interpersonal, authoritative and instructive talk with patients. Doctors adopted the language discourse of normalisation to standardise patients' illness experiences. Nurses and pharmacists employed the language discourses of preparedness and scrutiny to ensure that patient safety was maintained. Patients took up the discourse of politeness to raise medication concerns and question treatment decisions made by doctors, in their attempts to challenge decision-making about their health care treatment. In addition, the video method revealed clinicians' extensive use of body language in communication processes for medication management. The use of communication strategies by nurses, doctors, pharmacists and patients created opportunities for improved interdisciplinary collaboration and patient-centred medication

  20. [How to make regional medicine revive from the medical crisis or collapse due to the severe paucity of medical doctors: a plan with "the magnet hospital"].

    Science.gov (United States)

    Itoh, Tsunetoshi

    2009-01-01

    In 2002-2003, the practice of doctors lending their names to appear as "staff" of hospitals became known. Problems regarding funds from public hospitals were also revealed. Tohoku University asked regional societies how to improve the medical situation, and redefined its responsibilities. The Educational Development Center for Local Medicine and Department of Local Medical Service System were set up (2005-2008). A severe shortage of medical doctors prevails in Japan: the number of doctors per population is at the 4th lowest among OECD countries, and the number per hospital bed is the lowest. We have no nursing homes whose beds are not counted as hospital beds. The number of faculty staff in Japanese medical schools is 1/3 to those of Western countries. The reported number of doctors working in hospitals and offices surpasses that by census for medical doctors by >40,000. Japanese doctors work for >60 hours per week. I propose essential plans to improve Japanese situation for medical service: 1. Immediately increase the number of doctors by at least 50%. Based on our calculation, we need 450,000 doctors. 2. When the shortage of doctors is severe, establish a magnet hospital with c.a. 500 beds for every 200,000 population, capable of treating highly emergency patients and attracting doctors who need medical training. Hospitals should not belong to each city or town. 3. Establish a comprehensive organization to nurture doctors on a long-term basis. It should consist of a medical school, hospitals, and the prefectural government. It should help doctors to move between hospitals, and be responsible both for designing doctors' career paths and for allocating them appropriately.

  1. Hernia Surgery in Nyeri Provincial General Hospital, Kenya: Our 6 ...

    African Journals Online (AJOL)

    The average length of hospital stay was 3 days. Of the inguinal ... on hernia disease with reference to prevalence, pattern and management at a provincial general hospital in Kenya. Methods. After obtaining permission from the hospital administration, we .... financial constraint on hospitals, length of hospital stay and enable ...

  2. Book Review: Review Manual for Massachusetts General Hospital ...

    African Journals Online (AJOL)

    Abstract. Book Title: Review Manual for Massachusetts General Hospital Handbook of. General Hospital Psychiatry. 5th ed. Book Author: Theodore A. Stern. Pp 121. Philadelphia: Elsevier Mosby. 2004. ISBN 0-323-02768-7.

  3. [Prevalence of smoking among doctors and paramedical staff in Hospital University Center Mohammed VI, Marrakech].

    Science.gov (United States)

    Badri, Farid; Sajiai, Hafsa; Amro, Lamyae

    2017-01-01

    Smoking is a major public health problem. Doctors and paramedical staff are not excluded from this plague. Smoking ban in hospitals originated from government effort to reduce passive smoking. The objectives were to evaluate smoking habits among doctors and paramedical staff in order to implement tobacco control strategy in this study population and to refer them to the smoking-cessation counselling. We conducted a descriptive cross-sectional study of the entire staff of the Hospital University Center Mohammed VI, Marrakech based on the distribution of anonymous questionnaires. A total of 530 questionnaires were distributed, and 380 were returned, a response rate of 71.7%. The study population consisted of 58.2% women (n=221) and 41.8% men (n=159). Doctors (n=220) were the most represented occupational category (57.9%) followed by nurses (31.8%). Smokers (n=62) accounted for 16.3% of our study population; the ex-smokers (n=31) accounted for 8.1% and the non-smokers (n=287) 75.5%. The average age of smokers was 31.1 years, ranging from 22 to 56 years. The prevalence of smoking was 16.3% (n=62) of study population, of whom 32.7% (n=52) among men compared to 4.5% (n=10) among women. The average age of smoking onset was 19 years with a range from 11 to 29 years and with a mean consumption of 9 cigarettes/day. 13% (n=50) of people even smoked narguilé, 9% (n=34) consumed alcohol, and 3% (n=21) cannabis. 67.7% of smokers (n=42) were planning to quit, of whom 30.9% (n=13) in the next 3 months, 52.4% (n=22) in the next 6 months and 16, 7% (n=16) were planning to quit in the year. Several activities encouraged smoking, including night shift, coffee breaks and meals in 90.3% (n=56), 64.3% (n=40) and 61.3% (n=38) of cases respectively. This survey highlights the need to carry out awareness-raising actions to strengthen people motivation to quit smoking and help them during their withdrawal.

  4. Hospital doctors' self-rated skills in and use of evidence-based medicine - a questionnaire survey

    DEFF Research Database (Denmark)

    Oliveri, Roberto S; Gluud, Christian; Wille-Jørgensen, Peer A

    2004-01-01

    Problems in understanding basic aspects of evidence-based medicine (EBM) may form barriers to its implementation into clinical practice. We examined hospital doctors' skills in EBM terms and related these skills to their use of information sources, critical appraisal, and implementation of EBM...

  5. Are the General Medical Council's Tests of Competence fair to long standing doctors? A retrospective cohort study.

    Science.gov (United States)

    Mehdizadeh, Leila; Sturrock, Alison; Dacre, Jane

    2015-04-21

    The General Medical Council's Fitness to Practise investigations may involve a test of competence for doctors with performance concerns. Concern has been raised about the suitability of the test format for doctors who qualified before the introduction of Single Best Answer and Objective Structured Clinical Examination assessments, both of which form the test of competence. This study explored whether the examination formats used in the tests of competence are fair to long standing doctors who have undergone fitness to practise investigation. A retrospective cohort design was used to determine an association between year of primary medical qualification and doctors' test of competence performance. Performance of 95 general practitioners under investigation was compared with a group of 376 volunteer doctors. We analysed performance on knowledge test, OSCE overall, and three individual OSCE stations using Spearman's correlation and regression models. Doctors under investigation performed worse on all test outcomes compared to the comparison group. Qualification year correlated positively with performance on all outcomes except for physical examination (e.g. knowledge test r = 0.48, p fitness to practise investigation performed less well on the test of competence than their more recently qualified peers under investigation. The performance of the comparator group tended to stay consistent irrespective of year qualified. Our results suggest that the test format does not disadvantage early qualified doctors. We discuss findings in relation to the GMC's fitness to practise procedures and suggest alternative explanations for the poorer performance of long standing doctors under investigation.

  6. Barriers to effective, safe communication and workflow between nurses and non-consultant hospital doctors during out-of-hours.

    Science.gov (United States)

    Brady, Anne-Marie; Byrne, Gobnait; Quirke, Mary Brigid; Lynch, Aine; Ennis, Shauna; Bhangu, Jaspreet; Prendergast, Meabh

    2017-11-01

    This study aimed to evaluate the nature and type of communication and workflow arrangements between nurses and doctors out-of-hours (OOH). Effective communication and workflow arrangements between nurses and doctors are essential to minimize risk in hospital settings, particularly in the out-of-hour's period. Timely patient flow is a priority for all healthcare organizations and the quality of communication and workflow arrangements influences patient safety. Qualitative descriptive design and data collection methods included focus groups and individual interviews. A 500 bed tertiary referral acute hospital in Ireland. Junior and senior Non-Consultant Hospital Doctors, staff nurses and nurse managers. Both nurses and doctors acknowledged the importance of good interdisciplinary communication and collaborative working, in sustaining effective workflow and enabling a supportive working environment and patient safety. Indeed, issues of safety and missed care OOH were found to be primarily due to difficulties of communication and workflow. Medical workflow OOH is often dependent on cues and communication to/from nursing. However, communication systems and, in particular the bleep system, considered central to the process of communication between doctors and nurses OOH, can contribute to workflow challenges and increased staff stress. It was reported as commonplace for routine work, that should be completed during normal hours, to fall into OOH when resources were most limited, further compounding risk to patient safety. Enhancement of communication strategies between nurses and doctors has the potential to remove barriers to effective decision-making and patient flow. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  7. Assessing the functional performance of post-call hospital doctors using a Nintendo Wii.

    LENUS (Irish Health Repository)

    Clancy, K

    2012-02-01

    Sleep deprivation is an established part of the working life for Non-Consultant Hospital Doctors (NCHDs) in Ireland. Concern exists about the effect of extended NCHD work hours. We utilised a Nintendo Wii to evaluate motor function of NCHDs both prior to their on-call shift and the day afterwards. Data was exported to SPSS ver. 15 for statistical analysis with p < 0.05 considered significant. A total of 72 NCHDs were invited to participate in this study. There was a 62.5% (45) rate of follow-up. Overall 27 (60%) NCHDs were on medical call, with 18 (40%) on surgical call. There was no statistically significant difference between NCHDs pre-and post-call motor assessment scores. The majority of study participants (75.5%, n = 34) had four or more hours sleep. On-call duty allows for a greater than anticipated amount of sleep per on-call shift and therefore has a negligible effect on the motor skills of medical staff.

  8. [Job satisfaction among Norwegian doctors].

    Science.gov (United States)

    Nylenna, Magne; Aasland, Olaf Gjerløw

    2010-05-20

    Doctors' job satisfaction has been discussed internationally in recent years based on reports of increasing professional dissatisfaction. We have studied Norwegian doctors' job satisfaction and their general satisfaction with life. A survey was conducted among a representative sample of practicing Norwegian doctors in 2008. The validated 10-item Job Satisfaction Scale was used to assess job satisfaction. 1,072 (65 %) doctors responded. They reported a mean job satisfaction of 5.3 on a scale from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction increased with increasing age. Private practice specialists reported the highest level of job satisfaction (5.8), and general practitioners reported higher job satisfaction (5.5) than hospital doctors (5.1). Among specialty groups, community doctors scored highest (5.6) and doctors in surgical disciplines lowest (5.0). While long working hours was negatively correlated with job satisfaction, the perception of being professionally updated and having part-time affiliation(s) in addition to a regular job were positively correlated with job satisfaction. 52.9 % of doctors reported a very high general satisfaction. Norwegian doctors have a high level of job satisfaction. Satisfaction with life in general is also high and at least in line with that in the Norwegian population.

  9. Women doctors and their careers in a large university hospital in Spain at the beginning of the 21st century.

    Science.gov (United States)

    Arrizabalaga, Pilar; Abellana, Rosa; Viñas, Odette; Merino, Anna; Ascaso, Carlos

    2015-03-29

    The feminization of medicine has risen dramatically over the past decades. The aim of this article was to compare the advance of women with that of men and determine the differences between hierarchical status and professional recognition achieved by women in medicine. A retrospective study was carried out in the Hospital Clinic Barcelona, Spain, of the period from 1996 to 2008. Data relating to temporary and permanent positions, hierarchy and career promotion achieved, specialty, age and the sex of the participants were analysed with the ANOVA test and logistic regression using the generalized estimated equation. After completion of specialist training, fewer women than men doctors obtained permanent positions. The ratios between the proportions of women and men remained 1.2 for permanent non-hierarchal medical positions and below 0.2 for higher hierarchal levels. Fewer women than men with hierarchy and fewer women than men achieved the rank of consultant. Promotion to consultant and senior consultant was lower than that to senior specialist, being higher in specialties with gender parity and in masculinised specialties. On comparing the two genders using a statistical model, the probability of continuous promotion decreased with the year of the application and the age of the applicant, except in women. Despite the number of women training as specialists having increased to 50%, women remained in temporary positions twofold longer than men. Compared to women, men showed significant representation in hierarchal medical positions, and women showed a lower adjusted probability of internal professional promotion throughout the study period.

  10. Quality of life of young clinical doctors in public hospitals in China's developed cities as measured by the Nottingham Health Profile (NHP).

    Science.gov (United States)

    Liang, Ying; Wang, Hanwei; Tao, Xiaojun

    2015-09-24

    In contemporary Chinese society, obstacles such as frequent violence against medical workers and tense doctor-patient relationships affect the health of Chinese doctors. This study attempted to explore the quality of life (QOL) of young clinical doctors in public hospitals in China's developed cities to study the psychometric properties of QOL and related risk factors of doctors' health. This study sampled young doctors aged 15-45 in 18 public hospitals of three cities in East China (Shanghai, Nanjing, and Hangzhou, N = 762). The Nottingham Health Profile was used to measure QOL, the dependent variable of this study. Methodologies such as reliability analysis, mean comparison, and exploratory factor analysis were used to study related psychometric properties. Almost 90 % of young Chinese clinical doctors have a bachelor's degree or above. Approximately 70.4 % of the doctors have relatively low job titles. Among the sample, 76.1 % have a monthly income ranging from USD 326 to USD 1139, and 91.3 % work over eight hours daily. These respondents have poor sleeping habits and mental functions, but have relatively good physical functions. Being female, low education, low job title, low salary, and long work hours are factors associated with doctors' poor QOL. Regression analysis results emphasize the great effect of high education on the improvement of QOL. Young clinical doctors in public hospitals in Chinese developed cities have poor QOL. Reforms on the current medical health system, improving the working environment of doctors and relieve their occupational stress should be required.

  11. EPIDURAL LABOUR ANALGESIA IN IZOLA GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sabina Verem

    2018-02-01

    Full Text Available Background. The study presents the experience with epidural analgesia (EPA for pain relief in Izola General Hospital from 2003 to 2006, the differences of labour between epidural analgesia and without it and the parturients’ satisfaction. Methods. A retrospective observational study was performed. Data were compared between 214 parturients with EPA matched by 214 parturients without. The control parturient was the equiipara with a term birth and the cephalic presentation of fetus that delivered just before the parturient of the EPA group. Maternal age, labor length, rate of oxitocin use, instrumental deliveries and cesarean sections, Apgar scores and birthweights were compared. The questionnaire was used to estimate the pain in 62 parturients. Results. In GH Izola in 214 parturients (10 % EPA was applied for labour pain relief in the period from July 2003 till December 2006. In the EPA group there was a statistically significance compared with the control group: higher parturients’ mean age (30.5 vs 28.7 y.o.; p < 0.0005, longer labour length (278 vs 222 min; p < 0.0005, higher oxitocin use rate (93.4 % vs 72.9 %; p < 0.0001 and higher instrumental delivery rate (vacuum extraction 14 % vs 1.9 %; p < 0.0001. The cesarean section rates were equal in both groups. Despite the higher instrumental delivery rate and the longer labour length in the EPA group there were no worse perinatal outcomes, neither was statisticaly significant difference in Apgar scores compared with the control group. The mean intensity of pain was highest before the EPA application (VAS 7, lowest during the transition stage (VAS 1.5 and some higher during the second phase (VAS 2.7. Most of parturients in the EPA group were satisfied; 92 % of them evaluated the EPA as good or very good. Conclusions. EPA is a very effective method for pain control during labor. The parturients’ satisfaction with this pain control method is appropriate. Despite the higher instrumental

  12. The involvement of medical doctors in hospital governance and implications for quality management: a quick scan in 19 and an in depth study in 7 OECD countries.

    Science.gov (United States)

    Rotar, A M; Botje, D; Klazinga, N S; Lombarts, K M; Groene, O; Sunol, R; Plochg, T

    2016-05-24

    Hospital governance is broadening its orientation from cost and production controls towards 'improving performance on clinical outcomes'. Given this new focus one might assume that doctors are drawn into hospital management across OECD countries. Hospital performance in terms of patient health, quality of care and efficiency outcomes is supposed to benefit from their involvement. However, international comparative evidence supporting this idea is limited. Just a few studies indicate that there may be a positive relationship between medical doctors being part of hospital boards, and overall hospital performance. More importantly, the assumed relationship between these so-called doctor managers and hospital performance has remained a 'black-box' thus far. However, there is an increasing literature on the implementation of quality management systems in hospitals and their relation with improved performance. It seems therefore fair to assume that the relation between the involvement of doctors in hospital management and improved hospital performance is partly mediated via quality management systems. The threefold aim of this paper is to 1) perform a quick scan of the current situation with regard to doctor managers in hospital management in 19 OECD countries, 2) explore the phenomenon of doctor managers in depth in 7 OECD countries, and 3) investigate whether doctor involvement in hospital management is associated with more advanced implementation of quality management systems. This study draws both on a quick scan amongst country coordinators in OECD's Health Care Quality Indicator program, and on the DUQuE project which focused on the implementation of quality management systems in European hospitals. This paper reports two main findings. First, medical doctors fulfil a broad scope of managerial roles at departmental and hospital level but only partly accompanied by formal decision making responsibilities. Second, doctor managers having more formal decision making

  13. Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?

    Science.gov (United States)

    Clay-Williams, Robyn; Ludlow, Kristiana; Testa, Luke; Li, Zhicheng; Braithwaite, Jeffrey

    2017-09-24

    Despite common assumptions that doctors are well placed to lead hospitals and healthcare organisations, the peer-reviewed literature contains little evidence on the performance of doctors in leadership roles in comparison with that of non-medical managers. To determine whether there is an association between the leader's medical background and management performance in terms of organisational performance or patient outcomes. We searched for peer-reviewed, English language studies using Medline, Embase and Emerald Management between 2005 and 2017. We included quantitative, qualitative and mixed method empirical studies on the performance of senior healthcare managers where participants were described as doctors or leaders and where comparative performance data were provided on non-medical leaders. Studies without full text available, or no organisational, leadership behaviour or patient measures, were excluded. The search, conducted in Medline (n=3395), Embase (n=1913) and Emerald Management (n=454) databases, yielded 3926 entries. After the application of inclusion and exclusion criteria, 16 studies remained. Twelve studies found that there were positive differences between medical and non-medical leaders, and eight studies correlated those findings with hospital performance or patient outcomes. Six studies examined the composition of boards of directors; otherwise, there were few common areas of investigation. Five inter-related themes emerged from a narrative analysis: the impact of medical leadership on outcomes; doctors on boards; contribution of qualifications and experience; the medical leader as an individual or part of a team and doctors transitioning into the medical leadership role. A modest body of evidence supports the importance of including doctors on organisational governing boards. Despite many published articles on the topic of whether hospitals and healthcare organisations perform better when led by doctors, there were few empirical studies that

  14. Time to talk, time to see: changing microeconomies of professional practice among nurses and doctors in Australian general practice.

    Science.gov (United States)

    Phillips, Christine; Dwan, Kathryn; Pearce, Christopher; Hall, Sally; Porritt, Julie; Yates, Rachel; Sibbald, Bonnie

    2007-08-01

    In Australia, more nurses are entering general practice, and nurses' work is being funded in increasingly complex ways through Medicare. Little research has explored the ways doctors and nurses realign their priorities and activities when working together in general practice. We undertook rapid, intensive multimethod studies of 25 general practices to explore the ways in which the labour of nurses and doctors was structured, and the implicit decisions made by both professions about the values placed on different ways of working and on their time. Data collected included photographs, floor-plans, interviews with 37 nurses, 24 doctors and 22 practice managers, and 50 hours of structured observation. Nursing time was constructed by both nurses and doctors as being fluid and non-contingent; they were regarded as being 'available' to patients in a way that doctors were not. Compared to medical time, nursing time could be disposed more flexibly, underpinning a valorized attribute of nursing: deep clinical and personal contact with patients. The location of practice nurses' desks in areas of traffic, such as administrative stations, or in the treatment room, underpinned this valuable unstructured contact with patients. Changes to the practice nurse role through direct fee-for-service items for nurses may lead to greater congruence between the microeconomies of nursing and medicine in general practice. In a time of pressure upon a primary care workforce, this is likely to lead to more independent clinical work by nurses, but may also lead to a decrease in flexible contact with patients.

  15. General principles of radiation protection in hospital media

    International Nuclear Information System (INIS)

    Chanteur, J.

    1993-01-01

    Principles of radiation protection given by ICRP in term of justification, optimization, limitation are applicable in hospital media. The medical act has to be justified and, in France, it is not possible to use ionizing radiations without a prescription from a doctor. The acceleration of technologies development make non radiological techniques more employed than radiologic ones, in an aim of efficiency more than an aim radiation protection. The second principle of optimization means to give medical care with the minimum of ionizing radiations for the patients as well the operators. For the principle of limitation which applied only for operators, we have the new recommends of ICRP, but it would be reasonable to give the most part of decision to the works doctor to decide if somebody has the aptitude to work at an exposed place. The last points concern the quality of equipment, the safety of installations, the organization of works which are under laws and regulations. 3 tabs

  16. Hospital structure and technical efficiency in the production of nuclear medicine. Doctoral thesis

    International Nuclear Information System (INIS)

    Wilson, G.W.

    1976-01-01

    The relationship of hospital structure to production efficiency is explored. The hospital subindustry on which this research centers is nuclear medicine. The hypotheses generated were that technical efficiency is reduced by increased competitive intensity, by a lack of profit incentive, by a broader service range, and by in-house training of technical personnel. Most data employed in the study were gathered from the American College of Radiology and the Energy Research and Development Administration Census of Nuclear Medicine. More specific information came from questionnaires sent to 2,050 short-term general hospitals known to have a nuclear medicine facility. Of the responses 1,362 were usable for the study. A major study finding was that over half of the variations observed in technical efficiency were attributable to the structural elements being studied. The research indicated that competition for staff physicians has a role in reducing technical efficiency; that the output effect of in-house manpower training was relatively unimportant; and that profit incentives do have a significant impact. It is suggested that increased technical efficiency could be achieved through reduced competitive intensity, stronger profit orientation, and reduced service range. A bibliography is included

  17. Barriers to healthy eating by National Health Service (NHS hospital doctors in the hospital setting: results of a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Wilson Sue

    2008-08-01

    Full Text Available Abstract Background With high levels of obesity and related illness, improving the health of the nation is a major public health concern. This study aimed to identify factors that prevent healthy eating among doctors, and that are associated with satisfaction with catering services. Findings Methods: Cross-sectional survey of 328 NHS doctors working in two NHS Trusts with on-site hospital canteen. Questionnaire to establish perceived barriers to healthy eating, weekly use and satisfaction with the hospital canteen, lifestyle and dietary habits, gender, age, height, weight, job details, and affect. Results: 70% of doctors reported using their hospital canteen each week, with 2 visits per week on average. Canteen opening times, lack of selection and lack of breaks were the most commonly perceived barriers to healthy eating. Availability of healthy options caused the most dissatisfaction. Only 12% felt the NHS was supportive of healthy eating. 74% did not feel their canteen advocated healthy eating. Canteen use is associated with younger age (r = -0.254, p Conclusion Interventions to encourage regular meal breaks, eating breakfast and drinking more water each day need developing. Improved canteen accessibility and availability of healthy options at evenings and weekends may be beneficial.

  18. The effects of EMR deployment on doctors' work practices: a qualitative study in the emergency department of a teaching hospital.

    Science.gov (United States)

    Park, Sun Young; Lee, So Young; Chen, Yunan

    2012-03-01

    The goal of this study was to examine the effects of medical notes (MD) in an electronic medical records (EMR) system on doctors' work practices at an Emergency Department (ED). We conducted a six-month qualitative study, including in situ field observations and semi-structured interviews, in an ED affiliated with a large teaching hospital during the time periods of before, after, and during the paper-to-electronic transition of the rollout of an EMR system. Data were analyzed using open coding method and various visual representations of workflow diagrams. The use of the EMR in the ED resulted in both direct and indirect effects on ED doctors' work practices. It directly influenced the ED doctors' documentation process: (i) increasing documentation time four to five fold, which in turn significantly increased the number of incomplete charts, (ii) obscuring the distinction between residents' charting inputs and those of attendings, shifting more documentation responsibilities to the residents, and (iii) leading to the use of paper notes as documentation aids to transfer information from the patient bedside to the charting room. EMR use also had indirect consequences: it increased the cognitive burden of doctors, since they had to remember multiple patients' data; it aggravated doctors' multi-tasking due to flexibility in the system use allowing more interruptions; and it caused ED doctors' work to become largely stationary in the charting room, which further contributed to reducing doctors' time with patients and their interaction with nurses. We suggest three guidelines for designing future EMR systems to be used in teaching hospitals. First, the design of documentation tools in EMR needs to take into account what we called "note-intensive tasks" to support the collaborative nature of medical work. Second, it should clearly define roles and responsibilities. Lastly, the system should provide a balance between flexibility and interruption to better manage the

  19. Factors influencing the recommendation of the Human Papillomavirus vaccine by South African doctors working in a tertiary hospital.

    Science.gov (United States)

    Hoque, Muhammad Ehsanul

    2016-06-01

    In South Africa, HPV vaccination programme has been incorporated recently in the school health system. Since doctors are the most trusted people regarding health issues in general, their knowledge and attitudes regarding HPV infections and vaccination are very important for HPV vaccine program nationally. The objective of this study was to investigate factors contributing to recommendation of HPV vaccines to the patients. This was a quantitative cross-sectional study conducted among 320 doctors, using a self-administered anonymous questionnaire. All the doctors were aware of HPV and knew that HPV is transmitted sexually. Their overall level of knowledge regarding HPV infections and HPV vaccine was poor. But the majority intended to prescribe the vaccine to their patients. It was found that doctors who knew that HPV 6 and 11 are responsible for >90% of anogenital warts, their patients would comply with the counselling regarding HPV vaccination, and received sufficient information about HPV vaccination were 5.68, 4.91 and 4.46 times respectively more likely to recommend HPV vaccination to their patients, compared to their counterparts (p<0.05). There was a knowledge gap regarding HPV infection and HPV vaccine among the doctors.

  20. Effects of coaching supervision, mentoring supervision and abusive supervision on talent development among trainee doctors in public hospitals: moderating role of clinical learning environment.

    Science.gov (United States)

    Subramaniam, Anusuiya; Silong, Abu Daud; Uli, Jegak; Ismail, Ismi Arif

    2015-08-13

    Effective talent development requires robust supervision. However, the effects of supervisory styles (coaching, mentoring and abusive supervision) on talent development and the moderating effects of clinical learning environment in the relationship between supervisory styles and talent development among public hospital trainee doctors have not been thoroughly researched. In this study, we aim to achieve the following, (1) identify the extent to which supervisory styles (coaching, mentoring and abusive supervision) can facilitate talent development among trainee doctors in public hospital and (2) examine whether coaching, mentoring and abusive supervision are moderated by clinical learning environment in predicting talent development among trainee doctors in public hospital. A questionnaire-based critical survey was conducted among trainee doctors undergoing housemanship at six public hospitals in the Klang Valley, Malaysia. Prior permission was obtained from the Ministry of Health Malaysia to conduct the research in the identified public hospitals. The survey yielded 355 responses. The results were analysed using SPSS 20.0 and SEM with AMOS 20.0. The findings of this research indicate that coaching and mentoring supervision are positively associated with talent development, and that there is no significant relationship between abusive supervision and talent development. The findings also support the moderating role of clinical learning environment on the relationships between coaching supervision-talent development, mentoring supervision-talent development and abusive supervision-talent development among public hospital trainee doctors. Overall, the proposed model indicates a 26 % variance in talent development. This study provides an improved understanding on the role of the supervisory styles (coaching and mentoring supervision) on facilitating talent development among public hospital trainee doctors. Furthermore, this study extends the literature to better

  1. The involvement of medical doctors in hospital governance and implications for quality management: a quick scan in 19 and an in depth study in 7 OECD countries

    NARCIS (Netherlands)

    Rotar, A. M.; Botje, D.; Klazinga, N. S.; Lombarts, K. M.; Groene, O.; Sunol, R.; Plochg, T.

    2016-01-01

    Hospital governance is broadening its orientation from cost and production controls towards 'improving performance on clinical outcomes'. Given this new focus one might assume that doctors are drawn into hospital management across OECD countries. Hospital performance in terms of patient health,

  2. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital.

    Science.gov (United States)

    Lambrou, Persefoni; Kontodimopoulos, Nick; Niakas, Dimitris

    2010-11-16

    The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) was used. Two categories of health care professionals, medical doctors and dentists (N = 67) and nurses (N = 219) participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E) outpatient doctors reporting greater mean scores (p job satisfaction compared to the nursing staff. Surgical sector nurses and those >55 years of age reported higher job satisfaction when compared to the other groups. The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.

  3. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

    Directory of Open Access Journals (Sweden)

    Kontodimopoulos Nick

    2010-11-01

    Full Text Available Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements was used. Two categories of health care professionals, medical doctors and dentists (N = 67 and nurses (N = 219 participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E outpatient doctors reporting greater mean scores (p 55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.

  4. Knowledge, awareness and practice of ethics among doctors in tertiary care hospital.

    Science.gov (United States)

    Singh, Surjit; Sharma, Pramod Kumar; Bhandari, Bharti; Kaur, Rimplejeet

    2016-10-01

    With the advancement of healthcare and medical research, doctors need to be aware of the basic ethical principles. This cross-sectional study is an attempt to assess the knowledge, awareness, and practice of health-care ethics among health-care professionals. After taking written informed consent, a standard questionnaire was administered to 117 doctors. No personal information was recorded on the questionnaire so as to ensure the confidentiality and anonymity of participants. Data analysis was done using SPSS version 21 (IBM Corp., Armonk, NY, USA). Statistically significant difference observed between the opinions of consultant and senior resident (SRs) on issues like, adherence to confidentiality; paternalistic attitude of doctors (doctors should do their best for the patient irrespective of patient's opinion); doctor's decision should be final in case of disagreement and interest in learning ethics ( P patient wishes, informing patient regarding wrongdoing, informing close relatives, seeking consent for children and patients' consent for procedures. Furthermore, no significant difference observed between the two with respect to the practice of health-care ethics. Surprisingly, the response of clinical and nonclinical faculty did not differ as far as awareness and practice of ethics were concerned. The significant difference is observed in the knowledge, awareness, and practice of ethics among consultants and SRs. Conferences, symposium, and workshops, on health-care ethics, may act as a means of sensitizing doctors and thus will help to bridge this gap and protect the well-being and confidentiality of the patients. Such an effort may bring about harmonious change in the doctor-patient relationship.

  5. Trabeculectomy outcomes in a Malaysian general hospital.

    Science.gov (United States)

    Hooi, S T; Hooi, S H

    2003-10-01

    A retrospective study was conducted at the Hospital Sultanah Aminah Johor Bahru to determine the outcome of trabeculectomy surgeries over a period of 4 years. One hundred and two eyes were followed up to a maximum of 63 months (mean 34.2 months). The 2-year survival rates for plain trabeculectomies, 5-Fluorouracil augmented trabeculectomies and Mitomycin-C augmented trabeculectomies were 52.9%, 27.3% and 60.5% respectively. The commonest complications noted were cataract formation (25%) and hyphaema (11%). Mitomycin-C induced complications were rarely seen. At last follow-up, 54% of eyes had intraocular pressures below 21 mmHg without medication, while 34% of eyes had intraocular pressures below 21 mmHg with medication. Vitreous at the trabeculectomy site was a statistically significant predictor of operative failure.

  6. Preparation to care for confused older patients in general hospitals: a study of UK health professionals.

    Science.gov (United States)

    Griffiths, Amanda; Knight, Alec; Harwood, Rowan; Gladman, John R F

    2014-07-01

    in the UK, two-thirds of patients in general hospitals are older than 70, of whom half have dementia or delirium or both. Our objective was to explore doctors, nurses and allied health professionals' perceptions of their preparation to care for confused older patients on general hospital wards. : using a quota sampling strategy across 11 medical, geriatric and orthopaedic wards in a British teaching hospital, we conducted 60 semi-structured interviews with doctors, nurses and allied healthcare professionals and analysed the data using the Consensual Qualitative Research approach. : there was consensus among participants that education, induction and in-service training left them inadequately prepared and under-confident to care for confused older patients. Many doctors reported initial assessments of confused older patients as difficult. They admitted inadequate knowledge of mental health disorders, including the diagnostic features of delirium and dementia. Handling agitation and aggression were considered top priorities for training, particularly for nurses. Multidisciplinary team meetings were highly valued but were reported as too infrequent. Participants valued specialist input but reported difficulties gaining such support. Communication with confused patients was regarded as particularly challenging, both in terms of patients making their needs known, and staff conveying information to patients. Participants reported emotional and behavioural responses including frustration, stress, empathy, avoidance and low job satisfaction. : our findings indicate that a revision of training across healthcare professions in the UK is required, and that increased specialist support should be provided, so that the workforce is properly prepared to care for older patients with cognitive problems. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society.

  7. Patients' choice of general practitioner: importance of patients' and doctors' sex and ethnicity.

    OpenAIRE

    Ahmad, W I; Kernohan, E E; Baker, M R

    1991-01-01

    The relative importance of sex and ethnicity in patients' choice of doctor is not known. A total of 1633 consultations at a health centre in Bradford, with a mixed ethnic list, were examined over a four week period to test the relative importance of these variables. Patients had the choice to consult any one of: a male Asian, a male white or a female white doctor. Asian patients, irrespective of sex, were significantly (P less than 0.001) more likely to consult the Asian doctor then either of...

  8. The Best of Intentions. Interior Architecture: Massachusetts General Hospital

    Science.gov (United States)

    Ryder, Sharon Lee

    1974-01-01

    The Massachusetts General Hospital/Surgical and Special Services study, an information processing system for redesigning an outmoded existing hospital, structured information into small-scale elements that could be analyzed, reassembled into different solutions, and the solution selected that best accommodates all of the complex requirements. (MF)

  9. Hip osteoarthritis in Douala General Hospital: Clinical, radiological ...

    African Journals Online (AJOL)

    Objectives: To describe the epidemiological, clinical and radiological profile of hip OA, and also treatment options offered to patients presenting with this condition at the Douala General Hospital, Cameroon. Methods: After prior ethical clearance, a hospital-based cross sectional descriptive study was carried out, including ...

  10. Does an activity based remuneration system attract young doctors to general practice?

    Directory of Open Access Journals (Sweden)

    Abelsen Birgit

    2012-03-01

    Full Text Available Abstract Background The use of increasingly complex payment schemes in primary care may represent a barrier to recruiting general practitioners (GP. The existing Norwegian remuneration system is fully activity based - 2/3 fee-for-service and 1/3 capitation. Given that the system has been designed and revised in close collaborations with the medical association, it is likely to correspond - at least to some degree - with the preferences of current GPs (men in majority. The objective of this paper was to study which preferences that young doctors (women in majority, who are the potential entrants to general practice have for activity based vs. salary based payment systems. Methods In November-December 2010 all last year medical students and all interns in Norway (n = 1.562 were invited to participate in an online survey. The respondents were asked their opinion on systems of remuneration for GPs; inclination to work as a GP; risk attitude; income preferences; work pace tolerance. The data was analysed using one-way ANOVA and multinomial logistic regression analysis. Results A total of 831 (53% responded. Nearly half the sample (47% did not consider the remuneration system to be important for their inclination to work as GP; 36% considered the current system to make general practice more attractive, while 17% considered it to make general practice less attractive. Those who are attracted by the existing system were men and those who think high income is important, while those who are deterred by the system are risk averse and less happy with a high work pace. On the question of preferred remuneration system, half the sample preferred a mix of salary and activity based remuneration (the median respondent would prefer a 50/50 mix. Only 20% preferred a fully activity based system like the existing one. A salary system was preferred by women, and those less concerned with high income, while a fully activity based system was preferred by men, and those

  11. Does an activity based remuneration system attract young doctors to general practice?

    Science.gov (United States)

    2012-01-01

    Background The use of increasingly complex payment schemes in primary care may represent a barrier to recruiting general practitioners (GP). The existing Norwegian remuneration system is fully activity based - 2/3 fee-for-service and 1/3 capitation. Given that the system has been designed and revised in close collaborations with the medical association, it is likely to correspond - at least to some degree - with the preferences of current GPs (men in majority). The objective of this paper was to study which preferences that young doctors (women in majority), who are the potential entrants to general practice have for activity based vs. salary based payment systems. Methods In November-December 2010 all last year medical students and all interns in Norway (n = 1.562) were invited to participate in an online survey. The respondents were asked their opinion on systems of remuneration for GPs; inclination to work as a GP; risk attitude; income preferences; work pace tolerance. The data was analysed using one-way ANOVA and multinomial logistic regression analysis. Results A total of 831 (53%) responded. Nearly half the sample (47%) did not consider the remuneration system to be important for their inclination to work as GP; 36% considered the current system to make general practice more attractive, while 17% considered it to make general practice less attractive. Those who are attracted by the existing system were men and those who think high income is important, while those who are deterred by the system are risk averse and less happy with a high work pace. On the question of preferred remuneration system, half the sample preferred a mix of salary and activity based remuneration (the median respondent would prefer a 50/50 mix). Only 20% preferred a fully activity based system like the existing one. A salary system was preferred by women, and those less concerned with high income, while a fully activity based system was preferred by men, and those happy with a high work

  12. Does an activity based remuneration system attract young doctors to general practice?

    Science.gov (United States)

    Abelsen, Birgit; Olsen, Jan Abel

    2012-03-20

    The use of increasingly complex payment schemes in primary care may represent a barrier to recruiting general practitioners (GP). The existing Norwegian remuneration system is fully activity based - 2/3 fee-for-service and 1/3 capitation. Given that the system has been designed and revised in close collaborations with the medical association, it is likely to correspond - at least to some degree - with the preferences of current GPs (men in majority). The objective of this paper was to study which preferences that young doctors (women in majority), who are the potential entrants to general practice have for activity based vs. salary based payment systems. In November-December 2010 all last year medical students and all interns in Norway (n = 1.562) were invited to participate in an online survey. The respondents were asked their opinion on systems of remuneration for GPs; inclination to work as a GP; risk attitude; income preferences; work pace tolerance. The data was analysed using one-way ANOVA and multinomial logistic regression analysis. A total of 831 (53%) responded. Nearly half the sample (47%) did not consider the remuneration system to be important for their inclination to work as GP; 36% considered the current system to make general practice more attractive, while 17% considered it to make general practice less attractive. Those who are attracted by the existing system were men and those who think high income is important, while those who are deterred by the system are risk averse and less happy with a high work pace. On the question of preferred remuneration system, half the sample preferred a mix of salary and activity based remuneration (the median respondent would prefer a 50/50 mix). Only 20% preferred a fully activity based system like the existing one. A salary system was preferred by women, and those less concerned with high income, while a fully activity based system was preferred by men, and those happy with a high work pace. Given a concern

  13. Psychiatric units in Brazilian general hospitals: a growing philanthropic field.

    Science.gov (United States)

    Botega, Neury José

    2002-06-01

    Some countries, mainly in North America and Europe, have adopted psychiatric wards in the general hospital as an alternative to the classic psychiatric hospital. In Brazil there are 6,169 general hospitals, 1.3% of which with a psychiatric unit. This service strategy is scarcely developed in the country and comprises only 4% of all psychiatric admissions. There was no information on the facilities and functioning of the psychiatric units in general hospitals. To determine the main characteristics of psychiatric units in Brazilian general hospitals and to assess the current trends in the services provided. A mailing survey assessed all 94 Brazilian general hospitals which made psychiatric admissions. A two-page questionnaire was designed to determine the main characteristics of each institution and of the psychiatric unit. Seventy-nine (84%) questionnaires were returned. In contrast to the 1970s and 1980s, in the last decade the installation of psychiatric units has spread to smaller philanthropic institutions that are not linked to medical schools. A fifth of hospitals admit psychiatric patients to medical wards because there is no specialist psychiatric ward. They try to meet all the local emergency demands, usually alcohol-dependent patients who need short term admission. This could signal the beginning of a program through which mental health professionals may become an integral part of general health services. The inauguration of psychiatric wards in philanthropic hospitals, as well as the admission of psychiatric patients in their medical wards, is a phenomenon peculiar to this decade. The installation of psychiatric services in these and other general hospitals would overcome two of major difficulties encountered: prejudice and a lack of financial resources.

  14. nutritional status in pregnant women attending kiru general hospital

    African Journals Online (AJOL)

    DR. AMINU

    2012-12-02

    Dec 2, 2012 ... of pregnant women in General Hospital Kiru, Kiru. Local Government .... AACC, American Association for Clinical Chemistry,. 2012. ... Animal. Reproductive Science. 72: pp. 235. Das, S. C. and Isechei, U. P. (1996). Serum ...

  15. LIGASURE (PRECISION HAEMORROIDECTOMY AT GOVT. GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Anand

    2015-09-01

    Full Text Available BACKGROUND : Haemorrhoids is a common problem throughout the world. Many procedures are available for management of grade II and grade III hemorrhoids. The main postoperative complications associated with any of these procedures are pain and bleeding per rectum and pro longed healing time. Liga Surel TM haemorroidectomy was evaluated in this study for post - operative complications and symptomatic relief. METHODS: We analyzed 50 patients of hemorrhoids of grade II, III and IV who underwent Ligasure Precise haemorroidectomy by a classical Milligan - Morgan technique. The outcome factors analyzed were total operative time, blood loss, post - operative pain on visual analogue scale, any other complication and days of hospital stay. RESULTS: Of all the 50 patients, the operative ti me was less than 10 minutes in 27 patients (54% and the blood loss, as was measured by number of soaked gauze pieces only one gauze piece was soaked in 31 patients (62%. The Average Post - operative pain score measured on Visual Analogue Scale (VAS at 12, 24 & 48 hours were 6.54, 4.52 and 3.12 respectively. In all patients postoperative period and follow up was uneventful except for one patient who developed transient flatus incontinence. With physiotherapy and dietary management this problem resolved ther eafter. CONCLUSIONS: Liga Sure Hemarrhoidectomy is a safe, Technically easy and fast modality of treatment for 2 nd , 3 rd & 4 th degree of hemorrhoids whether single or multiple, requiring very less operating ti me, with no major post - operative complications an d early return to day to day activities

  16. Personal Health Practices of Doctors in a Teaching Hospital in Nigeria

    African Journals Online (AJOL)

    Healthy lifestyle and clinical preventive activities have been shown to improve health status of individuals. However routine health promotion and preventive services is limited in medical practice due to time and cost constraint. This study examines how physicians themselves try to promote their own health. Ninety doctors ...

  17. Quality of clinical supervision as perceived by attending doctors in university and district teaching hospitals

    NARCIS (Netherlands)

    Busari, Jamiu O.; Koot, Bart G.

    2007-01-01

    Attending doctors (ADs) play important roles in the supervision of specialist registrars. Little is known, however, about how they perceive the quality of their supervision in different teaching settings. We decided to investigate whether there is any difference in how ADs perceive the quality of

  18. A study on the interactions of doctors with medical representatives of pharmaceutical companies in a Tertiary Care Teaching Hospital of South India

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar Gupta

    2016-01-01

    Full Text Available Background: The promotional activities by medical representatives (MRs of the pharmaceutical companies can impact the prescribing pattern of doctors. Hence, the interaction between doctors and the pharmaceutical industry is coming under increasing scrutiny. Objective: The primary objective was to assess the attitude of the doctors toward the interaction with the MRs of the pharmaceutical company. The secondary objective was to assess the awareness of the doctors about regulations governing their interaction with the pharmaceutical company. Materials and Methods: This was a cross-sectional study. This study was carried out using a pretested questionnaire containing 10 questions between June and September 2014. The doctors working in the Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur (Tamil Nadu during the study period was included. Results: A total of 100 pretested questionnaires were distributed, and 81 doctors responded (response rate 81%. 37% doctors responded that they interacted with MR once a week whereas 25.9% told that they interact with MRs twice a month. About 69.1% doctors think that MR exaggerate the benefits of medicines and downplays the risks and contraindications of medicine(P = 0.000. 61.7% doctors think that MR has an impact on their prescribing (P = 0.000. 63% doctors stated that they had received promotional tools such as stationery items, drug sample, textbooks or journal reprints from MR in last 12 months (P = 0.0012. Unfortunately, 70.4% doctors have not read the guidelines about interacting with the pharmaceutical industry or its representative (P = 0.000. Conclusion: Rather than forbidding any connection between doctors and industry, it is better to establish ethical guidelines. The Medical Council of India code is a step in the right direction, but the majority of doctors in this study have not read the guidelines about interacting with the pharmaceutical industry or its representative.

  19. A study on the interactions of doctors with medical representatives of pharmaceutical companies in a Tertiary Care Teaching Hospital of South India.

    Science.gov (United States)

    Gupta, Sandeep Kumar; Nayak, Roopa P; Sivaranjani, R

    2016-01-01

    The promotional activities by medical representatives (MRs) of the pharmaceutical companies can impact the prescribing pattern of doctors. Hence, the interaction between doctors and the pharmaceutical industry is coming under increasing scrutiny. The primary objective was to assess the attitude of the doctors toward the interaction with the MRs of the pharmaceutical company. The secondary objective was to assess the awareness of the doctors about regulations governing their interaction with the pharmaceutical company. This was a cross-sectional study. This study was carried out using a pretested questionnaire containing 10 questions between June and September 2014. The doctors working in the Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur (Tamil Nadu) during the study period was included. A total of 100 pretested questionnaires were distributed, and 81 doctors responded (response rate 81%). 37% doctors responded that they interacted with MR once a week whereas 25.9% told that they interact with MRs twice a month. About 69.1% doctors think that MR exaggerate the benefits of medicines and downplays the risks and contraindications of medicine(P = 0.000). 61.7% doctors think that MR has an impact on their prescribing (P = 0.000). 63% doctors stated that they had received promotional tools such as stationery items, drug sample, textbooks or journal reprints from MR in last 12 months (P = 0.0012). Unfortunately, 70.4% doctors have not read the guidelines about interacting with the pharmaceutical industry or its representative (P = 0.000). Rather than forbidding any connection between doctors and industry, it is better to establish ethical guidelines. The Medical Council of India code is a step in the right direction, but the majority of doctors in this study have not read the guidelines about interacting with the pharmaceutical industry or its representative.

  20. Finding the Right Doctor

    Science.gov (United States)

    ... certified hospital Communicating with Healthcare Professionals for Caregivers Consumer Health Care • Home • Health Insurance Information • Your Healthcare Team Introduction Finding the Right Doctor Talking to Your Doctor Getting a Second ...

  1. The Citadel cannot hold: technologies go outside the hospital, patients and doctors too.

    Science.gov (United States)

    Stoeckle, J D

    1995-01-01

    Use of the acute hospital has markedly decreased over the past four decades for various reasons: the decentralization of diagnostic treatment technologies to out-of-hospital sites; the clinical substitutions of quick diagnostic testing of the ambulatory patient for the longer diagnostic testing of the hospitalized patient; the diminished use of hospital bed rest and the expanded use of exercise for treatment; the corporate organization of hospital work that emphasizes efficiency; and the group practice organization of generalists and specialists that avoids hospital use for the diagnosis of complex disorders in ambulatory patients. A smaller domain for hospital bed care and renewed attention to chronic disease and prevention in the community diminish the hold of the acute hospital on care. The evolution of more collaborative, decentralized arrangements promises to be a positive development for community care.

  2. HIV/AIDS treatment in two Ghanaian hospitals : experiences of patients, nurses and doctors

    NARCIS (Netherlands)

    Dapaah, Jonathan Mensah

    2012-01-01

    This thesis is based on fifteen months of anthropological research in the voluntary counselling and testing centres and antiretroviral therapy clinics of two hospitals in Ghana, St. Patrick's Hospital at Maase-Offinso and Komfo Anokye Teaching Hospital in Kumasi, including in-depth conversations

  3. Hospital emergency on-call coverage: is there a doctor in the house?

    Science.gov (United States)

    O'Malley, Ann S; Draper, Debra A; Felland, Laurie E

    2007-11-01

    The nation's community hospitals face increasing problems obtaining emergency on-call coverage from specialist physicians, according to findings from the Center for Studying Health System Change's (HSC) 2007 site visits to 12 nationally representative metropolitan communities. The diminished willingness of specialist physicians to provide on-call coverage is occurring as hospital emergency departments confront an ever-increasing demand for services. Factors influencing physician reluctance to provide on-call coverage include decreased dependence on hospital admitting privileges as more services shift to non-hospital settings; payment for emergency care, especially for uninsured patients; and medical liability concerns. Hospital strategies to secure on-call coverage include enforcing hospital medical staff bylaws that require physicians to take call, contracting with physicians to provide coverage, paying physicians stipends, and employing physicians. Nonetheless, many hospitals continue to struggle with inadequate on-call coverage, which threatens patients' timely access to high-quality emergency care and may raise health care costs.

  4. General beliefs about medicines among doctors and nurses in out-patient care: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Hedenrud Tove

    2009-05-01

    Full Text Available Abstract Background Doctors and nurses are two natural partners in the healthcare team, but they usually differ in their perspectives on how to work for increased health. These professions may also have different beliefs about medicines, a factor important for adherence to medicines. The aim was to explore general beliefs about medicines among doctors and nurses. Methods Questionnaires were sent to 306 private practitioners (PPs, 298 general practitioners (GPs and 303 nurses in the county of Västra Götaland, Sweden. The questionnaire included sociodemographic questions and the general part of the Beliefs about Medicines Questionnaire (BMQ, which measures the beliefs people have about medicines in general. General beliefs about medicines in relation to background variables were explored with independent t-tests and ANOVA analyses. Differences between occupations and influences of interaction variables were analysed with multiple linear regression models for general beliefs about medicines. Results The data collection resulted in 616 questionnaires (62.1% PPs; 61.6% GPs; 80.5% nurses. The majority of the PPs and 40% of the GPs were male but most of the nurses were female. The GPs' mean age was 47 years, PPs' 60 years and nurses' 52 years. Few nurses originated from non-Nordic countries while 15% of the PPs and 25% of the GPs did. Nurses saw medicines as more harmful and less beneficial than did PPs and GPs. These differences could not be explained by the included interaction variables. GPs with a Nordic background saw medicines as more beneficial and less harmful than did GPs with a non-Nordic background. Furthermore, GPs of non-Nordic origin were most likely to believe that medicines were overprescribed by doctors. Conclusion Doctors were more positive about medicines than nurses. The differences in beliefs about medicines found between doctors and nurses could not be explained by any of the included interaction variables. These differences in

  5. Exploring the Dimensions of Doctor-Patient Relationship in Clinical Practice in Hospital Settings

    Directory of Open Access Journals (Sweden)

    Saurabh RamBiharilal Shrivastava

    2014-05-01

    Full Text Available The Doctor-Patient Relationship (DPR is a complex concept in the medical sociology in which patients voluntarily approach a doctor and thus become a part of a contract in which they tends to abide with the doctor’s guidance. Globally, the DPR has changed drastically over the years owing to the commercialization and privatization of the health sector. Furthermore, the dynamics of the DPR has shown a significant change because of the formulation of consumer protection acts; clauses for professional misconduct and criminal negligence; establishment of patient forums and organizations; massive expansion of the mass media sector leading to increase in health awareness among people; and changes in the status of the doctors. Realizing the importance of DPR in the final outcome and quality of life of the patient, multiple measures have been suggested to make a correct diagnosis and enhance healing. To conclude, good DPR is the crucial determinant for a better clinical outcome and satisfaction with the patients, irrespective of the socio-cultural determinants.

  6. Perceptions of gender equality, work environment, support and social issues for women doctors at a university hospital in Riyadh, Kingdom of Saudi Arabia.

    Directory of Open Access Journals (Sweden)

    Shehla Baqi

    Full Text Available The Kingdom of Saudi Arabia (KSA is an Islamic monarchy and was established in 1932. Saudi women first entered the medical field in 1975 and the country has since seen a steady increase in women pursuing medicine. However, there is limited data on gender related issues for women doctors practicing in Saudi Arabia. Therefore, our study objective was to assess the perception amongst peers regarding gender equality and social issues faced by women doctors in Saudi Arabia. An online anonymous cross-sectional survey was administered in English to doctors at King Khalid Hospital, affiliated to King Saud University, in Riyadh, between April and May of 2016. Of 1015 doctors, 304 (30% participated, of which 129 (42.4% were females and 231 (76% were Saudi nationals. The average age was 32.4 years (±SD: 8.7. The majority opined that there was no gender discrimination in salaries (73.7% p-value = 0.4, hospital benefits (62.2% p-value = 0.06 or entry into any field of Medicine/Pediatrics (68.4% p-value = 0.207. However, only a minority believed that there was no gender discrimination for entry into surgery (37.3% p-value = .091. A higher proportion of male doctors agreed that promotion opportunities are equal (66.3% vs 45.7%, p-value = 0.002. However, of 54 consultants, only 18 (33.3% were women. Over half of the women (52.3% reported that they never wear the face veil. Only a minority of male and female doctors (12.2% believed women doctors should wear the veil since they examine male patients. Fewer respondents believed that female doctors face harassment from male doctors (14.5% whereas 30.7% believed female doctors face harassment from male patients. More females, than males, agreed with the statement that female doctors are as committed to their careers as are males (92.2% vs 67.4%, p-value<0.0001. Of 304 participants, 210 (69.1% said that they would still choose to become a doctor with approximately equal proportions between males and females (68% vs

  7. Non-fatal suicidal behaviour at the Johannesburg General Hospital ...

    African Journals Online (AJOL)

    Non-fatal suicidal behaviour at the Johannesburg General Hospital. ... African Journal of Psychiatry ... Patients who threaten deliberate self-harm and who have a history of previous NFSB, past psychiatric illness and physical or sexual abuse, are at a higher risk of this behaviour as compared to the general population.

  8. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  9. An email-based intervention to improve the number and timeliness of letters sent from the hospital outpatient clinic to the general practitioner: A pair-randomized controlled trial

    NARCIS (Netherlands)

    Medlock, Stephanie; Parlevliet, Juliette L.; Sent, Danielle; Eslami, Saeid; Askari, Marjan; Arts, Derk L.; Hoekstra, Joost B.; de Rooij, Sophia E.; Abu-Hanna, Ameen

    2017-01-01

    Letters from the hospital to the general practitioner are important for maintaining continuity of care. Although doctors feel letters are important, they are often not written on time. To improve the number and timeliness of letters sent from the hospital outpatient department to the general

  10. Perceptions of gender equality, work environment, support and social issues for women doctors at a university hospital in Riyadh, Kingdom of Saudi Arabia.

    Science.gov (United States)

    Baqi, Shehla; Albalbeesi, Amal; Iftikhar, Sundus; Baig-Ansari, Naila; Alanazi, Mohammad; Alanazi, Awadh

    2017-01-01

    The Kingdom of Saudi Arabia (KSA) is an Islamic monarchy and was established in 1932. Saudi women first entered the medical field in 1975 and the country has since seen a steady increase in women pursuing medicine. However, there is limited data on gender related issues for women doctors practicing in Saudi Arabia. Therefore, our study objective was to assess the perception amongst peers regarding gender equality and social issues faced by women doctors in Saudi Arabia. An online anonymous cross-sectional survey was administered in English to doctors at King Khalid Hospital, affiliated to King Saud University, in Riyadh, between April and May of 2016. Of 1015 doctors, 304 (30%) participated, of which 129 (42.4%) were females and 231 (76%) were Saudi nationals. The average age was 32.4 years (±SD: 8.7). The majority opined that there was no gender discrimination in salaries (73.7% p-value = 0.4), hospital benefits (62.2% p-value = 0.06) or entry into any field of Medicine/Pediatrics (68.4% p-value = 0.207). However, only a minority believed that there was no gender discrimination for entry into surgery (37.3% p-value = .091). A higher proportion of male doctors agreed that promotion opportunities are equal (66.3% vs 45.7%, p-value = 0.002). However, of 54 consultants, only 18 (33.3%) were women. Over half of the women (52.3%) reported that they never wear the face veil. Only a minority of male and female doctors (12.2%) believed women doctors should wear the veil since they examine male patients. Fewer respondents believed that female doctors face harassment from male doctors (14.5%) whereas 30.7% believed female doctors face harassment from male patients. More females, than males, agreed with the statement that female doctors are as committed to their careers as are males (92.2% vs 67.4%, p-valueequal proportions between males and females (68% vs 70.5%, p-value = 0.79). In conclusion, our survey of male and female doctors at a government university hospital in

  11. Change in practice: a qualitative exploration of midwives' and doctors' views about the introduction of STan monitoring in an Australian hospital.

    Science.gov (United States)

    Mayes, M E; Wilkinson, C; Kuah, S; Matthews, G; Turnbull, D

    2018-02-17

    The present study examines the introduction of an innovation in intrapartum foetal monitoring practice in Australia. ST-Analysis (STan) is a technology that adds information to conventional fetal monitoring (cardiotocography) during labour, with the aim of reducing unnecessary obstetric intervention. Adoption of this technology has been controversial amongst obstetricians and midwives, particularly as its use necessitates a more invasive means of monitoring (a scalp clip), compared to external monitoring from cardiotocography alone. If adoption of this technology is going to be successful, then understanding staff opinions about the implementation of STan in an Australian setting is an important issue for maternity care providers and policy makers. Using a maximum variation purposive sampling method, 18 interviews were conducted with 10 midwives and 8 doctors from the Women's and Children's Hospital, South Australia to explore views about the introduction of the new technology. The data were analysed using Framework Analysis. Midwives and doctors indicated four important areas of consideration when introducing STan: 1) philosophy of care; 2) the implementation process including training and education; 3) the existence of research evidence; and 4) attitudes towards the new technology. Views were expressed about the management of change process, the fit of the new technology within the current models of care, the need for ongoing training and the importance of having local evidence. These findings, coupled with the general literature about introducing innovation and change, can be used by other centres looking to introduce STan technology.

  12. Continuing Medical Education for European General Practitioners in Doctor-Patient Relationship Skills and Psychosocial Issues.

    Science.gov (United States)

    Barker, L. Randol

    1998-01-01

    Most of the 23 European providers of continuing medical education (CME) surveyed reported programming on the doctor-patient relationship and psychosocial issues. Visits to programs in France, the Netherlands, and Spain identified the formats used most often in small group instruction, intensive individual learning, and national-level CME. (SK)

  13. [Philanthropic general hospitals: a new setting for psychiatric admissions].

    Science.gov (United States)

    Larrobla, Cristina; Botega, Neury José

    2006-12-01

    To understand the process that led Brazilian philanthropic general hospitals to implement psychiatric units and to describe the main characteristics and therapeutic approaches of these services. Ten institutions in three Brazilian states (Minas Gerais, São Paulo e Santa Catarina) were assessed in 2002. Forty-three semi-structured interviews were carried out with health professionals who worked at the hospitals to collect data on service implementation process, therapeutic approaches and current situation. The interviews were audio-recorded and their content was analyzed. There was no mental hospital in the cities where the institutions were located. In five hospitals, psychiatric patients were admitted to general medical wards because there was no psychiatric unit. The therapeutic approach in six hospitals was based on psychopharmacological treatment. Due to lack of resources and more appropriate therapeutic planning, the admission of patients presenting psychomotor agitation increases resistance against psychiatric patients in general hospitals. Financial constraints regarding laboratory testing is still a challenge. There is no exchange between local authorities and hospital administrators of these institutions that are compelled to exceed the allowed number of admissions to meet the demand of neighboring cities. The need for mental health care to local populations combined with individual requests of local authorities and psychiatrists made possible the implementation of psychiatric units in these localities. In spite of the efforts and flexibility of health professional working in these institutions, there are some obstacles to be overcome: resistance of hospital community against psychiatric admissions, financial constraints, limited professional training in mental health and the lack of a therapeutic approach that goes beyond psychopharmacological treatment alone.

  14. Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.

    Science.gov (United States)

    Streit, Sven; Baumann, Philippe; Barth, Jürgen; Mattle, Heinrich P; Arnold, Marcel; Bassetti, Claudio L; Meli, Damian N; Fischer, Urs

    2015-01-01

    Transient ischemic attacks (TIA) are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs) and hospital physicians (HPs) knew about stroke risk after TIA, and to measure their referral rates. We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients. Of the 1545 physicians, 40% (614) returned the survey. Of these, 75% (457) overestimated stroke risk within 24 hours, and 40% (245) overestimated risk within 3 months after TIA. Only 9% (53) underestimated stroke risk within 24 hours and 26% (158) underestimated risk within 3 months; 78% (473) of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543) would rigorously investigate the cause of a TIA, but only 38% (229) would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care. Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

  15. Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.

    Directory of Open Access Journals (Sweden)

    Sven Streit

    Full Text Available Transient ischemic attacks (TIA are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs and hospital physicians (HPs knew about stroke risk after TIA, and to measure their referral rates.We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients.Of the 1545 physicians, 40% (614 returned the survey. Of these, 75% (457 overestimated stroke risk within 24 hours, and 40% (245 overestimated risk within 3 months after TIA. Only 9% (53 underestimated stroke risk within 24 hours and 26% (158 underestimated risk within 3 months; 78% (473 of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543 would rigorously investigate the cause of a TIA, but only 38% (229 would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care.Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

  16. Use of electronic medical records and quality of patient data: different reaction patterns of doctors and nurses to the hospital organization.

    Science.gov (United States)

    Lambooij, Mattijs S; Drewes, Hanneke W; Koster, Ferry

    2017-02-10

    As the implementation of Electronic Medical Records (EMRs) in hospitals may be challenged by different responses of different user groups, this paper examines the differences between doctors and nurses in their response to the implementation and use of EMRs in their hospital and how this affects the perceived quality of the data in EMRs. Questionnaire data of 402 doctors and 512 nurses who had experience with the implementation and the use of EMRs in hospitals was analysed with Multi group Structural equation modelling (SEM). The models included measures of organisational factors, results of the implementation (ease of use and alignment of EMR with daily routine), perceived added value, timeliness of use and perceived quality of patient data. Doctors and nurses differ in their response to the organisational factors (support of IT, HR and administrative departments) considering the success of the implementation. Nurses respond to culture while doctors do not. Doctors and nurses agree that an EMR that is easier to work with and better aligned with their work has more added value, but for the doctors this is more pronounced. The doctors and nurses perceive that the quality of the patient data is better when EMRs are easier to use and better aligned with their daily routine. The result of the implementation, in terms of ease of use and alignment with work, seems to affect the perceived quality of patient data more strongly than timeliness of entering patient data. Doctors and nurses value bottom-up communication and support of the IT department for the result of the implementation, and nurses respond to an open and innovative organisational culture.

  17. [Dementia friendly care services in general hospitals : Representative results of the general hospital study (GHoSt)].

    Science.gov (United States)

    Hendlmeier, Ingrid; Bickel, Horst; Hessler, Johannes Baltasar; Weber, Joshua; Junge, Magdalena Nora; Leonhardt, Sarah; Schäufele, Martina

    2017-11-06

    Mostly model projects report on special care services and procedures for general hospital patients with cognitive impairment. The objective of this study was to determine the frequency of special care services and procedures in general hospitals on the basis of a representative cross-sectional study. From a list of all general hospitals in southern Germany we randomly selected a specified number of hospitals und somatic wards. The hospitals were visited and all older patients on the selected wards on that day were included in the study. Information about care services and their utilization was collected with standardized instruments. A total of 33 general hospitals and 172 wards participated in the study. The patient sample included 1469 persons over 65 (mean age 78.6 years) and 40% of the patients showed cognitive impairments. The staff reported that the most frequent measures for patients with cognitive impairments concerned patients with wandering behavior (63.1%), efforts to involve the patients' relatives to help with their daily care (60.1%), conducting nonintrusive interviews to identify cognitive impairments (59.9%), allocation to other rooms (58%) and visual aids for place orientation of patients (50.6%). In accordance with earlier studies our results show that other dementia friendly services implemented in pilot projects were rare. The existing special services for patients with cognitive impairment were rarely used by the patients or their relatives. The results demonstrate the urgent need to improve special care services and routines for identification of elderly patients with cognitive impairment and risk of delirium in general hospitals.

  18. Determining the agent factors related with time management of responsible doctors and nurses in clinics at Ankara University hospitals.

    Science.gov (United States)

    Acuner, Ahmet Munir; Nilgun, Sarp; Cifteli, F Gulay

    2006-01-01

    This research has been planned and conducted as a descriptive scanning model field study in order to determine the agent factors related with time management of doctors and nurses in positions of responsibility at Ankara University hospitals. As data collection instruments; the "Personal Information Form" which has been developed to determine the socio-demographical characteristics of the research group, the questionnaire of "Determining the Time Management Attitudes and Behaviour of Managers, Time Management Opportunities of the Managers, Prodcutive Working Times of the Managers and the Factors Causing Them to Lose Time", developed by Erdem has been used. It has been determined that the time management attitudes and behaviour of doctors, nurses and nurse assistants responsible for clinics are all different. It was found that nurse assistants graduated from pre-undergraduate or high schools are the least conscious of time management. In particular, nurse assistants of 36 years old and over with 21 years of work experience and 11 years of management experience show little awareness of time management. The time losing factors of the research group were found to be unnecessary visitors, lack of materials and the excessive amount of time spent on obtaining the necessary equipment.

  19. Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

    Directory of Open Access Journals (Sweden)

    Tsagkaraki Petroula A

    2009-01-01

    Full Text Available Abstract Background Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice. Methods A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England. Results Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed. Conclusion The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.

  20. 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

    devices clinicians completed a very low proportion of observed tasks at the bedside. The design of the devices and ward space configurations place limitations on how and where devices are used and on the mobility of clinical work. In such circumstances, clinicians will initiate workarounds to compensate......, 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...... and doctors were observed performing workarounds, such as transcribing medication orders from the computer to paper. CONCLUSIONS: The choice of device was related to clinical role, nature of the clinical task, degree of mobility required, including where task completion occurs, and device design. Nurses' work...

  1. Bed blocking by elderly patients in general-hospital wards.

    Science.gov (United States)

    Rubin, S G; Davies, G H

    1975-08-01

    A point prevalence survey, using a questionnaire, was performed in three general hospitals to investigate the problem of elderly patients blocking acute-hospital beds. A total of 1010 occupied general beds were surveyed and all patients, over the age of 60 years, who had been in hospital more than four weeks, and who, in the opinion of medical and nursing staff, were no longer in need of the facilities of a general hospital, were investigated. Forty-eight patients (4.8 per cent of the total) were found to be genuinely in bed inappropriate to their needs. Rehabilitation, together with assessment of these patients, appeared disorganized and lacked consistency, and decisions regarding suitable 'disposal' appeared to be made without sufficient consultation and conformed to no detectable pattern. The main reason for the continuing bed occupancy of the patients was the length of the waiting lists for alternative residential accommodation and the main single medical factor preventing discharge home or to a hostel was the problem of mobility. By interviewing staff and patients and scrutinizing the questionnaires, it was found that 23 patients (48 per cent) were only suitable for transfer to a long-stay hospital. Of these, however, 15 (31 per cent) could be placed in specialized accommodation if some degree of nursing care, at present not available, was provided.

  2. A survey of doctors at a UK teaching hospital to assess understanding of recent changes to consent law.

    Science.gov (United States)

    O'Brien, J W; Natarajan, M; Shaikh, I

    2017-06-01

    The UK Supreme Court recently ruled that when consenting patients for treatments or procedures, clinicians must also discuss any associated material risks. We surveyed medical staff at a large UK teaching hospital in order to ascertain knowledge of consent law and current understanding of this change. Email survey sent to medical staff in all specialities at Norfolk and Norwich University Hospital in February 2016. 245 responses (141 Consultants and 104 junior doctors, response rate 32%). 82% consent patients for procedures at least monthly and 23% daily. 31% were not familiar with the concept of material risk. 35% were familiar with the recent change in consent law, 41% were not. 18% were "very uncertain" and 64% "a little uncertain" that their consenting process meets current legal requirements. >92% think that landmark cases and changes in law should be discussed through professional bodies and circulated better locally. The majority were not familiar with the concept of material risk and recent legal changes. A majority were not confident that their practice meets current requirements, suggesting that recent changes in consent law may not be widely understood at this hospital. We suggest more guidance and education may be necessary than is currently available. Increased understanding of recent changes to consent law will reduce the risk taken by NHS trusts and offer patients a service compliant with Supreme Court guidance.

  3. A survey on the relationship between organizational citizenship behavior and job performance of the staff at doctor Kermanshahi hospital

    Directory of Open Access Journals (Sweden)

    Ashkan Chavoshi

    2014-02-01

    Full Text Available Background: Understanding the factors affecting the performance of the staff in organizations will lead to increased their efficiency. The purpose of this study was to investigate the impact of organizational citizenship behavior (OCB on job performance in Dr. Kermanshahi hospital in Kermanshah. OCB is a voluntary behavior that goes beyond formal job descriptions of the staff and improves organizational performance . Methods: This descriptive-analytical study, which was based on structural equation modeling, was conducted in 2012.The study population included 311 staff at doctor Muhammad Kermanshahi hospital that were selected by simple random sampling. To evaluate the concepts of organizational citizenship behavior, job performance and personality attributes, Podsakoff, Patterson and NEO questionnaires were used, respectively. Data were analyzed by SPSS and AMOS software (version 21. Results: The results of the study revealed that 57% of respondents were women, 37.8% were in the age group 25 to 35 years, 40.7% had bachelor's degree and 30.2% had less than 5 years of experience. Also, personality characteristics of the staff affected their job performance. There was a significant relationship between organizational citizenship behaviour and job performance. Conclusions: This study confirmed the effects of OCB on promoting the performance of the staff. So, we can reinforce OCB in the hospital by taking advantage of the benefits of meta-functional behaviors in organization and consequently promoting the performance of the staff to.

  4. History of Cardiovascular Surgery at Toronto General Hospital.

    Science.gov (United States)

    Lee, Myunghyun M; Alvarez, Juglans; Rao, Vivek

    2016-01-01

    The Division of Cardiovascular Surgery at Toronto General Hospital has enjoyed an enviable history of academic achievement and clinical success. The foundations of this success are innovation, creativity and excellence in patient care, which continue to influence the current members of the division. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. [Successful patient-activated help call for a doctor during in-hospital stay].

    Science.gov (United States)

    Hansen, Mette Mejlby; Hasselkvist, Birgith; Thordal, Sofie; Riiskjær, Erik; Kelsen, Jens

    2014-09-29

    Department of Medicine, Randers Regional Hospital, conducted a study of patient-activated help call, involving 1,050 patients with nearly 3,700 days in-hospital stay. Patients were encou-raged to bypass traditional clinical hierarchy of communication when they felt, that their concern was not met by the staff. Three help calls were related to the management of pain. In two cases it resulted in a surgical procedure. A survey including 104 patients revealed that one third reported that patient safety was improved by the initiative and nearly three quarters re-ported that they would be willing to activate the call.

  6. Maribor General Hospital from its foundation until World War II.

    Science.gov (United States)

    Pivec, Gregor

    2006-01-01

    The author describes the history of Maribor General Hospital from its foundation in 1799 until the beginning of World War II. In 1799 the magistrate of the town of Maribor issued a memorandum regarding the establishment of a town hospital in the renovated building of the town hospice, providing space for 24 patients. The work of the hospital was carried out in the former hospice building until 1855. In the period between its establishment and eventual relocation 26 beds were added. The last two decades of the hospital's operation at the original location were marked by the assiduous work of the town's physicist, Dr. Anton Kuker. In the first half of the 19th century, the population of Maribor grew rapidly as a consequence of the construction of the Southern Railway. The town authorities therefore purchased the Prosenjak family villa in the Magdalena suburbs and relocated the hospital to it in 1855, providing 28 rooms for 110 patients. For a whole century, the care of patients was taken over by the Daughters of Charity of Saint Vincent de Paul. The hospital was soon admitting over 1000 patients a year, the most common complaints being pulmonary catarrh, gastritis and fever. In 1872, when the Master of Surgery Feliks Ferk joined the hospital, the internal "medical" and the "external" surgical departments were formed. Although medical studies were not easily accessible, there were a number of Slovene physicians working in the hospital and the town in that period. In the last decades of the 19th century, the hospital was often renovated and enlarged. The infrastructure (telephone, water supply system, heating, lighting) had also been modernized before World War I. In 1914, the first X-ray apparatus was purchased. Between the wars, the hospital's development was boosted by recruitment of the Slovene physicians Ivan Matko, Mirko Cernic, Janko Dernovsek and Hugon Robic. The initial external and medical departments split into several departments: internal medicine, surgery

  7. Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work–home balance and the European Working Time Directive: a panel study

    Science.gov (United States)

    Rosta, Judith; Aasland, Olaf G

    2014-01-01

    Objectives To examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work–home balance, and in relation to the requirements of the European Working Time Directive (EWTD). Design Panel study based on postal questionnaires. Setting Norway. Participants Unbalanced cohort of 1300–1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012. Outcome measures Self-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors. Results From 1994 to 2012, the number of weekly working hours was stable for senior (46–47 h) and junior (45–46 h) hospital doctors. In 2012, significantly more senior (27–35%) than junior (11–20%) doctors reported suboptimal work–home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer. Conclusions The weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations. PMID:25311038

  8. Weekly working hours for Norwegian hospital doctors since 1994 with special attention to postgraduate training, work-home balance and the European working time directive: a panel study.

    Science.gov (United States)

    Rosta, Judith; Aasland, Olaf G

    2014-10-13

    To examine the weekly working hours of Norwegian hospital doctors from 1994 to 2012 with special emphasis on the quality of postgraduate training and work-home balance, and in relation to the requirements of the European Working Time Directive (EWTD). Panel study based on postal questionnaires. Norway. Unbalanced cohort of 1300-1600 doctors in 1994, 1995, 1996, 1997, 2000, 2002, 2004, 2006, 2008, 2010 and 2012. Self-reported total weekly working hours and whether 45 weekly working hours are too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors. From 1994 to 2012, the number of weekly working hours was stable for senior (46-47 h) and junior (45-46 h) hospital doctors. In 2012, significantly more senior (27-35%) than junior (11-20%) doctors reported suboptimal work-home balance, defined as working more than 48 h a week. The majority perceived the present situation with an average of 45 h per week for juniors as sufficient for obligatory postgraduate specialist training, but doctors of higher age (OR 1.04, 95% CI 1.01 to 1.08), senior doctors (1.07, 1.04 to 1.11) and doctors working in surgical specialties (OR 1 vs laboratory medicine 0.03, 0.01 to 0.25, internal medicine 0.31, 0.17 to 0.58, psychiatry 0.12, 0.04 to 0.36, paediatrics 0.36, 0.12 to 1.07, anaesthesiology 0.08, 0.02 to 0.39, gynaecology 0.07, 0.01 to 0.56 and others 0.39, 0.04 to 3.56) were more likely to want the work-week to be longer. The weekly working hours of Norwegian hospital doctors were always below the EWTD requirements. A significant growth of hospital doctor density over the past two decades, national regulations and cultural values might be important factors. Specialty differences in perception of sufficient training time may call for more flexibility in working time regulations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Assessing the extent of utilization of biopsychosocial model in doctor-patient interaction in public sector hospitals of a developing country.

    Science.gov (United States)

    Nadir, Maha; Hamza, Muhammad; Mehmood, Nadir

    2018-01-01

    Biopsychosocial (BPS) model has been a mainstay in the ideal practice of modern medicine. It is attributed to improve patient care, compliance, and satisfaction and to reduce doctor-patient conflict. The study aimed to understand the importance given to BPS model while conducting routine doctor-patient interactions in public sector hospitals of a developing country where health resources are limited. The study was conducted in Rawalpindi, Pakistan. The study design is qualitative. Structured interviews were conducted from 44 patients from surgical and medical units of Benazir Bhutto Hospital and Holy Family Hospital. The questions were formulated based on patient-centered interviewing methods by reviewing the literature on BPS model. The analysis was done thematically using the software NVivo 11 for qualitative data. The study revealed four emerging themes: (1) Lack of doctor-patient rapport. (2) Utilization of a paternalistic approach during treatment. (3) Utilization of a reductionist biomedical approach during treatment. (4) Patients' concern with their improvement in health and doctor's demeanor. The study highlights the fact that BPS is not given considerable importance while taking routine medical history. This process remains doctor centered and paternalistic. However, patients are more concerned with their improvement in health rather than whether or not they are being provided informational care. Sequential studies will have to be conducted to determine whether this significantly affects patient care and compliance and whether BPS is a workable model in the healthcare system in the third world.

  10. [Audit of general hospitals and private surgical clinics in Israel].

    Science.gov (United States)

    Freund, Ruth; Dor, Michael; Lotan, Yoram; Haver, Eitan

    2007-12-01

    Supervision and inspection of medical facilities are among the responsibilities of the Ministry of Health (MOH) anchored in the "Public Health Act 1940". In order to implement the law, the General Medical Division of the MOH began the process of auditing hospitals and private surgical clinics prior to considering the reissue of their license. The audit aimed to implement the law, activate supervision on general hospitals and private surgical clinics, provide feed-back to the audited institution and upgrade quality assurance, regulate medical activities according to the activities elaborated in the license and recommend the license renewal. Prior to the audits, 20 areas of activity were chosen for inspection. For each activity a check list was developed as a tool for inspection. Each area was inspected during a 4-5 hour visit by a MOH expert, accompanied by the local service manager in the institution under inspection. A comprehensive report, summarizing the findings was sent to the medical institute, requesting correction in those areas where improvements were needed. Recommendation for license renewal was sent to the Director of Licensing Division Ministry of Health. Between June 2003 and July 2006, 91 structured audits took place. A total of 47 general hospitals and 24 private surgical clinics were visited at least once. Most general hospitals were found abiding, functioning according to the required standards and eligible for license renewal. Licenses of institutions that complied with the standards determined by the audit teams, were renewed. Two private hospitals in central Israel, that were given an overall poor evaluation, were issued with a temporary license and subsequently re-audited 4 times over the next two years. Generally, the standards in private surgical clinics were lower than those found in general public hospitals. In one clinic the license was not renewed, and in another an order was issued to cease surgical procedures requiring general

  11. Martin Luther King, Jr., General Hospital and community involvement.

    Science.gov (United States)

    Humphrey, M M

    1973-07-01

    Community involvement is not just one facet of the new Martin Luther King, Jr., General Hospital's existence. It is the mainstream from which all other activities flow. In addition to meeting the conventional needs of a conventional hospital staff with the core collection of texts and journals, this library goes one step further. It acts as a resource for its community health workers, dietitians, and nurses in their various outreach programs. It serves as a stimulus for the high school or community college student who may be curious about a health career. It also finds time to provide reading material for its patients.

  12. Does Seeing the Doctor More Often Keep You Out of the Hospital?

    OpenAIRE

    Robert Kaestner; Anthony T. Lo Sasso

    2012-01-01

    By exploiting a unique health insurance benefit design, we provide novel evidence on the causal association between outpatient and inpatient care. Our results indicate that greater outpatient spending was associated with more hospital admissions: a $100 increase in outpatient spending was associated with a 2.7% increase in the probability of having an inpatient event and a 4.6% increase in inpatient spending among enrollees in our sample. Moreover, we present evidence that the increase in hos...

  13. GENERAL HOSPITAL MARIBOR FROM ITS FOUNDATION TILL WORLD WAR II

    Directory of Open Access Journals (Sweden)

    Gregor Pivec

    2004-04-01

    Full Text Available Author describes the history of General Hospital Maribor from its foundation (1799 to the beginning of World War II. In 1799 the magistrate of the town Maribor issued a memorandum regarding establishment of a town hospital in the renovated building of the town hospice, providing space for 24 patients. The work of the hospital was carried out in the former hospice building until 1855. 26 beds were added in the period between its establishment and eventual relocation. The last two decades of the hospital’s operation at the original location were marked by the assiduous work of the town’s physicist, Dr. Anton Kuker. In the first half of the 19th century, the population of Maribor rapidly grew as a consequence of the construction of the Southern Railway. The city authorities therefore purchased the Prosenjak family villa in the Magdalena suburbs and relocated the hospital to it in 1855, providing 28 rooms for 110 patients. For a whole century, the care of patients was taken over by the Daughters of Charity of Saint Vincent de Paul. The hospital was soon admitting over 1000 patients a year; the most common complaints being pulmonary catarrh, gastritis and fever. In 1872, when the Master of Surgery, Feliks Ferk, joined the hospital, the internal, medical, and the »external« surgical departments were formed. Although medical studies were not easily accessible, there was a number of Slovene physicians working in the hospital and the town in that period. In the last decades of the 19th century, the hospital was often renovated and enlarged. The infrastructure (telephone, water supply system, heating, lighting had also been modernized by World War I. In 1914, the first X-ray apparatus was purchased. Between the wars, the hospital’s development was stepped up by the recruitment of the Slovene physicians Ivan Matko, Mirko Černič, Janko Dernovšek and Hugon Robič. The initial external and medical departments split into several departments

  14. Work related stress and its anticipated solutions among post-graduate medical resident doctors: a cross-sectional survey conducted at a tertiary municipal hospital in Mumbai, India.

    Science.gov (United States)

    Rajan, Pavithra; Bellare, Bharati

    2011-03-01

    It is now known that resident doctors registered for postgraduate studies are prone to work related stress and eventual burnout. Though stress can happen in any profession, reduced performance of resident doctors due to vocational stress could cause an increase in medical errors and thus affect the quality of life of the patients. Resident doctors at a Municipal hospital in India form a unique population as number of stresses they undergo are many and varied. To study the prevalence of work-related stress and its anticipated solutions among the resident doctors registered for postgraduate studies in clinical subjects at a tertiary Municipal hospital. A stratified sampling cross-sectional survey was conducted at the Inpatient, Outpatient, and Intensive Care Units at a tertiary Municipal hospital in Mumbai, India. Data collection was done using a validated 20-point questionnaire to assess the factors causing stress and their anticipated solutions. Simple percentage analysis of stress questionnaire. 71 resident doctors completed the survey. The major stressors in this cohort were inadequate hostel/quarter facilities (92.1%), and the need to perform extra duties (80.0%). Also, non-conducive environment for clinical training and studies (81.7%), inadequate study (78.9%) and break (81.2%), threat from deadly infections (74.6%), and overburdening with work (69.0%) were the other major stress causing factors. The perceived stress busters were good music (40.8%) and family and friends (40.8%). Eighty-seven percent of the respondents perceived regular physical exercise to be an effective mode of stress management and 83.8% expressed their need to have a simple therapeutic gymnasium established within the campus with a qualified trainer. There is a high level of work related stress among the resident doctors registered for postgraduate clinical studies at a tertiary Municipal hospital in Mumbai. One of the perceived stress busters is regular physical exercise that is

  15. First 101 Robotic General Surgery Cases in a Community Hospital

    Science.gov (United States)

    Robertson, Jarrod C.; Alrajhi, Sharifah

    2016-01-01

    Background and Objectives: The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed. Methods: Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics. Results: Between March 2014 and August 2015, 101 robotic general surgery cases were performed by a single surgeon in a 266-bed community hospital, including laparoscopic cholecystectomies, inguinal hernia repairs; ventral, incisional, and umbilical hernia repairs; and colorectal, foregut, bariatric, and miscellaneous procedures. Ninety-nine of the cases were completed robotically. Seven patients were readmitted within 30 days. There were 8 complications (7.92%). There were no mortalities and all complications were resolved with good outcomes. The mean operative time was 233.0 minutes. The mean console operative time was 117.6 minutes. Conclusion: A robotic general surgery program can be safely implemented in a small community hospital with extensive training of the surgical team through basic robotic skills courses as well as supplemental educational experiences. Although the use of the robotic platform in general surgery could be limited to complex procedures such as foregut and colorectal surgery, it can also be safely used in a large variety of operations with results similar to those of conventional laparoscopy. PMID:27667913

  16. Exposure to coughed airborne pathogens in a double bed hospital patient room with overhead mixing ventilation: impact of posture of coughing patient and location of doctor

    DEFF Research Database (Denmark)

    Kierat, W.; Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor

    2010-01-01

    The exposure of a doctor and a patient to air coughed by a second infected patient was studied in a mock-up of two-bed hospital infectious ward with mixing ventilation at 22oC (71.6 F) room air temperature. The effect of posture of the coughing patient lying sideways or on back), position...

  17. The value of vaccination: results of an Italian survey among Medical Doctors, Policy Makers and General Population

    Directory of Open Access Journals (Sweden)

    Chiara Cadeddu

    2012-03-01

    Full Text Available

    Abstract:

    Background: In the Italian context, evolving toward the abandonment of compulsory vaccination, the
    maintenance of adequate levels of coverage appears as essential. The promotion of a good vaccination
    knowledge, supported by strong scientific evidence, and the collaboration of all the involved stakeholders,
    appears hence fundamental. The aim of this survey was to understand why vaccination is not appreciated
    for its real value by different stakeholders.
    Methods: In collaboration with other Italian Universities and Health Districts, in Summer 2011 we submitted
    a survey of 17 questions to a convenience sample of Italian Medical Doctors, Policy Makers and General
    Population. The main questions analyzed the importance of vaccination for health, actions to attain vaccination
    value and consequences of a free choice policy.
    Results: Of the 173 stakeholders interviewed, 78% of Medical Doctors, 82% Policy Makers and 46%
    General Population believe that vaccination is important for health. The most important actions suggested
    for strengthening vaccination were information about its efficacy and safety and studies on its impact on
    Public Health, according to most of General Population and of Medical Doctors and Policy Makers, respectively.
    According to 60.4% Medical Doctors, 72.8% Policy Makers and 56.3% General Population the abolition
    of compulsory vaccination would lead to a reduction of vaccinees in all the Italian regions.
    Conclusions: Our study confirms the need for a thorough “education in vaccination”. Among stakeholders
    there are still doubts that hinder the decision process about vaccination policies and programmes. On
    the other hand, a call for an “Alliance” for promoting and implementing vaccination to its full potential
    would be favoured, as

  18. Medical taking-decisions in the health primary assistance context. Transcendence of a problem from a general comprehensive doctor´s perspective.

    OpenAIRE

    Luis Alberto Corona Martínez

    2003-01-01

    This article is aimed at deepening on the consequences of the deficient development of abilities in decision making in the speciality of medicine, analysed from the prospective of the Comprehensive General Doctor . A psychological and professional characterisation of the Comprehensive General Doctors are developed from the analysis of their environment and on these bases the paper presents how these problems are reflected in the professional assistance. The conclusions are good to recognise h...

  19. General self-efficacy and the effect of hospital workplace violence on doctors’ stress and job satisfaction in China

    Directory of Open Access Journals (Sweden)

    Yongcheng Yao

    2014-08-01

    Full Text Available Objectives: This study aims at exploring associations of general self-efficacy (GSE, workplace violence and doctors' work-related attitudes. Material and Methods: In this study a cross-sectional survey design was applied. Questionnaires were administrated to 758 doctors working in 9 hospitals of Zhengzhou, Henan province, China, between June and October 2010. General information on age, gender, and years of working was collected, and the doctors' experience and witnessing workplace violence, job satisfaction, job initiative, occupational stress as well as GSE were measured. General linear regression analysis was performed in association analyses. Results: Both experiencing and witnessing workplace violence were significantly positively correlated with the level of occupational stress but significantly negatively correlated with job satisfaction, job initiative, and GSE. General self-efficacy significantly modified relationships between both experiencing and witnessing workplace violence with occupational stress (β = 0.49 for experiencing violence; β = 0.43 for witnessing violence; p 0.05. The levels of occupational stress declined significantly with the increase of GSE, while job satisfaction increased significantly along with its increase. The effects of GSE on occupational stress and job satisfaction weakened as the frequency of violence increased. Conclusions: The findings suggest that GSE can modify effects of workplace violence on health care workers' stress and job satisfaction. Enhancing GSE in combination with stress reduction may lead to facilitating health care workers' recovery from workplace violence, and thereby improving their work-related attitudes.

  20. An email-based intervention to improve the number and timeliness of letters sent from the hospital outpatient clinic to the general practitioner : A pair-randomized controlled trial

    NARCIS (Netherlands)

    Medlock, Stephanie; Parlevliet, Juliette L.; Sent, Danielle; Eslami, Saeid; Askari, Marjan; Arts, Derk L.; Hoekstra, Joost B.; de Rooij, Sophia E.; Abu-Hanna, Ameen

    2017-01-01

    Objective: Letters from the hospital to the general practitioner are important for maintaining continuity of care. Although doctors feel letters are important, they are often not written on time. To improve the number and timeliness of letters sent from the hospital outpatient department to the

  1. [Continuous medical education of general practitioners/family doctors in chronic wound care].

    Science.gov (United States)

    Sinozić, Tamara; Kovacević, Jadranka

    2014-10-01

    A number of healthcare professionals, specialists in different fields and with different levels of education, as well as non-healthcare professionals, are involved in the care of chronic wound patients, thus forming a multidisciplinary team that is not only responsible for the course and outcome of treatment, but also for the patient quality of life. Family doctor is also member of the team the task of which is to prevent, diagnose, monitor and anticipate complications and relapses, as well as complete recovery of chronic wound patients, with the overall care continuing even after the wound has healed, or is involved in palliative care. A family medicine practitioner with specialized education and their team of associates in the primary health care, along with material conditions and equipment improvement, can provide quality care for patients with peripheral cardiovascular diseases and chronic wounds, organized according to the holistic approach. It is essential that all professional associations of family medicine as well as professional associations of other specialties - fields that are involved in wound prevention and treatment - be included in developing the continuous medical education program. The benefits of modern information technology should be used to good advantage. The education should be adapted to the needs of family practitioners in terms of the form, place, time, volume, financial affordability and choice of topic. The interest shown in team education should be transformed into specialized programs in the creation of which it is essential to include both physicians and nurses and their respective professional associations. Special attention should be paid to education and training of young doctors/nurses, those with less work experience, those that have not yet been part of such education, those that lack experience in working with wound patients, those whose teams deal mostly with elderly patients, and also residents in family medicine and

  2. Group of family companions of hospitalized patients: an occupational therapy intervention strategy in a general hospital

    Directory of Open Access Journals (Sweden)

    Daniel Ferreira Dahdah

    2013-08-01

    Full Text Available There is a consensus in the literature that the company of a family member during the hospitalization period increases patient recovery. However, this can have some negative effects on the caregiver’s health. With the purpose of reducing these negatives effects, it is useful to let family members express themselves. The State Hospital of Ribeirão Preto created a Group of Family Companions coordinated by the Occupational Therapy and Social Service. This study focuses on the assistance offered in a general hospital to families that undergo the whole illness and hospitalization process of their family member, suffering the impacts of this process in their daily lives, and on the intervention of Occupational Therapy in these cases.

  3. Severe acute respiratory syndrome in a doctor working at the Prince of Wales Hospital.

    Science.gov (United States)

    Wong, R S M

    2003-06-01

    Severe acute respiratory syndrome is a new disease that is highly contagious and is spreading in the local community and worldwide. This report is of a hospital medical officer with severe acute respiratory syndrome. He presented with sudden onset of fever, chills, myalgia, headache, and dizziness in early March 2003. He developed progressive respiratory symptoms and bilateral pulmonary infiltrates during the second week of his illness. Blood tests showed lymphopenia, mild thrombocytopenia, and prolonged activated partial thromboplastin time with normal d-dimer level. His chest condition gradually responded to ribavirin and corticosteroids, and serial chest X-ray showed resolving pulmonary infiltrates. The importance of early diagnosis lies in the potential for early treatment, leading to better response.

  4. Terapia ocupacional en un hospital general de pacientes agudos = Occupational therapy in a general hospital for acute pacients

    Directory of Open Access Journals (Sweden)

    Ocello, M. G

    2006-09-01

    Full Text Available RESUMEN Desde su creación, el Hospital Provincial “Dr. José María Cullen” posee la característica de ser un hospital de emergencias, sostenido por la Sociedad de Beneficencia y la Hermanas de la Caridad.Su funcionamiento responde a un Modelo Clínico-Asistencial, lo cual influye en la inserción de Terapia Ocupacional debiendo adaptar sus funciones a las características de la Institución.Los marcos de referencia teóricos y programas que se implementandeber ser acordes con las necesidades surgidas de un Hospital General de Agudos y de emergencias.En el Sector de Terapia Ocupacional se desarrolla la actividad docente cumpliendo con los requisitos reglamentados por el Ministerio de Salud de la Provincia de Santa Fe.ABSTRACT Ever since its start the Provincial Hospital “Dr. José María Cullen” is characterised for being an emergency hospital under the guidance of the Benfit Society of Hermanas de la Caridad.Its function responds to a Clinical Assistential Model, which influences the insertion of Occupational Therapy, adapting its functiones to the characteristics of the Institution as and when called for.The theoretical points of reference and programmes that are used must be in accordance with tehe necessities that appear in an Acute and Emergency General Hospital.In the Occupational Therapy Sector the teaching activity is developed as required by rules and regulations of the Ministry of Health for the Province of Santa Fe.

  5. Stroke admissions in Kubwa General Hospital: A 30-month review

    Directory of Open Access Journals (Sweden)

    Osaze Ojo

    2017-01-01

    Full Text Available >Background: Stroke is a common neurological disorder that contributes significantly to the morbidity and mortality of medical admissions.Objectives: To review the types, risk factors, hemispheric involvement, and outcomes of admitted stroke patients in Kubwa General Hospital, Abuja, Nigeria.Subjects and Methods: We carried out a retrospective study of patients who had a clinical diagnosis of stroke in Kubwa General Hospital, Abuja, Nigeria, between January 2013 and June 2015.Results: A total of 60 patients who had stroke were admitted during this period, accounting for 4.25% of medical admissions. Men and women accounted for 68.3% and 31.7%, respectively, with a male-to-female ratio of 2:1. Their mean age was 54.9 ± 13.5 years while the median age was 52.5 years. The mean hospital stay for these patients was 8.4 ± 5.5 days. Ischemic stroke occurred more frequently (65% compared with hemorrhagic stroke (35%. Hypertension (65%, alcohol (25%, previous stroke (18.3%, diabetes mellitus, and hypercholesterolemia (18.3% were the common identifiable risk factors for stroke. Ten patients (16.7% had two risk factors for stroke, whereas 8 patients (13.3% had three risk factors for stroke. The mean systolic and diastolic blood pressures on admission were 171.5 ± 41.6 mmHg and 103.3 ± 24.0 mmHg, respectively. The left hemisphere (53.3% was more often affected than the right hemisphere in these patients. Majority of the patients (48.3% were discharged following improvement while the case fatality was 11.7%.Conclusion: Stroke is not uncommon as a cause of medical admission in Kubwa General Hospital. Ischemic stroke occurred more commonly and the left hemisphere was more often involved compared with the right hemisphere. Hypertension was the most common risk factor for stroke in these patients.

  6. General practice: the DREEM attachment? Comparing the educational environment of hospital and general practice placements.

    Science.gov (United States)

    Kelly, Martina; Bennett, Deirdre; O'Flynn, Siun

    2012-01-01

    The clinical learning environment is changing. General practice placements are now a fundamental part of undergraduate medical education. There is growing recognition that changes in hospital work practices are altering the breadth of exposure available to students. Surprisingly little work has been done comparing the quality of clinical placements between the hospital and community using validated tools. Such comparisons inform curriculum planning and resource allocation. The aim of this study was to compare the quality of the educational environment experienced by junior medical students during hospital and general practice placements using a widely used tool. Following the introduction of a new integrated curriculum, all Year 3 students (n=108) completed a standardised evaluation instrument, the Dundee Ready Education Environment Measure (DREEM) at the end of each of their clinical attachments (two different hospital sites and one in general practice), giving a total of 324 questionnaires. All forms were analysed and input into Graphpad INSTAT version 3. Total DREEM scores as well as subscale scores were calculated for each site. These were compared across sites using a Mann-Whitney U non-parametric test. By comparison with international standards, clinical attachments in our new integrated curriculum were rated highly. In particular, attachments in general practice scored highly with a mean score of 156.6 and perform significantly better (P students' perceptions of atmosphere and students' social self-perceptions. Finally, significant differences also emerged in students' perceptions of teachers in general practice when compared to those in the hospital setting. These findings provide evidence of the high-quality educational environment afforded students in primary care. They challenge the traditional emphasis on hospital-based teaching and preempt the question - Is the community a better place for junior students to learn?

  7. Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

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    Simon Munyua

    2015-08-01

    Full Text Available Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH to assess how access to technology affects the adoption of mHealth in maternal healthcare to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial General Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts percentages and measures of central tendency. Inferential statistics on the other hand include t-test analysis and spearman correlation

  8. Work of female rural doctors.

    Science.gov (United States)

    Wainer, Jo

    2004-04-01

    To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are

  9. Hospital Anxiety and Depression Scale (HADS: validation in a Greek general hospital sample

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    Patapis Paulos

    2008-03-01

    Full Text Available Abstract Background The Hospital Anxiety and Depression Scale (HADS has been used in several languages to assess anxiety and depression in general hospital patients with good results. Methods The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of the Internal Medicine and Surgical Departments in 'Attikon' General Hospital in Athens. The Beck Depression Inventory (BDI and the State-Trait Anxiety Inventory (STAI were used as 'gold standards' for depression and anxiety respectively. Results The HADS presented high internal consistency; Cronbach's α cofficient was 0.884 (0.829 for anxiety and 0.840 for depression and stability (test-retest intraclass correlation coefficient 0.944. Factor analysis showed a two-factor structure. The HADS showed high concurrent validity; the correlations of the scale and its subscales with the BDI and the STAI were high (0.722 – 0.749. Conclusion The Greek version of HADS showed good psychometric properties and could serve as a useful tool for clinicians to assess anxiety and depression in general hospital patients.

  10. Improving the smoking patterns in a general hospital psychiatric unit

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    Celso Iglesias García

    2009-01-01

    Full Text Available Objectives: The purpose of the present paper is to evaluate the effects of a smoking ban in a general hospital psychiatric unit. Methods: We study the effects of smoking ban in 40 consecutive psychiatric inpatients. The staff registered socio-demographic and tobacco-related variables. We also registered any kind of behavioral effects of smoking ban.Results: The patients were willing to stop smoking during their hospital stay (with or without nicotine replacement with two mild behavioural incidences registered throughout the study. Conclusions: The benefits of non-smoking policy in a psychiatric unit can be significant. The introduction of smoking bans in psychiatric inpatients settings is possible and safe.

  11. Burnout syndrome among non-consultant hospital doctors in Ireland: relationship with self-reported patient care.

    Science.gov (United States)

    Sulaiman, Che Fatehah Che; Henn, Patrick; Smith, Simon; O'Tuathaigh, Colm M P

    2017-10-01

    Intensive workload and limited training opportunities for Irish non-consultant hospital doctors (NCHDs) has a negative effect on their health and well-being, and can result in burnout. Burnout affects physician performance and can lead to medical errors. This study examined the prevalence of burnout syndrome among Irish NCHDs and its association with self-reported medical error and poor quality of patient care. A cross-sectional quantitative survey-based design. All teaching hospitals affiliated with University College Cork. NCHDs of all grades and specialties. The following instruments were completed by all participants: Maslach Burnout Inventory-Human Service Survey (MBI-HSS), assessing three categories of burnout syndrome: Emotional exhaustion (EE), Personal Achievement (PA) and Depersonalization (DP); questions related to self-reported medical errors/poor patient care quality and socio-demographic information. Self-reported measures of burnout and poor quality of patient care. Prevalence of burnout among physicians (n = 265) was 26.4%. There was a significant gender difference for EE and DP, but none for PA. A positive weak correlation was observed between EE and DP with medical error or poor patient care. A negative association was reported between PA and medical error and reduced quality of patient care. Burnout is prevalent among NCHDs in Ireland. Burnout syndrome is associated with self-reported medical error and quality of care in this sample population. Measures need to be taken to address this issue, with a view to protecting health of NCHDs and maintaining quality of patient care. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  12. When and why do doctors decide to become general practitioners? Implications for recruitment into UK general practice specialty training.

    Science.gov (United States)

    Irish, Bill; Lake, Jonathan

    2011-01-01

    All applicants to round 1 of national recruitment into the general practice specialty recruitment process were surveyed as to the reasons for, and the timing of their career choices. Most applicants reported decision making after completing undergraduate training citing variety, continuity of care and work-life balance as their main drivers for a career in general practice. Applicants were statistically more likely to have undertaken a Foundation placement in general practice than their peers on a Foundation programme. Reasons for choice of deanery were largely related to location and social ties, rather than to the educational 'reputation' of its programmes.

  13. Acute general hospital admissions in people with serious mental illness.

    Science.gov (United States)

    Jayatilleke, Nishamali; Hayes, Richard D; Chang, Chin-Kuo; Stewart, Robert

    2018-02-28

    Serious mental illness (SMI, including schizophrenia, schizoaffective disorder, and bipolar disorder) is associated with worse general health. However, admissions to general hospitals have received little investigation. We sought to delineate frequencies of and causes for non-psychiatric hospital admissions in SMI and compare with the general population in the same area. Records of 18 380 individuals with SMI aged ⩾20 years in southeast London were linked to hospitalisation data. Age- and gender-standardised admission ratios (SARs) were calculated by primary discharge diagnoses in the 10th edition of the World Health Organization International Classification of Diseases (ICD-10) codes, referencing geographic catchment data. Commonest discharge diagnosis categories in the SMI cohort were urinary conditions, digestive conditions, unclassified symptoms, neoplasms, and respiratory conditions. SARs were raised for most major categories, except neoplasms for a significantly lower risk. Hospitalisation risks were specifically higher for poisoning and external causes, injury, endocrine/metabolic conditions, haematological, neurological, dermatological, infectious and non-specific ('Z-code') causes. The five commonest specific ICD-10 diagnoses at discharge were 'chronic renal failure' (N18), a non-specific code (Z04), 'dental caries' (K02), 'other disorders of the urinary system' (N39), and 'pain in throat and chest' (R07), all of which were higher than expected (SARs ranging 1.57-6.66). A range of reasons for non-psychiatric hospitalisation in SMI is apparent, with self-harm, self-neglect and/or reduced healthcare access, and medically unexplained symptoms as potential underlying explanations.

  14. [What Makes Happy Doctors? Job Satisfaction of General Practitioners in Mecklenburg-Western Pomerania - a Representative Cross-sectional Study].

    Science.gov (United States)

    Löffler, C; Höck, J; Hornung, A; Kundt, G; Drewelow, E; Völker, S; Kreiser, B; Riedel, J; Altiner, A

    2015-12-01

    Studies provide evidence for the importance of general practitioners (GPs) job satisfaction for a secure and high quality health care provision. This study focuses on job satisfaction of GPs in Mecklenburg-Western Pomerania (MV), a rural area threatened by a lack of GPs. We investigate how satisfied GPs are with their job and which factors influence their job satisfaction. All 1 133 GPs working in MV in December 2011 were asked to complete a 57-item-questionnaire. The response rate reached 50.1%. The sample is representative for GPs in MV. Levels of job satisfaction are high and correlate with age and sex: females and GPs below 50 years of age are more satisfied. Factors contributing to high job satisfaction include a good doctor-patient relationship, fair pay, and the variety of reasons for doctor-patient consultations in primary care. Although all GPs were dissatisfied with bureaucracy, this factor has little impact on GPs' overall job satisfaction. In light of the imminent lack of GPs, in future it will be important to improve factors that have been demonstrated to increase job satisfaction. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Management of perforated peptic ulcer in a district general hospital.

    Science.gov (United States)

    Critchley, A C; Phillips, A W; Bawa, S M; Gallagher, P V

    2011-11-01

    Laparoscopic surgery has become increasingly popular for elective surgery but it has gained slow transference to emergency surgery. The management of perforated peptic ulcers (PPU) laparoscopically is an accepted strategy yet it still remains infrequently used. The purpose of this study was to analyse the utility and outcomes of laparoscopy versus open repair for PPU in a district general hospital. In addition, we evaluated whether the subspecialty of the on-call consultant affected the method of repair performed and the training opportunities for trainee surgeons. Between 2003 and 2009, 53 patients underwent laparoscopic repair, 89 patients underwent open repair and a further 20 patients had laparoscopic repair that was converted to open repair for PPU. The results from a prospectively compiled database were analysed with primary outcome measures including operative time, length of hospital stay and mortality. The median operating time in the laparoscopic group was 60.0 minutes compared with 50.5 minutes in the open group. Hospital stay in surviving patients was significantly shorter in patients treated completely laparoscopically (5 days) when compared with the open group (6 days) ( p management of PPU. Our findings support the view that this procedure can be successfully used as a training operation.

  16. Characterizing and predicting rates of delirium across general hospital settings.

    Science.gov (United States)

    McCoy, Thomas H; Hart, Kamber L; Perlis, Roy H

    2017-05-01

    To better understand variation in reported rates of delirium, this study characterized delirium occurrence rate by department of service and primary admitting diagnosis. Nine consecutive years (2005-2013) of general hospital admissions (N=831,348) were identified across two academic medical centers using electronic health records. The primary admitting diagnosis and the treating clinical department were used to calculate occurrence rates of a previously published delirium definition composed of billing codes and natural language processing of discharge summaries. Delirium rates varied significantly across both admitting diagnosis group (X 2 10 =12786, pdelirium (86/109764; 0.08%) and neurological admissions the greatest (2851/25450; 11.2%). Although the rate of delirium varied across the two hospitals the relative rates within departments (r=0.96, pdelirium varies significantly across admitting diagnosis and hospital department. Both admitting diagnosis and department of care are even stronger predictors of risk than age; as such, simple risk stratification may offer avenues for targeted prevention and treatment efforts. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. [Prevalence of negative stereotypes towards old age among personnel of a general hospital].

    Science.gov (United States)

    Franco S, Mireya; Villarreal R, Enrique; Vargas D, Emma R; Martínez G, Lidia; Galicia R, Liliana

    2010-08-01

    Social representations are value systems. Social stereotypes are a social consensus of traits associated with a specific group. Stereotypes about older subjects, generally have negative connotations. To assess the prevalence of negative stereotypes towards older subjects among health care personnel. A questionnaire about stereotypes towards old age, with Likert type questions that included health, social motivations and personality-character domains, was applied to 52 doctors, 12 residents, 80 general nurses, 36 auxiliary nurses, four social workers and 10 medical assistants, working at a general hospital. The mean age of the professionals who answered the questionnaire was 38 years (95% confidence intervals (CI) 37-39 years) and 78% were women. The prevalence of a Global negative stereotype was 65.0%(95% CI: 59.5-70.5). The figure for the health domain was 64.5% (IC95%; 59.0-70.0), for the social motivation domain was 60%(5%CI: 54.3-65.7) and for the character personality domain was 64% (95%CI: 58.4-69.6). There is a high prevalence of a negative stereotype towards old age among health care personnel.

  18. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals

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    Judith McLenan

    2016-12-01

    Full Text Available Objective: The aim of this study was to evaluate the type, severity and progression of psychiatric pathologies in a sample of 372 outpatients (age range 18–65 years referred by their primary general practitioners (GPs to an Urgent Referral Team (URT based in a psychiatric hospital in Aberdeen, Scotland. This team offers immediate appointments (1- to 7-day delays for rapid assessments and early interventions to the outpatients referred by their primary family doctors.Method: One-sample t-test and z statistic were used for data analysis. From the total population, a convenience sample of 40 people was selected and assessed to evaluate whether follow-up appointments after the first visit could reduce the severity of suicidal ideation, depression and anxiety in the outpatients seen by the URT. A two-sample t-test and a Wilcoxon signed-rank test were used to assess the variations in the scores during the follow-up visits.Results: We found a statistically significant prevalence of depressive disorders, comorbid with anxiety at first presentation in people who were females, white, never married, living with a partner, not studying and not in paid employment. The common presentation of borderline personality disorder and dysthymia in this population underscores its vulnerability to major socioeconomic challenges.Conclusion: The data confirmed the impact that primary care cooperation with psychiatric hospitals can have on the psychiatric system, and as a reflection, on the population’s mental health and well-being. In fact, active cooperation and early diagnosis and intervention will help detect cases at risk in the general population and reduce admissions into hospitals.

  19. Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

    Science.gov (United States)

    Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

    2015-12-01

    We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

  20. Front-line management, staffing and nurse-doctor relationships as predictors of nurse and patient outcomes. a survey of Icelandic hospital nurses.

    Science.gov (United States)

    Gunnarsdóttir, Sigrún; Clarke, Sean P; Rafferty, Anne Marie; Nutbeam, Don

    2009-07-01

    To investigate aspects of nurses' work environments linked with job outcomes and assessments of quality of care in an Icelandic hospital. Prior research suggests that poor working environments in hospitals significantly hinder retention of nurses and high quality patient care. On the other hand, hospitals with high retention rates (such as Magnet hospitals) show supportive management, professional autonomy, good inter-professional relations and nurse job satisfaction, reduced nurse burnout and improved quality of patient care. Cross-sectional survey of 695 nurses at Landspitali University Hospital, Reykjavík. Nurses' work environments were measured using the nursing work index-revised (NWI-R) and examined as predictors of job satisfaction, the Maslach burnout inventory (MBI) and nurse-assessed quality of patient care using linear and logistic regression approaches. An Icelandic adaptation of the NWI-R showed a five-factor structure similar to that of Lake (2002). After controlling for nurses' personal characteristics, job satisfaction, emotional exhaustion and nurse rated quality of care were found to be independently associated with perceptions of support from unit-level managers, staffing adequacy, and nurse-doctor relations. The NWI-R measures elements of hospital nurses' work environments that predict job outcomes and nurses' ratings of the quality of patient care in Iceland. Efforts to improve and maintain nurses' relations with nurse managers and doctors, as well as their perceptions of staffing adequacy, will likely improve nurse job satisfaction and employee retention, and may improve the quality of patient care.

  1. Interoperability prototype between hospitals and general practitioners in Switzerland.

    Science.gov (United States)

    Alves, Bruno; Müller, Henning; Schumacher, Michael; Godel, David; Abu Khaled, Omar

    2010-01-01

    Interoperability in data exchange has the potential to improve the care processes and decrease costs of the health care system. Many countries have related eHealth initiatives in preparation or already implemented. In this area, Switzerland has yet to catch up. Its health system is fragmented, because of the federated nature of cantons. It is thus more difficult to coordinate efforts between the existing healthcare actors. In the Medicoordination project a pragmatic approach was selected: integrating several partners in healthcare on a regional scale in French speaking Switzerland. In parallel with the Swiss eHealth strategy, currently being elaborated by the Swiss confederation, particularly medium-sized hospitals and general practitioners were targeted in Medicoordination to implement concrete scenarios of information exchange between hospitals and general practitioners with a high added value. In this paper we focus our attention on a prototype implementation of one chosen scenario: the discharge summary. Although simple in concept, exchanging release letters shows small, hidden difficulties due to the multi-partner nature of the project. The added value of such a prototype is potentially high and it is now important to show that interoperability can work in practice.

  2. URGENCIAS PSIQUIÁTRICAS EN EL HOSPITAL GENERAL

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    Dr. Rodrigo Nieto

    2017-11-01

    Full Text Available Las urgencias psiquiátricas pueden presentarse en diversos escenarios clínicos, incluyendo la consulta ambulatoria, el servicio de urgencias, o el hospital general. Por este motivo, es importante que tanto psiquiatras como médicos de otras especialidades estén capacitados para su reconocimiento y manejo inicial. Especialmente en el contexto del hospital general, es importante considerar la relación entre enfermedades médicas y psiquiátricas, desde los síntomas físicos que pueden presentarse producto de un trastorno psiquiátrico, hasta los síntomas psiquiátricos que son el resultado de enfermedades orgánicas, medicamentos o abuso de sustancias. Adicionalmente, en este artículo se entregan elementos para el manejo de algunas urgencias psiquiátricas particularmente relevantes, tales como la ideación suicida, la agitación psicomotora o el delirium, donde las intervenciones iniciales pueden ser de gran importancia para la evolución y el pronóstico del paciente.

  3. Causes of recurrent pneumonia in children in a general hospital.

    Science.gov (United States)

    Hoving, M F Paulien; Brand, Paul L P

    2013-03-01

    Because the few previous studies on underlying causes of recurrent pneumonia in children have come from tertiary care referral centres where selection bias may be important, the aim of this study was to examine underlying causes of recurrent pneumonia in children in a general hospital. We performed a retrospective chart review in a general hospital of 62 children with recurrent pneumonia over a 7.5 years period. In 19 patients (30.6%), no cause was identified, commonly because favourable natural history obviated the need for a full and invasive diagnostic work-up. Other underlying causes included recurrent aspiration in 16 patients (25.7%), lung disease (airway stenosis, bronchiectasis, middle lobe syndrome or tracheooesophageal fistula) in 10 patients (16.1%) and immune deficiency in 10 patients (16.1%). In contrast to previous studies, asthma was never diagnosed as an underlying cause, but diagnostic confusion between asthma (or recurrent upper respiratory tract infections) and recurrent pneumonia was common. The cause of recurrent pneumonia in children remains elusive in almost a third of patients, partly because the favourable natural history consistent with immune system maturation eliminates the need for further diagnostic procedures. Asthma is more likely a differential diagnostic consideration than an underlying cause of recurrent pneumonia in children. A standardised diagnostic guideline is needed to improve knowledge on causes of recurrent pneumonia in children. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  4. Alcohol misuse in the general hospital: some hard facts.

    LENUS (Irish Health Repository)

    Bradshaw, P

    2012-02-03

    AIMS: To examine (1) the prevalence of alcohol use disorders in adult general hospital inpatients; (2) the accuracy of documentation in relation to alcohol use. METHODS: A total of 210 random patients were interviewed out of 1,448 consecutive new admissions to CUH over 7 days. Case notes were reviewed for 206 (98%). Alcohol consumption was assessed using the Fast Alcohol Screening Test (FAST) and weekly drinking diary. FAST-positive (and a random sample of FAST-negative) patients then had a standardized interview. RESULTS: A total of 82% admitted for drinking alcohol. Among them 22% were drinking in excess of guidelines, 9% had DSM-IV Alcohol Abuse and 7% dependence. The sensitivity and specificity of the FAST for detecting those drinking above guidelines were 89 and 94% and for detecting a DSM-IV diagnosis was 100 and 73%. The majority of case notes contained inadequate information about alcohol intake. CONCLUSION: Alcohol use disorders are common and often undetected in the general hospital setting.

  5. Financial management challenges for general hospital psychiatry 2001.

    Science.gov (United States)

    Goldberg, R J

    2001-01-01

    Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability.

  6. Initial Results of the Master's Degree Programme in "Leadership in Medicine" – Impact on hospital-based follow-on training of doctors

    Directory of Open Access Journals (Sweden)

    Wulfert, Chris-Henrik

    2017-11-01

    Full Text Available Objective: This pilot project, which was jointly conducted by a hospital and a university, describes the development of the Master's Degree Programme in Leadership in Medicine, a course designed to supplement medical specialty training. The aim of the pilot project is to demonstrate how hospital-based projects on personnel and organisational development undertaken under academic supervision can be used to increase leadership responsibility among doctors whose duties include providing initial and follow-on training and to professionalise medical specialty training as a leadership task. This need arose from the nationwide requirements and an internal audit regarding follow-on training. The version of the degree programme described below aims to further the personnel development of the participants in the field of didactics. Method: Each of the nine modules is made up of two classroom-based phases and one distance learning phase. The distance learning phase involves undertaking hospital-based projects on personnel and organisational development under academic supervision. The pilot phase participants were hospital doctors who, as part of their duties, hold leadership responsibility or are involved in the follow-on training of doctors.Results: The 17 participants successfully implemented more than 30 hospital-based projects during the distance learning phases of the nine modules. These projects included the development of medical specialty curricula, relevant didactic methods and evaluation design and were subsequently presented and subjected to reflection in interdisciplinary groups. The project presentation together with the project report were regarded as proof of competency. Conclusion: In addition to enhancing participant competency, the degree model described, which interlinks theory and practice, promotes organisational development through the implementation of projects undertaken under academic supervision. This has a double impact on the

  7. Zolpidem prescribing and adverse drug reactions in hospitalized general medicine patients at a Veterans Affairs hospital.

    Science.gov (United States)

    Mahoney, Jane E; Webb, Melissa J; Gray, Shelly L

    2004-03-01

    Zolpidem is prescribed for sleep disruption in hospitalized patients, but data on the incidence of adverse drug reactions (ADRs) are based largely on outpatient studies. Thus, the incidence of ADRs in hospitalized patients may be much higher. The goal of this study was to describe prescribing patterns of zolpidem for hospitalized medical patients aged 50 years, the incidence of ADRs possibly and probably associated with its use, and the factors associated with central nervous system (CNS) ADRs. This case series was conducted in 4 general medicine wards at a Veterans Affairs hospital and was a consecutive sample of patients aged 50 years who were hospitalized between 1993 and 1997 and received zolpidem as a hypnotic during hospitalization, but had not received it in the previous 3 months. Chart review was conducted by 2 evaluators. Data extracted from the medical records included admission demographic characteristics, medications, comorbidities, and levels of function in performing basic and instrumental activities of daily living. The main outcome measure was ADRs possibly or probably related to zolpidem use. The association between zolpidem and the occurrence of CNS ADRs (eg, confusion, dizziness, daytime somnolence) was analyzed separately. The review included 119 medical patients aged > or =50 years who had newly received zolpidem for sleep disruption during hospitalization. The median age of the population was 70 years; 86 (72.3%) patients were aged 65 years. The initial zolpidem dose was 5 mg in 42 patients (35.3%) and 10 mg in 77 patients (64.7%). Twenty-three patients had a respective 16 and 10 ADRs possibly and probably related to zolpidem use (19.3% incidence). Of a total of 26 ADRs, 21 (80.8%) were CNS ADRs, occurring with both zolpidem 5 mg (10.8% of users) and 10 mg (18.3% of users). On univariate analyses, the only factor significantly associated with a CNS ADR was functional impairment at baseline (P = 0.003). Zolpidem was discontinued in 38.8% of

  8. How Six Sigma Methodology Improved Doctors' Performance

    Science.gov (United States)

    Zafiropoulos, George

    2015-01-01

    Six Sigma methodology was used in a District General Hospital to assess the effect of the introduction of an educational programme to limit unnecessary admissions. The performance of the doctors involved in the programme was assessed. Ishikawa Fishbone and 5 S's were initially used and Pareto analysis of their findings was performed. The results…

  9. Doctor-patient relationships in general practice--a different model.

    Science.gov (United States)

    Kushner, T

    1981-09-01

    Philosophical concerns cannot be excluded from even a cursory examination of the physician-patient relationship. Two possible alternatives for determining what this relationship entails are the teleological (outcome) approach vs the deontological (process) one. Traditionally, this relationship has been structured around the 'clinical model' which views the physician-patient relationship in teleological terms. Data on the actual content of general medical practice indicate the advisability of reassessing this relationship, and suggest that the 'clinical model' may be too limiting, and that a more appropriate basis for the physician-patient relationship is one described in this paper as the 'relational model'.

  10. Evolution of the Whipple procedure at the Massachusetts General Hospital.

    Science.gov (United States)

    Fernández-del Castillo, Carlos; Morales-Oyarvide, Vicente; McGrath, Deborah; Wargo, Jennifer A; Ferrone, Cristina R; Thayer, Sarah P; Lillemoe, Keith D; Warshaw, Andrew L

    2012-09-01

    Since Allen O. Whipple published his seminal paper in 1935, the procedure that bears his name has been performed widely throughout the world and is now a common operation in major medical centers. The goal of this study was to investigate the evolution of pancreatoduodenectomy at the Massachusetts General Hospital (MGH). We sought to identify all pancreatoduodenectomies performed at the MGH since 1935. Cases were obtained from a computerized database, hospital medical records, and the MGH historical archive. Demographics, diagnosis, intraoperative variables and short-term surgical outcomes were recorded. The first pancreatoduodenectomy at the MGH was carried out in 1941; since then, 2,050 Whipple procedures have been performed. Pancreatic ductal adenocarcinoma was the most frequent indication (36%). Pylorus preservation has been the most important variation in technique, accounting for 45% of Whipple procedures in the 1980s; observation of frequent delayed gastric emptying after this procedure led to decline in its use. Pancreatic fistula was the most frequent complication (13%). Operative blood replacement and reoperation rates have decreased markedly over time; the most frequent indication for reoperation was intra-abdominal bleeding. Mortality has decreased from 45% to 0.8%, with sepsis and hypovolemic shock being the most frequent causes of death. Mean duration of hospital stay has decreased from >30 to 9.5 days, along with an increasing readmission rate (currently 19%). The Whipple procedure in the 21st century is a well-established operation. Improvements in operative technique and perioperative care have contributed in making it a safe operation that continues evolving. Copyright © 2012 Mosby, Inc. All rights reserved.

  11. The patient, the doctor, and the patient’s loyalty: a qualitative study in French general practice

    Science.gov (United States)

    Gérard, Laura; François, Mathilde; de Chefdebien, Marine; Saint-Lary, Oliver; Jami, Alain

    2016-01-01

    Background The term loyalty can be defined as the attachment that characterises someone who consistent in their feelings, affections, or habits. By introducing the Declaration of General Practitioner (or preferred doctor declaration) in 2004, France adopted a formal incentive for patients to be faithful to their doctor since it entailed optimal coverage of medical care by their national health insurance There has been no research evaluating the impact of this measure and to determine the components of doctor–patient loyalty. Aim To explore what builds and maintains patients’ loyalty to their GP. Design and setting Qualitative study based on semi-structured interviews close to Paris (the département of Yvelines’), France. Method Twenty-eight patients were interviewed in five surgeries of self-employed GPs with different demographics. Interviews were transcribed and a thematic analysis conducted to categorise the data. Phenomenological analysis was used to analyse the transcripts. Results Patient loyalty is based mainly on trust. Trust can be reinforced by certain comforting factors such as the ability to listen, a sense of carefulness, and the quality of care. Loyalty is both a dynamic construct and a relational exchange subject to various influences. Patients find advantages in being loyal. The model of the ‘family doctor’ has always been the archetype of loyalty for several generations within one family. A GP’s inability to meet all of the patient’s requirements is not necessarily a determining factor in breaking the patient’s loyalty. Conclusion Loyalty is more complex than commonly assumed and involves dimensions of trust, listening, quality of care, availability, and familiarity. The observations drawn out from this study warrant a larger scale investigation. PMID:27789510

  12. Nurses' experiences of inpatients suicide in a general hospital*

    Directory of Open Access Journals (Sweden)

    Mirriam Matandela

    2016-10-01

    Full Text Available When suicide occurs, it is regarded as an adverse event. Often, little attention is given to the nurses who cared for the patients prior to the adverse event. Instead the affected nurses are expected to write statements and incident reports about the adverse event. The aim was to explore the experiences of nurses who cared for patients who successfully committed suicide whilst admitted at a specific general hospital in Gauteng Province, South Africa. A qualitative exploratory research was conducted. Data were collected through in-depth interviews with a purposive sample of six nurses and content analysis was done. Nurses experienced feelings of shock; blame and condemnation; inadequacy and feared reprisal. This study suggests a basis for development of support strategies to assist the nurses to deal with their emotions following experience of adverse events.

  13. Relação entre enfermeiros e médicos em hospital escola: a perspectiva dos médicos Professional relationship between nurses and doctors at the hospital of medical school: the view of doctors

    Directory of Open Access Journals (Sweden)

    Ana Maria de Oliveira

    2010-12-01

    determine, in the view of physicians, the existence of conflict in the relationship between them and nurses at the Hospital das Clinicas, Universidade Federal de Goiás (HC / UFG and what factors are associated with it. To this goal, 30 doctors completed a questionnaire with demographic data and questions about the variables that affect the relationship, using a Lickert scale. Among the results, the average of age is 42.7 years, 50% of participants are female and 93.3% of the respondents worked elsewhere. The average of years of working in the HC is 16.3. Concerning to the conflict, we highlighted four factors of conflict prevention (Pc, with Middle Ranking (RM greater than 3.0, and two others generators of conflict (2Gc. These factors are: Interprofessional Communication (RM=3.03; Autonomy in Team (RM=3.63; Interprofessional Relationship (RM=3.36; Working Conditions (RM=2.26, Influence of Hospital as a School (RM=2.83 and Patient Benefits (RM = 3,93. We concluded that in the analyzed reality the conflict is considered non-existent, because there is a favorable ratio of protective factors (4Pc:2Gc, but it is imminent, due to the persistence of factors that can unleash it ("Working Conditions" and "Influence of Hospital as a School ". Moreover, there is power struggle with nursing, which can unbalance the situation and create ethical problems.

  14. Attitudes toward euthanasia among doctors in a tertiary care hospital in South India: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Sneha Kamath

    2011-01-01

    Conclusions: A majority of the doctors in this study supported euthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia.

  15. Interprofessional collaboration between junior doctors and nurses in the general ward setting: A qualitative exploratory study.

    Science.gov (United States)

    Tang, Charmaine J; Zhou, Wen T; Chan, Sally W-C; Liaw, Sok Y

    2018-01-01

    To explore the collaboration experiences of junior physicians and nurses in the general ward setting. Junior physicians and nurses do not always work collaboratively and this could affect the quality of patient care. The understanding of the issues affecting junior physicians and nurses working together is needed to inform strategies to improve interprofessional collaboration. Nineteen junior physicians and nurses were interviewed in 2012 and 2013. Interviews were transcribed and analysed using thematic analysis. Junior physicians and nurses acknowledged the importance of working collaboratively to achieve better patient care, but they are struggling to cope due to heavy clinical workload, organisational constraints and differing power relationships. Nurses have to take on more responsibilities in the decision-making process of patients' care to foster effective interprofessional collaboration. The study calls for educational and organisational strategies to improve interprofessional collaboration between junior physicians and nurses. Nurse leaders should ensure that ward nurses are given a designated time to participate in ward rounds with physicians and have access to a communication tool that assists them in contributing proactively in the decision-making process of patient care. © 2017 John Wiley & Sons Ltd.

  16. “No generics, Doctor!” The perspective of general practitioners in two French regions

    Directory of Open Access Journals (Sweden)

    Béatrice Riner

    2017-11-01

    Full Text Available Abstract Background Generic medicines are essential to controlling health expenditures. Their market share is still small in France. The discourse and practices of prescribers may play a major role in their use. The purpose of this study was to explore the knowledge, attitudes and practices of general practitioners (GPs toward generic medicines in two French regions with the lowest penetration rate of these products. Methods An observational study was carried out from October 2015 to February 2016 in Guadeloupe and Martinique. The first qualitative phase involved a diversified sample of 14 GPs who underwent semi-structured interviews. The second phase involved a random sample of 316 GPs (response rate = 74% who were administered a structured questionnaire developed from the results of the first phase. Results Seventy-eight percent of the participants defined a generic drug as a drug containing an active substance identical to a brand-name drug, but only 11% considered generic drugs to be equivalent to brand-name drugs, and the same proportion believed that the generic drugs were of doubtful quality. The primary recognized advantage of generic medicines was their lower cost (82%. The main drawbacks cited were the variability of their presentation (44%, the confusion that they caused for some patients (47%, frequent allegations of adverse side effects (37% and a lack of efficacy (24%, and frequent refusal by patients (26%. Seventy-four percent of the participants stated that they adapted their prescribing practices to the situation, and of this group, 47% prescribed the originator product simply on demand. Conclusion Most surveyed GPs were not hostile towards generic medicines. They were caught between the requirements of health insurance regimes and the opposition of numerous users and suggested that the patient information provided by health authorities should be improved and that drug composition and packaging should be made uniform.

  17. Review of maternal deaths at Umtata General Hospital - 1981 - 1985 ...

    African Journals Online (AJOL)

    The three major causes were medical conditions, hypertension and obstetric haemorrhage. Conclusion. Doctor-related, patient-related and transportation problems were identified as the main avoidable factors. Improvement in primary heaJth care, medical staffing and the transport system are the main recommendations ...

  18. Causes and predictors of mortality in hospitalized lupus patient in Sarawak General Hospital, Malaysia.

    Science.gov (United States)

    Teh, C L; Ling, G R

    2013-01-01

    Systemic lupus erythematosus (SLE) is a serious autoimmune disease that can be life threatening and fatal if left untreated. Causes and prognostic indicators of death in SLE have been well studied in developed countries but lacking in developing countries. We aimed to investigate the causes of mortality in hospitalized patients with SLE and determine the prognostic indicators of mortality during hospitalization in our center. All SLE patients who were admitted to Sarawak General Hospital from January 1, 2006 to December 31, 2010, were followed up in a prospective study using a standard protocol. Demographic data, clinical features, disease activities and damage indices were collected. Logistic regression and Cox regression analysis were used to determine the prognostic indicators of mortality in our patients. There were a total of 251 patients in our study, with the female to male ratio 10 to 1. Our study patients were of multiethnic origins. They had a mean age of 30.5 ± 12.2 years and a mean duration of illness of 36.5 ± 51.6 months. The main involvements were hematologic (73.3%), renal (70.9%) and mucocutaneous (67.3%). There were 26 deaths (10.4%), with the main causes being: infection and flare (50%), infection alone (19%), flare alone (19%) and others (12%). Independent predictors of mortality in our cohort of SLE patients were the presence of both infection and flare of disease (hazard ratio (HR) 5.56) and high damage indices at the time of admission (HR 1.91). Infection and flare were the main causes of death in hospitalized Asian patients with SLE. The presence of infection with flare and high damage indices at the time of admission were independent prognostic indicators of mortality.

  19. [Importance of the hyperuricaemia, gout and gender nosological features in the activity of general practitioner - family doctor].

    Science.gov (United States)

    Rudichenko, V M

    2012-01-01

    In this article there were analyzed gender data about features of hyperuricaemia and gout: women are much older at the onset of gout arthritis (one of main reasons, probably, makes menopause by itself), have more associated comorbid deseases as hypertension and kidney failure and drinks less alcoholic beverages. It was noticed, that typical localisation of the lesion on the first toe is less often in women, and women are more inclined to use diuretics among medical drugs. Abovementioned clinical features are of some importance for the broad activity of general practitioners - family doctors. Gender features of polyarthicular gout are not uniformed. Scientific researches confirmed possibility of the genetic basis of the uric acid metabolism, which influences some fenotypical features of the organism. Several genes are known for their influence on serum uric acid: PDZK1, GCKR, SLC2A9, ABCG2, LRRC16A, SLC17A3, SLC16A9 and SLC22A12. However, conclusions of the research works confirm the necessity of scientific clarification of the importance of different factors of gender differences.

  20. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Science.gov (United States)

    2010-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective payment...

  1. Risk factor for preterm labor in Haji Adam Malik General Hospital, Pirngadi General hospital and satellite hospitals in Medan from January 2014 to December 2016

    Science.gov (United States)

    Sukatendel, K.; Hasibuan, C. L.; Pasaribu, H. P.; Sihite, H.; Ardyansah, E.; Situmorang, M. F.

    2018-03-01

    In 2010, Indonesia was ranked fifth in the world for the number of premature birth. Prematurity is a multifactorial problem. Preterm Labor (PTL) can occur spontaneously without a clear cause. Preventing PTL, its associated risk factors must be recognized first. To analyze risk factors associated with the incidence of PTL. It is a cross sectional study using secondary data obtained from medical records in Haji Adam Malik general hospital, Pirngadi general hospital and satellite hospitals in Medan from January 2014 to December 2016. Data were analyzed using chi-square method and logistic regression test. 148 cases for each group of preterm labor and obtained term laborin this study. Using the logistic regression test, three factors with astrong association to the incidence of identifiedpreterm labor. Antenatal Care frequency (OR 2,326; CI 95%), leucorrhea (OR 6,291; 95%), and premature rupture of membrane (OR 9,755; CI 95%). In conclusion, antenatal care frequency, leucorrhea, and history of premature rupture of themembrane may increase the incidence of Preterm Labor (PTL).

  2. Toshiba General Hospital PACS for routine in- and outpatient clinics

    Science.gov (United States)

    Toshimitsu, Akihiro; Okazaki, Nobuo; Kura, Hiroyuki; Nishihara, Eitaro; Tsubura, Shinichi

    1996-05-01

    The Toshiba General Hospital introduced a departmental RIS/PACS (Radiology Information System/Picture Archiving and Communication System) in the radiology department in May, 1993. It has been used routinely since that time. In order to provide efficient means for clinicians to find and read many images, the system has been expanded to the neurosurgery and urology clinics and wards since May, 1995, and five image referring workstations now provide digital images to clinicians. In this paper we discuss an algorithm for image migration, one of the key issues to accomplish the expansion to outpatient clinics successfully, and propose the WYWIWYG (what you want is what you get) image transfer logic. This is the logic used to transfer images that physicians require refer without increasing the traffic between the image server and referring workstations. We accomplish the WYWIWYG logic by prioritizing exams the physicians have not yet viewed and by finding historical exams according to the modality, anatomy, and marking. Clinicians gave us comments from their first use of the system and suggested that the PACS enables clinicians to review images more efficiently compared to a film-based system. Our experience suggests that it is a key to the effective application of PACS in outpatient clinics to incorporate consideration patterns of clinicians on the migration algorithm.

  3. Prevalence of depression in a general hospital in Izhevsk, Russia.

    Science.gov (United States)

    Pakriev, Sergei; Kovalev, Juri; Mozhaev, Mikhail

    2009-11-01

    There are a lot of studies on depressive disorders in a general hospital done across the world, but no data from Russia on this subject was found in international psychiatric journals or MEDLINE. to determine the prevalence of depressive disorders in medical inpatients in Izhevsk, the capital of the Udmurt Republic, a region in Russia, and to identify associated factors. A sample of 323 adult medical inpatients was composed. The Russian version of the MINI 5.0.0 was used. The prevalence of lifetime and current depressive disorders was 30% and 20.7%, respectively. Depression was more common in women, widowed or divorced, retired or disabled, with low income and bad family relationships, and among respondents with a chronic somatic illness. Depression had a high comorbidity with organic mental and anxiety disorders. Only 40.3% of the individuals with depression had referred for psychiatric consultations, most of them being treated with fluvoxamine. Prevalence of depression was substantial but consistent with other studies. Taking into consideration associated factors, physicians can improve recognition and treatment of depression in medical inpatients.

  4. End-of-life care in the general wards of a Singaporean hospital: an Asian perspective.

    Science.gov (United States)

    Phua, Jason; Kee, Adrian Chin-Leong; Tan, Adeline; Mukhopadhyay, Amartya; See, Kay Choong; Aung, Ngu Wah; Seah, Angeline S T; Lim, Tow Keang

    2011-12-01

    Despite international differences in cultural perspectives on end-of-life issues, little is known of the care for the dying in the general wards of acute hospitals in Asia. We performed a retrospective medical chart review of all 683 adult patients who died without intensive care unit (ICU) admission in our Singaporean hospital in 2007. We first evaluated the prevalence of do-not-resuscitate (DNR) orders and orders for or against life-sustaining therapies; second, if such orders were discussed with the patients and/or family members; and third, the actual treatments provided before death. There were DNR orders for 66.2% of patients and neither commitment for DNR nor cardiopulmonary resuscitation (CPR) for 28.1%. Orders to limit life-sustaining therapies, including ICU admission, intubation, and vasopressors/inotropes were infrequent. Only 6.2% of the alert and conversant patients with DNR orders were involved in discussions on these orders. In contrast, such discussions with their family members occurred 82.9% of the time. Interventions in the last 24 hours of life included CPR (9.4%), intubation (6.4%), vasopressors/inotropes (14.8%), tube feeding (24.7%), and antibiotics (44.9%). Analgesia was provided in 29.1% of patients. There was a lack of commitment by doctors on orders for DNR/CPR and to limit life-sustaining therapies, infrequent discussions with patients on end-of-life decisions, and excessive burdensome interventions with inadequate palliative care for the dying. These findings may reflect certain Asian cultural biases. More work is required to improve our quality of end-of-life care.

  5. Readmissions due to traffic accidents at a general hospital.

    Science.gov (United States)

    Paiva, Luciana; Monteiro, Damiana Aparecida Trindade; Pompeo, Daniele Alcalá; Ciol, Márcia Aparecida; Dantas, Rosana Aparecida Spadotti; Rossi, Lídia Aparecida

    2015-01-01

    to verify the occurrence and the causes of hospital readmissions within a year after discharge from hospitalizations due to traffic accidents. victims of multiple traumas due to traffic accidents were included, who were admitted to an Intensive Care Unit. Sociodemographic data, accident circumstances, body regions affected and cause of readmission were collected from the patient histories. among the 109 victims of traffic accidents, the majority were young and adult men. Most hospitalizations due to accidents involved motorcycle drivers (56.9%). The causes of the return to the hospital were: need to continue the surgical treatment (63.2%), surgical site infection (26.3%) and fall related to the physical sequelae of the trauma (10.5%). The rehospitalization rate corresponded to 174/1,000 people/year. the hospital readmission rate in the study population is similar to the rates found in other studies. Victims of severe limb traumas need multiple surgical procedures, lengthier hospitalizations and extended rehabilitation.

  6. Profilaxia para tromboembolia venosa em um hospital geral Venous thromboembolism prophylaxis in a general hospital

    Directory of Open Access Journals (Sweden)

    Fernanda Fuzinatto

    2011-04-01

    Full Text Available OBJETIVO: Avaliar a prática de profilaxia para tromboembolia venosa (TEV em pacientes em um hospital geral. MÉTODOS: Estudo de coorte transversal conduzido no Hospital Nossa Senhora da Conceição, localizado na cidade de Porto Alegre (RS, com uma amostra constituída de pacientes internados selecionados randomicamente entre outubro de 2008 e fevereiro de 2009. Foram incluídos pacientes maiores de 18 anos e internados por mais de 48 h. Os critérios de exclusão foram pacientes em uso de anticoagulantes, história de doença tromboembólica, gestação e puerpério. A adequação da profilaxia foi avaliada seguindo as recomendações de um protocolo criado pela instituição e tendo como base principal a diretriz da American College of Chest Physician, oitava edição. RESULTADOS: Foram incluídos 262 pacientes com média de idade de 59,1 ± 16,6 anos. Os fatores de risco mais comuns foram imobilização (70,6%, infecção (44,3%, câncer (27,5%, obesidade (23,3% e cirurgia maior (14,1%. Na avaliação do nível de risco para TEV, 143 (54,6% e 117 pacientes (44,7%, respectivamente, foram classificados como de risco alto e moderado. No geral, 46,2% dos pacientes tiveram profilaxia adequada, assim como 25% dos pacientes com três ou mais fatores de risco e 18% dos pacientes com câncer, e houve diferenças estatisticamente significativas entre esses grupos quando comparados àqueles com menos de três fatores de risco e sem câncer (p OBJECTIVE: To evaluate the use of venous thromboembolism (VTE prophylaxis in a general hospital. METHODS: A cross-sectional cohort study at the Hospital Nossa Senhora da Conceição, located in the city of Porto Alegre, Brazil, involving a random sample of patients admitted between October of 2008 and February of 2009. We included patients over 18 years of age and hospitalized for more than 48 h. The exclusion criteria were anticoagulant use, pregnancy, puerperium, and a history of thromboembolic disease. The

  7. Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

    OpenAIRE

    Simon Munyua; Dr. Gladys Rotich; Dr. Michael Kimwele

    2015-01-01

    Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting...

  8. Agency doctorates

    International Nuclear Information System (INIS)

    1970-01-01

    Staff members of the Agency working at the Seibersdorf laboratory are continuing to achieve high academic distinction. Two more - both Austrian - have now been awarded the degree of Doctor of Agriculture. Joachim Kramer, who is 26, graduated from the Hochschule fur Bodenkultur in 1967 with the degree of Diplom-Ingenieur and then started work in the plant breeding and genetics section of the laboratory under the direction of Dr. Knut Mikaelsen. The results of the research work he carried out were accepted as the subject of a thesis for which he has now been granted his doctorate. The doctoral promotion took place on 30 June, at a ceremony attended by Dr. Andre Finkelstein, Deputy Director General for Research and Isotopes. The subject of Dr. Kramer's thesis was a comprehensive study of the mutagenic effects of fast neutrons and gamma rays, and the influence of various modifying factors such as water content, oxygen and metabolic state of seeds at the time of irradiation. This work has contributed significantly to the understanding of the mechanisms by which these two types of ionizing radiation produce mutations in seeds. The knowledge gained will be of great importance in the efficient use of ionizing radiation in practical plant breeding. Paul Wassermann, who is 33 years old, joined the Agency in 1965. He, too, graduated from the Hochschule fur Bodenkultur as Diplom-Ingenieur in agriculture, having graduated with honours previously from the agricultural secondary school at Raumberg, Austria, in 1958. Dr. Wassermann's own words may be used to explain how he came to gain his doctorate. 'In October, 1966, I completed my studies at the Hochschule,' he writes. 'I was employed at the Agency laboratories in Seibersdorf, working in the plant and soils group. Encouraged by the interesting research which was performed there, a thesis entitled 'the Fate of Nitrogen in Submerged Rice Soils' was started, which finally led to the doctor's degree in Agriculture in June this year

  9. Awareness about medical research among resident doctors in a tertiary care hospital: A cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Dattatray B Pawar

    2012-01-01

    Full Text Available Context: Every medical practitioner should strive to contribute to the generation of evidence by conducting research. For carrying out research, adequate knowledge, practical skills, and development of the right attitude are crucial. A literature review shows that data regarding knowledge, attitude, and practices toward medical research, among resident doctors in India, is lacking. Aims: This study was conducted to assess research-related knowledge, attitude, and practices among resident doctors. Settings and Design: A cross-sectional survey was conducted using a pretested, structured, and pre-validated questionnaire. Materials and Methods: With approval of the Institutional Ethics Committee and a verbal consent, a cross-sectional survey among 100 resident doctors pursuing their second and third years in the MD and MS courses was conducted using a structured and pre-validated questionnaire. Statistical Analysis: Descriptive statistics were used to analyze the results. Results: The concept of research hypothesis was known to 58% of the residents. Ninety-eight percent of the residents were aware of the procedure to obtain informed consent. Seventy-six percent agreed that research training should be mandatory. Although 88% of the residents were interested in conducting research in future, 50% had participated in research other than a dissertation project, 28% had made scientific presentations, and only 4% had publications. Lack of time (74%, lack of research curriculum (42%, and inadequate facilities (38% were stated as major obstacles for pursuing research. Conclusions: Although resident doctors demonstrated a fairly good knowledge and positive attitude toward research, it did not translate into practice for most of them. There is a need to improve the existing medical education system to foster research culture among resident doctors

  10. [Prevalence of depressive and anxiety disorders in cardiovascular outpatients from 14 tertiary general hospitals of 5 Chinese cities].

    Science.gov (United States)

    Li, Guo; Jiang, Ronghuan; Guo, Chengjun; Liu, Meiyan; Zhang, Lijun

    2014-12-01

    To explore the prevalence of depression and (or) anxiety disorders among cardiovascular outpatients of tertiary general hospitals of five Chinese cities. A hospital-based cross-sectional survey was conducted in the cardiovascular out-patient departments of 14 tertiary general hospitals in five Chinese cities. The patients aged 18 years and over were recruited consecutively, who were conscious and with informed consent, and can finish the questionnaire independently. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using mini international neuropsychiatric interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Subjects who refused MINI were defined as the case of loss of follow-up. A total 2 123 subjects were included in the survey. The adjusted prevalence rate of depressive and anxiety disorder was 4.05% (86/2 123), the depressive and/or anxiety disorder was 14.27 % (303/2 123), depressive and anxiety disorder and mixed depressive or anxiety disorder was 14.37% (305/2 123) according to MINI. The adjusted prevalence of lifetime depressive and anxiety disorder was 5.37% (114/2 123), depressive and/or anxiety disorder was 16.91% (359/2 123), depressive and anxiety disorder and mixed depressive-anxiety disorder was 17.00% (361/2 123). There is a high prevalence of depressive and anxiety disorder among cardiovascular outpatients from tertiary general hospitals in China. Therefore, doctors must pay attention to this disorder and try to reduce the impact of this disorder in cardiovascular patients.

  11. Suicide in doctors and wives of doctors.

    Science.gov (United States)

    Sakinofsky, I

    1980-06-01

    This paper re-examines the widespread belief that doctors have a proneness for suicide greater than the general population. The Standardized Mortality Ratio for male physicians is 335 and for single women doctors 257. Doctors' wives have an even greater risk: their SMR is 458. These rates for doctors are higher than for most other professional groups (except pharmacists) and the rate for doctors' wives far exceeds that for wives of other professionals. The intrinsic causes of the physician's high occupational mortality include his knowledge of toxicology and ready access to lethal drugs, so that impulsive suicide is more often successful. Professional stress and overwork, particularly the unrelenting responsibility for decisions upon which the lives of others may depend, have been inculpated. These stresses interact with the decline in the doctors' self-respect and with a personality that is prestige-oriented and independent. Some physicians turn in their frustration to alcohol/and or drugs, accelerating the process of deterioration. The high suicide rate in doctors' wives appears to be the result of unrequited needs for caring and dependency which the doctors' career demands and personality deny them.

  12. Economic impact of surgery cancellation in a general hospital, Iran

    African Journals Online (AJOL)

    unhcc

    cause of inefficient use of operating room (OR) time and a drain on finite .... of total hospitalizations. In this hospital (270 beds ... Preoperative instructions not followed or patient not instructed. Change in .... concrete possibilities of reducing the level of surgical cancellations by .... room case-mix problem under uncertainty and.

  13. Left ventricular assist device exchange: the Toronto General Hospital experience.

    Science.gov (United States)

    Tsubota, Hideki; Ribeiro, Roberto V P; Billia, Filio; Cusimano, Robert J; Yau, Terrence M; Badiwala, Mitesh V; Stansfield, William E; Rao, Vivek

    2017-08-01

    As support times for left ventricular assist devices (LVADs) become longer, several complications requiring device exchange may occur. To our knowledge, this is the first Canadian report regarding implantable LVAD exchange. We retrospectively reviewed the cases of consecutive, unique patients implanted with an LVAD between June 2006 and October 2015 at Toronto General Hospital. In total, 122 patients were impanted with an LVAD during the study period. Eight patients required LVAD exchange, and 1 patient had 2 replacements (9 of 122, 7.3%). There were 7 HeartMate II (HMII), 1 HVAD and 1 DuraHeart pumps exchanged. Two of these exchanges occurred early at the time of initial implant, whereas 7 occurred late (range 8-623 d). Six exchanges were made owing to pump thrombosis. Of the 3 exchanges made for other causes, 1 HMII exchange was owing to a driveline fracture, 1 DuraHeart patient had early inflow obstruction requiring exchange to HMII at the initial implant, and the third had a suspected inflow obstruction with no evidence of thrombosis at the time of the procedure. The mean support time before exchange was 225 days, and time from exchange to transplant, death or ongoing support was 245 days. Three patients were successfully bridged to transplant, and at the time of data collection 2 were supported awaiting transplant. Three patients died after a mean duration of 394.3 days (range 78-673 d) of support postreplacement. Four cases were successfully performed using a subcostal approach. Pump thrombosis is the most common cause for LVAD exchange, which can be performed with acceptable morbidity and mortality. The subcostal approach may be the preferred procedure for an HMII exchange when indicated.

  14. Behavior Assessment in Children Following Hospital-Based General Anesthesia versus Office-Based General Anesthesia

    Directory of Open Access Journals (Sweden)

    LaQuia A. Vinson

    2016-08-01

    Full Text Available The purpose of this study was to determine if differences in behavior exist following dental treatment under hospital-based general anesthesia (HBGA or office-based general anesthesia (OBGA in the percentage of patients exhibiting positive behavior and in the mean Frankl scores at recall visits. This retrospective study examined records of a pediatric dental office over a 4 year period. Patients presenting before 48 months of age for an initial exam who were diagnosed with early childhood caries were included in the study. Following an initial exam, patients were treated under HBGA or OBGA. Patients were followed to determine their behavior at 6-, 12- and 18-month recall appointments. Fifty-four patients received treatment under HBGA and 26 were treated under OBGA. OBGA patients were significantly more likely to exhibit positive behavior at the 6- and 12-month recall visits p = 0.038 & p = 0.029. Clinicians should consider future behavior when determining general anesthesia treatment modalities in children with early childhood caries presenting to their office.

  15. Readmissions due to traffic accidents at a general hospital

    Directory of Open Access Journals (Sweden)

    Luciana Paiva

    2015-08-01

    Full Text Available AbstractObjective: to verify the occurrence and the causes of hospital readmissions within a year after discharge from hospitalizations due to traffic accidents.Methods: victims of multiple traumas due to traffic accidents were included, who were admitted to an Intensive Care Unit. Sociodemographic data, accident circumstances, body regions affected and cause of readmission were collected from the patient histories.Results: among the 109 victims of traffic accidents, the majority were young and adult men. Most hospitalizations due to accidents involved motorcycle drivers (56.9%. The causes of the return to the hospital were: need to continue the surgical treatment (63.2%, surgical site infection (26.3% and fall related to the physical sequelae of the trauma (10.5%. The rehospitalization rate corresponded to 174/1,000 people/year.Conclusion: the hospital readmission rate in the study population is similar to the rates found in other studies. Victims of severe limb traumas need multiple surgical procedures, lengthier hospitalizations and extended rehabilitation.

  16. Where have all the doctors gone? (2). Intraurban trends: changes in the geographic distribution of general practitioners in Auckland, 1980-7.

    Science.gov (United States)

    Barnett, J R

    1991-08-14

    During the 1980s the Auckland metropolitan area increased its share of all general practitioners in New Zealand at a much faster rate than its share of the population, resulting in a high level of availability by 1987. In the light of such trends, neoclassical theory would predict a diffusion of general practitioners into areas with fewer doctors where there is less competition for patients. Data for 1980-7, however, indicates that for every FTE general practitioner who located in doctor poor areas of the city, 1.87 general practitioners continued to open practices in areas already well provided for. Or, for every extra consultation that took place in low income suburbs, 1.51 extra consultations occurred in more affluent localities. These results do not provide strong support for a market led diffusion of doctors into areas of need and any gains in increased equity appear to have been achieved at the expense of considerable inefficiency given the likely presence of induced demand.

  17. Admission rates in a general practitioner-based versus a hospital specialist based, hospital-at-home model

    DEFF Research Database (Denmark)

    Mogensen, Christian Backer; Ankersen, Ejnar Skytte; Lindberg, Mats J

    2018-01-01

    . CONCLUSIONS: The GP based HaH model was more effective than the hospital specialist model in avoiding hospital admissions within 7 days among elderly patients with an acute medical condition with no differences in mental or physical recovery rates or deaths between the two models. REGISTRATION: No. NCT......BACKGROUND: Hospital at home (HaH) is an alternative to acute admission for elderly patients. It is unclear if should be cared for a primarily by a hospital intern specialist or by the patient's own general practitioner (GP). The study assessed whether a GP based model was more effective than...... Denmark, including + 65 years old patients with an acute medical condition that required acute hospital in-patient care. The patients were randomly assigned to hospital specialist based model or GP model of HaH care. Five physical and cognitive performance tests were performed at inclusion and after 7...

  18. A comparison of antibiotic point prevalence survey data from four Irish regional/general hospitals.

    LENUS (Irish Health Repository)

    Naughton, C

    2011-06-01

    Point prevalence surveys (PPS) are increasingly used to examining and compare hospital antibiotic consumption. The aim of this study was to identify the (1) point prevalence of antibiotic use in one regional hospital and (2) compare PPS data from similar regional\\/general hospitals.

  19. Synthesis of qualitative linguistic research--a pilot review integrating and generalizing findings on doctor-patient interaction.

    Science.gov (United States)

    Nowak, Peter

    2011-03-01

    There is a broad range qualitative linguistic research (sequential analysis) on doctor-patient interaction that had only a marginal impact on clinical research and practice. At least in parts this is due to the lack of qualitative research synthesis in the field. Available research summaries are not systematic in their methodology. This paper proposes a synthesis methodology for qualitative, sequential analytic research on doctor-patient interaction. The presented methodology is not new but specifies standard methodology of qualitative research synthesis for sequential analytic research. This pilot review synthesizes twelve studies on German-speaking doctor-patient interactions, identifies 45 verbal actions of doctors and structures them in a systematics of eight interaction components. Three interaction components ("Listening", "Asking for information", and "Giving information") seem to be central and cover two thirds of the identified action types. This pilot review demonstrates that sequential analytic research can be synthesized in a consistent and meaningful way, thus providing a more comprehensive and unbiased integration of research. Future synthesis of qualitative research in the area of health communication research is very much needed. Qualitative research synthesis can support the development of quantitative research and of educational materials in medical training and patient training. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Knowledge, Attitude, and Perception of Postmortem Examination Among Doctors and Nurses in a Tertiary Hospital of Sokoto, Nigeria

    Directory of Open Access Journals (Sweden)

    A U Kaoje

    2016-01-01

    Full Text Available Postmortem examination is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present. This study aimed to assess the knowledge, attitude, and perception of postmortem examination among doctors and nurses in a tertiary health care of Sokoto state. A cross-sectional study design was used, and a total of 149 doctors and nurses participated in the study. Respondents were recruited into the study using probability proportionate to size followed by a simple random sampling method. Data were obtained through self-administered questionnaires, and the data were analyzed using Statistical Package for Social Sciences Version 17.0. Descriptive statistics, Chi-square test, and multinomial logistic regression analysis were carried out. The mean age of respondents was 31.6 (5.6 years. There were more nurses than doctors (60.4% vs. 39.6% in the study. More than three-quarter (80% of the respondents had fair to good knowledge of postmortem examination. While many respondents expressed positive attitudes and perceptions, less than half were willing to accept organs from deceased donors. Respondents' profession influenced both the knowledge (P > 0.001, odds ratio [OR] = 13.95 and attitude (P < 0.04, OR = 2.49 to postmortem examination. Although greater than three-quarter of respondents had fair to good knowledge and many expressed positive attitudes and perceptions with respect to postmortem examination, there is need to create more awareness on medical benefit of postmortem examination.

  1. Knowledge and attitudes of doctors towards e-health use in healthcare delivery in government and private hospitals in Northern Uganda: a cross-sectional study.

    Science.gov (United States)

    Olok, Geoffrey Tabo; Yagos, Walter Onen; Ovuga, Emilio

    2015-11-04

    E-health is an essential information sharing tool in healthcare management and delivery worldwide. However, utilization of e-health may only be possible if healthcare professionals have positive attitudes towards e-health. This study aimed to determine the relationships between healthcare professionals' attitudes towards e-health, level of ICT skills and e-Health use in healthcare delivery in government and private hospitals in northern Uganda. Cross-sectional survey design was used. Sixty-eight medical doctors in three government hospitals and four private hospitals in Northern Uganda participated in the study. A pretested self-administered questionnaire was used to collect the required data. Data was analysed using SPSS software Version 19. Out of the 68 respondents, 39 (57.4 %) reported access to computer and 29 (48.5 %) accessed Internet in the workplace. Majority of healthcare professionals had positive attitudes towards e-health attributes (mean 3.5). The level of skills was moderate (mean 3.66), and was the most important and significant predictor of ICT use among healthcare professionals (r = .522, p < .001); however, attitudes towards e-health attributes did not contribute significantly in predicting e-health use. The findings suggest need for hospitals managements to strengthen e-health services in healthcare delivery in Northern Uganda.

  2. Microbiological etiology of bacterial prostatitis in general hospital and primary care clinic in Korea

    Directory of Open Access Journals (Sweden)

    Yong Sun Choi

    2013-09-01

    Conclusions: The total portion of chronic bacterial prostatitis was 59.3% (174/293. Culture-positive patients in the PCC were significantly higher than in the general hospital, but the number of PCR positive patients in the PCC was the same as in the general hospital.

  3. The first general practitioner hospital in The Netherlands: towards a new form of integrated care?

    NARCIS (Netherlands)

    Moll van Charante, E.; Hartman, E.; IJzermans, J.; Voogt, E.; Klazinga, N.; Bindels, P.

    2004-01-01

    Objective: To describe the types of patients admitted to the first Dutch general practitioner (GP) hospital, their health-related quality of life and its substitute function. Design: A prospective observational study. Setting. The remaining 20-bed ward of a former district general hospital west of

  4. The first general practitioner hospital in The Netherlands: towards a new form of integrated care?

    NARCIS (Netherlands)

    Moll van Charante, Eric; Hartman, Esther; Yzermans, Joris; Voogt, Elsbeth; Klazinga, Niek; Bindels, Patrick

    2004-01-01

    Objective - To describe the types of patients admitted to the first Dutch general practitioner (GP) hospital, their health-related quality of life and its substitute function. Design - A prospective observational study. Setting - The remaining 20-bed ward of a former district general hospital west

  5. An internet-based survey in Japan concerning social distance and stigmatization toward the mentally ill among doctors, nurses, pharmacists, and the general public.

    Science.gov (United States)

    Fujii, Tomoo; Hanya, Manako; Kishi, Masanori; Kondo, Yuki; Cates, Marshall E; Kamei, Hiroyuki

    2018-05-28

    Stigma associated with psychiatric disorders tends to be manifested as negative attitudes or behavior toward the mentally ill. It has negative influences, such as leading to difficulty in establishing trust-based relationships and interfering with medical treatment. In order to reduce such stigma, it is necessary to clarify its extent and characteristics in healthcare professionals. Considering this, an Internet-based questionnaire survey was conducted, involving doctors (n = 186), nurses (n = 161), and pharmacists (n = 192) in comparison with the general public (n = 331), and using the Whatley Social Distance Scale (WSDS) and Index of Attitudes toward the Mentally Ill (IATM) as stigma-related indices. Median total WSDS scores and interquartile range were as follows: doctors: 15.5(12.0-18.0), nurses: 14.0(12.0-16.5), pharmacists: 15.0(13.0-17.0), and the general public: 16.0(13.0-18.0). Similarly, median IATM scores were as follows: doctors: 39.0(36.0-42.0), nurses: 39.0(37.0-43.0), pharmacists: 40.0(36.0-42.0), and the general public: 37.0(33.0-41.0). IATM scores were significantly higher in the professional groups than the general public group. Both healthcare professionals and the general public with prior exposure to mental illness were more favorable attitudes toward the mentally ill. Especially among healthcare professionals, they working in psychiatric departments were more favorable attitudes. These results suggest that the stigma of healthcare professionals toward the mentally ill was shown to have a smaller and relatively favorable attitude than that of the general public. In order to correct the stigma it was suggested that a good contact experience with the patient such as work and training in psychiatry is effective. Copyright © 2018. Published by Elsevier B.V.

  6. Patients' Care Needs: Documentation Analysis in General Hospitals.

    Science.gov (United States)

    Paans, Wolter; Müller-Staub, Maria

    2015-10-01

    The purpose of the study is (a) to describe care needs derived from records of patients in Dutch hospitals, and (b) to evaluate whether nurses employed the NANDA-I classification to formulate patients' care needs. A stratified cross-sectional random-sampling nursing documentation audit was conducted employing the D-Catch instrument in 10 hospitals comprising 37 wards. The most prevalent nursing diagnoses were acute pain, nausea, fatigue, and risk for impaired skin integrity. Most care needs were determined in physiological health patterns and few in psychosocial patterns. To perform effective interventions leading to high-quality nursing-sensitive outcomes, nurses should also diagnose patients' care needs in the health management, value-belief, and coping stress patterns. © 2014 NANDA International, Inc.

  7. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX; Asesoria especializada en seguridad radiologica al hospital general Ciudad del Carmen, PEMEX

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J. E.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Ciudad del Carmen general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  8. In a niche of time: do specialty hospitals outperform general services hospitals?

    Science.gov (United States)

    Poole, LeJon; Davis, Jullet A; Gunby, Norris W

    2013-01-01

    Niche hospitals represent a growing segment in the health care industry. Niche facilities are primarily engaged in the treatment of cardiac or orthopedic conditions. The effectiveness of this strategy is of interest because niche hospitals focus on only the most profitable services. The purpose of this research was to assess the financial effectiveness of the niche strategy. We theorize that firm and market-level factors concomitantly with the strategy of the hospital-niche versus traditional-are associated with financial performance. This research used 2 data sources, the 2003 Medicare Cost Report and the 2003 Area Resource File. The sample was limited to only for-profit, urban, nongovernmental hospitals (n = 995). The data were analyzed using hierarchical least squares regression. Financial performance was operationalized using the hospital's return on assets. The principal finding of this project is that niche hospitals had significantly higher performance than traditional facilities. From the organizational perspective, the niche strategy leads to better financial performance. From a societal perspective, the niche strategy provides increased focus and efficiencies through repetition. Despite the limited focus of this strategy, patients who can access these providers may experience better outcomes than patients in more traditional hospitals.

  9. [History of the 4th Department of Internal Medicine of the First Faculty of Medicine at Charles University and the General University Hospital in Prague].

    Science.gov (United States)

    Bartůněk, Petr

    In 2015, the doctors and nurses of the 4th Department of Internal Medicine of the First Faculty of Medicine, Charles University and the General University Hospital in Prague celebrated the 70th anniversary of its founding. The article summarizes the clinics contribution to the field of internal medicine, and particularly to angiology, hepatogastroenterology and lipidology. It comments the clinics current activities and the possibilities of its further development. Attention is also paid to the tradition of high ethical and professional standards of medical care in accordance with the norms established by the clinic's founder, prof. MUDr. Bohumil Prusík.

  10. [Orientation of patients referred by their general practionner to the public or private hospital sector in France: A prospective epidemiologic study].

    Science.gov (United States)

    Reuter, P-G; Kernéis, S; Turbelin, C; Souty, C; Arena, C; Gavazzi, G; Sarazin, M; Blanchon, T; Hanslik, T

    2012-12-01

    In-patients characteristics generate cost differences between hospitals. In France, there are few data on the characteristics on the patients referred to hospitals by their general practitioners (GPs) and none on the predictors of referral to the public or for-profit hospitals. The aim of this study was to analyze those characteristics and the predictors of referral to the public or for-profit hospitals. We collected, prospectively, the request for hospitalizations made by the GPs of the Sentinelles network in France, from 2007 to 2009. Patients' characteristics and also the reasons for that request were analyzed. A logistic regression was used to compare the population between local hospitals. Ten thousand seven hundred and eighteen statements were collected. The median age was 73 years. Patients were women in 51% of the cases, and only 14% of the hospitalizations had been planned. Hospitalization in the public sector was preferred for young children and the elderly (Pprivate sector, patients addressed to the public sector were more often seen for emergencies (OR: 2.3 [2.0-2.8]), by a doctor different from their referring GP (OR: 1.7 [1.4-2.1]) and out of the GP's office. The reasons for hospital admission were different depending on the sector of hospitalization (Ppublic sector hospitals presented with greater comorbidity or more complex diagnosis (for example: feeling ill, fainting or syncope and fever) or a greater disability (for example: stroke, neurological and psychiatric diseases). This study suggests that GPs send their patients to the public or for-profit hospitals according to criteria of severity, comorbidity and disability. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  11. Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan

    Directory of Open Access Journals (Sweden)

    Nishikitani Mariko

    2010-06-01

    Full Text Available Abstract Background Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs. Methods This cross-sectional anonymous questionnaire-based survey was conducted to clarify physicians' attitudes toward continual collaboration with PCTs and to describe the factors that contribute to such attitudes. We surveyed 339 full-time physicians, including interns, employed in a general acute-care hospital in an urban area in Japan; the response rate was 53% (N = 155. We assessed the basic characteristics, experience, knowledge, and education of respondents. Multiple logistic regression analysis was used to determine the main factors affecting the physicians' attitudes toward PCTs. Results We found that the physicians who were aware of the World Health Organization (WHO analgesic ladder were 6.7 times (OR = 6.7, 95% CI = 1.98-25.79 more likely to want to treat and care for their patients in collaboration with the hospital-based PCTs than were those physicians without such awareness. Conclusion Basic knowledge of palliative care is important in promoting physicians' positive attitudes toward collaboration with hospital-based PCTs.

  12. Parasuicide among youth in a general hospital in South Africa

    Directory of Open Access Journals (Sweden)

    T Mhlongo

    1999-09-01

    Full Text Available Parasuicide cases among youth (15-24 years referred to the clinical psychology section of a regional hospital from 1995 to 1998 were reviewed. In all 100 cases (37 males and 63 females were identified being about 10% of the caseload. As part of the clinical psychological assessment sociodemographic, clinical characteristics, trigger factors, employed methods and suicide intentions were analysed. Most patients were students (79% or unemployed (16%. The major method employed to attempt suicide was ingestion of harmful substances (like paraffin, pesticides or battery acid(73%. Acute social conflicts (38%, socio-economic deprivation (17%, AIDS phobia (17%, academic failure (14%, teenage pregnancy (10% and mental illness (5% triggered suicide attempts. Fifty-eight percent of the attempts were categorised as demonstrative and 27% as genuine. The psychodynamics of parasuicides are discussed in case studies and with reference to other studies.

  13. Telemedicine in general neurology: use of audiovisual consultation for on call back-up service in an acute care hospital.

    Science.gov (United States)

    Janssen, Frank; Awadallah, Mohammed; Alhalabi, Awed; Körber, Barbara; Lang, Reinhard; Scibor, Mateusz; Handschu, René

    2018-04-01

    While telemedicine is in expanding use in acute stroke care, little is known about its use in general neurology, especially in acute care. We sought to investigate the feasibility and possible effects of a telemedicine device within the neurological back-up service of an acute care hospital. In a 450 bed academic teaching hospital an experienced neurologist (EN) is on call to support the junior doctor at the hospital. Support was possible whether by standard telephone advice (TA) or by audiovisual consultations (AVC). In AVC the expert used a mobile telemedicine device and so he could establish audiovisual contact from his home to the emergency room and examine newly admitted patients. Technical and patient details including timing and diagnosis were recorded. Video and audio quality as well as impact of AVC on diagnosis was rated by the EN. Out of about 1200 cases in off peak times, during the study period, 164 AVC including remote video examination were done (13.6%). Also 48 cases were documented by pure TA. Video quality was rated to a medium of 1.7, audio quality to 2.1. In 36 cases the audiovisual consultation was influenced by technical issues leading to cessation of AVC in 8 cases. Duration of teleconsultation was 17.3 min in AVC compared to 8.7 min for TA. The consultation diagnosis in AVC was confirmed in 74.4% of all cases compared to 57.7% in TA. AVC was rated as a valuable contribution to the diagnostic workup in 74.3% of all cases seen. In about 40% of all cases AVC was not possible due to technical or organizational reasons. Audiovisual consultation seems to be a feasible and useful support in routine neurology back-up service of an acute care hospital. Better mobility of devices and flexibility of service is needed to improve availability and quality of this valuable tool.

  14. Appropriateness of hospitalization for CAP-affected pediatric patients: report from a Southern Italy General Hospital

    Directory of Open Access Journals (Sweden)

    Antonelli Fabio

    2009-09-01

    Full Text Available Abstract Background Community-acquired pneumonia (CAP is a common disease, responsible for significant healthcare expenditures, mostly because of hospitalization. Many practice guidelines on CAP have been developed, including admission criteria, but a few on appropriate hospitalization in children. The aim of this study was to evaluate appropriate hospital admission for CAP in a pediatric population. Methods We evaluated appropriate admission to a Pediatric Unit performing a retrospective analysis on CAP admitted pediatric patients from a Southern Italy area. Diagnosis was made based on clinical and radiological signs. Appropriate hospital admission was evaluated following clinical and non-clinical international criteria. Family ability to care children was assessed by evaluating social deprivation status. Results In 2 winter seasons 120 pediatric patients aged 1-129 months were admitted because of CAP. Median age was 28.7 months. Raised body temperature was scored in 68.3% of patients, cough was present in 100% of cases, and abdominal pain was rarely evidenced. Inflammatory indices (ESR and CRP were found elevated in 33.3% of cases. Anti-Mycoplasma pneumoniae antibodies were found positive in 20.4%. Trans-cutaneous (TC SaO2 was found lower than 92% in 14.6%. Dyspnoea was present in 43.3%. Dehydration requiring i.v. fluid supplementation was scored in 13.3%. Evaluation of familial ability to care their children revealed that 76% of families (derived from socially depressed areas were "at social risk", thus not able to appropriately care their children. Furthermore, analysis of CAP patients revealed that "at social risk" people accessed E.D. and were hospitalized more frequently than "not at risk" patients (odds ratio = 3.59, 95% CI: 1,15 to 11,12; p = 0.01, and that admitted "at social risk" people presented without clinical signs of severity (namely dyspnoea, and/or SaO2 ≤ 92%, and/or dehydration more frequently than "not at risk" population

  15. Nurses' work-related stress in China: a comparison between psychiatric and general hospitals.

    Science.gov (United States)

    Qi, Yun-Ke; Xiang, Yu-Tao; An, Feng-Rong; Wang, Jing; Zeng, Jiao-Ying; Ungvari, Gabor S; Newhouse, Robin; Yu, Doris S F; Lai, Kelly Y C; Ding, Yan-Ming; Yu, Liuyang; Zhang, Xiang-Yang; Chiu, Helen F K

    2014-01-01

    Little is known about the level of work-related stress in nurses in China.This study compared the level of work-related stress between female nurses working in psychiatric and general hospitals in China. A descriptive comparative cross-sectional design was used.A consecutive sample of nurses from two psychiatric hospitals (N = 297) and a medical unit (N = 408) of a general hospital completed a written survey including socio-demographic data and a measure of work-related stress (Nurse Stress Inventory). Compared to the nurses working in the general hospital, those working in the psychiatric setting had a higher level of stress in the domains of working environment and resources (p working experience, and working in psychiatric hospitals were associated with high work-related stress (b = .2, p work-related stress, specific stress management workshops and effective staff supportive initiatives for Chinese nurses are warranted.

  16. Planning Development for a Family Planning Centre in Nursing Unit of the General Hospital of Argolida

    OpenAIRE

    Koukoufilippou J; Koinis A.

    2015-01-01

    Introduction: The family planning centres must be upgraded to a cornerstone of primary health care, and prevent, advise and protect the citizen's health while reducing hospitalization costs for hospitals. Aim: The purpose of this literature review is the family planning centre development in general hospital of Argolida that has a similar clinic. Material and Methods: Literature review was conducted of published English and Greek Articles from bibliographic databases Medline, Goog...

  17. Ambulatory surgery center and general hospital competition: entry decisions and strategic choices.

    Science.gov (United States)

    Al-Amin, Mona; Housman, Michael

    2012-01-01

    General hospitals are consistently under pressure to control cost and improve quality. In addition to mounting payers' demands, hospitals operate under evolving market conditions that might threaten their survival. While hospitals traditionally were concerned mainly with competition from other hospitals, today's reimbursement schemes and entrepreneurial activities encouraged the proliferation of outpatient facilities such as ambulatory surgery centers (ASCs) that can jeopardize hospitals' survival. The purpose of this article was to examine the relationship between ASCs and general hospitals. More specifically, we apply the niche overlap theory to study the impact that competition between ASCs and general hospitals has on the survival chances of both of these organizational populations. Our analysis examined interpopulation competition in models of organizational mortality and market demand. We utilized Cox proportional hazard models to evaluate the impact of competition from each on ASC and hospital exit while controlling for market factors. We relied on two data sets collected and developed by Florida's Agency for Health Care Administration: outpatient facility licensure data and inpatient and outpatient surgical procedure data. Although ASCs do tend to exit markets in which there are high levels of ASC competition, we found no evidence to suggest that ASC exit rates are affected by hospital density. On the other hand, hospitals not only tend to exit markets with high levels of hospital competition but also experience high exit rates in markets with high ASC density. The implications from our study differ for ASCs and hospitals. When making decisions about market entry, ASCs should choose their markets according to the following: demand for outpatient surgery, number of physicians who would practice in the surgery center, and the number of surgery centers that already exist in the market. Hospitals, on the other hand, should account for competition from ASCs

  18. Elaboration of protocols as a guide in musculoskeletal ultrasound for radiology service of the Hospital Doctor Rafael A. Calderon Guardia

    International Nuclear Information System (INIS)

    Campos Hernandez, Luis Diego

    2010-01-01

    A protocol to guide residents and attending physicians at the Hospital Dr. Rafael Angel Calderon Guardia has been provided for regulating the work in the field the ultrasound of muscles, tendons and sonography. The staff has handled the ultrasound devices must understand the basis of the interaction of acoustic energy to the tissues and to know the methods and instruments have been used to produce and improve the quality of the image obtained. The guide ultrasound normal locomotor allowed to have a model for service members and medical imaging radiology hospital; it has been prepared through a comprehensive literature review based on textbooks and current articles concerning the most important theoretical bases of the Doppler study, which covers the assessment of shoulder, elbow, wrist, knee and ankle. The data obtained in the study process, facilitated access to printed and digital information, which has led to diagnostic certainty and reliability of results. (author) [es

  19. Neurasthenia, Generalized Anxiety Disorder, and the Medicalization of Worry in a Vietnamese Psychiatric Hospital.

    Science.gov (United States)

    Tran, Allen L

    2017-06-01

    This article examines two forms of the medicalization of worry in an outpatient psychiatric clinic in Ho Chi Minh City, Vietnam. Biomedical psychiatrists understand patients' symptoms as manifestations of the excessive worry associated with generalized anxiety disorder (GAD). Drawing on an ethnopsychology of emotion that reflects increasingly popular models of neoliberal selfhood, these psychiatrists encourage patients to frame psychic distress in terms of private feelings to address the conditions in their lives that lead to chronic anxiety. However, most patients attribute their symptoms to neurasthenia instead of GAD. Differences between doctors' and patients' explanatory models are not just rooted in their understandings of illness but also in their respective conceptualizations of worry in terms of emotion and sentiment. Patients with neurasthenia reject doctors' attempts to psychologize distress and maintain a model of worry that supports a sense of moral selfhood based on notions of obligation and sacrifice. © 2016 by the American Anthropological Association.

  20. A Proposed Solution for Managing Doctor's Smart Cards in Hospitals Using a Single Sign-On Central Architecture

    OpenAIRE

    Mauro, Christian;Sunyaev, Ali;Leimeister, Jan Marco;Schweiger, Andreas;Krcmar, Helmut

    2014-01-01

    This paper describes a single sign-on solution for the central management of health care provider?s smart cards in hospitals. The proposed approach which is expected to be an improvement over current methods is made possible through the introduction of a national healthcare telematics infrastructure in Germany where every physician and every patient will automatically be given an electronic health smart card (for patients) and a corresponding health professional card (for health care provider...

  1. A survey of doctors at a UK teaching hospital to assess understanding of recent changes to consent law

    Directory of Open Access Journals (Sweden)

    J.W. O'Brien, BSc MRCS

    2017-06-01

    Conclusion: The majority were not familiar with the concept of material risk and recent legal changes. A majority were not confident that their practice meets current requirements, suggesting that recent changes in consent law may not be widely understood at this hospital. We suggest more guidance and education may be necessary than is currently available. Increased understanding of recent changes to consent law will reduce the risk taken by NHS trusts and offer patients a service compliant with Supreme Court guidance.

  2. A methodology model for quality management in a general hospital.

    Science.gov (United States)

    Stern, Z; Naveh, E

    1997-01-01

    A reappraisal is made of the relevance of industrial modes of quality management to the issues of medical care. Analysis of the nature of medical care, which differentiates it from the supplier-client relationships of industry, presents the main intrinsic characteristics, which create problems in application of the industrial quality management approaches to medical care. Several examples are the complexity of the relationship between the medical action and the result obtained, the client's nonacceptance of economic profitability as a value in his medical care, and customer satisfaction biased by variable standards of knowledge. The real problems unique to hospitals are addressed, and a methodology model for their quality management is offered. Included is a sample of indicator vectors, measurements of quality care, cost of medical care, quality of service, and human resources. These are based on the trilogy of planning quality, quality control, and improving quality. The conclusions confirm the inadequacy of industrial quality management approaches for medical institutions and recommend investment in formulation of appropriate concepts.

  3. Culture-proven bacterial keratitis in a Malaysian general hospital.

    Science.gov (United States)

    Hooi, S H; Hooi, S T

    2005-12-01

    One hundred patients (101 eyes) with culture-proven bacterial keratitis were treated in the Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, over a 4-year period. The majority of patients was male (63%), Malay (60%), from the Johor Bahru district (62%) and aged between 41 to 50 years (20%). The ocular predisposing factors were ocular trauma (41 eyes), ocular surface disease (28 eyes) and contact lens wear (26 eyes). The corneal ulcers were mainly large (50.5%), central (59.4%) and colonized by Gram-negative bacteria (78.1%). The most frequently isolated microorganisms were Pseudomonas aeruginosa (67 eyes), Staphylococcus aureus (12 eyes), Acinetobacter baumanii (6 eyes), Klebsiella pneumoniae (5 eyes), Corynebacterium sp. (3 eyes:) and Streptococcus pneumonliae (3 eyes). Twelve eyes (11.8%) had polymicrobial infection. A good visual outcome occurred in 52.5% of eyes analysed. Prognostic factors for visual outcome include presenting Snellen visual acuity, time to presentation after onset of ocular symptoms, ocular predisposing factor, corneal ulcer location and corneal ulcer size.

  4. Care complexity in the general hospital - Results from a European study

    NARCIS (Netherlands)

    de Jonge, P; Huyse, FJ; Slaets, JPJ; Herzog, T; Lobo, A; Lyons, JS; Opmeer, BC; Stein, B; Arolt, [No Value; Balogh, N; Cardoso, G; Fink, P; Rigatelli, M; van Dijck, R; Mellenbergh, GJ

    2001-01-01

    There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between

  5. Transferable and non-transferable drug resistance in enteric bacteria from hospital and from general practice

    DEFF Research Database (Denmark)

    Møller, JK; Bak, AL; Bülow, P

    1976-01-01

    Drug resistance to 8 different antibiotics in Enterobacteriaceae isolated from different hospitals and two groups of general practitioners was studied. Escherichia coli dominated among the 632 strains investigated. Drug resistance was found in 62% of the 512 hospital strains and in 38% of the 120...

  6. [Benefits and usability of a pharmaceutical record in medical practice. A survey of hospital doctors and pharmacists (MATRIX study)].

    Science.gov (United States)

    Schuers, M; Timsit, M; Gillibert, A; Fred, A; Griffon, N; Bénichou, J; Darmoni, S J; Staccini, P

    2016-09-01

    To evaluate the impact of the pharmaceutical patient record use in emergency, geriatric and anaesthesia and intensive care departments, an experimentation was launched in 2013 in 55 hospitals. The purpose of the study was to assess the opinions of physicians and pharmacists about the benefits and usability of the patient pharmaceutical record. An e-mailed self-administered questionnaire was sent to all the pharmacists, anaesthesiologists, geriatricians and emergency physicians of the 55 hospitals involved in the patient pharmaceutical record experimentation. The questionnaire assessed the usability of the patient pharmaceutical record using the "System Usability Scale", as well as its use, its benefits and limitations perceived in clinical practice, and overall user satisfaction. Questionnaires were collected from November 2014 to January 2015. Ninety-six questionnaires were collected, from 47 hospitals, representing 86% of the hospitals involved in the experimentation. The patient pharmaceutical record was effectively operational in 36 hospitals. Data from 73 questionnaires filled by physicians and pharmacists with potential experience with the patient pharmaceutical record were used for evaluation. Forty-two respondents were pharmacists (57%) and 31 were physicians (43%), including 13 geriatricians, 11 emergency physicians and 7 anaesthesiologists. Patient pharmaceutical record overall usability score was 62.5 out of 100. It did not vary with the profession or seniority of the respondent. It was positively correlated with the frequency of use. More than half of respondents reported that they never or uncommonly used the patient pharmaceutical record. The length of access to data period was considered as insufficient. Main obstacles to more utilization of the patient pharmaceutical record were the lack of information about the dosage of dispensed drugs, the low number of patients in possession of their health card and the low number of patients with an activated

  7. Screening, diagnosing and treating deafness: the knowledge and conduct of doctors serving in neonatology and/or pediatrics in a tertiary teaching hospital

    Directory of Open Access Journals (Sweden)

    Patrícia Colozza

    Full Text Available CONTEXT AND OBJECTIVE: Infant hearing deficiency is a human disorder with devastating effects and serious implications for the development of speech and language. Early diagnosis of hearing loss should be the objective of a multidisciplinary team, and early-intervention programs should immediately follow this. The aim of this study was to investigate the knowledge and conduct of pediatricians and pediatric residents in a tertiary teaching hospital regarding deafness. DESIGN AND SETTING: Cross-sectional study in a tertiary hospital in the state of São Paulo, Brazil. METHODS: Eighty-eight questionnaires were randomly distributed to pediatricians and pediatric residents. RESULTS: Thirty-six questionnaires were analyzed. Most respondents (61.1% were residents in pediatrics and/or neonatology. Eighty-three percent of them performed special procedures on babies presenting a high risk of deafness, and 55% reported that they had no knowledge of techniques for screening hearing. Most of them were unaware of the classifications of level and type of hearing loss. According to 47.2% of them, infants could begin to use a hearing aid at six months of age. Most of them reported that infants could undergo hearing rehabilitation during the first six months of life, and all respondents stated 's responsibilities. CONCLUSIONS: Even though most of the participants followed special procedures with babies presenting a high risk of deafness, they did not routinely investigate hearing. All respondents believed that it is a doctor's responsibility to be concerned about child communication.

  8. Well-Differentiated Thyroid Cancer: The Philippine General Hospital Experience

    Directory of Open Access Journals (Sweden)

    Tom Edward N. Lo

    2016-03-01

    Full Text Available BackgroundWell-differentiated thyroid cancer (WDTC is the most common form of thyroid malignancy. While it is typically associated with good prognosis, it may exhibit higher recurrence and mortality rates in selected groups, particularly Filipinos. This paper aims to describe the experience of a Philippine Hospital in managing patients with differentiated thyroid cancer.MethodsWe performed a retrospective cohort study of 723 patients with WDTC (649 papillary and 79 follicular, evaluating the clinicopathologic profiles, ultrasound features, management received, tumor recurrence, and eventual outcome over a mean follow-up period of 5 years.ResultsThe mean age at diagnosis was 44±13 years (range, 18 to 82, with a majority of cases occurring in the younger age group (<45 years. Most tumors were between 2 and 4 cm in size. The majority of papillary thyroid cancers (PTCs, 63.2% and follicular thyroid cancers (FTCs, 54.4% initially presented as stage 1, with a greater proportion of FTC cases (12.7% vs. 3.7% presenting with distant metastases. Nodal metastases at presentation were more frequent among patients with PTC (29.9% vs. 7.6%. A majority of cases were treated by complete thyroidectomy, followed by radioactive iodine therapy and thyroid stimulating hormone suppression, resulting in a disease-free state. Excluding patients with distant metastases at presentation, the recurrence rates for papillary and FTC were 30.1% and 18.8%, respectively.ConclusionOverall, PTC among Filipinos was associated with a more aggressive and recurrent behavior. FTC among Filipinos appeared to behave similarly with other racial groups.

  9. 'I used to fight with them but now I have stopped!': conflict and doctor-nurse anaesthetists' motivation in maternal and neonatal care provision in a specialist referral hospital

    NARCIS (Netherlands)

    Aberese-Ako, M.; Agyepong, I.A.; Gerrits, T.; van Dijk, H.

    2015-01-01

    Background and Objectives: This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. Methodology: The study used ethnographic methods including participant

  10. Self medication amongst general outpatients in a nigerian community hospital.

    Science.gov (United States)

    Omolase, C O; Adeleke, O E; Afolabi, A O; Afolabi, O T

    2007-12-01

    This study was designed to determine the proportion of general out patients who practice self medication, the drugs employed and the reasons for resorting to self medication. This study was conducted between June and December, 2007 at the General Outpatient Clinic of the Federal Medical Centre, Owo, Ondo State, Nigeria. Two hundred consenting respondents were selected by simple random sampling and interviewed with the aid of semi structured questionnaire by the authors with three assistants. Information regarding their bio-data, history of self medication, drugs used and the reasons for resorting to self medication were obtained. Majority of the respondents (85%) admitted to self medication while the remaining proportion (15%) did not practice it. Drugs utilized could be single, usually analgesics (26.5%) and anti-malaria (15.9%) or in combinations, usually antimalaria-analgesics (22.4%), antimalariaanalgesic- antibiotic (15.3%) and antibiotic-analgesic (10.0%). The reasons cited by respondents for self medication were their perception of their complaints been minor enough to be amenable to self medication (54.7%) and financial constraint (22.4%). Majority of the respondents practiced self medication using an array of drugs like analgesics, anti-malaria and antibiotics used either singly or in combination. The main reasons identified for self medication were that the ailments were minor and financial constraint.

  11. Satisfaction degree evaluation of the users of "Attikon" University General Hospital's library.

    Science.gov (United States)

    Stamouli, Maria-Aggeliki; Balis, Charalampos; Georgakopoulou, Konstantina-Maria

    2013-01-01

    The ability of hospital medical libraries to meet users' needs is a complicated issue and has been examined by many surveys. The aim of this study is to evaluate the satisfaction degree of the users of "Attikon" University General Hospital's medical library. A questionnaire was used to collect the necessary information Although, in general, the users seems to be satisfied, some adjustments, such as up-to-date books, journals and computers, have to be made.

  12. Experience as a doctor in the developing world: does it benefit the clinical and organisational performance in general practice?

    Directory of Open Access Journals (Sweden)

    de Wit Niek J

    2009-12-01

    Full Text Available Abstract Background Many physicians have medical experience in developing countries early in their career, but its association with their medical performance later is not known. To explore possible associations we compared primary care physicians (GPs with and without professional experience in a developing country in performance both clinical and organisational. Methods A retrospective survey using two databases to analyse clinical and organisational performance respectively. Analysis was done at the GP level and practice level. 517 GPs received a questionnaire regarding relevant working experience in a developing country. Indicators for clinical performance were: prescription, referral, external diagnostic procedures and minor procedures. We used the district health insurance data base covering 570.000 patients. Explorative secondary analysis of practice visits of 1004 GPs in 566 practices in the Netherlands from 1999 till 2001. We used a validated practice visit method (VIP; 385 indicators in 51 dimensions of practice management to compare having experience in a developing country or not. Results Almost 8% of the GPs had experience in a developing country of at least two years. These GPs referred 9,5% less than their colleagues and did more surgical procedures. However, in the multivariate analysis 'experience in a developing country' was not significantly associated with clinical performance or with other GP- and practice characteristics. 16% of the practices a GP or GPs with at least two years experience in a developing country. They worked more often in group and rural practices with less patients per fte GP and more often part-time. These practices are more hygienic, collaborate more with the hospital and score better on organisation of the practice. These practices score less on service and availability, spend less time on patients in the consultation and the quality of recording in the EMD is lower. Conclusions We found interesting

  13. Impact of hyperglycemia on morbidity and mortality, length of hospitalization and rates of re-hospitalization in a general hospital setting in Brazil

    Directory of Open Access Journals (Sweden)

    Leite Silmara AO

    2010-07-01

    Full Text Available Abstract Background Hyperglycemia in hospitalized patients is known to be related to a higher incidence of clinical and surgical complications and poorer outcomes. Adequate glycemic control and earlier diagnosis of type 2 diabetes during hospitalization are cost-effective measures. Methods This prospective cohort study was designed to determine the impact of hyperglycemia on morbidity and mortality in a general hospital setting during a 3-month period by reviewing patients' records. The primary purposes of this trial were to verify that hyperglycemia was diagnosed properly and sufficiently early and that it was managed during the hospital stay; we also aimed to evaluate the relationship between in-hospital hyperglycemia control and outcomes such as complications during the hospital stay, extent of hospitalization, frequency of re-hospitalization, death rates and number of days in the ICU (Intensive Care Unit after admission. Statistical analyses utilized the Kruskall-Wallis complemented by the "a posteriori" d.m.s. test, Spearman correlation and Chi-squared test, with a level of significance of 5% (p Results We reviewed 779 patient records that fulfilled inclusion criteria. The patients were divided into 5 groups: group (1 diabetic with normal glycemic levels according to American Diabetes Association criteria for in-hospital patients (n = 123; group (2 diabetics with hyperglycemia (n = 76; group (3 non-diabetics with hyperglycemia (n = 225; group (4diabetics and non-diabetics with persistent hyperglycemia during 3 consecutive days (n = 57 and group (5 those with normal glucose control (n = 298. Compared to patients in groups 1 and 5, patients in groups 2, 3 and 4 had significantly higher mortality rates (17.7% vs. 2.8% and Intensive Care Unit admissions with complications (23.3% vs. 4.5%. Patients in group 4 had the longest hospitalizations (mean 15.5 days, and group 5 had the lowest re-hospitalization rate (mean of 1.28 hospitalizations. Only

  14. [Mental Health in the General Hospital: Results of the Patient Health Questionnaire (PHQ) in Four Hospital Services].

    Science.gov (United States)

    Castro-Camacho, Leonidas; Escobar, Juan Manuel; Sáenz-Moncaleano, Camilo; Delgado-Barrera, Lucía; Aparicio-Turbay, Soraya; Molano, Juan Carlos; Noguera, Efraín

    2012-03-01

    Few individuals have access to mental health services due in part to underdetection. As it is more likely to consult for medical conditions, primary care may be a useful gateway for early detection of mental health problems. Detection of the frequency of mental health problems in four hospital services at the Fundación Santa Fe de Bogotá: Outpatient unit, hospitalization, emergency department, and primary care through a brief detection questionnaire, the Patient Health Questionnaire (PHQ). Cross-sectional study of patients seen at the four services who answered a Demographic Data Questionnaire and the PHQ together with information gathered about current medical diagnosis, history of visits, and hospitalizations during the last year. 1094 patients seen at the four hospital services between September 2010 and May 2011 were selected at random. A mental health problem was detected in 36.7% of the total sample. Major depressive disorder (7.3%), alcohol abuse (14.4%), and any anxiety disorder (7.7%) showed the highest prevalence with the emergency department showing the highest frequency of detection. The usefulness of a brief detection questionnaire such as the PHQ in hospital settings is demonstrated and implications in the design of mental health programs in the general hospital are discussed. The need to replicate this study in other settings and to undertake further research is outlined. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  15. Ten thousand steps: a pedometer study of junior dentists in a major British teaching hospital and a district general hospital.

    Science.gov (United States)

    Keat, R M; Thomas, M; McKechnie, A

    2017-05-01

    Sedentary behaviour is widely associated with deleterious health outcomes that in modern medicine have similar connotations to smoking tobacco and alcohol misuse. The integration of e-portfolio, e-logbook, British National Formulary (BNF) and encrypted emails has made smartphones a necessity for trainees. Smartphones also have the ability to record the amount of exercise taken, which allows activity at work to be monitored. The aim of this study to compare the activity of the same group of dental core trainees when they worked within a large multisite teaching hospital and a smaller district general hospital, to find out if supplementary activity was needed outside work. Data were collected from smartphones. To ensure continuity, data were collected only from those who had calibrated iPhones (n=10). At the teaching hospital six of the trainees walked over 10 000 steps a day while working (mean (SD) 10 004 (639)). At the district hospital none of the trainees walked 10 000 steps. The mean (SD) number of steps completed by all trainees was 6265 (119). Walking at work provides the full quota of recommended daily exercise most of the time for those working in the teaching hospital, but additional exercise is occasionally required. While working at the district hospital they walk less, meaning that they should try to increase their activity outside work. Trainees working in the teaching hospital walk significantly more steps than in the district hospital. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. A review of governance of maternity services at South Tipperary general hospital

    LENUS (Irish Health Repository)

    Flory, David

    2015-09-01

    This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

  17. DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Max Joseph Herman

    2009-12-01

    Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

  18. Characterization of mammographic findings radiological studies, in radiology service Hospital Doctor Rafael Angel Calderon Guardia during the year 2012

    International Nuclear Information System (INIS)

    Ugalde Gatjens, Mauricio

    2013-01-01

    The radiological findings are determined in reading mammography studies between the months of May and June 2012 in the radiology service of Hospital Calderon Guardia. The association of pathologies is determined between breast pathology, age group and sex. A control allowing identification of geographic areas with higher reference is established for realization of mammograms. The pathologies resulting from the reading of mammographic studies are quantified and classified. The patients have presented 42% of risk factors with the potential predisposition to develop breast cancer. Mammography applications have been coming in 22% of Montes de Oca EBAIS and Curridabat, being presented in most lesions in women between 45 and 74 years old. Mammograms analyzed are classified as BIRADS 2 and to a lesser extent as BIRADS 0 [es

  19. The determinants of patient waiting time in the general outpatient department of Debre Markos and Felege Hiwot hospitals in Amhara regional state, North West, Ethiopia

    Directory of Open Access Journals (Sweden)

    Melesse Belayneh

    2017-01-01

    Full Text Available Background Patient waiting time is defined as the total time from registration until consultation with a doctor. Experiences of waiting in general are perceived as complex, subjective, and culturally influenced. Registration time, payment process/cash billing, recording classification/triaged time, few human resources and work process are the determinants of patient waiting time in the general outpatient departments. However, the complexity of wait time is poorly understood and has been explored only to a limited extent. The main objective of this study to assess patient waiting time and its determinants in Debre Markos and Felge Hiwot Referral hospitals of Amhara Regional State in North West, Ethiopia. Methods A hospital based comparative cross sectional study design was employed from October 20‐ November 20, 2014. The study population was patients presenting to general outpatient departments, from which 464 patients was selected using systematic random sampling technique. Quantitative Data was collected using structured questionnaire and A check list adopted from studies. Quantitative data was coded, entered, cleaned and analyzed using SPSS Software for windows version 20.0. Linear regression and bivariate logistic regression was applied to identify the determinants of each explanatory variable on outcome (patient waiting time. Finally data was interpreted by referring to the pertinent findings from the relevant literature reviewed. Ethical approval and clearance was obtained from ethical clearance committee of the Jimma University College of Public Health & Medical Sciences Result The measured waiting time in Felge Hiwot referral hospital mean waiting time was and its standard deviation 149.2±72.1 minutes whereas 94.2±58.3 minutes in debere markos referral hospital. The major causes of the long patient waiting time was large numbers of patient with a few doctors 94(40.5%,67(28.9% ,long searching of the cards 67(28.9%,73(31.5,and long

  20. Doctors Today

    LENUS (Irish Health Repository)

    Murphy, JFA

    2012-03-01

    Doctors’ relationship with patients and their role in society is changing. Until the 1960s doctors concentrated on the welfare of patients with less emphasis placed on patients’ rights1. Over recent decades there has been increasing empowerment of the individual across all facets of society including health care. Doctors continue to be perceived as having expertise and authority over medical science. Patients, however, now hold sway over questions of values or preferences. We all must be aware of this change in the doctor- patient interaction. We need to be more aware of the outcomes that patients view as important. The concept of shared decision-making with the patient is now widely appreciated. The process involves a change in mind set particularly for doctors who trained in an earlier era.

  1. Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

    Science.gov (United States)

    Zhao, Lue-Ping; Yu, Guo-Pei; Liu, Hui; Ma, Xie-Min; Wang, Jing; Kong, Gui-Lan; Li, Yi; Ma, Wen; Cui, Yong; Xu, Beibei; Yu, Na; Bao, Xiao-Yuan; Guo, Yu; Wang, Fei; Zhang, Jun; Li, Yan; Xie, Xue-Qin; Jiang, Bao-Guo; Ke, Yang

    2013-01-01

    With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS), cost per day (CPD), inpatient mortality rate (IMR), and length of stay (LOS), using a generalized additive model. There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (Phospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role. However, purely market-oriented health-care reform could also misguide future healthcare reform.

  2. Spin doctoring

    OpenAIRE

    Vozková, Markéta

    2011-01-01

    1 ABSTRACT The aim of this text is to provide an analysis of the phenomenon of spin doctoring in the Euro-Atlantic area. Spin doctors are educated people in the fields of semiotics, cultural studies, public relations, political communication and especially familiar with the infrastructure and the functioning of the media industry. Critical reflection of manipulative communication techniques puts spin phenomenon in historical perspective and traces its practical use in today's social communica...

  3. Behavioural and psychological symptoms in general hospital patients with dementia, distress for nursing staff and complications in care: results of the General Hospital Study.

    Science.gov (United States)

    Hessler, J B; Schäufele, M; Hendlmeier, I; Junge, M N; Leonhardt, S; Weber, J; Bickel, H

    2018-06-01

    Little is known about how behavioural and psychological symptoms of dementia (BPSD) manifest in the general hospital. The aim was to examine the frequency of BPSD in general hospitals and their associations with nursing staff distress and complications in care. Cross-sectional representative study with 1469 patients aged ≥65, including 270 patients with dementia, of 33 randomly selected general hospitals in Germany. BPSD and complications were reported by nurses. Overall frequency of BPSD was higher in patients with dementia (76%) than without (38%). The most frequent symptoms in patients with dementia were nighttime disturbances (38%), depression (29%) and aberrant motor behaviour (28%) and the most distressing symptoms for nursing staff were delusions, aggression and nighttime disturbances. The overall frequency of BPSD increased from 67% in mild dementia, to 76% in moderate dementia and to 88% in severe dementia. The most frequent symptoms in patients without dementia were depression (19%), nighttime disturbances (13%) and irritability (13%). The most distressing symptoms were aggression and delusions, while the same symptoms were consistently rated as less distressing than in patients with dementia. Factor analysis revealed three independent groups of BPSD that explained 45% of the total variance. First, expansive symptoms (aggression, irritability, nighttime disturbances, aberrant motor behaviour and disinhibition) were frequent, distressing for nursing staff and associated with many complications. Second, psychotic symptoms (delusions and hallucinations) were infrequent, distressing and associated with some complications. Third, affective symptoms (apathy, anxiety and depression) were frequent, non-distressing and associated with few complications. The results did not change when cases with delirium were excluded from both groups. BPSD are common in older hospital patients with dementia and associated with considerable distress in nursing staff, as well as

  4. Communication at the interface between hospitals and primary care - a general practice audit of hospital discharge summaries.

    Science.gov (United States)

    Belleli, Esther; Naccarella, Lucio; Pirotta, Marie

    2013-12-01

    Timeliness and quality of hospital discharge summaries are crucial for patient safety and efficient health service provision after discharge. We audited receipt rates, timeliness and the quality of discharge summaries for 49 admissions among 38 patients in an urban general practice. For missing discharge summaries, a hospital medical record search was performed. Discharge summaries were received for 92% of identified admissions; 73% were received within three days and 55% before the first post-discharge visit to the general practitioner (GP). Administrative information and clinical content, including diagnosis, treatment and follow-up plans, were well reported. However, information regarding tests, referrals and discharge medication was often missing; 57% of summaries were entirely typed and 13% had legibility issues. Completion rates were good but utility was compromised by delays, content omissions and formatting. Digital searching enables extraction of information from rich existing datasets contained in GP records for accurate measurement of discharge summary receipt rate and timing.

  5. Strategy, leadership and change: the North York General Hospital transformation journey.

    Science.gov (United States)

    Adamson, Bonnie; Kwolek, Susan

    2008-01-01

    Improvements in the emergency department and general internal medicine will serve as a case study to examine how North York General Hospital cultural transformation efforts led to improvements in these departments, and why we believe this approach will enable the organization to sustain these improvements over time.

  6. Changing patterns of psychiatric inpatient care for children and adolescents in general hospitals, 1988-1995.

    Science.gov (United States)

    Pottick, K J; McAlpine, D D; Andelman, R B

    2000-08-01

    The authors examine patterns in utilization of psychiatric inpatient services by children and adolescents in general hospitals during 1988-1995. National Hospital Discharge Survey data were used to describe utilization patterns for children and adolescents with primary psychiatric diagnoses in general hospitals from 1988 to 1995. During the study period, there was a 36% increase in hospital discharges and a 44% decline in mean length of stay, resulting in a 23% decline in the number of bed-days, from more than 3 million to about 2.5 million. The number of nonpsychotic major depressive disorders increased significantly. Discharges from public hospitals have declined, and those from proprietary hospitals have risen. Concurrently, the role of private insurance declined and the role of Medicaid increased. During the period of study, the mean and median length of stay declined most for children and adolescents who were hospitalized in private facilities and those covered by private insurance. Across the United States, the mean length of stay declined significantly; this decline was almost 60% in the West. Discharges also declined in the West, in contrast to the Midwest and the South, where they significantly increased. Increased numbers of discharges and decreased length of stay may reflect evolving market forces and characteristics of hospitals. Further penetration by managed care into the public insurance system or modifications in existing Medicaid policy could have a profound impact on the availability of inpatient resources.

  7. [The new methods to define the staffing requirements for doctors,nurses and nurses aides: an example of their implementation in an Italian hospital].

    Science.gov (United States)

    Laquintana, Dario; Pazzaglia, Silvia; Demarchi, Antonia

    2017-01-01

    . The new methods to define the staffing requirements for doctors, nurses and nurses aides: an example of their implementation in an Italian hospital. The Italian government, after the transposition of European Union legislation on working hours, made a declaration of commitment to increase the number of staff of the National Health Service (NHS). The method for assessing the staffing needs innovates the old one that dated back a few decades. To implement the method proposed by the Ministry of Health to an Italian hospital and assess its impact on staffing and costs. The model was implemented on all the wards, multiplying the minutes of care expected in 2016, dividing the result by 60 to obtain the hours of care, and further dividing by the number of yearly hours of work of a nurse (1418). Same was done for nurses aides. The minutes of care were related to mean weight of the Diagnosis Related Groups of the ward and the results obtained compared to the actual staffing of nurses and nurses aides. The costs of the differences were calculated. The implementation of the model produced an excess of 23 nurses and a scarcity of 95 nurses aides compared to the actual staffing, with an increase of the costs of € 1.828.562,00. The results obtained and the criticisms received so far show the need of major changes. The data from international studies that associate staffing and patients outcomes and the nurse/patient ratio are macro-indicators already available that may orient choices and investments on the health care professions.

  8. Semi-structured interview is a reliable and feasible tool for selection of doctors for general practice specialist training.

    Science.gov (United States)

    Isaksen, Jesper Hesselbjerg; Hertel, Niels Thomas; Kjær, Niels Kristian

    2013-09-01

    In order to optimise the selection process for admission to specialist training in family medicine, we developed a new design for structured applications and selection interviews. The design contains semi-structured interviews, which combine individualised elements from the applications with standardised behaviour-based questions. This paper describes the design of the tool, and offers reflections concerning its acceptability, reliability and feasibility. We used a combined quantitative and qualitative evaluation method. Ratings obtained by the applicants in two selection rounds were analysed for reliability and generalisability using the GENOVA programme. Applicants and assessors were randomly selected for individual semi-structured in-depth interviews. The qualitative data were analysed in accordance with the grounded theory method. Quantitative analysis yielded a high Cronbach's alpha of 0.97 for the first round and 0.90 for the second round, and a G coefficient of the first round of 0.74 and of the second round of 0.40. Qualitative analysis demonstrated high acceptability and fairness and it improved the assessors' judgment. Applicants reported concerns about loss of personality and some anxiety. The applicants' ability to reflect on their competences was important. The developed selection tool demonstrated an acceptable level of reliability, but only moderate generalisability. The users found that the tool provided a high degree of acceptability; it is a feasible and useful tool for -selection of doctors for specialist training if combined with work-based assessment. Studies on the benefits and drawbacks of this tool compared with other selection models are relevant. not relevant. not relevant.

  9. Breaking bad news: doctors' skills in communicating with patients.

    Science.gov (United States)

    Ferreira da Silveira, Francisco José; Botelho, Camila Carvalho; Valadão, Carolina Cirino

    2017-01-01

    Breaking bad news is one of doctors' duties and it requires them to have some skills, given that this situation is difficult and distressful for patients and their families. Moreover, it is also an uncomfortable condition for doctors. The aim of this study was to evaluate doctors' capacity to break bad news, ascertain which specialties are best prepared for doing this and assess the importance of including this topic within undergraduate courses. Observational cross-sectional quantitative study conducted at a university hospital in Belo Horizonte (MG), Brazil. This study used a questionnaire based on the SPIKES protocol, which was answered by 121 doctors at this university hospital. This questionnaire investigated their attitudes, posture, behavior and fears relating to breaking bad news. The majority of the doctors did not have problems regarding the concept of bad news. Nevertheless, their abilities diverged depending on the stage of the protocol and on their specialty and length of time since graduation. Generally, doctors who had graduated more than ten years before this survey felt more comfortable and confident, and thus transmitted the bad news in a better conducted manner. Much needs to be improved regarding this technique. Therefore, inclusion of this topic in undergraduate courses is necessary and proposals should be put forward and verified.

  10. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. VI. - December of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  11. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. IV. - October of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  12. STUDIES OF ADVERSE DRUG REACTION PROFILE OF ANTISNAKE VENOM AT DISTRICT GENERAL HOSPITAL

    OpenAIRE

    Mulchand Shende *, Sneha Gawali , Kanchan Bhongade , Vivek Bhuskade , Abhijit Nandgaonkar

    2017-01-01

    Snake bite is a common predominant problem of the rural and periurban areas, neglected and frequently devastating environmental and occupational disease, especially in rural areas of tropical developing countries. This study aimed to investigate of the adverse drug reaction profile of anti-snake venom (ASV) in a district general hospital. An observational study was conducted in hospital for six months. A total number of 142 indoor case papers of snake bite from October 2016 to April 2017 were...

  13. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX

    International Nuclear Information System (INIS)

    Angeles C, A.; Hernandez C, J. E.; Rodriguez A, F.; Garcia A, J.

    2003-02-01

    The Ciudad del Carmen general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  14. MANAGEMENT OF DIABETES IN ACUTE MYOCARDIAL INFARCTION IN CELJE GENERAL HOSPITAL IN 1999

    Directory of Open Access Journals (Sweden)

    Gregor Veninšek

    2001-12-01

    Full Text Available Background. DIGAMI study showed that intrahospital mortality and mortality at one year after myocardial infarction can be significantly reduced in diabetics treated in acute phase of myocardial infarction by GI infusion and afterwards for at least three months with intensive insulin treatment. Mortality can be reduced for more than 50% in a subgroup of patients younger than 70 years, without congestive heart failure, with first myocardial infarction, not treated with insulin or digitalis. In this perspective we reviewed treatment of diabetics with acute myocardial infarction in 1999 in Celje General Hospital.Methods. We reviewed documentation of treatment of all diabetics with acute myocardial infarction treated in Celje General Hospital in 1999. We collected data on number of newly discovered diabetes, on previous treatment of diabetes, on treatment of diabetes during hospitalization and at discharge, on drugs used for treatment of diabetes and on mortality during hospitalization.Results. Diabetics presented 20% of all patients with acute myocardial infarction treated in Celje General Hospital in 1999. None of patients received GI infusion, none had intensively managed blood sugar. 24% of patients were treated with sulfonylureas in acute phase of myocardial infarction. 33% of patients were discharged from hospital with insulin therapy. Intrahospital mortality was 9%, comparable with patients without diabetes.Conclusions. In 1999 was intrahospital treatment of diabetics with acute myocardial infarction in Celje General Hospital successful as their intrahospital mortality equaled non-diabetics. Treatment of diabetes itself, during hospitalization and after discharge, on the other hand, in 1999 had not been up to date according to results of recent studies. In our opinion, it is mandatory for diabetologist to make part of the team that treats diabetic with acute myocardial infarction

  15. New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate

    OpenAIRE

    Ho, An; Raja, Bronson; Waldhorn, Richard; Baez, Valentina; Mohammed, Idiris

    2017-01-01

    ABSTRACT Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors f...

  16. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. I.- July of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.

    2001-09-01

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic. The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  17. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. II.- August of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J.

    2001-10-01

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  18. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. III.- September of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J.

    2001-12-01

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  19. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. V. - November of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  20. Management of spontaneous pneumothorax compared to British Thoracic Society (BTS) 2003 guidelines: a district general hospital audit.

    Science.gov (United States)

    Medford, Andrew Rl; Pepperell, Justin Ct

    2007-10-01

    In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax (SP). These were refined in 2003. To determine adherence to the 2003 BTS SP guidelines in a district general hospital. An initial retrospective audit of 52 episodes of acute SP was performed. Subsequent intervention involved a junior doctor educational update on both the 2003 BTS guidelines and the initial audit results, and the setting up of an online guideline hyperlink. After the educational intervention a further prospective re-audit of 28 SP episodes was performed. Management of SP deviated considerably from the 2003 BTS guidelines in the initial audit - deviation rate 26.9%. After the intervention, a number of clinical management deviations persisted (32.1% deviation rate); these included failure to insert a chest drain despite unsuccessful aspiration, and attempting aspiration of symptomatic secondary SPs. Specific tools to improve standards might include a pneumothorax proforma to improve record keeping and a pneumothorax care pathway to reduce management deviations compared to BTS guidelines. Successful change also requires identification of the total target audience for any educational intervention.

  1. Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Lue-Ping Zhao

    Full Text Available BACKGROUND: With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. METHODS: We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS, cost per day (CPD, inpatient mortality rate (IMR, and length of stay (LOS, using a generalized additive model. FINDINGS: There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001, from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. INTERPRETATIONS: These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role

  2. Bullying and harassment – Are junior doctors always the victims?

    International Nuclear Information System (INIS)

    Nyhsen, C.M.; Patel, P.; O'Connell, J.E.

    2016-01-01

    Introduction: NHS staff have the right to work in an environment free from bullying, harassment and violence. There should be good team-working with colleagues from all disciplines. Reports of bullying experienced by junior doctors resulted in mandatory annual GMC surveys regarding the quality of training. This led to medical trainees being surveyed more than any other staff. Radiographers informally reported bullying and harassment (B&H) incidents involving trainees. This survey aims to quantify the issue. Methods: Online survey of general and CT radiographers at a large acute hospital in the North East of England addressing incidents involving junior doctors and occurring in the preceding 12 months. Results: The survey was completed by 86% (44/51) general and 5/7 CT radiographers. Overall 45% experienced bullying, 92% had their own/witnessed a colleague's opinion being ignored and 57% were the target of loud verbal abuse/anger or witnessed colleagues being treated in that way. Several radiographers reported 5 or more B&H incidents. 26 radiographers (51%) were shouted at/ridiculed in theatre, 4 feeling unsafe/physically threatened. Junior doctors regularly queried the need to supervise CT contrast injections on call. Free text comments highlighted that doctors rarely introduced themselves to radiology staff. Conclusion: Radiographers report significant incidents of B&H involving junior doctors, who do not always seem to appreciate radiation exposure legislation, patient safety protocols or respect the seniority of highly trained radiographers. Measures introduced subsequently include guidance for radiographers, a dedicated radiology e-learning package for trainees and classroom sessions for foundation doctors and final year undergraduate students. - Highlights: • Bullying and harassment of radiographers is a persistent problem. • Some radiographers reported feeling physically threatened in theatre. • Some junior doctors do not respect radiation exposure

  3. Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

    Directory of Open Access Journals (Sweden)

    Midin Marhani

    2011-05-01

    Full Text Available Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356 gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298. Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented

  4. Caring for homeless persons with serious mental illness in general hospitals.

    Science.gov (United States)

    Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

    2013-01-01

    The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  5. A comparative analysis of exposure doses between the radiation workers in dental and general hospital

    International Nuclear Information System (INIS)

    Yang, Nam Hee; Chung, Woon Kwan; Dong, Kyung Rae; Ju, Yong Jin; Song, Ha Jin; Choi, Eun Jin

    2015-01-01

    Research and investigation is required for the exposure dose of radiation workers to work in the dental hospital as increasing interest in exposure dose of the dental hospital recently accordingly, study aim to minimize radiation exposure by making a follow-up study of individual exposure doses of radiation workers, analyzing the status on individual radiation exposure management, prediction the radiation disability risk levels by radiation, and alerting the workers to the danger of radiation exposure. Especially given the changes in the dental hospital radiation safety awareness conducted the study in order to minimize radiation exposure. This study performed analyses by a comparison between general and dental hospital, comparing each occupation, with the 116,220 exposure dose data by quarter and year of 5,811 subjects at general and dental hospital across South Korea from January 1, 2008 through December 31, 2012. The following are the results obtained by analyzing average values year and quarter. In term of hospital, average doses were significantly higher in general hospitals than detal ones. In terms of job, average doses were higher in radiological technologists the other workers. Especially, they showed statistically significant differences between radiological technologists than dentists. The above-mentioned results indicate that radiation workers were exposed to radiation for the past 5 years to the extent not exceeding the dose limit (maximum 50 mSv y -1 ). The limitation of this study is that radiation workers before 2008 were excluded from the study. Objective evaluation standards did not apply to the work circumstance or condition of each hospital. Therefore, it is deemed necessary to work out analysis criteria that will be used as objective evaluation standard. It will be necessary to study radiation exposure in more precise ways on the basis of objective analysis standard in the future. Should try to minimize the radiation individual dose of

  6. A comparative analysis of exposure doses between the radiation workers in dental and general hospital

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Nam Hee; Chung, Woon Kwan; Dong, Kyung Rae; Ju, Yong Jin; Song, Ha Jin [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of); Choi, Eun Jin [Dept. of Public Health and Medicine, Dongshin University, Naju (Korea, Republic of)

    2015-02-15

    Research and investigation is required for the exposure dose of radiation workers to work in the dental hospital as increasing interest in exposure dose of the dental hospital recently accordingly, study aim to minimize radiation exposure by making a follow-up study of individual exposure doses of radiation workers, analyzing the status on individual radiation exposure management, prediction the radiation disability risk levels by radiation, and alerting the workers to the danger of radiation exposure. Especially given the changes in the dental hospital radiation safety awareness conducted the study in order to minimize radiation exposure. This study performed analyses by a comparison between general and dental hospital, comparing each occupation, with the 116,220 exposure dose data by quarter and year of 5,811 subjects at general and dental hospital across South Korea from January 1, 2008 through December 31, 2012. The following are the results obtained by analyzing average values year and quarter. In term of hospital, average doses were significantly higher in general hospitals than detal ones. In terms of job, average doses were higher in radiological technologists the other workers. Especially, they showed statistically significant differences between radiological technologists than dentists. The above-mentioned results indicate that radiation workers were exposed to radiation for the past 5 years to the extent not exceeding the dose limit (maximum 50 mSv y{sup -1}). The limitation of this study is that radiation workers before 2008 were excluded from the study. Objective evaluation standards did not apply to the work circumstance or condition of each hospital. Therefore, it is deemed necessary to work out analysis criteria that will be used as objective evaluation standard. It will be necessary to study radiation exposure in more precise ways on the basis of objective analysis standard in the future. Should try to minimize the radiation individual dose of

  7. Review of paediatric cardiology services in district general hospitals in the United Kingdom.

    Science.gov (United States)

    Andrews, Hannah; Singh, Yogen

    2016-03-01

    Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

  8. Periodontal Diseases and Systemic Disorders: What Do Our Doctors Know? A General Practitioner's Survey Conducted in Southern France.

    Science.gov (United States)

    Alexia, Vinel; Chloé, Vachon; Pierre, Barthet; Sara, Laurencin-Dalicieux

    2017-12-01

    With 39,359 entries on PubMed, periodontal medicine has a prominent position in periodontal research. Good patient care requires well-advised physicians, and whereas the dental community is informed about the relationships between periodontal diseases (PDs) and an increasing number of systemic pathologies, we wondered whether general practitioners were too. Thus, we aimed to evaluate their knowledge of the links between periodontal and systemic diseases. To this end, we sent an electronic questionnaire to the 2350 general practitioners registered to the URPS (Union régionale des Professionnels de Santé) of Midi-Pyrénées, France. They were asked about their practice, their attitude during a medical examination, and their knowledge about PDs. The analysis of 222 properly answered questionnaires showed that while most general practitioners are aware of the relationships between PDs and diabetes or cardiovascular diseases, the majority of them are unaware that obesity and respiratory and joint diseases are also concerned. Indeed, 94% of the questioned subjects consider their insight of PDs to be insufficient. Nevertheless, more than half of the interrogated physicians cared about their patients' oral health and dental care. Education regarding relationships between periodontal and systemic diseases must be improved among general practitioners who are in the front line to refer high-risk patients to a periodontist. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Doctor's Orders

    Institute of Scientific and Technical Information of China (English)

    VALERIE SARTOR

    2010-01-01

    @@ "To become a doctor is like becoming a bomb expert:It takes a long time to learn this skill; you must use care and intuition; and you must understand that your work has grave consequences for those around you,"said Amgalan Gamazhapov,an advanced medical student who studies traditional Chinese and Mongolian medicine at the Inner Mongolia Medical University.

  10. Doctor Down

    Directory of Open Access Journals (Sweden)

    N.V. Nagornaya

    2013-09-01

    Full Text Available The article presents the biographical data of John Langdon Down, his invaluable contribution to the development of rehabilitation programs for children with Down syndrome. The basis of these programs was the socialization of people with intellectual disabilities. In doctor Down’s rehabilitation center there were used methods, including health care, education, physical education, the formation of correct behavior.

  11. Postnatal gestational diabetes mellitus follow-up: Perspectives of Australian hospital clinicians and general practitioners.

    Science.gov (United States)

    Kilgour, Catherine; Bogossian, Fiona Elizabeth; Callaway, Leonie; Gallois, Cindy

    2018-05-04

    The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up. Describe and analyse communication processes between hospital clinicians (midwives, medical, allied staff) and general practitioners who provide postnatal gestational diabetes mellitus care. Purposive sampling and convergent interviews explored participants' communication experiences providing gestational diabetes mellitus postnatal follow-up. Data were analysed with Leximancer automated content analysis software; interpretation was undertaken using Communication Accommodation Theory. Clinicians who provided maternity care at a tertiary referral hospital (n=13) in Queensland, Australia, and general practitioners (n=16) who provided maternity shared care with that hospital between December 2012 and July 2013. Thematic analysis identified very different perspectives between the experiences of General Practitioners and hospital clinicians; six themes emerged. General practitioners were concerned about themes relating to discharge summaries and follow-up guidelines. In contrast, hospital clinicians were more concerned about themes relating to gestational diabetes mellitus antenatal care and specialist clinics. Two themes, gestational diabetes mellitus women and postnatal checks were shared. Gestational diabetes mellitus follow-up is characterised by communication where general practitioners appear to be information seekers whose communication needs are not met by hospital clinicians. Midwives are ideally placed to assist in improving communication and postnatal gestational diabetes mellitus follow-up. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights

  12. Doctor-patient communication in Southeast Asia: a different culture?

    Science.gov (United States)

    Claramita, Mora; Nugraheni, Mubarika D F; van Dalen, Jan; van der Vleuten, Cees

    2013-03-01

    Studies of doctor-patient communication generally advocate a partnership communication style. However, in Southeast Asian settings, we often see a more one-way style with little input from the patient. We investigated factors underlying the use of a one-way consultation style by doctors in a Southeast Asian setting. We conducted a qualitative study based on principles of grounded theory. Twenty residents and specialists and 20 patients of a low or high educational level were interviewed in internal medicine outpatient clinics of an Indonesian teaching hospital and two affiliated hospitals. During 26 weeks we engaged in an iterative interview and coding process to identify emergent factors. Patients were generally dissatisfied with doctors' communication style. The doctors indicated that they did not deliberately use a one-way style. Communication style appeared to be associated with characteristics of Southeast Asian culture, the health care setting and medical education. Doctor-patient communication appeared to be affected by cultural characteristics which fell into two broad categories representing key features of Southeast Asian culture, "social distance" and "closeness of relationships", and to characteristics categorized as "specific clinical context". Consideration of these characteristics could be helpful in promoting the use of a partnership communication style.

  13. The association between job satisfaction and general health among employees of Golestan Hospital in Ahvaz, Iran.

    Science.gov (United States)

    Khiavi, Farzad Faraji; Dashti, Rezvan; Zergani, Nadia

    2016-04-01

    Job satisfaction is one of the most challenging organizational concepts, and it is the basis of management policies to increase productivity and efficiency of the organization. The general health rate may affect job satisfaction in several ways. This study aimed to determine the association between job satisfaction and general health among employees of Golestan Hospital in Ahvaz, Iran. The study population of this cross-sectional research included 100 employees of Golestan Hospital in Ahvaz, Iran. The data collection instruments were the General Health Questionnaire (28-GHQ) and the Job Descriptive Index (JDI) questionnaire. The data were analyzed using Pearson's product-moment correlation coefficient, independent samples t-test, and ANOVA statistical tests in SPSS software. The mean general health was calculated as 26.19 ± 11.04, which indicated a positive psychiatric condition. Job satisfaction with a mean score of 89.67 ± 23.3 was deemed to be relatively dissatisfied. A medium negative and significant association was observed between job satisfaction and general health and its subscales (physical health, anxiety, social, and depression). General health subscales and job satisfaction are associated. Some actions must be planned to cope with the negative factors in general health in order to increase employees' satisfaction in university educational hospitals.

  14. Liaison psychiatry professionals' views of general hospital care for patients with mental illness: The care of patients with mental illness in the general hospital setting.

    Science.gov (United States)

    Noblett, J; Caffrey, A; Deb, T; Khan, A; Lagunes-Cordoba, E; Gale-Grant, O; Henderson, C

    2017-04-01

    Explore the experiences of liaison psychiatry professionals, to gain a greater understanding of the quality of care patients with mental illness receive in the general hospital setting; the factors that affect the quality of care; and their insights on interventions that could improve care. A survey questionnaire and qualitative in depth interviews were used to collect data. Data collection took place at the Royal College of Psychiatrists Faculty of Liaison Psychiatry Annual conference. Qualitative analysis was done using thematic analysis. Areas of concern in the quality of care of patients with co-morbid mental illness included 'diagnostic overshadowing', 'poor communication with patient', 'patient dignity not respected' and 'delay in investigation or treatment'. Eleven contributing factors were identified, the two most frequently mentioned were 'stigmatising attitudes of staff towards patients with co-morbid mental illness' and 'complex diagnosis'. The general overview of care was positive with areas for improvement highlighted. Interventions suggested included 'formal education' and 'changing the liaison psychiatry team'. The cases discussed highlighted several areas where the quality of care received by patients with co-morbid mental illness is lacking, the consequences of which could be contributing to physical health disparities. It was acknowledged that it is the dual responsibility of both the general hospital staff and liaison staff in improving care. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. The 6-Item Cognitive Impairment Test as a bedside screening for dementia in general hospital patients: results of the General Hospital Study (GHoSt).

    Science.gov (United States)

    Hessler, Johannes Baltasar; Schäufele, Martina; Hendlmeier, Ingrid; Nora Junge, Magdalena; Leonhardt, Sarah; Weber, Joshua; Bickel, Horst

    2017-07-01

    The objective of this study was to examine the psychometric quality of the 6-Item Cognitive Impairment Test (6CIT) as a bedside screening for the detection of dementia in general hospital patients. Participants (N = 1,440) were inpatients aged ≥65 of 33 randomly selected general hospitals in Southern Germany. The 6CIT was conducted at bedside, and dementia was diagnosed according to DSM-IV. Nursing staff was asked to rate the patients' cognitive status, and previous diagnoses of dementia were extracted from medical records. Completion rates and validity statistics were calculated. Two-hundred seventy patients had dementia. Cases with delirium but no dementia were excluded. Feasibility was 97.9% and 83.3% for patients without and with dementia, respectively, and decreased from moderate (93.8%) to severe dementia (53%). The area under the curve of the 6CIT was 0.98. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated for the cutoffs 7/8 (0.96, 0.82, 0.85, 0.52, 0.99) and 10/11 (0.88, 0.95, 0.94, 0.76, 0.98). The nurse ratings and medical records information had lower validity statistics. Logistic regression analyses revealed that the 6CIT statistically significantly provided information above nurse ratings and medical records. Twenty-five and 37 additional patients were correctly classified by the 7/8 and 10/11 cutoffs, respectively. The 6CIT is a feasible and valid screening tool for the detection of dementia in older general hospital patients. The 6CIT outperformed the nurse ratings of cognitive status and dementia diagnoses from medical records, suggesting that standardized screening may have benefits with regard to case finding. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  16. The use of the truth and deception in dementia care amongst general hospital staff.

    Science.gov (United States)

    Turner, Alex; Eccles, Fiona; Keady, John; Simpson, Jane; Elvish, Ruth

    2017-08-01

    Deceptive practice has been shown to be endemic in long-term care settings. However, little is known about the use of deception in dementia care within general hospitals and staff attitudes towards this practice. This study aimed to develop understanding of the experiences of general hospital staff and explore their decision-making processes when choosing whether to tell the truth or deceive a patient with dementia. This qualitative study drew upon a constructivist grounded theory approach to analyse data gathered from semi-structured interviews with a range of hospital staff. A model, grounded in participant experiences, was developed to describe their decision-making processes. Participants identified particular triggers that set in motion the need for a response. Various mediating factors influenced how staff chose to respond to these triggers. Overall, hospital staff were reluctant to either tell the truth or to lie to patients. Instead, 'distracting' or 'passing the buck' to another member of staff were preferred strategies. The issue of how truth and deception are defined was identified. The study adds to the growing research regarding the use of lies in dementia care by considering the decision-making processes for staff in general hospitals. Various factors influence how staff choose to respond to patients with dementia and whether deception is used. Similarities and differences with long-term dementia care settings are discussed. Clinical and research implications include: opening up the topic for further debate, implementing staff training about communication and evaluating the impact of these processes.

  17. Ben Taub General Hospital & LifeGift: Strengthening a Partnership to Save Lives and Improve Healthcare Delivery

    National Research Council Canada - National Science Library

    Philpot, Douglas G

    2007-01-01

    Ben Taub General Hospital, working closely with LifeGift, consistently ranks at or near the top of the list of hospitals in the United States that receive informed consent for organ donation from patients' families...

  18. Audit and account billing process in a private general hospital: a case study

    Directory of Open Access Journals (Sweden)

    Raquel Silva Bicalho Zunta

    2017-12-01

    Full Text Available Our study aimed to map, describe and, validate the audit, account billing and billing reports processes in a large, private general hospital.  An exploratory, descriptive, case report study. We conducted non-participatory observation moments in Internal Audit Sectors and  Billing Reports from the hospital, aiming to map the processes which were the study objects. The data obtained was validated by internal and external audit specialists in hospital bills. The described and illustrated processes in three flow-charts favor professionals to rationalize their activities and the time spent in hospital billing, avoiding or minimizing the occurrence of flaws and, generating more effective financial results. The mapping, the description and the audit validation process and billing and, the billing reports propitiated more visibility and legitimacy to actions developed by auditor nurses.

  19. Assessing knowledge and attitudes towards addictions in medical residents of a general hospital

    OpenAIRE

    Barral, Carmen; Eiroa-Orosa, Francisco Jose; Navarro-Marfisis, Maria Cecilia; Roncero, Carlos; Casas, Miguel

    2014-01-01

    Addiction treatment training has been recognized to be an essential part of the curriculum in psychiatry and general medicine. Our objective in this study was to measure the knowledge and attitudes towards addictions among medical residents of a general hospital in Catalonia, Spain.\\ud \\ud Method\\ud Within a sample of medical residents, we administered a questionnaire based on previous literature including attitudes towards patients with drug use problems, evaluation of knowledge and beliefs ...

  20. The hospital component of general practice vocational training--the Irish experience.

    Science.gov (United States)

    Murphy, A W

    1992-12-01

    All second and third year general practice vocational trainees in the Irish Republic in 1991 were invited to complete a questionnaire concerning the hospital component of their training. The questionnaire was based on specific recommendations published by the I.C.G.P. regarding hospital training posts. Replies were received from 39 trainees constituting 70% of the total number of eligible trainees. In general, hospital posts were perceived to be of relevance and to offer adequate exposure to outpatient management and to the development of useful practical skills. More than 70% of the trainees were free to attend at least 75% of the study release course. Everyone entitled to study leave for examination purposes obtained it. However, 95% of trainees found their hospital teachers unfamiliar with the aims and objectives of Vocational Training. Two-thirds of trainees received less than two hours a week of formal or informal teaching. More than two-thirds did not participate in an introductory general practice period and less than a quarter had their individual needs assessed early on. Substantial realisation of the guidelines issued by the ICGP has been achieved. Further work is necessary in the areas of individual needs assessment, relevant structured teaching and general practice liaison. Three specific recommendations are made to achieve these aims.

  1. Assessment of the Penta-XT radiography table at Mansfield General Hospital

    International Nuclear Information System (INIS)

    1984-07-01

    A DHSS assessment report, prepared by Mansfield General Hospital, is presented for a Penta-XT radiographic table. The table has a fully floating table top with longitudinal and lateral movement and a variable height which has proved to be very acceptable to both staff and patients utilising the equipment. Details of operational experience and reliability are given. (U.K.)

  2. An analysis of acute admissions to a general hospital psychiatric unit

    African Journals Online (AJOL)

    Rapid turnover of patients in a general hospital psychiatric unit demands stabilization and discharge as soon as possible. It is likely that patients are being prematurely discharged because of this pressure. Aim: The study sought to analyse admissions to an acute psychiatric unit with a view to determining the demographic ...

  3. Intolerance and Violence Against Doctors.

    Science.gov (United States)

    Singh, Meharban

    2017-10-01

    Intolerance and grouse against doctors is a global phenomenon but India seems to lead the world in violence against doctors. According to World Health Organization, about 8-38% healthcare workers suffer physical violence at some point in their careers. Many more are verbally abused or threatened. Public is almost behaving like health sector terrorists. The spate of increasing attacks on doctors by damaging their property and causing physical injury is not acceptable by any civilized society. The public is becoming increasingly intolerant to a large number of social issues because of poor governance and vote bank politics. There is a need to arrest the development of further distrust between doctors and their patients/relatives, otherwise it will compromise all achievements of medical science and adversely affect healing capabilities of doctors. Rude and aggressive behavior of the patients or their family members, and arrogant and lackadaisical approach of the doctor, adversely affects the doctor-patient relationship and the outcome of the patient. The doctors, hospital administration and government must exercise "zero tolerance" with respect to acts of violence against healthcare professionals. It is possible to reduce the incidence of intolerance against doctors but difficult to eliminate it completely. The healthcare providers should demonstrate greater compassion and empathy with improved communication skills. The hospitals must have adequate infrastructure, facilities and staff to handle emergencies without delay and with due confidence and skills. The security of healthcare providers, especially in sensitive areas, should be improved by having adequate number of security guards, frisking facilities, extensive CCTV network and availability of "Quick response team" to handle unruly mob. In case of any grievances for alleged mismanagement, the public should handle the situation in a civilized manner and seek redressal through Medical Protection Act and legal

  4. TRANSPORT OF PATIENTS FOR PRIMARY PTCA FROM GENERAL HOSPITAL NOVO MESTO TO LJUBLJANA IN 2002

    Directory of Open Access Journals (Sweden)

    Renata Okrajšek

    2004-12-01

    Full Text Available Background. The treatment of acute coronary syndrome (ACS with ST-segment elevation with primary percutaneous transluminal coronary angioplasty (PTCA is the best way to treat these patients. Primary PTCA is also practicable with patients who are admitted into institution without catheter laboratory. The transport of patients into the tertiary institution is safe, but it is important to keep the time of ischemia as short as possible and to reach the time interval of door-balloon as recommended by the guidelines. The ACS patients with ST-segment elevation that were directed into General Hospital Novo mesto after examination at the internistic emergency department have been redirected to KC Ljubljana for realization of PTCA since October 2001.Methods. A prospective analysis of patients with ACS with STsegment elevation, who had been transferred from General Hospital Novo mesto to KC Ljubljana in the period from January 1, 2002 to December 31, 2002 to have a primary PTCA, was performed. The analysis comprised the following: the time interval of handling the patients at Internistic department of General Hospital Novo mesto, the time of transport of patients to Ljubljana and total time interval from the arrival of patients to General Hospital Novo mesto to the first inflation of balloon in Ljubljana. We monitored the complications that occurred during the treatment of the patients.Results. In the above mentioned period 29 patients (24 males and 5 females were transported from the General Hospital Novo mesto to the KC Ljubljana to have a primary PTCA performed. The total time interval measured between the patients’ arrival to General Hospital Novo mesto to the first inflation of balloon in Ljubljana in the year 2002 was 145 minutes, which is 17 minutes better than in the previous period. The time interval recommended by the guidelines was achieved with four patients.Conclusions. By recognizing the problems that had encountered with directing the

  5. Antibiotic Conformity with Culture Results of Hospitalized Pneumonia Patients in Melati Ward at Dr. Hasan Sadikin General Hospital Bandung, Indonesia

    Directory of Open Access Journals (Sweden)

    Randhi Rinaldi

    2016-12-01

    Full Text Available Background: Pneumonia is an infection with the highest mortality rate in Indonesian hospitals. According to The American Thoracic Society and The Infectious Diseases Society of America (ATS/IDSA, empirical use of antibiotics is still effective for pneumonia treatment. Inappropriate use of antibiotics would cause negative effects such as prolonged hospitalization, a high cost of treatment, and increased antibiotic-resistant bacteria. The goal of this study was to clarify the empirical use of antibiotic conformity with a bacteria culture. Methods: This study was conducted from August to October 2013 using a descriptive retrospective method based on 116 medical records of pneumonia patients hospitalized in Melati Ward, Dr. Hasan Sadikin General Hospital Bandung during 2011–2012. The type of bacteria, conformity with antibiotics given to patients, and type of antibiotics were analyzed. The conformity of antibiotics was assessed based on the resistance test. If the results were sensitive, they would be put in the conforming group and in the non-conforming group if the results were resistant or intermediate. Data was derived with descriptive statistics, using percentage and frequency distribution, illustrated in tables and figures. Results: Based on culture results and sensitivity of antibiotic empirical therapy given, 55.17% cases were conformed. The most widely used antibiotic group was Third-generation Cephalosporin (60.34%. The most common bacterias were Klebsiella pneumonia (34.5% and Acinetobacter baumanni (13.8%. Conclusions: Most of the antibiotics given to pneumonia patients are still appropriate with results of the bacteria culture test and resistance test.

  6. [Acute care of critically ill children in general hospitals: organisation and training].

    Science.gov (United States)

    van Sambeeck, S J L; Janssen, E J M; Hundscheid, T; Martens, S J L; Vos, G D

    2013-01-01

    To gain insight into how the acute care of critically ill children at general hospitals is organised, whether staff is sufficiently trained and whether the necessary materials and medications are present. Questionnaire combined with a site visit. Questionnaires were sent to all primarily involved specialists (emergency room specialists and paediatricians), and to the auxiliary anaesthetists and intensivists involved, at the nine general hospitals in Southeast Netherlands. Two researchers performed standardised interviews with the lead paediatricians on site and checked for materials and medication present in the emergency and paediatric departments. Of the 195 questionnaires sent, 97 (49.7%) were deemed suitable for analysis. The response from the primary specialists involved (77.6%) was more than twice that of the auxiliary specialists (31.9%). At 7 hospitals, verbal agreements on the organisation of acute care were maintained, 1 hospital had a written protocol, and 2 hospitals had a task force addressing this topic. One out of 5 respondents was unaware of the verbal agreements and 1 out of 3 mistakenly assumed that a protocol existed. Two out of 3 primary specialists involved were certified for Advanced Paediatric Life Support (APLS); 1 out of 13 of the auxiliary specialists had such a certificate. Scenario training was being conducted at 8 hospitals. A paediatric resuscitation cart was available at both the emergency and paediatric departments of 8 hospitals, 3 of which were fully stocked at both departments. Laryngeal mask airways and PEEP-valves (Positive End Expiratory Pressure) were lacking at 6 of the 9 hospitals. The medication stock was complete at all the hospitals. The organisation of and training for the acute care of critically ill children and presence of materials - the aspects we investigated - need attention at all general hospitals evaluated. It appeared that many specialists are not APLS certified and written protocols concerning organisation

  7. Prevalence and cost of hospital medical errors in the general and elderly United States populations.

    Science.gov (United States)

    Mallow, Peter J; Pandya, Bhavik; Horblyuk, Ruslan; Kaplan, Harold S

    2013-12-01

    The primary objective of this study was to quantify the differences in the prevalence rate and costs of hospital medical errors between the general population and an elderly population aged ≥65 years. Methods from an actuarial study of medical errors were modified to identify medical errors in the Premier Hospital Database using data from 2009. Visits with more than four medical errors were removed from the population to avoid over-estimation of cost. Prevalence rates were calculated based on the total number of inpatient visits. There were 3,466,596 total inpatient visits in 2009. Of these, 1,230,836 (36%) occurred in people aged ≥ 65. The prevalence rate was 49 medical errors per 1000 inpatient visits in the general cohort and 79 medical errors per 1000 inpatient visits for the elderly cohort. The top 10 medical errors accounted for more than 80% of the total in the general cohort and the 65+ cohort. The most costly medical error for the general population was postoperative infection ($569,287,000). Pressure ulcers were most costly ($347,166,257) in the elderly population. This study was conducted with a hospital administrative database, and assumptions were necessary to identify medical errors in the database. Further, there was no method to identify errors of omission or misdiagnoses within the database. This study indicates that prevalence of hospital medical errors for the elderly is greater than the general population and the associated cost of medical errors in the elderly population is quite substantial. Hospitals which further focus their attention on medical errors in the elderly population may see a significant reduction in costs due to medical errors as a disproportionate percentage of medical errors occur in this age group.

  8. Doctors' attitudes and confidence towards providing nutrition care in practice: Comparison of New Zealand medical students, general practice registrars and general practitioners.

    Science.gov (United States)

    Crowley, Jennifer; Ball, Lauren; Han, Dug Yeo; McGill, Anne-Thea; Arroll, Bruce; Leveritt, Michael; Wall, Clare

    2015-09-01

    Improvements in individuals' nutrition behaviour can improve risk factors and outcomes associated with lifestyle-related chronic diseases. This study describes and compares New Zealand medical students, general practice registrars and general practitioners' (GPs') attitudes towards incorporating nutrition care into practice, and self-perceived skills in providing nutrition care. A total of 183 New Zealand medical students, 51 general practice registrars and 57 GPs completed a 60-item questionnaire investigating attitudes towards incorporating nutrition care into practice and self-perceived skills in providing nutrition care. Items were scored using a 5-point Likert scale. Factor analysis was conducted to group questionnaire items and a generalised linear model compared differences between medical students, general practice registrars and GPs. All groups indicated that incorporating nutrition care into practice is important. GPs displayed more positive attitudes than students towards incorporating nutrition in routine care (ppractice registrars were more positive than students towards performing nutrition recommendations (p=0.004), specified practices (p=0.037), and eliciting behaviour change (p=0.024). All groups displayed moderate confidence towards providing nutrition care. GPs were more confident than students in areas relating to wellness and disease (pmedical students, general practice registrars and GPs have positive attitudes and moderate confidence towards incorporating nutrition care into practice. It is possible that GPs' experience providing nutrition care contributes to greater confidence. Strategies to facilitate medical students developing confidence in providing nutrition care are warranted.

  9. Doctoral Education

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2015-01-01

    Doctoral education covers the “third cycle” of degrees following the bachelor’s and the master’s degree. The education of researchers is necessary for developing music therapy as a scientific discipline and calls for a certain research culture that not only brings knowledge on research...... with an integration of science and practice. This leads to a description of the principles of problem-based learning as a social constructive approach, problematization, self-directed learning and learning community. The chapter is concluded with an example of a model of doctoral education, the Aalborg model, where...... the coursework, supervision, and curriculum is based on problem-based learning. About the book: 'International Perspectives in Music Therapy Education and Training: Adapting to a Changing World,' the first anthology of its kind, edited by Professor Karen Goodman, brings noted educators from Brazil, Canada...

  10. Knowledge, attitude, and behaviour of public health doctors towards pandemic influenza compared to the general population in Italy.

    Science.gov (United States)

    La Torre, Giuseppe; Semyonov, Leda; Mannocci, Alice; Boccia, Antonio

    2012-02-01

    To study differences between public health physicians' and general population's knowledge, attitude, and behaviours towards an influenza pandemic. During winter 2009, an anonymous questionnaire online (www.ijph.it) of 34 questions was available for participants, structured into three parts: socio-demographic information, people's knowledge, and behaviours about influenza H1N1. 836 persons were interviewed (335 physicians and 501 not physicians). Of these, 50.8% of physicians and 78.1% of not physicians were aged less than 50 years and 57.6% of physicians and 31.7% of not physicians were male. Physicians were more interested to be updated about the pandemic (90.6% versus 88.4% of not physicians; p = 0.003); not physicians were more inclined to avoid crowded places (29.7% versus 17.6% of physicians; p health facilities' internal communication (33.1%), while for not physicians being watching the national television news (34.1%) and surfing the internet (30.9%). During the spread of the pandemic flu, a lot of information was propagated chaotically. The information given were not always truthful and often they were interpreted incorrectly or sometimes only partially understood by the population, and this needs to be taken into account for future successful communication in cases of emergency.

  11. Psychopathology of adolescents with an intellectual disability who present to general hospital services.

    Science.gov (United States)

    Theodoratos, Oreste; McPherson, Lyn; Franklin, Catherine; Tonge, Bruce; Einfeld, Stewart; Lennox, Nicholas; Ware, Robert S

    2017-10-01

    Adolescents with intellectual disability have increased rates of psychopathology compared with their typically developing peers and present to hospital more frequently for ambulant conditions. The aim of this study is to describe the psychopathology and related characteristics of a sample of adolescents with intellectual disability who presented to general hospital services. We investigated a cohort of adolescents with intellectual disability in South East Queensland, Australia between January 2006 and June 2010. Demographic and clinical data were obtained via mailed questionnaires and from general practice notes. Psychopathology was measured with the Short Form of the Developmental Behaviour Checklist. Of 98 individuals presenting to hospital, 71 (72.5%) had significant levels of psychopathology. Unknown aetiology for the intellectual disability was associated with presence of problem behaviours. Adolescents with more severe intellectual disability were more likely to have major problem behaviours. Co-morbid physical health issues were not associated with psychopathology. Only 12 (12.1%) adolescents had undergone specialized mental health intervention. The general hospital environment may offer opportunities for liaison psychiatry services to screen and provide management expertise for adolescent individuals with intellectual disability presenting for physical health issues.

  12. Simulating policy options for psychiatric care in general hospitals under Medicare's PPS.

    Science.gov (United States)

    Freiman, M P; Mitchell, J B; Rosenbach, M L

    1988-11-01

    Psychiatric hospitals and certain distinct part psychiatric units of general hospitals are currently exempt from diagnosis related group (DRG)-based payment under Medicare's prospective payment system (PPS), in large part due to concern about the degree to which such payment would match historical costs for these facilities. This communication simulates DRG-based payments for psychiatric admissions to general hospitals under the PPS and also under a modified version of the PPS. Two major types of modifications are made: (1) an increase in the role of outlier payments and (2) a restructuring of the DRG classification to allow for a difference in the basic payment rate, depending on whether or not care is provided in a facility that is currently exempt. When compared with cost data from just before the start of the PPS, the simulation results show the degree to which these hypothetical modifications will decrease the systematic risk of general hospitals with exempt units from receiving payments that fall short of costs.

  13. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general.

    OpenAIRE

    Casas, Paola; Varela, Luis; Tello, Tania; Ortiz, Pedro; Chávez, Helver

    2012-01-01

    Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH), entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,...

  14. Comparing salivary cotinine concentration in non-smokers from the general population and hospitality workers in Spain.

    Science.gov (United States)

    Martínez-Sánchez, Jose M; Fu, Marcela; Pérez-Ríos, Mónica; López, María J; Moncada, Albert; Fernández, Esteve

    2009-12-01

    The objective was to compare the pattern of exposure to second-hand smoke (SHS) among non-smokers in the general population and in hospitality workers. We used the adult (16-64 years) non-smokers of two independent studies (general population and hospitality workers) in Spain. We assessed the exposure to SHS by means of questionnaire and salivary cotinine concentration. The salivary cotinine concentration by sex, age, educational level, day of week of saliva collection, and exposure to SHS were always higher in hospitality workers than in the general population. Our results indicated that non-smoker hospitality workers have higher levels of exposure to SHS than general population.

  15. Zmiany rol zarzadczych lekarzy w szpitalach: czego mozemy sie nauczyc od Brytyjczykow? (Change of managerial roles of doctors in hospitals: what can we learn from the British?)

    OpenAIRE

    Marcin Kautsch; Kathy Hartley

    2013-01-01

    This paper surveys the attitudes to managerial roles shown by Polish and British doctors and their evolution over the past decades. The paper is based on a review and analysis of literature, policy documents, healthcare statistic sand semi-structured interviews. Results of this research show that in the past doctors were reluctant to assume managerial roles in the UK system, whereas they were actually keen to do so in the Polish one. Changes in both countries (more market orientation in both ...

  16. Five-Year Data of Clinical Characteristics and Laboratory Findings of Hospitalized Hemophilic Patients in Dr. Hasan Sadikin General Hospital

    Directory of Open Access Journals (Sweden)

    Dina Marlina

    2016-12-01

    Full Text Available Background: Hemophilia A has the highest incidence, more than 80% of 172.323 cases worldwide in 2012. It is stated that clinical characteristics of hemophilia A is worse than others, so it is required to prove and to know further about the clinical characteristics and severity likelihood in all hemophilic patients in order to prevent re-bleeding and re-injury and also for a better medical response. Methods: A retrospective cross-sectional study was carried out to 43 medical records of hospitalized hemophilic patients from 2009 to 2013 in Dr Hasan Sadikin General Hospital. The inclusion criteria were a complete patient identity (name, age, sex, written chief complaint, complete physical examination (bleeding, edema, hematoma, hemarthrosis, anemic symptoms and laboratory test results (factor level, hemoglobin, hematocrit, platelet and Activated Partial Thromboplastin Time. The data was collected from August‒October 2014, analyzed and presented using frequency distribution. Results: Most of the patients were 5-10 years old, male and had hemophilia A. The most common complaint was external bleeding, followed by edema. From 43 patients, 38 (88% cases were classified as severe factor deficiency, had mild to severe anemia, however the platelet count in most of the cases was in normal value. About 91% cases had prolonged Activated Partial Thromboplastin Time in moderate to severe level. Conclusions: Similar with other studies worldwide, most of the hospitalized hemophilic patients have hemophilia A. Most of the patents has moderate to severe bleeding with laboratory test result between moderate to severe level as well.

  17. Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients.

    Science.gov (United States)

    Pitt, Henry A; Tsypenyuk, Ella; Freeman, Susan L; Carson, Steven R; Shinefeld, Jonathan A; Hinkle, Sally M; Powers, Benjamin D; Goldberg, Amy J; DiSesa, Verdi J; Kaiser, Larry R

    2016-04-01

    Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  18. An analysis of OSHA inspections assessing contaminant exposures in general medical and surgical hospitals.

    Science.gov (United States)

    Knight, Jordan L; Sleeth, Darrah K; Larson, Rodney R; Pahler, Leon F

    2013-04-01

    This study analyzed data from the Occupational Safety and Health Administration's (OSHA) Chemical Exposure Health Database to assess contaminant exposures in general medical and surgical hospitals. Seventy-five inspections conducted in these hospitals from 2005 through 2009 were identified. Five categories of inspections were conducted, the three most common being complaint-based, planned, and referral-based inspections. Complaint-based inspections comprised the majority of inspections-55 (73%) of the 75 conducted. The overall violation rate for all inspection types was 68%. This finding was compared to the violation rates of planned inspections (100%), referral-based inspections (83%), and complaint-based inspections (62%). Asbestos was the hazardous substance most commonly sampled and cited by OSHA in hospitals, with 127 samples collected during 24 inspections; 31% of the total 75 inspections resulting in one or more violations were due to asbestos. Copyright 2013, SLACK Incorporated.

  19. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service.

    Science.gov (United States)

    Lord, Kito; Parwani, Vivek; Ulrich, Andrew; Finn, Emily B; Rothenberg, Craig; Emerson, Beth; Rosenberg, Alana; Venkatesh, Arjun K

    2018-03-20

    Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. We conducted an observational analysis of consecutive patient encounters admitted from the ED to the general medical service between February 2013 and June 2015. This study was conducted in an urban, academic hospital with an annual adult ED census over 90,000. We defined boarding as patients with greater than 4h from ED bed order to ED departure to hospital ward. The primary outcome was a composite of adverse outcomes in the first 24h of admission, including RRT activation, care escalation to intensive care, or in-hospital mortality. A total of 31,426 patient encounters were included of which 3978 (12.7%) boarded in the ED for 4h or more. Adverse outcomes occurred in 1.92% of all encounters. Comparing boarded vs. non-boarded patients, 41 (1.03%) vs. 244 (0.90%) patients experienced a RRT activation, 53 (1.33%) vs. 387 (1.42%) experienced a care escalation, and 1 (0.03%) vs.12 (0.04%) experienced unanticipated in-hospital death, within 24h of ED admission. In unadjusted analysis, there was no difference in the composite outcome between boarding and non-boarding patients (1.91% vs. 1.91%, p=0.994). Regression analysis adjusted for patient demographics, acuity, and comorbidities also showed no association between boarding and the primary outcome. A sensitivity analysis showed an association between ED boarding and the composite outcome inclusive of the entire inpatient hospital stay (5.8% vs. 4.7%, p=0.003). Within the first 24h of hospital admission to a general medicine service, adverse hospitalization outcomes are rare and not associated with ED boarding. Copyright © 2018 Elsevier Inc. All rights

  20. Determination of Budget Expenditures for Hospital Units, Using Econometric Techniques. Case General Hospital “Dr. Juan Bruno Zayas”

    Directory of Open Access Journals (Sweden)

    Rafael Ángel Formigo–Tejera

    2015-12-01

    Full Text Available In the Guidelines for Economic and Social Policy of the Party and the Revolution adopted at the Sixth Congress of the PCC is a need to raise the quality of health care services and improve the attention to the health personnel. In this regard, it has prioritized improving budget planning spending at all levels. The results obtained by applying the method of Exponential Smoothing for 2012, in the General Hospital "Dr. Juan Bruno Zayas Alfonso" will meet the aforementioned objectives. Comparing these results with what really executed in the first quarter, the estimate is closer, in relation with the traditional method, meaning a decrease in expenses of 1,8 %. 

  1. Agency doctorates

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1970-07-01

    Mr. Wen-chuan Li of China has become the first student to obtain a doctor's degree as a result of research work carried out in the Agency. Mr. Li, who is 33, graduated as a Bachelor of Agriculture at Taiwan Provincial Chung-hsing University in 1960 and in 1966 was granted a fellowship to study mutations in plant breeding at the Agency's Seibersdorf Laboratory near Vienna, under the direction of Dr. Knut Mikaelsen, a professor of the University of Bergen. The Hochschule fur Bodenkultur of Vienna accepted the research as being suitable for a thesis and have now granted the degree of Doctor of Agriculture. The subject of the thesis was modifying factors influencing the mutagenic effects of alkylating agents as compared with ionizing radiations in barley. Alkylating agents are involved in the use of chemicals as a means of changing the characteristics of seeds to bring about changes aimed at improving the quality of crops. Mr. Li's work is regarded as a significant contribution to the understanding of the mechanics by which mutations are induced, to the efficient use of chemicals and ionizing radiations in practical applications, and to the efforts of the Agency in collaboration with the Food and Agriculture Organization to benefit food supplies. Mr. Li has now completed his fellowship with the Agency and has been appointed an Assistant Professor in Plant Breeding at Taiwan Provincial Chung-hsing University. The photograph, taken in the plastic hot house at Seibersdorf, shows him studying rice plants grown from seeds subjected to irradiation. Another noteworthy achievement is that of Mr. Karl-Franz Lacina, a security guard at the Agency's headquarters. At the age of 50 he has been accorded the degree of Doctor of Philosophy at Vienna University, the result of six years' work in his leisure time. The major subject was Arabic, with French and philosophy as supporting subject. (author)

  2. Agency doctorates

    International Nuclear Information System (INIS)

    1970-01-01

    Mr. Wen-chuan Li of China has become the first student to obtain a doctor's degree as a result of research work carried out in the Agency. Mr. Li, who is 33, graduated as a Bachelor of Agriculture at Taiwan Provincial Chung-hsing University in 1960 and in 1966 was granted a fellowship to study mutations in plant breeding at the Agency's Seibersdorf Laboratory near Vienna, under the direction of Dr. Knut Mikaelsen, a professor of the University of Bergen. The Hochschule fur Bodenkultur of Vienna accepted the research as being suitable for a thesis and have now granted the degree of Doctor of Agriculture. The subject of the thesis was modifying factors influencing the mutagenic effects of alkylating agents as compared with ionizing radiations in barley. Alkylating agents are involved in the use of chemicals as a means of changing the characteristics of seeds to bring about changes aimed at improving the quality of crops. Mr. Li's work is regarded as a significant contribution to the understanding of the mechanics by which mutations are induced, to the efficient use of chemicals and ionizing radiations in practical applications, and to the efforts of the Agency in collaboration with the Food and Agriculture Organization to benefit food supplies. Mr. Li has now completed his fellowship with the Agency and has been appointed an Assistant Professor in Plant Breeding at Taiwan Provincial Chung-hsing University. The photograph, taken in the plastic hot house at Seibersdorf, shows him studying rice plants grown from seeds subjected to irradiation. Another noteworthy achievement is that of Mr. Karl-Franz Lacina, a security guard at the Agency's headquarters. At the age of 50 he has been accorded the degree of Doctor of Philosophy at Vienna University, the result of six years' work in his leisure time. The major subject was Arabic, with French and philosophy as supporting subject. (author)

  3. Investigation of Irrigation Reuse Potential of Wastewater Treatment Effluent from Hamedan Atieh-Sazan General Hospital

    Directory of Open Access Journals (Sweden)

    Mohammad Binavapour

    2007-12-01

    Full Text Available Hospital wastewater is a type of municipal wastewater which may contain pathogenic agents and different microorganisms. If properly treated, the effluent from hospital wastewater treatment facilities can be used for irrigation purposes. To investigate this, the effluent from Hamedan Atieh-Sazan General Hospital was studied. The existing treatment facility uses an extended aeration system with an average wastewater flow rate of approximately 150 m3/day. In addition to evaluating the performance of the wastewater facility at Atieh-Sazan General Hospital, quality parameters of the raw wastewater and the effluent were measured. The mean values obtained for pH, BOD, COD, MPN for total Coliform/100ml, and Nematode/lit in raw wastewater were about 7.1, 238 mg/l, 352 mg/l, 5.5´106, and 2340, respectively. The mean values obtained for pH, BOD, COD, Na%, MPN for total Coliform/100 ml, and Nematode/lit in the effluent were 7.1, 35 mg/L, 77 mg/L, 61, 1561, and 575, respectively. Based on these results, the efficiency of the existing system in removing BOD, COD, and MPN/100 ml were %85.3, %78.3, and %99.97, respectively. With respect to water quality standards available, the quality of the effluent was considered to be suitable for irrigation except for its Na%, MPN for total Coliform, and Nematodes values.

  4. Workplace sexual harassment in two general hospitals in Taiwan: the incidence, perception, and gender differences.

    Science.gov (United States)

    Wang, Liang-Jen; Chen, Chih-Ken; Sheng, Yi-Chen; Lu, Pei-Wen; Chen, Yi-Ting; Chen, Huei-Jun; Lin, Jyh-Sheng

    2012-01-01

    The aims of this study were to examine sexual harassment (SH) among hospital staffs in Taiwan, in terms of three-month incidence rate, the frequency of each type and the perception of SH, perpetrated by coworkers, patients and patients' families and to investigate the gender differences for these issues. The subjects were employees at two general hospitals in Taiwan. The self-administered "Hospital Sexual Harassment Questionnaire" was sent to eligible staff, and the voluntary respondents answered the questionnaire anonymously. There were 536 respondents available for analysis, with an overall response rate of 43.4%. The three-month incidence rates of SH by coworkers, patients, and patients' families in our study population were 2.4, 4.3, and 1.7%, respectively. Telling sexual jokes was the most common type of SH. The males had greater opportunities to be exposed to porn videos by their coworkers. The females were more frequently exposed to sex jokes and remarks made by patients and their family members and unwanted physical touching by patients in the workplace. There were significant differences with regard to the perception of sex jokes and sexually explicit verbal descriptions as SH or not between genders. The information in this study can be a helpful reference for administrators in hospitals when they are establishing education plans and policies. It might be possible to prevent sexual harassment and misunderstandings between genders and to further avoid the negative impact on the emotional well-being of workers in hospitals.

  5. Evaluation of low-dose CT implementation for lung cancer screening in a general practice hospital

    Science.gov (United States)

    Karostik, D. V.; Kamyshanskaya, I. G.; Cheremisin, V. M.; Drozdov, A. A.; Vodovatov, A. V.

    2018-02-01

    The aim of the current study was to evaluate the possibility of the implementation of LDCT for the screening for lung cancer and tuberculosis in a typical general hospital practice. Diagnostic and economic effectiveness, patient doses and the corresponding radiation risks for LDCT were compared with the existing digital chest screening radiography. The results of the study indicate that the implementation of LDCT allowed verifying false-positive cases or providing additional excessive diagnostic information, but did not significantly improve the sensitivity of screening. Per capita costs for LDCT were higher compared to digital radiography up to a factor of 12; corresponding radiation risk - by a factor of 4. Hence, it was considered unjustified to implement LDCT in a general practice hospital.

  6. Mentor Tutoring: An Efficient Method for Teaching Laparoscopic Colorectal Surgical Skills in a General Hospital.

    Science.gov (United States)

    Ichikawa, Nobuki; Homma, Shigenori; Yoshida, Tadashi; Ohno, Yosuke; Kawamura, Hideki; Wakizaka, Kazuki; Nakanishi, Kazuaki; Kazui, Keizo; Iijima, Hiroaki; Shomura, Hiroki; Funakoshi, Tohru; Nakano, Shiro; Taketomi, Akinobu

    2017-12-01

    We retrospectively assessed the efficacy of our mentor tutoring system for teaching laparoscopic colorectal surgical skills in a general hospital. A series of 55 laparoscopic colectomies performed by 1 trainee were evaluated. Next, the learning curves for high anterior resection performed by the trainee (n=20) were compared with those of a self-trained surgeon (n=19). Cumulative sum analysis and multivariate regression analyses showed that 38 completed cases were needed to reduce the operative time. In high anterior resection, the mean operative times were significantly shorter after the seventh average for the tutored surgeon compared with that for the self-trained surgeon. In cumulative sum charting, the curve reached a plateau by the seventh case for the tutored surgeon, but continued to increase for the self-trained surgeon. Mentor tutoring effectively teaches laparoscopic colorectal surgical skills in a general hospital setting.

  7. Attitude and practice of patients and doctors towards complementary and alternative medicine.

    Science.gov (United States)

    Junaid, Rabyyan; Abaas, Mustafa; Fatima, Batool; Anis, Irma; Hussain, Mehwish

    2012-08-01

    To determine the attitude towards complementary and alternative medicine among the doctors and patients. The study was carried out at Civil Hospital Karachi and Liaquat National University Hospital, Karachi during April to September 2010. Two sets of questionnaires were developed separately for doctors and patients. Each set consisted of queries regarding demographic data of patients and doctors. The questionnaire for the patients contained questions reflecting the general attitude, mode of complimentary and alternative medicine usage, disease referred and the underlined reasons behind pricking the options. The questionnaires for doctors in general laid focus on the personal opinion about the practice not only for their own use, but also related to their concern towards those patients who used complimentary and alternative medicine. Predictive analysis software statistics 18 was used for statistical analysis. Of the patients, 237 (59.3%) used complimentary and alternative medicine. Herbal medicine followed by homeopathic medicine were the most commonly used therapies. Fever and cough were the most common diseases for which patients used the options. The preference was mainly based on inter-personal communications, reliance on complimentary and alternative medicine, and financial restriction. Concealing from the doctors was common in patients. Only 62 (34.4%) out of 180 doctors used complimentary and alternative medicine themselves. Refusal by other doctors was because they considered the option ineffective, obsolete and unsatisfactory. About half of the doctors forbade the patients to use such therapies, but 31% (n=73) patients ignored the doctor's advice. The use of complimentary and alternative medicine is highly prevalent in our society by patients irrespective of their social class. Preference for such therapies, on the other hand, is quite low among medical doctors as they consider allopathic medicine to be effective.

  8. A qualitative study on nurses' reactions to inpatient suicide in a general hospital

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    Shujie Wang

    2016-12-01

    Conclusions: Nurses who experienced inpatient suicide became stressed. Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide. The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals. Such information can be used to develop effective strategies and provide individual support and ongoing education. Consequently, nurses will acquire suicide prevention skills and help patients achieve swift recovery.

  9. Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

    OpenAIRE

    Mosam Phirke; Harshal Sathe; Nilesh Shah; Sushma Sonavane; Anup Bharati; Avinash DeSousa

    2015-01-01

    Background: Electroconvulsive therapy (ECT) is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014...

  10. Dextrose infusion and glucose disorders in people without diabetes hospitalized in general wards.

    Science.gov (United States)

    Feldman-Billard, Sylvie; Joubert, Michael; Reznik, Yves

    2013-11-01

    We measured fasting plasma glucose (FPG) on a single day in all persons without diabetes history admitted in general wards (N=1922). After age and length of stay adjustment, dextrose infusion was associated with a 3-fold increase (p<0.001) of hospital-related hyperglycemia (FPG ≥ 7 mmol/l), highlighting the need to interpret glucose disorders cautiously. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Intervention pattern in crisis: mental health as a nursing care approach at a general hospital

    OpenAIRE

    Oliveira, Elias Barbosa; Kestenberg, Célia Caldeira Fonseca; Silva, Alexandre Vicente

    2013-01-01

    Objective: Testing and validating the application of Intervention in Crisis theory as an approach in mental health on HIV/AIDS patients care who are interned at a general hospital. Method: Help Interview has been accomplished as an activity for Mental Health subject according to an applied guide by graduation in nursing students in order to identify this illness psycho-social repercussion and draft therapeutic plan for patients under their care. The outcomes were the reports results presented...

  12. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

    OpenAIRE

    Lambrou, Persefoni; Kontodimopoulos, Nick; Niakas, Dimitris

    2010-01-01

    Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co...

  13. Consumption of psychiatric drugs by patients of medical and surgical clinics in a general hospital

    OpenAIRE

    Shirama,Flavio Hiroshi; Miasso,Adriana Inocenti

    2013-01-01

    PURPOSES: to identify the prevalence of the use of psychiatric drugs among patients admitted to medical and surgical clinics of a general hospital, and also the factors related to the consumption of this type of medication. METHOD: this is a transversal, descriptive, correlational study with quantitative analysis. For the collection of data, there was use of structured interviews and also reference to medical files. RESULTS: there was confirmation of a high prevalence of users of psy...

  14. The Japanese Version of the Massachusetts General Hospital Acupuncture Sensation Scale: A Validation Study

    OpenAIRE

    Masako Nishiwaki; Miho Takayama; Hiroyoshi Yajima; Morihiro Nasu; Jian Kong; Nobuari Takakura

    2017-01-01

    Acupuncture sensations are considered essential in producing the treatment effect of acupuncture. The Massachusetts General Hospital Acupuncture Sensation Scale (MASS) is a frequently used scale in acupuncture research to measure acupuncture sensations. We translated the MASS into Japanese (Japanese MASS) based on Beaton's guidelines. 30 acupuncturists evaluated the relevancy and meaning of the 12 descriptors included in the Japanese MASS. The content validity ratios for 10 of the 12 descript...

  15. Analysis on the Implementation of Nutrition Services in Tugurejo General Hospital Semarang

    OpenAIRE

    Dewi, Emy Shinta; Kartasurya, Martha Irene; Sriatmi, Ayun

    2015-01-01

    Nutrition was an important factor for patient care and cure. Results of an evaluation by nutritionalresearch and development unit of Tugurejo district general hospital (RSUD) in 2011 indicated thatfood remains of patient were still below the minimal standard of service. Objective of this study wasto analyze the implementation of nutritional service in the RSUD Tugurejo Semarang.This was a qualitative study with 4 nutritionists, 8 cook assistants, and 8 waitresses as maininformants. Triangulat...

  16. Perception of transformational leadership behaviour among general hospital nurses in Ogun State, Nigeria

    OpenAIRE

    Oluwatosin Olu-Abiodun; Olumide Abiodun

    2017-01-01

    Introduction: Effective nursing leadership engenders staff retention, job satisfaction, commitment, work unit climate and client satisfaction with nursing services. This study assessed the perception of transformational leadership among nurses working in general hospitals in Nigeria. Materials and methods: A cross-sectional study was conducted among 176 nurses in Ogun State, Nigeria. The independent student t-test was used to test the relationship between respondents’ characteristics and l...

  17. Psiquiatría de Enlace. Experiencia en el Hospital General de México

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    I.C. González-Salas

    2014-07-01

    El objetivo de este trabajo es revisar algunos antecedentes históricos de la Salud Mental en México y en el Hospital General de México «Dr. Eduardo Liceaga» (HGM-DEL considerando la evolución institucional y las características de los pacientes que recibe el Servicio de Salud Mental, como parte del equipo multidisciplinario de salud.

  18. Causes of prolonged hospitalization among general internal medicine patients of a tertiary care center.

    Science.gov (United States)

    Ruangkriengsin, Darat; Phisalprapa, Pochamana

    2014-03-01

    Unnecessary days of prolonged hospitalization may lead to the increase in hospital-related complications and costs, especially in tertiary care center Currently, there have not been many studies about the causes of prolonged hospitalization. Some identified causes could, however, be prevented and improved. To identify the prevalence, causes, predictive factors, prognosis, and economic burden of prolonged hospitalization in patients who had been in general internal medicine wards of the tertiary care center for 7 days or more. Retrospective chart review study was conducted among all patients who were admitted for 7 days or more in general internal medicine wards of Siriraj Hospital, the largest tertiary care center in Thailand. The period of this study was from 1 August 2012 to 30 September 2012. Demographic data, principle diagnosis, comorbid diseases, complications, discharge status, total costs of admission and percentage of reimbursement were collected. The causes of prolonged hospitalization at day 7, 14, 30, and 90 were assessed. Five hundred and sixty-two charts were reviewed. The average length of stay was 25.9 days. The two most common causes of prolonged admission at day 7 were treatment of main diagnosed disease with stable condition (27.6%) and waiting for completion of intravenous antibiotics administration with stable condition (19.5%). The causes of prolonged hospitalization at day 14 were unstable condition from complications (22.6%) and those waiting for completion of intravenous antibiotics administration with stable condition (15.8%). The causes of prolonged admission at day 30 were unstable conditions from complications (25.6%), difficulty weaning or ventilator dependence (17.6%), and caregiver problems (15.2%). The causes of prolonged hospitalization at day 90 were unstable condition from complications (30.0%), caregiver problems (30.0%), and palliative care (25.0%). Poor outcomes were shown in the patients admitted more than 90 days. Percentage

  19. Two decades of external peer review of cancer care in general hospitals; the Dutch experience.

    Science.gov (United States)

    Kilsdonk, Melvin J; Siesling, Sabine; Otter, Rene; van Harten, Wim H

    2016-03-01

    External peer review was introduced in general hospitals in the Netherlands in 1994 to assess and improve the multidisciplinary team approach in cancer care. This paper aims to explore the value, perceived impact, and (future) role of external peer review in cancer care. Semistructured interviews were held with clinicians, oncology nurses, and managers from fifteen general hospitals that participated in three rounds of peer review over a period of 16 years. Interviewees reflected on the goals and expectations, experiences, perceived impact, and future role of external peer review. Transcriptions of the interviews were coded to discover recurrent themes. Improving clinical care and organization were the main motives for participation. Positive impact was perceived on multiple aspects of care such as shared responsibilities, internal prioritization of cancer care, improved communication, and a clear structure and position of cancer care within general hospitals. Establishing a direct relationship between the external peer review and organizational or clinical impact proved to be difficult. Criticism was raised on the content of the program being too theoretical and organization-focussed after three rounds. According to most stakeholders, external peer review can improve multidisciplinary team work in cancer care; however, the acceptance is threatened by a perceived disbalance between effort and visible clinical impact. Leaner and more clinically focused programs are needed to keep repeated peer reviews challenging and worthwhile. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  20. Indications of Tonsillectomy and Adenoidectomy in Dr. Hasan Sadikin General Hospital Bandung

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    Dini Atiyah

    2015-03-01

    Full Text Available Background: Tonsillectomy is the intervention to take out the palatine tonsils either whole or sub capsular, while adenoidectomy is the intervention of extraction of the adenoid gland which is commonly done with curettage method. Both interventions are done to eliminate repeated infections and also obstructions due to inflammation and hypertrophy of the tonsils and adenoids. This study was conducted to examine the indications of tonsillectomy and adenoidectomy in the Departement of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital Bandung in the period of January 2009–December 2011. Methods: A cross-sectional descriptive study was conducted in October–November of 2012 using 207 medical records of patients who had tonsillectomy and adenoidectomy executed in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital, Bandung in the period of January 2009–December 2011. Data collected were age, gender, main complaint, tonsil size, history of repeated infections, history of snoring as well as of Obstructive Sleep Apnea Syndrome (OSAS. The indication for tonsillectomy and adenoidectomy such as infection, obstruction and neoplasia was selected. Results: The indications of tonsillectomy and adenoidectomy were infection at 106 (51.2% patients, obstruction at 100 (48.3% patients, and neoplasia at 1 (0.05% patient. Conclusions: The most numerous indications for tonsillectomy and tonsilloadenoidectomy in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital were infection.

  1. Trends in fatalities due to poisoning at Umtata General Hospital, Mthatha (1993–2005

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    Banwari L. Meel

    2009-08-01

    Full Text Available Poisoning is a common method of committing suicide in this region of South Africa. Females generally ingest poisons but it is increasingly becoming common in males too. This is a record review of autopsies carried out at the Umtata (Mthatha General Hospital mortuary, which forms part of the teaching hospital of the Walter Sisulu University Medical School. There were 10 230 unnatural deaths between 1993 and 2005. Of these deaths, 161 (1.6% were deaths due to poisoning. There was a marked increase in death by poisoning from 2.5% in 1993 to 13.7% in 2004. The highest percentage (17.4% of poison-related deaths was in 2001, and the lowest (2.5% was in 1993 and 1994. About two-thirds of victims (66% were males, and more than half of the victims (51.5% were in the 11 to 30 age group. There is an increasing trend in fatalities due to poisoning at Umtata General Hospital, Mthatha.

  2. Trastornos psicóticos en el servicio de urgencias de un Hospital General.

    OpenAIRE

    AI González Vázquez; F Battle Battle; E Ferrer Gómez del Valle; MC García Mahía; David Simón Lorda; L Docasar Bertolo; José Mazaira Castro; A Albarrán Barrado; A Rodríguez López

    1994-01-01

    El presente artículo pretende reflexionar acerca del papel que los Servicios de Urgencia Psiquiátrica están teniendo en la atención del paciente psicótico no institucionalizado, en el marco particular de un Area Sanitaria en plena reestructuración. Para ello se analizan diversos datos de los pacientes atendidos en el Servicio General de Urgencias de un Hospital General que fueron diagnosticados como trastornos psicóticos, tratándose de valorar los factores que influyen en la decisión de ingre...

  3. [Epidemiology of gunshot wounds at Ciudad Juárez, Chihuahua General Hospital].

    Science.gov (United States)

    Moye-Elizalde, G A; Ruiz-Martínez, F; Suarez-Santamaría, J J; Ruiz-Ramírez, M; Reyes-Gallardo, A; Díaz-Apodaca, B A

    2013-01-01

    Since 2007, Ciudad Juárez, Chihuahua has been considered as one of the most violent cities in the world. The General Hospital in this city is the main facility where patients with gunshot wounds are taken. The increased number of admissions of patients with these injuries to many hospitals in the country deserves special attention, as it has an impact on hospital resources and management protocols. To disseminate the epidemiology of fractures caused by gunshot wounds and the hospital care of these patients. A retrospective, observational cohort study was conducted of patients admitted to the Traumatology and Orthopedics Service, Cd. Juárez General Hospital, in Chihuahua, Mexico, from January 2008 to December 2010. All of them sustained fractures resulting from gunshot wounds. A total of 1281 patients with a diagnosis of gunshot wounds were admitted to the hospital; 402 of them were included in this study with 559 fractures; 329 were males and 73 females. Of the 559 fractures, 257 involved the upper limb, 294 the lower limb, and 8 the pelvis. Gunshot wounds-related fractures were classified according to the Gustilo classification. Seventy-nine patients had grade I fractures, 302 grade III, and 21 patients had both grades. Conservative treatment was used in 44.3% of fractures and osteosynthesis in 55%. One patient underwent amputation upon admission. The most widely used osteosynthesis methods were external fixator (37%), straight plates (21%) and intramedullary nail (17%). Five patients (1.3%) underwent amputation: two with femur fracture and 3 with humeral fracture. There were 27 deep infections (6%); one of them resulted in late amputation of the pelvic limb. The most common associated injuries included: chest injuries in 20 patients and abdominal injuries in 17. The range of hospital stay was 1-18 days, with a mean stay of 11 days. The overall mortality rate considering the total number of patients admitted (1,281) was 99 patients (7.72%). From 2006 to 2010 the

  4. Emergency general surgery in Rwandan district hospitals: a cross-sectional study of spectrum, management, and patient outcomes.

    Science.gov (United States)

    Mpirimbanyi, Christophe; Nyirimodoka, Alexandre; Lin, Yihan; Hedt-Gauthier, Bethany L; Odhiambo, Jackline; Nkurunziza, Theoneste; Havens, Joaquim M; Omondi, Jack; Rwamasirabo, Emile; Ntirenganya, Faustin; Toma, Gabriel; Mubiligi, Joel; Bayitondere, Scheilla; Riviello, Robert

    2017-12-01

    Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions. We describe patient demographics, clinical characteristics, management and outcomes. In 2015, 356 patients presented with emergency general surgical conditions. The majority were male (57.2%) and adults aged 15-60 years (54.5%). The most common diagnostic group was soft tissue infections (71.6%), followed by acute abdominal conditions (14.3%). The median length of symptoms prior to diagnosis differed significantly by diagnosis type (p operated on at the district hospital, either by a general surgeon or general practitioner. Patients were more likely to receive surgery if they presented to a hospital with a general surgeon compared to a hospital with only general practitioners (75% vs 43%, p operation in a hospital with a general surgeon as opposed to a general practitioner. This provides evidence to support increasing the surgical workforce in district hospitals in order to increase surgical availability for patients.

  5. Hospital costs associated with surgical site infections in general and vascular surgery patients.

    Science.gov (United States)

    Boltz, Melissa M; Hollenbeak, Christopher S; Julian, Kathleen G; Ortenzi, Gail; Dillon, Peter W

    2011-11-01

    Although much has been written about excess cost and duration of stay (DOS) associated with surgical site infections (SSIs) after cardiothoracic surgery, less has been reported after vascular and general surgery. We used data from the National Surgical Quality Improvement Program (NSQIP) to estimate the total cost and DOS associated with SSIs in patients undergoing general and vascular surgery. Using standard NSQIP practices, data were collected on patients undergoing general and vascular surgery at a single academic center between 2007 and 2009 and were merged with fully loaded operating costs obtained from the hospital accounting database. Logistic regression was used to determine which patient and preoperative variables influenced the occurrence of SSIs. After adjusting for patient characteristics, costs and DOS were fit to linear regression models to determine the effect of SSIs. Of the 2,250 general and vascular surgery patients sampled, SSIs were observed in 186 inpatients. Predisposing factors of SSIs were male sex, insulin-dependent diabetes, steroid use, wound classification, and operative time (P surgery. Although the excess costs and DOS associated with SSIs after general and vascular surgery are somewhat less, they still represent substantial financial and opportunity costs to hospitals and suggest, along with the implications for patient care, a continuing need for cost-effective quality improvement and programs of infection prevention. Copyright © 2011 Mosby, Inc. All rights reserved.

  6. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence.

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    Elizabeth da Trindade de Andrade

    Full Text Available The World Health Organization (WHO identifies 8.7 million new cases of tuberculosis (TB annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO's cure target.To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment.Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis.Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students' education. The existence of health programs and policies was mentioned as a potential enabler of adherence.The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship, assistance and educational health

  7. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence

    Science.gov (United States)

    de Andrade, Elizabeth da Trindade; Hennington, Élida Azevedo; de Siqueira, Hélio Ribeiro; Rolla, Valeria Cavalcanti; Mannarino, Celina

    2015-01-01

    Introduction The World Health Organization (WHO) identifies 8.7 million new cases of tuberculosis (TB) annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO’s cure target. Goal To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment. Methods Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis. Results Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students’ education. The existence of health programs and policies was mentioned as a potential enabler of adherence. Conclusion The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship

  8. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence.

    Science.gov (United States)

    de Andrade, Elizabeth da Trindade; Hennington, Élida Azevedo; Siqueira, Hélio Ribeiro de; Rolla, Valeria Cavalcanti; Mannarino, Celina

    2015-01-01

    The World Health Organization (WHO) identifies 8.7 million new cases of tuberculosis (TB) annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO's cure target. To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment. Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis. Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students' education. The existence of health programs and policies was mentioned as a potential enabler of adherence. The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship, assistance and educational health strategies.

  9. Perceived Transcultural Self-Efficacy of Nurses in General Hospitals in Guangzhou, China

    Science.gov (United States)

    Li, Juan; He, Zhuang; Luo, Yong; Zhang, Rong

    2016-01-01

    Background Conflicts arising from cultural diversity among patients and hospital staff in China have become intense. Hospitals have an urgent need to improve transcultural self-efficacy of nurses for providing effective transcultural nursing. Objective The purpose of the research was to (a) evaluate the current status of perceived transcultural self-efficacy of nurses in general hospitals in Guangzhou, China; (b) explore associations between demographic characteristics of nurses and their perceived transcultural self-efficacy; and (c) assess the reliability and validity of scores on the Chinese version of the Transcultural Self-Efficacy Tool (TSET). Methods A cross-sectional survey of registered nurses from three general hospitals was conducted. Quota and convenience sampling were used. Participants provided demographic information and answered questions on the TSET. Results A total of 1,156 registered nurses took part. Most nurses had a moderate level of self-efficacy on the Cognitive (87.9%), Practical (87%), and Affective (89.2%) TSET subscales. Nurses who were older; who had more years of work experience, higher professional titles, higher incomes, and a minority background; and who were officially employed (not temporary positions) had higher perceived transcultural self-efficacy. Reliability estimated using Cronbach’s alpha was .99 for the total TSET score; reliability for the three subscales ranged from .97 to .98. Confirmatory factor analysis of TSET scores showed good fit with a three-factor model. Conclusion The results of this study can provide insights and guidelines for hospital nursing management to facilitate design of in-service education systems to improve transcultural self-efficacy of nurses. PMID:27454552

  10. Outcomes of hospitalized patients undergoing emergency general surgery remote from admission.

    Science.gov (United States)

    Sharoky, Catherine E; Bailey, Elizabeth A; Sellers, Morgan M; Kaufman, Elinore J; Sinnamon, Andrew J; Wirtalla, Christopher J; Holena, Daniel N; Kelz, Rachel R

    2017-09-01

    Emergency general surgery during hospitalization has not been well characterized. We examined emergency operations remote from admission to identify predictors of postoperative 30-day mortality, postoperative duration of stay >30 days, and complications. Patients >18 years in The American College of Surgeons National Surgical Quality Improvement Program (2011-2014) who had 1 of 7 emergency operations between hospital day 3-18 were included. Patients with operations >95th percentile after admission (>18 days; n = 581) were excluded. Exploratory laparotomy only (with no secondary procedure) represented either nontherapeutic or decompressive laparotomy. Multivariable logistic regression was used to identify predictors of study outcomes. Of 10,093 patients with emergency operations, most were elderly (median 66 years old [interquartile ratio: 53-77 years]), white, and female. Postoperative 30-day mortality was 12.6% (n = 1,275). Almost half the cohort (40.1%) had a complication. A small subset (6.8%) had postoperative duration of stay >30 days. Postoperative mortality after exploratory laparotomy only was particularly high (>40%). In multivariable analysis, an operation on hospital day 11-18 compared with day 3-6 was associated with death (odds ratio 1.6 [1.3-2.0]), postoperative duration of stay >30 days (odds ratio 2.0 [1.6-2.6]), and complications (odds ratio 1.5 [1.3-1.8]). Exploratory laparotomy only also was associated with death (odds ratio 5.4 [2.8-10.4]). Emergency general surgery performed during a hospitalization is associated with high morbidity and mortality. A longer hospital course before an emergency operation is a predictor of poor outcomes, as is undergoing exploratory laparotomy only. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014.

    Science.gov (United States)

    Smith, Fay; Goldacre, Michael J; Lambert, Trevor W

    2017-05-01

    Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered 'yes' cited 'stress/work-life balance/workload' as an adverse effect, and 45% mentioned illness. In response to the statement 'The NHS of today is a good employer when doctors become ill themselves', 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers.

  12. Fourth Doctoral Student Assembly

    CERN Multimedia

    Ingrid Haug

    2016-01-01

    On 10 May, over 130 PhD students and their supervisors, from both CERN and partner universities, gathered for the 4th Doctoral Student Assembly in the Council Chamber.   The assembly was followed by a poster session, at which eighteen doctoral students presented the outcome of their scientific work. The CERN Doctoral Student Programme currently hosts just over 200 students in applied physics, engineering, computing and science communication/education. The programme has been in place since 1985. It enables students to do their research at CERN for a maximum of three years and to work on a PhD thesis, which they defend at their University. The programme is steered by the TSC committee, which holds two selection committees per year, in June and December. The Doctoral Student Assembly was opened by the Director-General, Fabiola Gianotti, who stressed the importance of the programme in the scientific environment at CERN, emphasising that there is no more rewarding activity than lear...

  13. 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.

  14. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey.

    Directory of Open Access Journals (Sweden)

    Kai Xing

    Full Text Available The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals.A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%.A total of 106 of the 840 (12.6% respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients' relatives (62.3%, followed by the patient (22.6%; 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60 resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%. Most respondents (62.8% did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc..Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue.

  15. Qualitative Performance Evaluation of Hospitals Using DEA, Balanced Scorecard and Servqual; A Case Study of General Hospitals of Yazd

    Directory of Open Access Journals (Sweden)

    M Asadi

    2011-02-01

    Full Text Available Introduction: Evaluation is an important factor in productivity context, and acts as a control system for other areas of productivity. Hospitals are large organizations incurring heavy expenses in every country. The level of efficiency in a hospital is a good criterion to understand how hospitals consume their resources. The goal of this research was to determine relative efficiency of 13 public hospitals in Yazd province by using integrated DEA, BSC and SERVQUAL model. Methods: In this study, relative efficiency of 13 public hospitals of Yazd province was calculated using data envelopment analysis technique(DEA and balanced score card and servqual. BSC was used as a tool for designing of performance evaluation indexes, while DEA was used as a tool of evaluating performance and ranking. Results: The mean relative efficiency of hospitals under study was about 0.945 in the Persian calendar year 2008-9. The efficiency levels of nine hospitals were borderline and the efficiency of four hospitals was less than 1. Hospital no.3 had the highest efficiency levels and hospital no.10 had the lowest efficiency level. Conclusion: In this stage, on the basis of references presented by the DEA model, solutions for increasing the quality performance levels of inefficient hospitals in fourth dimensions were determined and some suggestions were proposed. Although all performance indices of the inefficient hospitals need to be addressed, priorities have to be determined by the respective managers.

  16. Higher surgical training opportunities in the general hospital setting; getting the balance right.

    Science.gov (United States)

    Robertson, I; Traynor, O; Khan, W; Waldron, R; Barry, K

    2013-12-01

    The general hospital can play an important role in training of higher surgical trainees (HSTs) in Ireland and abroad. Training opportunities in such a setting have not been closely analysed to date. The aim of this study was to quantify operative exposure for HSTs over a 5-year period in a single institution. Analysis of electronic training logbooks (over a 5-year period, 2007-2012) was performed for general surgery trainees on the higher surgical training programme in Ireland. The most commonly performed adult and paediatric procedures per trainee, per year were analysed. Standard general surgery operations such as herniae (average 58, range 32-86) and cholecystectomy (average 60, range 49-72) ranked highly in each logbook. The most frequently performed emergency operations were appendicectomy (average 45, range 33-53) and laparotomy for acute abdomen (average 48, range 10-79). Paediatric surgical experience included appendicectomy, circumcision, orchidopexy and hernia/hydrocoele repair. Overall, the procedure most commonly performed in the adult setting was endoscopy, with each trainee recording an average of 116 (range 98-132) oesophagogastroduodenoscopies and 284 (range 227-354) colonoscopies. General hospitals continue to play a major role in the training of higher surgical trainees. Analysis of the electronic logbooks over a 5-year period reveals the high volume of procedures available to trainees in a non-specialist centre. Such training opportunities are invaluable in the context of changing work practices and limited resources.

  17. Use of antibacterial drugs in Jesenice General hospital in years 1998 to 2004

    Directory of Open Access Journals (Sweden)

    Brigita Mavsar-Najdenov

    2007-11-01

    Full Text Available Background: Continuous monitoring of drug consumption is an important strategy for prudent and cost-effective use of drugs. Antimicrobials are among the most prescribed drugs in outpatient practice and in hospital care. In most cases antimicrobials are improperly prescribed or are even misused. Irrational use of antimicrobials is clinically ineffective and leads to higher treatment costs. Clinical ineffectiveness due to irrational use additionally leads to loss of confidence in antimicrobial drugs, unnecessary exposure of patients and development of antimicrobial resistance. Antimicrobial resistance has become a major global health problem as it presents an imperative for development of new potent antimicrobials which are necessarily associated with markedly higher treatment costs.Material and methods: This survey was focused on rational prescribing of antimicrobial drugs. The data on consumption of antimicrobials for various clinical departments of the Jesenice General Hospital were collected by the hospital pharmacy. WHO ATC 2005 classification system, which ranks antimicrobials in a large group J01: drugs for systemic treatment of bacterial infections and Defined Daily Dose as a measuring unit according to the WHO ATC/DDD methodology was used. Antimicrobial use at the Jesenice General Hospital in the period between 1998 and 2004 was estimated by the Department of Infectious Diseases, Medical Centre Ljubljana as a part of European Surveillance on Antibiotic Consumption project (ESAC. Statistical part of survey was performed by the Chair of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Ljubljana.Results: After year 2000 a trend of decrease in antimicrobial consumption was observed. Compared to European Surveillance on Antibiotic Consumption results in the year 2003 higher usage of penicillins with extended spectrum, fluoroquinolones and 3rd generation cephalosporins in Slovenian hospitals was estimated. These three

  18. Changing Smoking Behavior of Staff at Dr. Zainoel Abidin Provincial General Hospital, Banda Aceh

    Directory of Open Access Journals (Sweden)

    Said Usman

    2014-01-01

    Full Text Available Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals.

  19. Pilot Quality Control Program for Brachytherapy of Low Dose Rate at the General Hospital of Mexico

    Science.gov (United States)

    Álvarez R., J. T.; Tovar M., V.; Salinas, B.; Hernández O., O.; Santillán B., L.; Molero M., C.; Montoya M., J.

    2004-09-01

    We describe the pilot quality control program for brachytherapy of low dose rate proposed to be used in the Radiotherapy Department at the General Hospital of Mexico. The program consists of three parts: a) development of calibration procedures, performed in terms of air-kerma strength for calibration of 137Cs and 192Ir brachytherapy sources, and for the calibration of well-type ionization chambers for 137Cs, b) performance of localisation and reconstruction techniques for radioactive sources with a Baltas' phantom. The results obtained for the media deviation , are in the optimum level, ± 0.5 mm hospital. It consists on the characterisation of a TLD-100 powder dosimetry system at SSDL: The calibration curves for powder response (nC or nC/ mg) vs Dw and the control charts for the Harshaw 3500 reader were obtained. The statistical validation of the calibration curve by normality of the residuals and the lack of fit tests were realised. In the other hand, TLD's were irradiated in the hospital to a nominal Dw = 2 Gy with sources of 137Cs. The percent deviations Δ%, between the Dw imparted by the Hospital and the determined by SSDL, are 1.2% Δ⩽ 6.5 % which are consistent with the expanded uncertainty U% for DW, 5.6 U% 10%.

  20. Pilot Quality Control Program for Brachytherapy of Low Dose Rate at the General Hospital of Mexico

    International Nuclear Information System (INIS)

    Alvarez R, J.T.; Tovar M, V.; Salinas, B.; Hernandez O, O.; Santillan B, L.; Molero M, C.; Montoya M, J.

    2004-01-01

    We describe the pilot quality control program for brachytherapy of low dose rate proposed to be used in the Radiotherapy Department at the General Hospital of Mexico. The program consists of three parts: a) development of calibration procedures, performed in terms of air-kerma strength for calibration of 137Cs and 192Ir brachytherapy sources, and for the calibration of well-type ionization chambers for 137Cs, b) performance of localisation and reconstruction techniques for radioactive sources with a Baltas' phantom. The results obtained for the media deviation , are in the optimum level, ± 0.5 mm < ± 1.0 mm; the confidence limit Δ, is in the emergency level, Δ=3.2 mm. c) verification of absorbed dose to water DW, given by the hospital. It consists on the characterisation of a TLD-100 powder dosimetry system at SSDL: The calibration curves for powder response (nC or nC/ mg) vs Dw and the control charts for the Harshaw 3500 reader were obtained. The statistical validation of the calibration curve by normality of the residuals and the lack of fit tests were realised. In the other hand, TLD's were irradiated in the hospital to a nominal Dw = 2 Gy with sources of 137Cs. The percent deviations Δ%, between the Dw imparted by the Hospital and the determined by SSDL, are 1.2% Δ≤ 6.5 % which are consistent with the expanded uncertainty U% for DW, 5.6 U% 10%

  1. Characteristics and outcomes of paracetamol poisoning cases at a general hospital in Northern Malaysia.

    Science.gov (United States)

    Mohd Zain, Z; Fathelrahman, A I; Ab Rahman, A F

    2006-02-01

    Paracetamol is available as an over-the-counter medication in many countries including Malaysia. This drug has been implicated in many poisoning cases admitted to hospitals throughout the country. We conducted a three-year retrospective review of 165 medical records of patients admitted to the Penang General Hospital for acute paracetamol poisoning. Cases were identified according to the discharge diagnosis documented in their medical records. Acute paracetamol poisoning occurred in all major ethnic groups. About 70 percent of our patients were female. There was minimal involvement of children. Admissions were more likely to be due to deliberate ingestions rather than accidental poisoning. In most cases, serum concentrations data plotted on the Rumack-Matthew nomogram predicted the majority of cases to be unlikely to be hepatotoxic, which were consistent with their mild clinical courses. Patients who acutely ingested more than 140 mg/kg or predicted to be hepatotoxic, based on their serum concentrations, had a significantly longer hospital stay. Although acute paracetamol poisoning was common, the outcome was generally good.

  2. The proton therapy system for Massachusetts General Hospital's Northeast Proton Therapy Center

    International Nuclear Information System (INIS)

    Jongen, Y.

    1996-01-01

    In 1989, two companies, Ion Beam Applications in Belgium (IBA) and Sumitomo Heavy Industries in Japan (SHI) started to design proton therapy equipments based on cyclotrons. In 1991, SHI and IBA decided to join their development efforts in this field. In 1993, the Massachusetts General Hospital (MGH), pioneer in the field of proton therapy, launched an international request for proposals for the procurement of an in-hospital proton therapy facility. The 18 may 1994, the contract was signed with a team of industries led by IBA, including also SHI and General Atomics (GA) of California. The proposed system is based on a fixed energy, isochronous cyclotron, followed by an energy degrader and an energy selection system. The variable energy beam can be rapidly switched in any one of three treatment rooms. Two rooms are equipped with large isocentric gantries and robotic patient positioners allowing to direct the proton beam within the patient from any direction. The third room is equipped with fixed horizontal beam. The complete system is computer controlled by a distributed network of computers, programmable logic controllers and workstations. This computer control allows to change the energy in one treatment room is less than two second, a performance matching or exceeding the flexibility offered by synchrotrons. The system is now built and undergoing factory tests. The beam has been accelerated to full energy in the cyclotron, and beam extraction tests are underway. Installation in the hospital building will take place in 1997. (author)

  3. Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

    Directory of Open Access Journals (Sweden)

    Amilton dos Santos Jr.

    2013-01-01

    Full Text Available Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02. Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5% reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

  4. The European Donor Hospital Education Programme (EDHEP): addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation

    NARCIS (Netherlands)

    Blok, G. A.; van Dalen, J.; Jager, K. J.; Ryan, M.; Wijnen, R. M.; Wight, C.; Morton, J. M.; Morley, M.; Cohen, B.

    1999-01-01

    The competence of critical care staff when it comes to death and organ donation can make the difference between a family's agreeing to or refusing the latter. Doctors and nurses often feel uncomfortable approaching relatives about donation and attribute this to a lack of training. Bereaved relatives

  5. Drug utilization pattern of Chinese herbal medicines in a general hospital in Taiwan.

    Science.gov (United States)

    Chen, L C; Wang, B R; Chou, Y C; Tien, J H

    2005-09-01

    Drug utilization studies are important for the optimization of drug therapy and have received a great attention in recent years. Most of the information on drug use patterns has been derived from studies in modern Western medicines; however, studies regarding the drug utilization of traditional Chinese medicine (CM) are few. The present study was the first clinical research to evaluate the drug utilization patterns of Chinese herbal medicines in a general hospital in Taiwan. Data were collected prospectively from the patients attending the Traditional Medicine Center of Taipei Veteran General Hospital under CM drug treatments. The study was carried out over a period of 1 year, from January 2002 to December 2002. Core drug use indicators, such as the average number of drugs per prescriptions, the dosing frequency of prescriptions, and the most common prescribed CM herbs and formulae were evaluated. The primary diagnosis and the CM drugs prescribed for were also revealed. All data were analyzed by descriptive statistics. A total of 10 737 patients, representing 52 255 CM drugs, were screened during the study period. Regarding the prescriptions, the average number of drugs per prescription was 4.87 and 37.21% of prescriptions were composed by five drugs. Most of prescriptions (91.38%) were prescribed for three times a day. The most often prescribed Chinese herb was Hong-Hwa (5.76%) and the most common Chinese herbal formula was Jia-Wey-Shiau-Yau-San (3.80%). The most frequent main diagnosis was insomnia (15.58%), followed by menopause (5.22%) and constipation (5.09%). The survey revealed the drug use pattern of CMs in a general hospital. The majority of CM prescriptions were composed by 3-6 drugs and often prescribed for three times a day. Generally, the rational drug uses of CM drugs were provided with respect to the various diagnoses. (c) 2005 John Wiley & Sons, Ltd.

  6. Hazardous alcohol use among doctors in a Tertiary Health Center

    Directory of Open Access Journals (Sweden)

    Adetunji Obadeji

    2015-01-01

    Full Text Available Background: Doctors have been identified as one of the key agents in the prevention of alcohol-related harm, however, their level of use and attitudes toward alcohol will affect such role. Aim: This study is aimed at describing the pattern of alcohol use and the predictors of hazardous drinking among hospital doctors. Setting: Study was conducted at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Design: A cross-sectional survey involving all the doctors in the teaching hospital. Materials and Methods: All the consenting clinicians completed a sociodemographic questionnaire and alcohol use was measured using the 10-item alcohol use disorder identification test (AUDIT and psychological well-being was measured by the 12-item General Health Questionnaire (GHQ-12. Statistical Analysis Used: Statistical analyses were done using the Statistical Package for Social Sciences version 16. Chi-square tests with Yates correction were used to describe the relationship between respondent′s characteristics and AUDIT scores as appropriate. Results: There were a total of 122 participants. Eighty-five (69.7% of them were abstainers, 28 (23% were moderate drinkers, and 9 (7.3% hazardous drinkers. With the exception of age, there was no significant relationship between sociodemographic status, years of practice, specialty of practice, and hazardous alcohol use. Experiencing stress or GHQ score above average is significantly associated with hazardous drinking. Conclusion: Hazardous drinking among hospital doctors appears to be essentially a problem of the male gender, especially among those older than 40 years. Stress and other form of psychological distress seem to play a significant role in predicting hazardous drinking among doctors.

  7. DETERMINANTS OF SPECIALTY CHOICE OF RESIDENT DOCTORS; CASE STUDY--AMONG RESIDENT DOCTORS IN NIGERIA.

    Science.gov (United States)

    Osuoji, Roland I; Adebanji, Atinuke; Abdulsalam, Moruf A; Oludara, Mobolaji A; Abolarinwa, Abimbola A

    2015-01-01

    This study examined medical specialty selection by Nigerian resident doctors using a marketing research approach to determine the selection criteria and the role of perceptions, expected remuneration, and job placement prospects of various specialties in the selection process. Data were from the Community of residents from April 2014 to July 2014. The cohort included 200 residents, but only 171 had complete information. Data were obtained from a cross section of resident doctors in the Lagos State University Teaching Hospital and at the 2014 Ordinary General Meeting of the National Association of Resident Doctors(NARD) where representatives from over 50 Teaching hospitals in Nigeria attended. Using a client behaviour model as a framework, a tripartite questionnaire was designed and administered to residents to deduce information on their knowledge about and interests in various specialties, their opinions of sixteen specialties, and the criteria they used in specialty selection. A total of 171 (85.5%) questionnaires were returned. ln many instances, consistency between selection criteria and perceptions of a specialty were accompanied by interest in pursuing the specialty. Job security, job availability on completion of programme, duration of training and qualifying examinations were highly correlated with p value marketing research concepts for medical specialty selection (Weissmanet al 2012) stipulates that choice of speciality is influenced by criteria and perception. This study shows that job security expected financial remuneration, and examination requirements for qualification are major determinants of the choice of speciality for residents.

  8. General aspects of radiological protection to consider for the licensing a hospital cyclotron

    International Nuclear Information System (INIS)

    Andrada Contardi, F.A.; Fruttero, N.H.; Bozzo, R.H.; Moschella, E.G.

    2010-01-01

    The use of PET/PET-CT studies for a variety of diagnoses has increased significantly on a global scale. Modern medical cyclotrons must be placed in or near hospitals on account of the short radioactive half-life of the pharmaceuticals used in such studies. Many countries in Latin America are now licensing cyclotrons and laboratories for the production of radio-pharmaceuticals for the first time, and most are expected to have installations within the near future. This report outlines the general aspects of radiological protection important to consideration during the licensing of these facilities, and includes the following: general operation of the cyclotron and laboratory for the production of radiopharmaceuticals, safety systems (shielding, interlocks, ventilation, manual safety systems, alarms and monitors), and general aspects for licensing an installation (monitoring, accidental and incidental events, activation of components, etc.) and personnel. (authors) [es

  9. Knowledge, attitude, and practices toward ayurvedic medicine use among allopathic resident doctors: A cross-sectional study at a tertiary care hospital in India.

    Science.gov (United States)

    Gawde, Suchita R; Shetty, Yashashri C; Pawar, Dattatray B

    2013-07-01

    Ayurveda is most commonly practiced form of complementary and alternative medicine (CAM) in India. There are very few studies showing the knowledge, attitude, and practices (KAP) of allopathic doctors about Ayurvedic drugs and its use. The study was initiated to assess KAP toward Ayurvedic medicine use among allopathic resident doctors. Cross-sectional and prospective study. After obtaining permission from the Institutional Ethics Committee, allopathic resident doctors from clinical departments were approached personally. They were given pre-formed validated questionnaire to assess KAP toward Ayurvedic medicine use. Descriptive statistics. Allopathic residents had little knowledge about basic concepts of Ayurveda, that is, 'panchakarma' and 'tridosha'. Majority residents (99%) had no opportunity to learn basics of Ayurveda, but 67% residents prescribed Ayurvedic medicines to patients. However, many residents (76%) mentioned that cross practice should not be allowed due to lack of knowledge. One resident knew that cross-practice was not allowed by law. The commonly prescribed proprietary Ayurvedic medicines were Liv-52 (39%), Shatavari (13%), Cystone (12%) and common ailments for which these medicines prescribed were liver disorders (34%), arthritis (18%), cough and cold (13%), kidney stones (11%), and piles (10%). Nearly 76% residents felt incorporation of Ayurveda with modern medicine would attract more patients and at the same time most residents (92%) agreed that Ayurvedic medicines need scientific testing before use. Though 50% of the residents agreed for voluntary training in Ayurveda, 80% denied compulsory training. Nearly 63% residents recommended Ayurveda among all CAMs. Most of residents heard of Ayurveda from their colleagues. This study reveals that allopathic resident doctors had little knowledge about Ayurveda and Ayurvedic medicine use but engaged in prescription of Ayurvedic medicines. So some interventions should be taken to increase the knowledge

  10. [Occupational stress and job burnout in doctors].

    Science.gov (United States)

    Zhu, Wei; Wang, Zhi-Ming; Wang, Mian-Zhen; Lan, Ya-Jia; Wu, Si-Ying

    2006-03-01

    To investigate the status of job burnout in doctors and its relationship with occupational stress. A total of 561 doctors from three provincial hospitals were randomly selected. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to identify job burnout. The occupation stress inventory revised edition (OSI-R) was used to evaluate the level of occupational stress. Surgeon and doctors working in the internal medicine wards scored significantly higher in job burnout than their colleagues (P < 0.05). The 30-40 years of age group scored highest in exhaustion. The score of professional efficacy decreased with age and increased with educational levels. Role overload, responsibility, physical environment, reaction and self-care were major predictors for exhaustion. Role insufficiency, role overload and responsibility were major predictors for cynicism. Role insufficiency, social support and rational/cognitive were major predictors for professional efficacy. Maintaining moderate professional duty and responsibility, clearly defining job requirements, enriching leisure activities, and improving self-care ability are important measures to preventing job burnout.

  11. [Influence of patients' attitude on doctors' satisfaction with the doctor-patient relationship].

    Science.gov (United States)

    Xie, Zheng; Qiu, Ze-qi; Zhang, Tuo-hong

    2009-04-18

    To describe the doctors' satisfaction of the doctor-patient relationship and find out the influencing factors of the patients, gathering evidence to improve the doctor-patient relationship. This study was a cross-sectional study, in which doctors and nurses in 10 hospitals of Beijing, Shandong and Chongqing were surveyed with structured questionnaires and in-depth interviews. The mean score of the doctors' satisfaction of the doctor-patient relationship was 59.97, which was much lower than the patients'. The patients' socio-demographic characteristics, social economic status (SES) and behavior characteristics influence the interaction of the doctors and the patients. The doctors' satisfaction of the doctor-patient relationship was influenced by the patients' trust. The doctors' perspective is helpful to define the tension and the cause of the doctor-patient relationship. The patients' characteristics have important influence on the doctor-patient relationship. It's necessary to take action on the patients to improve the doctor-patient relationship.

  12. Screening for sepsis in general hospitalized patients: a systematic review.

    Science.gov (United States)

    Alberto, L; Marshall, A P; Walker, R; Aitken, L M

    2017-08-01

    Sepsis is a condition widely observed outside critical care areas. To examine the application of sepsis screening tools for early recognition of sepsis in general hospitalized patients to: (i) identify the accuracy of these tools; (ii) determine the outcomes associated with their implementation; and (iii) describe the implementation process. A systematic review method was used. PubMed, CINAHL, Cochrane, Scopus, Web of Science, and Embase databases were systematically searched for primary articles, published from January 1990 to June 2016, that investigated screening tools or alert mechanisms for early identification of sepsis in adult general hospitalized patients. The review protocol was registered with PROSPERO (CRD42016042261). More than 8000 citations were screened for eligibility after duplicates had been removed. Six articles met the inclusion criteria testing two types of sepsis screening tools. Electronic tools can capture, recognize abnormal variables, and activate an alert in real time. However, accuracy of these tools was inconsistent across studies with only one demonstrating high specificity and sensitivity. Paper-based, nurse-led screening tools appear to be more sensitive in the identification of septic patients but were only studied in small samples and particular populations. The process of care measures appears to be enhanced; however, demonstrating improved outcomes is more challenging. Implementation details are rarely reported. Heterogeneity of studies prevented meta-analysis. Clinicians, researchers and health decision-makers should consider these findings and limitations when implementing screening tools, research or policy on sepsis recognition in general hospitalized patients. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  13. Bacterial contamination of medical doctors' white coats as ...

    African Journals Online (AJOL)

    Keywords: Medical doctors, White coats, Bacteria, Hospital, Infection, Healthcare. INTRODUCTION. Hospital environment have been reported to be strong ... the hospital environment to the perception of a .... impact on the number of isolates present on the sleeve. ..... healthcare setting to safeguard both the doctors and their ...

  14. Is it a matter of urgency? A survey of assessments by walk-in patients and doctors of the urgency level of their encounters at a general emergency outpatient clinic in Oslo, Norway.

    Science.gov (United States)

    Ruud, Sven Eirik; Hjortdahl, Per; Natvig, Bård

    2016-07-04

    Emergency room (ER) use is increasing in several countries. Variability in the proportion of non-urgent ER visits was found to range from 5 to 90 % (median 32 %). Non-urgent emergency visits are considered an inappropriate and inefficient use of the health-care system because they may lead to higher expenses, crowding, treatment delays, and loss of continuity of health care provided by a general practitioner. Urgency levels of doctor-walk-in patient encounters were assessed based on their region of origin in a diverse Norwegian population. An anonymous, multilingual questionnaire was distributed to all walk-in patients at a general emergency outpatient clinic in Oslo during two weeks in September 2009. We analysed demographic data, patient-doctor assessments of the level of urgency, and the results of the consultation. We used descriptive statistics to obtain frequencies with 95 % confidence interval (CI) for assessed levels of urgency and outcomes. Concordance between the patients' and doctors' assessments was analysed using a Kendall tau-b test. We used binary logistic regression modelling to quantify associations of explanatory variables and outcomes according to urgency level assessments. The analysis included 1821 walk-in patients. Twenty-four per cent of the patients considered their emergency consultation to be non-urgent, while the doctors considered 64 % of encounters to be non-urgent. The concordance between the assessments by the patient and by their doctor was positive but low, with a Kendall tau-b coefficient of 0.202 (p < 0.001). Adjusted logistic regression analysis showed that patients from Eastern Europe (odds ratio (OR) = 3.04; 95 % CI 1.60-5.78), Asia and Turkey (OR = 4.08; 95 % CI 2.43-6.84), and Africa (OR = 8.47; 95 % CI 3.87-18.5) reported significantly higher urgency levels compared with Norwegians. The doctors reported no significant difference in assessment of urgency based on the patient's region of origin, except

  15. Trato digno proporcionado por enfermería en unidades para adultos de un hospital general

    OpenAIRE

    Beltrán López, María Luisa

    2016-01-01

    El trato digno: Es la percepción que tiene el paciente o familiar del trato y atención proporcionada por el personal de enfermería durante su estancia hospitalaria, se mide a través de indicadores de calidad. Objetivo: Analizar el trato digno que proporciona el personal de enfermería a usuarios adultos hospitalizados en unidades de medicina interna y cirugía de un hospital general. Metodología: Estudio descriptivo transversal, realizado en los servicios de cirugías hombres, mujeres, m...

  16. [Cytostatic hyperthermic isolated limb perfusion (HILP) in VFN (General Faculty Hospital in Prague)].

    Science.gov (United States)

    Spacek, M; Mitás, P; Lacina, L; Krajsová, I; Hodková, G; Salmay, M; Spunda, R; Brlicová, L; Lindner, J

    2011-01-01

    Hyperthermic isolated limb perfusion (HILP) is a standardized method of treatment in selected patients with in-transient locoregional recurrence/methastasis of melanoma or, some other soft tissue tumors (incl. sarcoma etc.) Authors present history and current status of this treatment modality in General University Hospital in Prague. During one year period (7/2009-6/2010) 10 patients were indicated for this procedure. We performed 13 procedures (3x redo), 11 in lower extremity and 2 in upper extremity. There was no serious complication in this cohort of patiens. Multidisciplinar approach is indicated in melanoma patients care.

  17. When Suicide Is Not Suicide: Self-induced Morbidity and Mortality in the General Hospital

    Directory of Open Access Journals (Sweden)

    J. Michael Bostwick

    2015-04-01

    Full Text Available Suicidal phenomena in the general hospital can take a variety of forms that can be parsed by taking into account whether or not the patient 1 intended to hasten death, and 2 included collaborators, including family and health care providers, in the decision to act. These two criteria can be used to distinguish entities as diverse as true suicide, non-compliance, euthanasia/physician-assisted suicide, and hospice/palliative care. Characterizing the nature of “suicide” events facilitates appropriate decision-making around management and disposition.

  18. Enfermos del Hospital General de Mallorca a fines del siglo XV

    OpenAIRE

    Contreras Mas, Antonio

    2012-01-01

    Introducción: Presentamos un estudio sobre los hombres y mujeres que fueron internados en el Hospital General de Mallorca en los últimos años del siglo XV. Se basa en los listados donde se recogieron los detalles personales de algunos de los sujetos allí acogidos entre los años 1482 y 1494. Tras revisar las causas principales de la fundación del establecimiento y algunas noticias sobre este proceso, se examinan determinadas características de los hombres y mujeres a los que prestó asistencia ...

  19. [Access, use and preferences of Information and Communication Technologies by physicians in a general hospital in Peru].

    Science.gov (United States)

    Vásquez-Silva, Luis; Ticse, Ray; Alfaro-Carballido, Luz; Guerra-Castañon, Felix

    2015-01-01

    We assessed the access, use and preferences of information and communication technology (ICT) by physicians who practice at Cayetano Heredia National Hospital. The questionnaire explored the availability and skills of ICT, time, educational activities, search engines and technological applications most used as well as ICT preferences in education.211 physicians were surveyed; laptop use was 93%, tablet and smartphone use was 66% and 88%.68% have mobile Internet. Differences were evident in the frequency of use of ICT in 25-34 year old age group as well as a higher level of skills (pWhatsApp as a means of exchanging images and data related to health, 50% participated in medical blogs, online courses or videoconferences. The use and access of ICT is common among doctors in this hospital and there is positive interest in its use in education.

  20. [The department budget, in the context of the hospital global budget. Initial results in general medicine].

    Science.gov (United States)

    Besançon, F

    1984-02-23

    In a general hospital (Hôtel-Dieu, in the center of Paris), run with a global budget, budgets determined for each unit were introduced as an experiment in 1980. Physicians were in charge of certain expenses, mainly: linen, drugs, transportation of patients to and from other hospitals within Paris, and blood fractions. The whole does not exceed 4% of the turnover (FF 20 millions in 1980) of a 67 bed internal medicine unit. Other accounts deal with the stays, admissions, prescriptions of technical acts, laboratory analyses, and X-rays. In 1980, expenses were 11% more than budgeted, but the increase in stays and particularly in admissions was significantly greater. The resulting savings were 8.8% and 18.7% for stays and admissions respectively. Psychic reactions were variable. The subsequent budgets followed the fluctuations of recorded expenses, which were fairly important in both directions. The unit budget may be an advance or a regression, in a restrictive and past-perpetuating context. The coherence between the unit budget and the global hospital budget is questionable. Physicians were willing to take part in accounting and saving. They have good reason for not enlarging their financial responsibilities. Conversely, they may give more attention to diseases of public opinion.

  1. Diagnosis and first-line treatment of breast cancer in Italian general hospitals

    International Nuclear Information System (INIS)

    Interdisciplinary Group for Cancer Care Evaluation, Milan

    1986-01-01

    The quality of the diagnostic and therapeutic process of 1262 newly diagnosed breast cancer patients was evaluated in 63 Italian general hospital over the period March 1983 - April 1984. Most of the patients (91%) discovered their own lesion, which was a nodule in 83% of the cases. Practice of breast self examination was reported by 418 (33%) patients, only 28% of whom did that on a regular monthly basis. A diagnostic delay>3 months was present in 36% of the patients. Among the preoperative work-up examinations, skeletal X-ray or bone scan was not performed in 20% of patients, whereas other essential examinations were done in most. The Patey type of radical mastectomy was the most frequent surgical procedure; quadrantectomy was performed in only 26% of eligible patients, more frequently in younger (34%) than in older patients (21%). Adjuvant chemotherapy was recommended for 11% and 6% of pre- and postmenopausal N- patients, and for 78% and 47% of pre- and postmenopausal N+ patients. Forty-three of the 63 participating hospitals reported they adhered to the guidelines defined by the Italian Breast Cancer Task Force (F.O.N.Ca.M.) but this was not associated with substantial evidence of better quality of care. Similary, no associations emerged between several hospitals' organizational features and adherence to recommended treatment guidelines. The study is ongoing to assess the quality of postsurgical treatment and to measure its impact on patients' survival

  2. Dementia training programmes for staff working in general hospital settings - a systematic review of the literature.

    Science.gov (United States)

    Scerri, Anthony; Innes, Anthea; Scerri, Charles

    2017-08-01

    Although literature describing and evaluating training programmes in hospital settings increased in recent years, there are no reviews that summarise these programmes. This review sought to address this, by collecting the current evidence on dementia training programmes directed to staff working in general hospitals. Literature from five databases were searched, based on a number of inclusion criteria. The selected studies were summarised and data was extracted and compared using narrative synthesis based on a set of pre-defined categories. Methodological quality was assessed. Fourteen peer-reviewed studies were identified with the majority being pre-test post-test investigations. No randomised controlled trials were found. Methodological quality was variable with selection bias being the major limitation. There was a great variability in the development and mode of delivery although, interdisciplinary ward based, tailor-made, short sessions using experiential and active learning were the most utilised. The majority of the studies mainly evaluated learning, with few studies evaluating changes in staff behaviour/practices and patients' outcomes. This review indicates that high quality studies are needed that especially evaluate staff behaviours and patient outcomes and their sustainability over time. It also highlights measures that could be used to develop and deliver training programmes in hospital settings.

  3. Evaluation of Prescriptions and Use of Intravenous Pantoprazole in General Wards and Intensive Care Unit of Shahid Sadoughi Hospital in Yazd

    Directory of Open Access Journals (Sweden)

    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.

  4. A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic.

    Science.gov (United States)

    Shin, Bisol; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh; Kim, Jongbin

    2016-09-01

    In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was 132.7 ± 77.6 min, and the mean duration of treatment was 101.9 ± 71.2 min. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

  5. Pregnancy outcomes of women with HIV in a district general hospital in the UK.

    Science.gov (United States)

    Carey, L; Desouza, C; Moorcroft, A; Elgalib, A

    2018-03-12

    The aim of this study was to describe the obstetrical and virological outcomes in HIV-infected pregnant women who delivered at a district general hospital in south London in the period from 2008 to 2014. Our review identified 137 pregnancies; most (60%, 63/105) of them were unplanned. The commonest mode of delivery was spontaneous vaginal delivery (SVD) (42%, 48/114) followed by emergency Caesarean section (32%, 36/114). Gestational age at delivery was ≥37 weeks in most (84%, 91/106) of the cases. Maternal HIV VL at or closest to delivery was undetectable (1000 copies/mL in 73% (94/129), 90% (116/129) and 6% (8/129) of the pregnancies, respectively. None of the infants were infected with HIV making the rate of MTCT of HIV 0% (zero). Our study shows that favourable virological and obstetrical outcomes of HIV-infected pregnant women are achievable in non-tertiary HIV treatment centres. Impact Statement What is already known on this subject: Prevention of mother-to-child transmission (MTCT) of HIV has been one of the major public health successes in the last decades. This success was evident by the reduction of MTCT of HIV in the UK from 25.6% in the 1993 to only 0.46% in 2011. Furthermore, many reports from individual providers, mainly from tertiary centres, of HIV care in the UK also showed very low rates MTCT of HIV. What the results of this study add: Our study shows that favourable virological and obstetrical outcomes of HIV-infected pregnant women are achievable in non-tertiary HIV treatment centres. The MTCT of HIV rate in our hospital was zero in the period from 2008 to 2014. What the implications are of these findings for clinical practice and/or further research: Staff caring for pregnant HIV positive women in general hospitals and small-to-medium HIV clinics should liaise closely with each other and utilise the skill-mix within their hospital in order to provide a quality care that is similar to what is achieved in large teaching centres; however, a

  6. Cost implication of irrational prescribing of chloroquine in Lagos State general hospitals.

    Science.gov (United States)

    Aina, Bolajoko A; Tayo, Fola; Taylor, Ogori

    2008-02-01

    A major share of the hospital budget is spent on drugs. Irrational use of these drugs is a waste of financial and human resources that could have been deployed for another use within the hospital setting especially in cases where such drugs are provided free to patients. Also there is increased morbidity and progression of severity with irrational use. The objective of this study was to determine the irrational use of chloroquine and the subsequent cost implications in Lagos State general hospitals. A retrospective study period of one year (January to December, 2000) was selected. A total of 18,781 prescription forms of "Free Eko Malaria" were sampled for children and adults from all the Lagos State general hospitals. Drug costs in each prescription form were identified. Cost effectiveness analysis of chloroquine tablet and intramuscular injection was undertaken. The average cost of medicine per prescription was 132.071 ($1.03) which should have been 94.22 ($0.73) if prescribed rationally. The total cost of prescriptions for malaria under study was 2,480,425.00 ($19,348.09). About 68% {(1,679,444.00) ($13,100.19)} of the total cost was lost to irrational prescribing. This is a waste of scarce resources. When the prescriptions were differentiated into the different dosage forms prescribed, the prescriptions containing intramuscular injections only had over 90% of the cost lost to irrational prescribing. Cost effectiveness analysis showed that chloroquine tablet was 17 times more cost effective than chloroquine injection (intramuscular) from a health care system perspective while it was 14 times more cost effective from a patient perspective. There is waste of scarce resources with irrational dispensing of drugs and these resources could have been deployed to other uses or areas within the hospitals. The tablet chloroquine was more cost effective than injection chloroquine (intramuscular). Increasing the cost of tablets, decreasing effectiveness of tablets

  7. Realizacja zaleceń lekarza rodzinnego przez pacjentów w wybranych jednostkach chorobowych = Implementation of the recommendations of the General Practice Doctor by patients in selected disease entities.

    Directory of Open Access Journals (Sweden)

    Ewa Warchoł-Sławińska

    2016-12-01

      Introduction: The role of primary health care is to reduce the risk factors for lifestyle diseases, such as cardiovascular, and metabolic diseases. An important role of the family doctor is the health promotion, which focuses on health education through the transfer of knowledge and competence to increase control over one's health and its multiplication. Aim: The aim of this study was to assess the implementation of the recommendations of the family doctor by patients in selected disease entities. The study focused on responses to the question of the extent to which patients with selected disease units carried out the recommendations of General Practice Doctor.   Material and Methods: The survey of public opinion used diagnostic survey method, using a research technique in the form of a questionnaire. The study was conducted using a proprietary questionnaire containing 38 questions. The study included 99 patients of 2 primary care clinics, from the Lublin province. The results and conclusions: The research shows the need to increase health education activities in the areas of promoting healthy lifestyles. Particularly evident is the need to increase the promotion of screening, eliminating stimulants, increasing physical activity, increase the promotion of a healthy and balanced diet containing fruits and vegetables. This should contribute to increase the percentage of the population remains in good health. These study showed that 52% of the respondents from the group of 99 patients rated their health on average and bad. The most important role in improving this situation will be filled by a family doctor, because usually he is a person to which patients go first to solve their health problems.   Keywords: primary health care, General Practice Doctor.

  8. Data on motivational factors of the medical and nursing staff of a Greek Public Regional General Hospital during the economic crisis.

    Science.gov (United States)

    Charalambous, Marianna; Konstantinos, Mitosis; Talias, Michael A

    2017-04-01

    In this article, we present the data related to motivational factors given by the medical (n=118) and nursing (n=217) staff, of a Greek Public General Hospital during a period of financial austerity. The data collection has been based on a structured self-administrable questionnaire which was used in a previous survey in Cyprus (Chatzicharalambous, 2015) [1]. The incentives-rewards included amount in a total to 11 (both financial and non-financial). The data contains 4 parts: (1) demographics, (2) assessment of the degree to which this hospital provided such incentives-rewards, (3) personal assessment of the participants about the significance of these incentive-rewards and (4) to what extent these incentives-rewards have increased or decreased over the last five years due to the economic crisis. The sample was analyzed as a whole on demographics and by a professional subgroup (doctors and nurses) for the other three parts. The data include quantitative tables for all parts. Finally include three tables contain multilevel models.

  9. Data on motivational factors of the medical and nursing staff of a Greek Public Regional General Hospital during the economic crisis

    Directory of Open Access Journals (Sweden)

    Marianna Charalambous

    2017-04-01

    Full Text Available In this article, we present the data related to motivational factors given by the medical (n=118 and nursing (n=217 staff, of a Greek Public General Hospital during a period of financial austerity. The data collection has been based on a structured self-administrable questionnaire which was used in a previous survey in Cyprus (Chatzicharalambous, 2015 [1]. The incentives-rewards included amount in a total to 11 (both financial and non-financial. The data contains 4 parts: (1 demographics, (2 assessment of the degree to which this hospital provided such incentives-rewards, (3 personal assessment of the participants about the significance of these incentive-rewards and (4 to what extent these incentives-rewards have increased or decreased over the last five years due to the economic crisis. The sample was analyzed as a whole on demographics and by a professional subgroup (doctors and nurses for the other three parts. The data include quantitative tables for all parts. Finally include three tables contain multilevel models.

  10. The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals.

    Science.gov (United States)

    Wu, Robert C; Lo, Vivian; Morra, Dante; Wong, Brian M; Sargeant, Robert; Locke, Ken; Cavalcanti, Rodrigo; Quan, Sherman D; Rossos, Peter; Tran, Kim; Cheung, Mark

    2013-01-01

    Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. To describe the effects of different communication interventions and their problems. Prospective observational case study using a mixed methods approach of quantitative and qualitative methods. General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals. Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards. Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010. We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories. Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems.

  11. Morbilidad y mortalidad en pacientes con infarto agudo de miocardio ST elevado en un hospital general

    Directory of Open Access Journals (Sweden)

    Eduardo Carcausto

    2010-10-01

    Full Text Available Objetivo: Determinar la morbilidad y mortalidad de los pacientes con infarto agudo de miocardio ST elevado (IMA STE atendidos en un hospital general y describir sus características demográficas, clínicas y epidemiológicas. Material y métodos: Estudio descriptivo, serie de casos, retrospectivo, en pacientes con IMA STE en el Hospital Nacional Cayetano Heredia, del 1 de enero a 31 de diciembre del 2007. Se registraron variables clínicas y de laboratorio. Resultados: Se incluyeron 30 casos. El 86,7% fueron varones. La edad media fue de 62,8±12,6 años. El antecedente de hipertensión arterial se encontró en 57%, obesidad en 40%, tabaquismo en 40%, y de diabetes mellitus en 30%. El dolor torácico típico ocurrió en 75% de pacientes. El 50% de pacientes tuvieron hipertensión no controlada a la admisión, 33% leucocitosis, y 46% glicemia >110 mg/dl. Sólo 25% recibió terapia de reperfusión, 33,3% de casos de forma exitosa, siendo el tiempo puerta-aguja de 250 ± 114 minutos. Las complicaciones ocurrieron en 26,6% de pacientes, siendo la mortalidad de 13,3%. El 76% ingresó al hospital con un tiempo de dolor menor de 3 horas, Conclusiones: Los pacientes con IMA ST elevado fueron predominantemente varones, mayores de 60 años, ingresaron al hospital con un tiempo de dolor torácico menor de tres horas y un mínimo porcentaje recibió terapia de repercusión. Las arritmias fueron las complicaciones más frecuentes y la mortalidad post IMA alcanzó 13,3 % de los casos.(Rev Med Hered 2010;21:202-207.

  12. [Study of Staphylococcus aureus infections in a general acute care hospital (2002-2013)].

    Science.gov (United States)

    Togneri, Ana M; Podestá, Laura B; Pérez, Marcela P; Santiso, Gabriela M

    A twelve-year retrospective review of Staphylococcus aureus infections in adult and pediatric patients (AP and PP respectively) assisted in the Hospital Interzonal General de Agudos Evita in Lanús was performed to determine the incidence, foci of infection, the source of infection and to analyze the profile of antimicrobial resistance. An amount of 2125 cases of infection in AP and 361 in PP were documented. The incidence in AP decreased significantly in the last three years (χ i 2 ; p<0.05); in PP it increased significantly during the last five years (χ 2 ; p<0.0001). In both populations was detected a notable increase in skin infections and associated structures (PEA) in bacteremia to the starting point of a focus on PEA, and in total S. aureus infections of hospital-onset (χ 2 ; p < 0.005). Methicillin-resistance (MRSA) increased from 28 to 78% in PP; in AP it remained around 50%, with significant reduction in accompanying antimicrobial resistance to non-β-lactams in both groups of MRSA. In S. aureus documented from community onset infections (CO-MRSA) in the last three years, the percentage of methicillin-resistance was 57% in PP and 37% in AP; in hospital-onset infections it was 43% and 63% respectively. Although data showed that S. aureus remains a pathogen associated with the hospital-onset, there was an increase of CO-MRSA infections with predominance in PEA in both populations. Copyright © 2016 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  14. Dysphagia referrals to a district general hospital gastroenterology unit: hard to swallow.

    Science.gov (United States)

    Melleney, Elizabeth Mary-Ann; Subhani, Javaid Mohammed; Willoughby, Charles Peter

    2004-01-01

    The aim of our study was to audit dysphagia referrals received by a specialist gastroenterology unit during an entire year. We used a prospective audit carried out over a 12-month period at the District General Hospital gastroenterology unit. The audit included 396 consecutive patients who were referred with swallowing difficulties. We found that 60 referrals (15.2%) were inaccurate and the patients had no swallowing problem. Of the 336 patients with genuine dysphagia, only 29 (8.6%) were new cancer cases. The large majority of subjects had benign disease mostly related to acid reflux. Weight loss was significantly associated with malignancy but also occurred in one third of patients with reflux alone. The temporal pattern of dysphagia was not significantly predictive of cancer. All the cancer patients were above the age of 50 years. Although patients were in general assessed rapidly after hospital referral, the productivity, in terms of early tumor diagnosis, was extremely low. We conclude that there is a substantial rate of inaccurate referrals of dysphagia patients. Most true cases of swallowing difficulty relate to benign disease. Even the devotion of considerable resources to the early diagnosis of esophago gastric malignancy in an attempt to conform with best practice guidelines results in a very low success rate in terms of the detection of potentially curable tumors.

  15. [Burnout syndrome in medical residents at the General Hospital of Durango, México].

    Science.gov (United States)

    Terrones-Rodríguez, Jovany Francisco; Cisneros-Pérez, Vicente; Arreola-Rocha, José Jesús

    2016-01-01

    The burnout syndrome is commonly spread among health workers and students, due to the excessive demands they feel on their workspaces. Depersonalization, emotional exhaustion and personal accomplishment are the areas assessed. To determine the prevalence of burnout syndrome in medical residents at the General Hospital of Durango; a descriptive, prolective, cross-sectional study was designed and applied to residents of different specialties of the General Hospital of Durango who agreed to participate, the "Maslach Burnout Inventory" was applied. We surveyed 116 residents, 43.1 % (50) women and 56.89 % (66) men. The overall prevalence was 89.66 % (95 % CI: 82.63- 94.54). Affected in a single area the 48.28 % (95 % CI: 38.90-57.74), in two areas the 35.34 % (95 % CI: 26.69-44.76) and in the three areas 6.03 % (95 % CI: 2.46-12.04). Stratified by areas, high emotional exhaustion was 41.38 % (95 % CI: 32.31-50.90), high depersonalization in 54.31 % (95 % CI: 44.81-63.59), and low personal accomplishment 41.38 % (95 % CI: 32.31-50.90). The prevalence is higher than the reported. The most frequently affected is depersonalization, followed by emotional exhaustion and finally the personal accomplishment. In the areas of Gynecology and obstetrics, Internal medicine, Pediatrics and Orthopedics, the 100 % of the residents are affected.

  16. Balanced scorecard: application in the General Panarcadian Hospital of Tripolis, Greece.

    Science.gov (United States)

    Koumpouros, Yiannis

    2013-01-01

    The purpose of this paper is to discuss the application of the balanced scorecard (BSC) in the Greek public health sector. The basic balanced scorecard theory has been adopted in the characteristics and individualities of the Greek public health system. The theoretical model developed was applied in the General Panarcadian Hospital of Tripolis (GPHT) in Greece. GPHT is a representative paradigm of a big regional Greek public hospital. It has about 300 beds and many clinics and specialties (internal medicine, cardiology, general surgery, intensive care unit, artificial kidney unit, etc.). Strategic management was performed for almost three years. The BSC model was formulated in an appropriate software program. The problems (both technical and managerial) faced during a three-year period along with the results of this management approach are presented in the current paper. The paper highlights some important gaps in the Greek public health system, while proposing actions to be taken. The BSC theory can be very successful under certain conditions. Special attention is given to the peculiarities of the Greek public health situation. The paper presents for the first time a real life example of applying BSC in the Greek public health sector.

  17. Lahore general hospital protocol for treatment of neovascular glaucoma caused by retinal disease

    International Nuclear Information System (INIS)

    Khaqan, H.A.; Haider, S.A.

    2013-01-01

    To evaluate efficacy of LGH (Lahore General Hospital) protocol for treatment of neovascular glaucoma caused by retinal diseases. Material and Methods: This case series was performed on 9 consecutive eyes of nine patients with uncontrolled neovascular glaucoma at Department of Ophthalmology, Unit II, Lahore General Hospital/PGMI, Lahore. All nine patients completed six months follow up. Among them 6 patients were having PDR (proliferative diabetic retinopathy) and 3 patients having CRVO (central retinal vein occlusion). LGH protocol for treatment of neovascular glaucoma was: To give intravitreal injection of avastin and then PRP (Pan Retinal Photocoagulation) or Trabeculectomy with MMC (Mitomycin C), if PRP and intravitreal avastin fails to control the intra ocular-pressure (IOP). Results: Three patients had IOP control after intravitreal injection of avastin and PRP, 5 patients had uncontrolled IOP after intravitreal avastin and two sessions of PRP, so they under went trabeculectomy with MMC. One patient had uncontrolled IOP despite of full treatment protocol. All other 8 patients IOP remained stable for six months. Conclusion: Significant decrease in intraocular pressure was achieved after observing LGH protocol for treatment of NVG (Neovascular Glaucoma) caused by retinal diseases. (author)

  18. Aetiology and prognosis of encephalopathic patterns on electroencephalogram in a general hospital.

    LENUS (Irish Health Repository)

    O'Sullivan, S S

    2012-02-03

    The purpose of this study was to investigate the frequency and clinical outcome of patients with encephalopathic electroencephalograms (EEGs) in a neurophysiology department based in a general hospital. We performed a retrospective review of all EEGs obtained during an 18-month period in a large tertiary referral hospital. The referral reasons for EEG, the diagnoses reached, and patient outcomes were reviewed according to EEG severity. One hundred and twenty-three patients with encephalopathic EEGs were reviewed. The most common referral reason found was for an assessment of a possible first-onset seizure. The most common diagnosis found was one of dementia or learning disability. Of patients who were followed-up for a median of 19 months, 20.7% had died. The mortality rate generally increased according to the severity of the encephalopathy on EEG. However, 21.4% of those patients with excessive theta activity only on EEG had died. This study highlights an increased mortality even in the apparently \\'milder\\' degrees of EEG abnormalities.

  19. Leadership style and choice of strategy in conflict management among Israeli nurse managers in general hospitals.

    Science.gov (United States)

    Hendel, Tova; Fish, Miri; Galon, Vered

    2005-03-01

    To identify conflict mode choices of head nurses in general hospitals and examine the relationship between leadership style, choice of strategy in handling conflicts and demographic characteristics. Nurse managers deal with conflicts daily. The choice of conflict management mode is associated with managerial effectiveness. The ability to creatively manage conflict situations, towards constructive outcomes is becoming a standard requirement. Head nurses (N = 60) in five general hospitals in central Israel were surveyed, using a 3-part questionnaire: The Thomas-Kilmann Conflict Mode Instrument, the Multi-factor Leadership Questionnaire, Form 5X-Short (MLQ 5X) and demographic data. Head nurses perceive themselves significantly more as transformational leaders than as transactional leaders. Compromise was found to be the most commonly used conflict management strategy. Approximately half of the nurses surveyed used only one mode in conflict management. Transformational leadership significantly affected the conflict strategy chosen. Head nurses tend to choose a conflict-handling mode which is concerned a form of a Lose-Lose approach. Preparation in conflict management should start from undergraduate education.

  20. The Frequency and Pattern of Substance Use in Outpatients of General Hospitals

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    Behrouz Birashk

    2010-11-01

    Full Text Available Background:Patients with addictions have many acute and chronic medical illnesses, both related and unrelated to their addictions. In spite of high incidence of   substance-related disabilities, substance abuse is usually underdiagnosed in general   hospitals. The objective of the present study was to investigate the frequency and pattern of substance use in patients with different medical complaints.Methods: In this descriptive cross-sectional study , 1000 outpatients, aged 17 and   older with various medical complaints were participated. The patients were attending   neurology, ENT, nephrology, ophthalmology, cardiology, orthopedic, gastroenterology, surgical and dermatology clinics of four selected general hospitals. A 93 item clinicians-made scale, Rapid Situation Assessment of Drug Abuse in Iran, was used in this survey, and 30 items which focused on drug use were selected.   Results: 8.7% of the patients reported lifelong or recent substance use and Opium   was the most used substance, reported by 65.5% of the patients. Patients of neurology   ,ophthalmology and orthopedic clinics showed the highest consumption . Smoking   and injestion were the most frequent routes of substance used and the most reported   pattern of use were 2 or 4 times a day and once a week.   Conclusions: The current cohort of substance users were relatively young, and   many had reported detectable nervous system and orthopedic complications. Further   research must investigate -their outcomes in the long term.

  1. Care of "new" long-stay patients in a district general hospital psychiatric unit. The first two years of a hospital-hostel.

    Science.gov (United States)

    Gibbons, J S

    1986-05-01

    The paper describes the need for long-term inpatient care in an English health district whose psychiatric services were based on a unit in a District General Hospital. Patients who became long-stay were placed in a new hospital-hostel in a city centre. Three quarters of those eligible could be managed in the hostel, with those rejected posing more control problems. Patients in the hostel became less withdrawn and increased their activity and use of community facilities.

  2. An Outcomes Study on the Effects of the Singapore General Hospital Burns Protocol.

    Science.gov (United States)

    Liang, Weihao; Kok, Yee Onn; Tan, Bien Keem; Chong, Si Jack

    2018-01-01

    The Singapore General Hospital Burns Protocol was implemented in May 2014 to standardize treatment for all burns patients, incorporate new techniques and materials, and streamline the processes and workflow of burns management. This study aims to analyze the effects of the Burns Protocol 2 years after its implementation. Using a REDCap electronic database, all burns patients admitted from May 2013 to April 2016 were included in the study. The historical preimplementation control group composed of patients admitted from May 2013 to April 2014 (n = 96). The postimplementation prospective study cohort consisted of patients admitted from May 2014 to April 2016 (n = 243). Details of the patients collected included age, sex, comorbidities, total body surface area (TBSA) burns, time until surgery, number of surgeries, number of positive tissue and blood cultures, and length of hospital stay. There was no statistically significant difference in the demographics of both groups. The study group had a statistically significant shorter time to surgery compared with the control group (20.8 vs 38.1, P burns, was statistically significant (number of surgeries/TBSA, 0.324 vs 0.506; P = 0.0499). The study group also had significantly shorter length of stay (12.5 vs 16.8, P = 0.0273), a shorter length of stay/TBSA burns (0.874 vs 1.342, P = 0.0101), and fewer positive tissue cultures (0.6 vs 1.3, P = 0.0003). The study group also trended toward fewer positive blood culture results (0.09 vs 0.35, P = 0.0593), although the difference was just shy of statistical significance. The new Singapore General Hospital Burns Protocol had revolutionized Singapore burns care by introducing a streamlined, multidisciplinary burns management, resulting in improved patient outcomes, lowered health care costs, and improved system resource use.

  3. Our experiences with vancomycin-resistant enterococci in Jesenice General hospital

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    Helena Ribič

    2007-11-01

    Full Text Available Background: Vancomycin-resistant enterococci (VRE present a great problem in health care, especially because of their resistance to many groups of antibiotics and because of the way of their spreading in health care and long-term care institutions. Genes responsible for resistance to vancomycin can be transmitted to other species of enterococci and also to other grampositive cocci, for example Staphylococcus aureus. Experts anticipate that failure to control methicilin-resistant S. aureus and VRE may make control of vancomycin-resistant S. aureus impossible.Methods: In the medical microbiology laboratory of Institute Public Health Kranj we perform microbiology diagnosis for Jesenice General Hospital, where surveillance culturing for VRE started in May 2007. Until 15th June, 364 surveillance samples for VRE were taken from 92 patients. We also analysed the results of enterococci that were isolated in our laboratory during routine work in the period from 2004 to 2006.Results: In the three-year period we isolated 1593 strains of enterococci and among them 7 strains were VRE. In the Jesenice General Hospital, the first strain of vancomycin-resistant Enterococcus faecium was isolated in May 2007 in a patient, treated in internal intensive care unit. Nine strains of VRE with the same resistance type in nine patients followed the first case. The first four patients with VRE were moved from the same hospital. Among next six patients the common risk factor was contact with VRE positive patient.Conclusions: Control of VRE strains claims for intensive action. Active surveillance of colonised and infected patients, contact precautions with barrier isolation, intensive hand hygiene measures, aggressive environmental decontamination and prudent use of antimicrobials are needed.

  4. Surveillance of nosocomial infections in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, 1999-2002

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    Djoko Widodo

    2004-06-01

    Full Text Available Nosocomial infection are one of the main problem in hospital which are associated with significant morbidity, mortality and increased economic cost. Surveillance should be attempted regularly to obtain local data of incidence of nosocomial infections, types of infection, pathogen and resistance pattern. We reported the results of nosocomial surveillance in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, in year 1999 to 2002. The data were obtained from surveillance, conducted by Nosocomial Infection Control Committee. Surveillance were performed to patient in risk of nosocomial infections such as underwent surgical procedure, urinary catheter, peripheral or central venous catheter, ventilator and other invasive procedure. Criteria for nosocomial infection which were used, based on technical guidelines of nosocomial infection in Dr. Cipto Mangunkusumo National General Hospital, year 1999; which referred to CDC definition of nosocomial infections. Incidence rate of nosocomial infections in year 1999, 2000, 2001 and 2002 were 1.1, 0.9, 0.6 and 0.4 % respectively. Type of nosocomial infection include catheter related, surgical wound, urinary tract and respiratory tract infections, ranged between 0 to 5.6 %. Gram negative bacteria consist of Pseudomonas sp, Enterobacter aerogenes, Escherichia coli, Proteus mirabilis were the most common nosocomial pathogen. Gram positive bacteria consist of Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus anhemolyticus. Trend of increasing incidence of Gram positive nosocomial infection also showed in our surveillance. Mostly Gram negative bacteria had been resistant to penicillin, co amoxicillin-clavulanic acid and 3rd generation cephalosporin, but still sensitive to 4th generation cephalosporin and aminoglycoside. The Gram positive bacteria were still sensitive to penicillin, co amoxicillin-clavulanic acid, 4th generation cephalosporin and aminoglycoside. (Med J Indones 2004; 13: 107

  5. Interconsulta psicológica: demanda e assistência em hospital geral Interconsulta psicológica: demanda y asistencia en hospital general Consultation-liaison psychology: demand and assistance in general hospital

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    Nátali Castro Antunes Santos

    2011-06-01

    Full Text Available A interconsulta psicológica no hospital geral representa uma modalidade de atendimento clínico e um instrumento metodológico utilizado pelo psicólogo na assistência ao paciente internado, mediante solicitação de outros profissionais da saúde. O estudo objetivou caracterizar a demanda da interconsulta psicológica em um hospital geral, a partir da análise dos registros de solicitação de atendimento. Cento e sete pacientes foram atendidos entre janeiro e junho de 2010, dos quais 53% eram do sexo masculino e 57% eram adultos acima de 45 anos. A maioria das solicitações foi realizada por médicos (44% e enfermeiros (38%, formalmente (59%, e mediante contato prévio entre interconsultor e solicitante (85%. Os principais motivos alegados para a solicitação da interconsulta foram sintomas psicológicos relacionados ao adoecimento (43% e identificação de comprometimento na adaptação do paciente à hospitalização (41%. O modelo de interconsulta psicológica adotado no contexto estudado foi adequado, havendo engajamento da equipe multiprofissional na efetivação da prática.La interconsulta psicológica en los hospitals generales representan una modalidad de clínica y una herramienta metodológica utilizada por los psicólogos en la atención hospitalaria del paciente, a petición de los profesionales de la salud. El objetivo del estudio fue caracterizar la demanda psicológica para referirlo a un hospital general, desde el análisis del servicio de solicitud de registros. Ciento siete pacientes fueron tratados entre enero y junio de 2010, siendo 53% hombres y 57% de los adultos mayores de 45 años. La mayoría de las solicitudes fueron realizadas por los médicos (44% y enfermeras (38%, de manera formal (59% y el contacto previo entre interconsultor y su interés (85%. Las razones principales de la solicitud de remisión fueron: síntomas psicológicos relacionados con la enfermedad (43% y la identificación de la deficiencia en la

  6. How do NHS general hospitals in England deal with patients with alcohol-related problems? A questionnaire survey.

    Science.gov (United States)

    Owens, Lynn; Gilmore, Ian T; Pirmohamed, Munir

    2005-01-01

    Alcohol-related disease represents a major burden on hospitals. However, it is unclear whether hospitals have developed the necessary expertise and guidelines to deal with this burden. The aim of this survey was to determine what measures general hospital NHS Trusts in England had in place to deal with alcohol-related problems, including the employment of dedicated alcohol specialist nurses. Two postal surveys of all NHS general hospital Trusts in England, the first in 2000 (n = 138; 54% response rate) and the second in 2003 after the publication of the Royal College of Physicians (RCP) report on alcohol in secondary care (n = 164; 75% response rate). Between the two surveys, there was a significant increase (P = 0.005) in the number of dedicated alcohol nurses employed by general hospital trusts; however, the numbers remain low (n = 21). Additionally, the availability of prescribing guidelines for the management of alcohol withdrawal increased significantly (P = 0.0001). The survey indicates that most general hospitals do not have appropriate services in place to deal with such patients. Although there is a need and willingness to develop alcohol services in general hospitals, which is one of the key recommendations of the RCP report, the lack of funding is going to act as a major barrier.

  7. Radiographic quality and radiation protection in general medical practice and small hospitals

    International Nuclear Information System (INIS)

    Williamson, B.D.P.; Le Heron, J.C.

    1988-01-01

    Radiation protection and image quality were assessed in a survey of 22 general medical practices (GP) and the 24 smallest hospitals with x-ray facilities. Limited radiography, usually of extremities for trauma, was being performed in these facilities since access to regular radiology services was restricted, mainly for geographic reasons. An anthropomorphic phantom foot and ankle with two simulated fractures of the lateral and medical malleoli was presented at each facility for radiography, and the resulting films assessed for radiographic technique and basic diagnostic usefulness. The x-ray equipment was adequate for the range of procedures performed. While the standard of radiographic techniques was lower than in regular x-ray departments, most films of the phantom ankle were still diagnostically useful and only four were rejected entirely. The principal deficiency in general practice x-ray was in darkrooms and x-ray film processing. Consultation in this regard with registered medical radiation technologists is recommended. Generally, the x-ray equipment and working procedures complied with the National Radiation Laboratory Code of Safe Practice for the Use of X-rays in Diagnosis (Medical). Radiation doses to the phantom ankle ranged widely for effectively the same procedure, although none was excessive. Improved x-ray film processing, and tighter x-ray beam collimation, would result in a narrower range of doses to patients. Personnel exposures to radiation were satisfactorily low and special shieldings are not required in general practice. (author). 7 refs., 4 figs., 2 tabs

  8. Learning through inter- and intradisciplinary problem solving: using cognitive apprenticeship to analyse doctor-to-doctor consultation.

    Science.gov (United States)

    Pimmer, Christoph; Pachler, Norbert; Nierle, Julia; Genewein, Urs

    2012-12-01

    Today's healthcare can be characterised by the increasing importance of specialisation that requires cooperation across disciplines and specialities. In view of the number of educational programmes for interdisciplinary cooperation, surprisingly little is known on how learning arises from interdisciplinary work. In order to analyse the learning and teaching practices of interdisciplinary cooperation, a multiple case study research focused on how consults, i.e., doctor-to-doctor consultations between medical doctors from different disciplines were carried out: semi-structured interviews with doctors of all levels of seniority from two hospital sites in Switzerland were conducted. Starting with a priori constructs based on the 'methods' underpinning cognitive apprenticeship (CA), the transcribed interviews were analysed according to the principles of qualitative content analysis. The research contributes to three debates: (1) socio-cognitive and situated learning, (2) intra- and interdisciplinary learning in clinical settings, and (3), more generally, to cooperation and problem solving. Patient cases, which necessitate the cooperation of doctors in consults across boundaries of clinical specialisms, trigger intra- as well as interdisciplinary learning and offer numerous and varied opportunities for learning by requesting doctors as well as for on-call doctors, in particular those in residence. The relevance of consults for learning can also be verified from the perspective of CA which is commonly used by experts, albeit in varying forms, degrees of frequency and quality, and valued by learners. Through data analysis a model for collaborative problem-solving and help-seeking was developed which shows the interplay of pedagogical 'methods' of CA in informal clinical learning contexts.

  9. Controle de infecção oral em pacientes internados: uma abordagem direcionada aos médicos intensivistas e cardiologistas Oral infection control in hospitalized patients: an approach to cardiologist and intensive care units doctors

    Directory of Open Access Journals (Sweden)

    Sérgio Kahn

    2010-06-01

    Full Text Available O objetivo do presente estudo foi verificar o grau de conhecimento médico sobre medicina periodontal e verificar a existência de algum protocolo de controle de infecção da cavidade oral em pacientes internados em hospitais. Para tal, 110 médicos cardiologistas e intensivistas lotados em cinco hospitais no município do Rio de Janeiro foram entrevistados. Dentre os indivíduos, 75,4% afirmaram ter conhecimento sobre o termo medicina periodontal; entretanto, apenas 30% declararam já ter lido algo a respeito. Apenas 2,7% dos médicos possuem o hábito de coletar informações sobre a história odontológica de seus pacientes e 58,2% afirmaram que essa conduta é condicional ao quadro apresentado pelo paciente. Com base nos dados obtidos, pode-se concluir que o conhecimento sobre medicina periodontal e, consequentemente, sobre a importância do controle do biofilme oral na manutenção da saúde sistêmica, apresenta-se pouco difundido entre a classe médica. Verificou-se não haver setor ou pessoa responsável pelo controle de infecção oral dentro dos hospitais avaliados e, consequentemente, a não existência de qualquer protocolo, eficaz ou não, de controle de infecção oral nessas unidades.This paper aims to find the current level of periodontal med-care knowledge, as well as the possible existence of some oral infection control protocol regarding hospitalized patients. Our sample gathered 110 cardiologists and intensive care units doctors selected from medical teams of five Rio de Janeiro hospitals. Preliminary numbers: 75.4% said to have heard something about Periodontal Medicine, although only 30% out of this group admitted to have read something concerning such subject. On the other side, only 2.7% of the sample informed to do consistent information searching along their patients anamnese, while 58.2% out of this group admitted such procedure conditional to the patient's general state at the due moment. Through such numbers, we

  10. Radon house doctor

    International Nuclear Information System (INIS)

    Nitschke, I.A.; Brennan, T.; Wadach, J.B.; O'Neil, R.

    1986-01-01

    The term house doctor may be generalized to include persons skilled in the use of instruments and procedures necessary to identify, diagnose, and correct indoor air quality problems as well as energy, infiltration, and structural problems in houses. A radon house doctor would then be a specialist in radon house problems. Valuable experience in the skills necessary to be developed by radon house doctors has recently been gained in an extensive radon monitoring and mitigation program in upstate New York sponsored by Niagara Mohawk Power Corporation and the New York State Energy Research and Development Authority. These skills, to be described in detail in this paper, include: (i) the use of appropriate instruments, (ii) the evaluation of the symptoms of a radon-sick house, (iii) the diagnostic procedures required to characterize radon sources in houses, (iv) the prescription procedures needed to specify treatment of the problem, (v) the supervision of the implementation of the treatment program, (vi) the check-up procedures required to insure the house cured of radon problems. 31 references, 3 tables

  11. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital.

    Directory of Open Access Journals (Sweden)

    Matilda Aberese-Ako

    Full Text Available This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital.The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings.Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12 and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned.Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients.To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers and health workers on conflict management should be put in

  12. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital

    Science.gov (United States)

    Aberese-Ako, Matilda; Agyepong, Irene Akua; Gerrits, Trudie; Van Dijk, Han

    2015-01-01

    Background and Objectives This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. Methodology The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Ethics Statement Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12) and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned. Results Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients. Conclusion To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers

  13. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital.

    Science.gov (United States)

    Aberese-Ako, Matilda; Agyepong, Irene Akua; Gerrits, Trudie; Van Dijk, Han

    2015-01-01

    This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings. Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12) and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned. Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients. To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers and health workers on conflict management should be put in place

  14. Characteristics of High-Risk Pregnancy in Sanglah General Hospital 2011-2014

    Directory of Open Access Journals (Sweden)

    Ryan Saktika Mulyana

    2016-07-01

    Full Text Available Background: Pregnant women with a high-risk pregnancy are women with increased risk in pregnancy or childbirth. There is no readily available data available about the characteristics of the high-risk pregnancy in Bali. Objective: Our study aimed to provide a data, to be the base of Sanglah General Hospital resource planning to reduce maternal mortality and morbidity. Method: This was an observational study using medical records of high risk pregnancy patients at Sanglah General Hospital from 2011 to 2014. Inclusion criteria were the patients with complete medical record and exclusion criteria are patient whose medical report incomplete. There was no missing data in this study.Result Over the 4 year study period at Sanglah, there were 1027 high-risk deliveries in 2011, 1590 in 2012, 1590 in 2013, and 948 in 2014. In the 4 years, there were 748 with age ≥ 35 years. The majority were in the age group of 26-30 years. As many as 2932 were multiparous. Overall, 3082 were multigravida and only 197 were grandemultipara. There were 1406 preterm (<37 week. By onset and mode of delivery, 2027 (41.50% had a caesarean section, There were 9 (0.18% Breech deliveries and Neonatal outcomes were recorded, showing that 296 (6.29% had moderate asphyxia and 2189 (4.63% had severe asphyxia. The multiple pregnancy was 197 (3.82% twin pregnancies and 5 (0.1% cases of triplets. The largest group of obstetrics complications in Sanglah hospital was premature rupture of membrane 1652 cases (30.99%. The most common medical disorder of pregnant women at our hospital was anemia, 353 cases (45.43%. The most prevalent congenital anomalies were multiple congenital abnormalities, as many as 18 infants (20.22%.Conclusion: There were a significant number of high-risk pregnancies delivered at Sanglah, with nearly 46.85% being high risk deliveries. Characteristics of these high risk pregnancies can be used to plan appropriate care to reduce the maternal mortality rate.

  15. A 10-year trend of dental treatments under general anesthesia of children in Taipei Veterans General Hospital.

    Science.gov (United States)

    Chen, Yung-Pan; Hsieh, Chun-Yi; Hsu, Wen-Ting; Wu, Fu-Ya; Shih, Wen-Yu

    2017-04-01

    General anesthesia (GA) as a pediatric dental procedure is a well-established method of behavior management. However, studies of pediatric dentistry under GA have mostly focused on handicapped patients, and various retrospective studies in Taiwan have mainly reviewed only a limited number of years. The purpose of the present study was to report trends in pediatric dental treatment performed under GA over the past 10 years. A retrospective review of the hospital records of patients receiving dental treatment under GA from 2006 until 2015 was performed. The patients were divided into three age groups:  6 years. A range of information including basic patient characteristics and types of dental treatment was identified and then analyzed. A total of 791 cases ( 6 years old: 235; 549 male, 242 female) were treated under GA. The case number was found to have increased from 94 during 2006-2007 to 238 during 2014-2015, with the increase being especially pronounced among those aged 3-6 years (2006-2007: 49, 2014-2015: 165). The most common treatments (extraction, restoration, and pulp therapy) were associated with multiple dental caries (684, 86.4%). The  6-years-old group had the lowest mean number of treated teeth by stainless-steel crowns (SSCs) and fewest cases treated with pulp therapy. From 2011 onwards, the number of primary tooth extractions significantly increased, while in 2013, there was a crossover whereby the SSC count surpassed the composite resin filling count. Over the past 10 years, there has been an increased use of GA for pediatric dental treatments, in particular, in cases with multiple dental caries. In addition, there has also been an increasing trend towards extraction of primary teeth and the use of SSCs. Copyright © 2017. Published by Elsevier Taiwan LLC.

  16. Medical identity theft: prevention and reconciliation initiatives at Massachusetts General Hospital.

    Science.gov (United States)

    Judson, Timothy; Haas, Mark; Lagu, Tara

    2014-07-01

    Medical identity theft refers to the misuse of another individual's identifying medical information to receive medical care. Beyond the financial burden on patients, hospitals, health insurance companies, and government insurance programs, undetected cases pose major patient safety challenges. Inaccuracies in the medical record may persist even after the theft has been identified because of restrictions imposed by patient privacy laws. Massachusetts General Hospital (MGH; Boston) has conducted initiatives to prevent medical identity theft and to better identify and respond to cases when they occur. Since 2007, MGH has used a notification tree to standardize reporting of red flag incidents (warning signs of identity theft, such as suspicious personal identifiers or account activity). A Data Integrity Dashboard allows for tracking and reviewing of all potential incidents of medical identity theft to detect trends and targets for mitigation. An identity-checking policy, VERI-(Verify Everyone's Identity) Safe Patient Care, requires photo identification at every visit and follow-up if it is not provided. Data from MGH suggest that an estimated 120 duplicate medical records are created each month, 25 patient encounters are likely tied to identity theft or fraud each quarter, and 14 patients are treated under the wrong medical record number each year. As of December 2013, 80%-85% of patients were showing photo identification at appointments. Although an organization's policy changes and educational campaigns can improve detection and reconciliation of medical identity theft cases, national policies should be implemented to streamline the process of correcting errors in medical records, reduce the financial disincentive for hospitals to detect and report cases, and create a single point of entry to reduce the burden on individuals and providers to reconcile cases.

  17. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia

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    Almushayt Abdullah

    2009-02-01

    Full Text Available Abstract Background Review of post-operative morbidity reports for pediatric dental care under general anesthesia (GA show great variations. Until now, no morbidity data has been available to estimate the safety of pediatric patients under GA for dental rehabilitation in Saudi Arabia. The purposes of this study were to (1 investigate post-operative complications associated with dental care under GA and (2 correlate morbidity reports with patient's characteristics, dental procedures, and hospital protocol. Methods Study sample included 90 children attending GA for dental treatment at major governmental hospitals in Jeddah. Data were collected from every patient on three occasions, intra-operatively at the operating room, and post-operatively via phone calls in the first and third days after operation. Results Results showed that 99% of the children had one or more complaints in the first day in contrast to only 33% in the third day. Inability to eat (86%, sleepiness (71%, and pain (48% were the most common complaints in the first day, followed by bleeding (40%, drowsiness (39%, sore throat (34%, vomiting (26%, psychological changes (24%, fever (21%, cough (12%, and nausea (8%. A great significant complaints reduction was reported by the third post-operative day. Age, gender, admission type of the patients and GA duration were the factors that showed a significant relationship with post-operative complaints. Conclusion Post-operative morbidity was common, but mostly of mild severity and limited to the first day. Hospital staff efforts should be directed to control commonly reported postoperative complaints.

  18. [General surgery in a rural hospital in the State of Quintana Roo, Mexico].

    Science.gov (United States)

    Padrón-Arredondo, Guillermo

    2006-01-01

    The general surgeon maintains extraordinary validity worldwide, especially in countries like the United States, Canada, India, and continents such as Australia and Africa. In addition to their role as a general surgeon, they assist with surgical pathologies in rural areas where there is generally a lack of technology to carry out complicated procedures. Therefore, we undertook this study to determine the number and type of surgical procedures carried out in a rural hospital with three general surgeons, as well as to determine morbidity and respective mortality. The study was retrospective and longitudinal, using descriptive statistics during a 5.5-year period. During the period of June 1999 to December 2004, a total of 651 (100%) surgical procedures were carried out. There were 351 males (53%) and 300 females (47%) with average age of 28.5 +/- 16.0 years. There were 408 (63%) minor surgical procedures accomplished in the operating room: 150 (45%) for females with average age of 25.8 +/- 13.8 years old and 258 (55%) for males with average age of 27.7 +/- 15.5 years old. There were 243 major surgical procedures (37%): for females there were 150 (60%) with average age of 28.4 +/- 11.8 years old and for males there were 93 (40%) with average age of 29.5 +/- 16.6 years old [morbidity, six cases (0.9%) and mortality, two cases (0.3%)]. The demand for surgery in rural areas is not different from the surgery carried out in large cities, although there are limitations. It is important in this regard to adequately prepare the general surgeon in Mexico.

  19. Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece

    International Nuclear Information System (INIS)

    Voudrias, Evangelos; Goudakou, Lambrini; Kermenidou, Marianthi; Softa, Aikaterini

    2012-01-01

    Highlights: ► We studied pharmaceutical and chemical waste production in a Greek hospital. ► Pharmaceutical waste comprised 3.9% w/w of total hazardous medical waste. ► Unit production rate for total pharmaceutical waste was 12.4 ± 3.90 g/patient/d. ► Chemical waste comprised 1.8% w/w of total hazardous medical waste. ► Unit production rate for total chemical waste was 5.8 ± 2.2 g/patient/d. - Abstract: The objective of this work was to determine the composition and production rates of pharmaceutical and chemical waste produced by Xanthi General Hospital in Greece (XGH). This information is important to design and cost management systems for pharmaceutical and chemical waste, for safety and health considerations and for assessing environmental impact. A total of 233 kg pharmaceutical and 110 kg chemical waste was collected, manually separated and weighed over a period of five working weeks. The total production of pharmaceutical waste comprised 3.9% w/w of the total hazardous medical waste produced by the hospital. Total pharmaceutical waste was classified in three categories, vial waste comprising 51.1%, syringe waste with 11.4% and intravenous therapy (IV) waste with 37.5% w/w of the total. Vial pharmaceutical waste only was further classified in six major categories: antibiotics, digestive system drugs, analgesics, hormones, circulatory system drugs and “other”. Production data below are presented as average (standard deviation in parenthesis). The unit production rates for total pharmaceutical waste for the hospital were 12.4 (3.90) g/patient/d and 24.6 (7.48) g/bed/d. The respective unit production rates were: (1) for vial waste 6.4 (1.6) g/patient/d and 13 (2.6) g/bed/d, (2) for syringe waste 1.4 (0.4) g/patient/d and 2.8 (0.8) g/bed/d and (3) for IV waste 4.6 (3.0) g/patient/d and 9.2 (5.9) g/bed/d. Total chemical waste was classified in four categories, chemical reagents comprising 18.2%, solvents with 52.3%, dyes and tracers with 18.2% and

  20. Understanding doctors' ethical challenges as role virtue conflicts.

    Science.gov (United States)

    McDougall, Rosalind

    2013-01-01

    This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral considerations that are overlooked by other approaches to ethical analysis. © 2011 Blackwell Publishing Ltd.

  1. Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria.

    Science.gov (United States)

    Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

    2015-01-01

    Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (pservice quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.

  2. Use of antimicrobial drugs in general hospitals. I. Description of population and definition of methods.

    Science.gov (United States)

    Townsend, T R; Shapiro, M; Rosner, B; Kass, E H

    1979-06-01

    The patterns of use of antimicrobial drugs in a random sample of general hosptials in Pennsylvania were studied. The sample was tested for validity, and all deaths and discharges were analyzed for 10 random days drawn across the year spanning July 1973 to June 1974. Methods were developed for abstracting the hospital records and for determining the reproducibility of the findings of the physician and nonphysician chart reviewers. More than 99% of the requested charts were available. In the 5,288 charts reviewed, most of the required data were readily available. The study population was 84% white and 58% female; most patients were in hospitals that had more than 300 beds and that were located in towns with populations of greater than 10,000. In 41% of the 2,070 antimicrobial courses administered to almost 30% of the patients, an explicit clinical statement of why the drug was being given could be found in the chart. The information for review was found in clinical charts, but in half of the charts, the information required was not on face sheets and discharge summaries.

  3. Finger Replantation in Sanglah General Hospital: Report of Five Cases and Literature Review

    Directory of Open Access Journals (Sweden)

    Agus Roy Rusly Hariantana Hamid

    2016-11-01

    Full Text Available Background: Replantation is the prime treatment for amputated hands and fingers due to functional and aesthetic advantages. The absolute indications for replantation are amputations of the thumb, multiple fingers, trans metacarpal or hand, and any upper extremity in a child, regardless of the amputation level. A fingertip amputation distal to the insertion of the flexor digitorum superficialis (FDS is also a good indication. Indications have been expanded to include amputation at nail level, and when there is a request from the patient, replantation is attempted even for a single finger amputation regardless of the amputation level. Based on the mechanism of injury, a clean-cut sharp amputation is more likely replanted compare to a crush and avulsion injuries. With a proper management of the amputated finger, replantation can be attempted even after 24 hours. This report was written to provide examples of finger replantation cases and the measures that can be taken in a resource-limited hospital in order to conduct a replantation. Case Series: We reported five out of nine digital replantation cases in Sanglah General Hospital between January and July 2014. Two patients were a six and an eleven years old boys who accidentally cut their finger while playing, the rests were male labors between 20-30 years old whose amputations due to machine injuries. Result: A 100% replant survival was achieved. After a period of follow up with occupational therapy, all patients regain good functional and cosmetic results. 

  4. Hand hygiene compliance in patients under contact precautions and in the general hospital population.

    Science.gov (United States)

    Almaguer-Leyva, Martín; Mendoza-Flores, Lidia; Medina-Torres, Ana Gabriela; Salinas-Caballero, Ana Gabriela; Vidaña-Amaro, Jose Antonio; Garza-Gonzalez, Elvira; Camacho-Ortiz, Adrián

    2013-11-01

    Hand hygiene (HH) is the single most important intervention for preventing hospital-acquired infections. Contact precautions are a series of actions that infection control units take to reduce the transmission of nosocomial pathogens. We conducted an observational study of HH compliance. Observations were stratified as opportunities in patients under contact precautions and in the general hospital population. Trained infection control personnel performed all direct evaluations. A total of 3,270 opportunities were recorded. HH compliance was statistically higher in patients on contact precautions than in the overall population (70.3% vs 60.4%; P = .0001). Critical care areas had higher HH compliance when patients were isolated by contact precautions. Medical wards were statistically lower in HH when patients were under contact precautions. Respiratory technicians had the highest HH compliance in both overall performance and in patients under contact precautions. Medical students had a lower HH compliance in both evaluations (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  5. Child abuse and neglect as seen in General Hospital, Kuala Lumpur--a two year study.

    Science.gov (United States)

    Kassim, M S; George, R; Kassim, K; Begum, M; Cherian, M P; Tajudin, A K; Chandran, V; Anan, A; Reddy, R; Singh, J

    1989-06-01

    Eighty-six children diagnosed as child abuse and/or neglect were admitted to the Paediatric wards of the General Hospital, Kuala Lumpur during 1985 and 1986. Of these cases, 62 were of physical abuse, six of sexual abuse, one case of both physical and sexual abuse and 17 of neglect. There were 25 boys and 61 girls. Thirty-four of these children were Malays, 16 Chinese, 26 Indians, three mixed and seven illegal immigrants. Twenty-one were below the age of one year, 24 from one to four years, 25 from five to nine years and 16 were ten years and above. The abusers were mainly close members of the family. Of these children, 24 were sent back to their parents and 11 to their relatives home. Twenty-seven were taken into care by the Ministry of Social Welfare and the remaining seven children who were illegal immigrants, were deported with their parents. Only one child was successfully fostered. Eleven children were taken away from the hospital by their parents or guardians without the knowledge of the health staff. There were five deaths in the series.

  6. Anorectal pathology amongst HIV infected patients attending the Douala General Hospital: a cross-sectional study.

    Science.gov (United States)

    Luma, Henry Namme; Eloumou, Servais Albert Fiacre Bagnaka; Fualefeh-Morfaw, Ellis Atemlefeh; Malongue, Agnes; Temfack, Elvis; Lekpa, Fernando Kemta; Donfack-Sontsa, Olivier; Ndip, Lucy; Ditah, Ivo Che

    2017-03-01

    While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients' files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2-5) years and median CD4 cell count was 411 (interquartile range: 234-601) cells/mm 3 . Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7-27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.

  7. Pediatrics chest x-ray examination in general hospitals in Khartoum State

    International Nuclear Information System (INIS)

    Elawad, S. O. A.

    2011-01-01

    Study was performed to evaluate radiation dose for pediatric patients undergoing chest x-ray examination in selected general radiography hospitals in Khartoum State in seven x-ray machines. x-ray tube output measurements were made in the range of typical exposure parameters using calibrated dose rate meter. To estimate entrance surface air kerma (ESA K), the radiographer in charge of the facility was asked to provide typical exposure parameters (kV, m As and FSD) for each age category (newborn (1-30 days), 1,5.10 and years). ESA K was estimated using the x-ray tube output measurements and the recorded exposure parameters. The obtained mean ESA K range from /27/ to 57/ μGy, /25 -103/ μGy, /45-128/ μGy, /47-139/ μGy and from /68-299/ μGy for newborn, 1,5,10, and 15 years patients, respectively. The estimated ESA K were within the established international reference dose values and also the values obtained in previous studies. However, variations were observed in ESA K values among hospitals under study which could be due to the differences in exposure parameters used. Also tube output has some difference on the obtained ESA K. (Author)

  8. [A proposal to improve nursing fee differentiation policy for general hospitals using profitability-analysis in the national health insurance].

    Science.gov (United States)

    Kim, Sungjae; Kim, Jinhyun

    2012-06-01

    The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.

  9. The Montreal General Hospital Pain Centre (1974-2000: The Contributions of Ronald Melzack

    Directory of Open Access Journals (Sweden)

    Mary Ellen Jeans

    2000-01-01

    Full Text Available This paper chronicles the development of the Montreal General Hospital Pain Centre from its inception in 1974 to the present. Highlighted in particular are the contributions of Ronald Melzack to this history. Data for the article arose, in the main, from an interview with Dr Melzack carried out earlier in the year. Discussions with former and present members of the pain centre team, including former graduate students, provided additional information. The article begins with a recounting of those individuals and events that inspired Ron early in his 'pain career' to pursue his dream of a multidisciplinary pain centre, the first of its kind in Canada. The forces that helped shape the development of this centre and the challenges that had to be overcome are described.

  10. Development of the FISH technique for biological dosimetry applications in the Gregorio Maranon General University Hospital

    International Nuclear Information System (INIS)

    Moreno, M.; Jesus Prieto, M.; Olivares, P.; Gomez, M.; Herranz, R.

    1997-01-01

    Since 1989 cytogenetic analysis for dose estimation has been regularly used In the Gregorio Maranon General University Hospital (HGUGM) of Madrid on individuals suspected of having accidentally been exposed to ionizing radiation. The method used is the study of chromosomal aberrations found in lymphocytes of peripheral blood. The technique recommended by the IAEA in 1986 permits to establish a dicentrics/dose ratio through an effective dose calibration curve prepared in-vitro. This methodology of dose estimation presents serious limitations which can partially be eliminated by means of new molecular cytogenetic techniques, such as chromosomal painting through in-situ hybridization with fluorescence (FISH). At HGUGM, research work has been finished for standardization of the above mentioned technique including effective dose calibration curves, the utilization of adequate aberrations and the intercomparision of the results with other centres

  11. Can sonographers offer an accurate upper abdominal ultrasound service in a district general hospital?

    International Nuclear Information System (INIS)

    Dongola, N.A.; Guy, R.L.; Giles, J.A.; Ward, S.

    2003-01-01

    Purpose: This study was performed to evaluate the accuracy of upper abdominal ultrasound (US) scanning performed by sonographers in a district general hospital, to identify potential areas of weakness and to make recommendations to improve the service. Materials and methods: Upper abdominal US examinations performed and reported by sonographers over a 4-week period were retrospectively reviewed. The accuracy of the imaging findings and reports were assessed against other imaging, surgical, histological or laboratory findings and against clinical outcome. Results: A heterogenous group of 104 patients were included in the study, 62 of whom had an US abnormality. Errors of scanning or interpretation were identified in 10 patients (9.6%) of whom five (4.8%) were felt to be potentially significant. Conclusions: The sonographers' accuracy in reporting upper abdominal US scans was 90%. However, on the basis of this study we have implemented specific recommendations to improve the quality of the service

  12. Quality of stroke care at an Irish Regional General Hospital and Stroke Rehabilitation Unit.

    LENUS (Irish Health Repository)

    Walsh, T

    2012-01-31

    BACKGROUND: Robust international data support the effectiveness of stroke unit (SU) care. Despite this, most stroke care in Ireland are provided outside of this setting. Limited data currently exist on the quality of care provided. AIM: The aim of this study is to examine the quality of care for patients with stroke in two care settings-Regional General Hospital (RGH) and Stroke Rehabilitation Unit (SRU). METHODS: A retrospective analysis of the stroke records of consecutive patients admitted to the SRU between May-November 2002 and April-November 2004 was performed applying the UK National Sentinel Audit of Stroke (NSAS) tool. RESULTS: The results of the study reveal that while SRU processes of care was 74% compliant with standards; compliance with stroke service organisational standards was only 15 and 43% in the RGH and SRU, respectively. CONCLUSION: The quality of stroke care in our area is deficient. Comprehensive reorganisation of stroke services is imperative.

  13. Monitoring of the general population with an installed whole body counter at West Cumberland Hospital, Whitehaven

    International Nuclear Information System (INIS)

    Boddy, K.; Francis, R.A.; Fenwick, J.D.; McKenzie, A.L.

    1989-03-01

    Body radioactivity in the general public has been measured in 395 volunteers in the Whitehaven area, using a whole-body monitor at West Cumberland Hospital. Between October 1986 and October 1987, estimates of total body radiocaesium in 240 volunteers ranged from below detection level to 1844 Bq with a mean of 415 Bq. From October 1987 until May 1988, a further 155 volunteers were monitored, and radiation levels ranged from 34 Bq to 685 Bq, with a mean of 257 Bq. In all volunteers, the ratio of body radiocaesium to body potassium, was well below unity. The average ratio of caesium-137 to caesium-134 from October 1987 to May 1988 was 3.28, corresponding to a ratio of 1.99 at the date of Chernobyl accident. This is consistent with a Chernobyl origin as the primary source for the radiocaesium. There were discernible, but not marked, trends of increasing body radiocaesium with milk and meat/fish consumption. (author)

  14. The Experience of a District General Hospital with a Large Outdoor Music Festival in England.

    Science.gov (United States)

    Kamour, A; Yardley, R; Longshaw, M; Stuart, J

    2017-01-01

    To assess the impact of the Parklife annual music festival on the local hospital, North Manchester General. Data was obtained retrospectively by analysis of emergency department records during the weekend of Parklife 2015. 32 patients were identified, 56% reported taking drugs. 34% were admitted for overnight observation. 4 patients presented with methaemoglobinaemia following oral ingestion of amyl nitrate. One patient had a methaemoglobin fraction of 90.6%, which is amongst the most extreme recorded in literature. Music festivals can impose a burden on local health services. Organisers should operate an efficient surveillance system in order to prevent the sale and use of recreational drugs, providing adequate on-site health services and working in collaboration with local emergency services.

  15. Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: the case of a public hospital system in Taiwan.

    Science.gov (United States)

    Yang, Ming-Chin; Tung, Yu-Chi

    2006-01-01

    Examining whether the causal relationships among the performance indicators of the balanced scorecard (BSC) framework exist in hospitals is the aim of this article. Data were collected from all twenty-one general hospitals in a public hospital system and their supervising agency for the 3-year period, 2000-2002. The results of the path analyses identified significant causal relationships among four perspectives in the BSC model. We also verified the relationships among indicators within each perspective, some of which varied as time changed. We conclude that hospital administrators can use path analysis to help them identify and manage leading indicators when adopting the BSC model. However, they should also validate causal relationships between leading and lagging indicators periodically because the management environment changes constantly.

  16. Herniated Nucleus Pulposus in Dr. Hasan Sadikin General Hospital Bandung Indonesia

    Directory of Open Access Journals (Sweden)

    Annisa Ikhsanawati

    2015-06-01

    Full Text Available Background: Herniated nucleus pulposus (HNP is one of the most common diseases of the spine. For an optimal management and prevention, there’s a need for data on factors related to the onset of complaints because this disease lowers the quality of life and increases morbidity. This study is aimed to see the scale and pattern of the HNP in Dr. Hasan Sadikin General Hospital, Bandung. Methods: This is a descriptive study with the design of case series, data was obtained from medical records of patients with the diagnosis of HNP in the inpatient care of Dr. Hasan Sadikin General Hospital in the period of 2007–2011. Results: According to the study on 79 patients, with 43 men and 36 women, the highest incidence was at the age group of 51–60 years old (31.6% and most common occupation was civil servant (11.4%. The most common clinical symptoms were sciatica (51.9% and low back pain (51.9%. Most frequent location was in the lumbar vertebrae at the level of L5–S1 (58.2%. Trauma was found to be the highest relatable history in the patients (39.2%. Therapy of choice was primarily conservative (58.2% and most patients went home after the progression (84.8%. The year 2007 showed the highest prevalence of HNP at 25.3%. The most common clinical symptoms were sciatica (51.9% and low back pain (51.9% Conclusions: The most common clinical symptoms were sciatica and low back pain. Most frequent location was in the lumbar vertebrae at the level L5–S1.

  17. Exploring barriers to accessing physiotherapy services for stroke patients at Tema general hospital, Ghana.

    Science.gov (United States)

    Nketia-Kyere, Mercy; Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Aikins, Moses

    2017-01-01

    Physiotherapy has been shown to reduce the risk of disability among stroke patients. Poor adherence to physiotherapy can negatively affect outcomes and healthcare cost. However, very little is known about barriers especially to physiotherapy services in Ghana. The objective of this study was to assess the barriers to physiotherapy services for stroke patients at Tema General Hospital (TGH). The individual/personal and health system barriers to physiotherapy services at TGH were determined. A cross-sectional study design was employed. A simple random sampling technique was used to recruit 207 respondents for a face-to-face interview. Interviewer-administered questionnaires were used to collect data on individual/personal barriers of respondents to physiotherapy services and were described using the Likert's scale. Health system barriers were assessed using a self-structured questionnaire which had section under the following heading: human factors, physiotherapy modalities, physical barriers and material/equipment factors. The time spent waiting for physiotherapy and attitude of physiotherapist towards patients; physiotherapy modality such as electrotherapy, exercise therapy and massage therapy among others were some of the indices measured. Respondents' adherence to Medication was assessed with the Morisky 8-item medication adherence questionnaire. Data were entered and analysed using Epi info 7 and STATA 12.0. Associations between the variables were determined using a chi-square test and logistic regression model was used to test the strength of associations between the independent and the dependent variables. The level of statistical significance was set at p  Tema General Hospital.

  18. URGENT NEED OF A DOCTOR

    CERN Multimedia

    Medical Service

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGAD 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European EmergencyCall 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will...

  19. Comparative heart failure profile over a 3-year period in a Romanian general hospital

    Directory of Open Access Journals (Sweden)

    Pop D

    2013-07-01

    Full Text Available Dana Pop,1 Oana Maria Penciu,1 Adela Viviana Sitar-Taut,2 Dumitru Tudor Zdrenghea11Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2"Babes-Bolyai" University, Cluj-Napoca, RomaniaBackground: Heart failure (HF has become an increasingly significant public health problem, associated with repeated hospitalizations, high costs, low quality of life, and decreased survival rate. The progress of the disease may be slowed if treatment is administered in accordance with current guidelines.Objectives: To compare the clinical profile of HF patients in a Romanian general hospital over a 3-year period.Methods and results: We studied two cohorts of patients admitted in the cardiology department of a rehabilitation hospital with a diagnosis of chronic HF New York Heart Association class II–IV. The first, in 2006, included 415 patients, 67.08 ± 10.59 years; the second, in 2009, included 500 patients, 67.31 ± 11.27 years. Considering all patients, the left ventricle ejection fraction (LVEF was not statistically different in the two cohorts. Compared to the 2006 cohort, the 2009 female cohort had higher LVEF (60.49% ± 13.41% vs 64.42% ± 13.79%, P < 0.05, while males over 65 years of age had lower LVEF (52.75% ± 15.02% vs 54.37% ± 15.23%, P = NS. For females, the probability of having LVEF ,45% was higher in 2006 (odds ratio = 1.573. HF with preserved LVEF was more common in females, both in 2006 (78.2% vs 54.2% and 2009 (87.2% vs 57.3%. In the 2009 cohort, LVEF was higher both in young patients (59.08% ± 14.22% vs 55.35% ± 14.92% and patients ≥ than 75 years of age (62.28% ± 13.81% vs 56.79% ± 14.81% compared to the 2006 cohort. Ischemic heart disease was the main underlying cause for HF in both cohorts.Conclusion: HF appeared to have the same clinical profile over a 3-year period. Females diagnosed with HF showed higher rates of preserved LVEF.Keywords: heart

  20. Studies on failure kind analysis of the radiologic medical equipment in general hospital

    International Nuclear Information System (INIS)

    Lee, Woo Cheul; Kim, Jeong Lae

    1999-01-01

    This paper included a data analysis of the unit of medical devices using maintenance recording card that had medical devices of unit failure mode, hospital of failure mode and MTBF. The results of the analysis were as follows : 1. Medical devices of unit failure mode was the highest in QC/PM such A hospital as 33.9%, B hospital 30.9%, C hospital 30.3%, second degree was the Electrical and Electronic failure such A hospital as 23.5%, B hospital 25.3%, C hospital 28%, third degree was mechanical failure such A hospital as 19.6%, B hospital 22.5%, C hospital 25.4%. 2. Hospital of failure mode was the highest in Mobile X-ray device(A hospital 62.5%, B hospital 69.5%, C hospital 37.4%), and was the lowest in Sono devices(A hospital 16.76%, B hospital 8.4%, C hospital 7%). 3. Mean time between failures(MTBT) was the highest in SONO devices and was the lowest in Mobile X-ray devices which have 200 - 400 failure hours. 4. Average failure ratio was the highest in Mobile X-ray devices(A hospital 31.3%, B hospital 34.8%, C hospital 18.7%), and was the lowest in Sono(Ultrasound) devices (A hospital 8.4%, B hospital 4.2%, C hospital 3.5%). 5. Failure ratio results of medical devices according to QC/PM part of unit failure mode were as follows ; A hospital was the highest part of QC/PM (50%) in Mamo X-ray device and was the lowest part of QC/PM(26.4%) in Gastro X-ray. B hospital was the highest part of QC/PM(56%) in Mobile X-ray device, and the lowest part of QC/PM(12%) in Gastro X-ray. C hospital was the highest part of QC/PM(60%) in R/F X-ray device, and the lowest a part of QC/PM(21%) in Universal X-ray. It was found that the units responsible for most failure decreased by systematic management. We made the preventive maintenance schedule focusing on adjustment of operating and dust removal

  1. Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece.

    Science.gov (United States)

    Voudrias, Evangelos; Goudakou, Lambrini; Kermenidou, Marianthi; Softa, Aikaterini

    2012-07-01

    The objective of this work was to determine the composition and production rates of pharmaceutical and chemical waste produced by Xanthi General Hospital in Greece (XGH). This information is important to design and cost management systems for pharmaceutical and chemical waste, for safety and health considerations and for assessing environmental impact. A total of 233 kg pharmaceutical and 110 kg chemical waste was collected, manually separated and weighed over a period of five working weeks. The total production of pharmaceutical waste comprised 3.9% w/w of the total hazardous medical waste produced by the hospital. Total pharmaceutical waste was classified in three categories, vial waste comprising 51.1%, syringe waste with 11.4% and intravenous therapy (IV) waste with 37.5% w/w of the total. Vial pharmaceutical waste only was further classified in six major categories: antibiotics, digestive system drugs, analgesics, hormones, circulatory system drugs and "other". Production data below are presented as average (standard deviation in parenthesis). The unit production rates for total pharmaceutical waste for the hospital were 12.4 (3.90) g/patient/d and 24.6 (7.48) g/bed/d. The respective unit production rates were: (1) for vial waste 6.4 (1.6) g/patient/d and 13 (2.6) g/bed/d, (2) for syringe waste 1.4 (0.4) g/patient/d and 2.8 (0.8) g/bed/d and (3) for IV waste 4.6 (3.0) g/patient/d and 9.2 (5.9) g/bed/d. Total chemical waste was classified in four categories, chemical reagents comprising 18.2%, solvents with 52.3%, dyes and tracers with 18.2% and solid waste with 11.4% w/w of the total. The total production of chemical waste comprised 1.8% w/w of the total hazardous medical waste produced by the hospital. Thus, the sum of pharmaceutical and chemical waste was 5.7% w/w of the total hazardous medical waste produced by the hospital. The unit production rates for total chemical waste for the hospital were 5.8 (2.2) g/patient/d and 1.1 (0.4) g/exam/d. The respective

  2. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. V. - November of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. V.- Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  3. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. III.- September of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  4. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX. III.- September and October of 2002; Asesoria especializada en seguridad radiologica al hospital general Ciudad del Carmen, PEMEX. III.- Septiembre y Octubre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Ciudad del Carmen general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  5. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. IV. - October of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. IV.- Octubre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A; Vizuet G, J; Benitez S, J A; Garcia A, J; Rodriguez A, F

    2002-01-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  6. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. VI. - December of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. VI.- Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A; Vizuet G, J; Benitez S, J A; Garcia A, J; Rodriguez A, F

    2002-01-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  7. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. II.- August of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-10-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  8. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. I.- July of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J

    2001-09-15

    The Tula general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic. The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  9. A legal analysis of the use of ionising radiation in medical hospital practice: an inquiry into the influence of prevention and precaution on health protection and liability. Doctoral thesis prepared at SCK-CEN and defended in 2004

    International Nuclear Information System (INIS)

    Lierman, S.

    2005-01-01

    The article refers to an abstract of a doctoral thesis. From a legal perspective there exists a clear need for a general framework describing conditions and consequences of risk management in the field of high technology. Despite the existence of many kinds of Safety Procedures and Soft Law, specific guidelines are lacking for regulators and courts, especially in case of scientific controversy and uncertainty about the health effects of an activity or a product such as low doses of ionising radiation, electro-magnetic fields, genetically modified organisms, PCB's in salmon etc. The research of the PISA Project on Legal Aspects and Liability has been focussed on the medical applications of ionising radiation. The safety approach depends on the risk characterisation and differs for stochastic and deterministic effects. The most important objective was to find liability or funding systems which can cope with these differences, in particular between dose limits (as for the nuclear industry), reference dose levels foreseen in the EC medical Directive (as for nuclear medicine), and Optimisation referring to the ALARA principle. Risk assessment and risk management that are based on traditional narrow risk-assessment models have to be revised in the light of the Precautionary Principle. This principle urges policy-makers to adopt a broader, more pluralistic approach, considering the societal equilibrium, i.e. the general interest of the activity at stake, the general impact of individual protective measures and the existence of reasonable alternatives from a sociological, economical, scientific and technological point of view. One of the characteristics of the Precautionary Principle relates to our opinion to the collective damage to human health, i.e. a detriment that relates to a group of people. Nevertheless, as a result of the application of the Precautionary Principle, we believe that in case of individual damage the standard of care shall be more and more defined

  10. The Treatment of Anorexia Nervosa in a General Hospital: A Case Vignette of a Multi-Disciplinary General Hospital-Based Approach.

    Science.gov (United States)

    Kronenberg, J.; And Others

    1994-01-01

    Describes anorexia nervosa as condition variable in etiology and resistant to treatment, which may lead to mortality in 5% of treated cases. Notes that efforts have been made for treating disorder in nonstigmatizing medical units outside psychiatric hospitals. Describes, through presentation of short case vignette, advantages of treating…

  11. Injection laryngoplasty using BIOPEX calcium phosphate cement. The Sanokousei General Hospital experience

    International Nuclear Information System (INIS)

    Okubo, Keisuke; Shinnabe, Akihiro; Saito, Koichiro; Shiotani, Akihiro

    2008-01-01

    The calcium phosphate bone paste BIOPEX is an injectable material developed as a bone replacement that hardens into a hydroxylapatite block after injection. BIOPEX offers many advantages as a material for injection laryngoplasty: it induces little foreign-material reaction, is minimally absorbed, and is easy to prepare in the OR. Between 2004 and 2007, 14 patients, including 13 with vocal fold paralysis and 1 with severe atrophy of the vocal folds, were treated with BIOPEX-injection laryngoplasty at Sanokousei General Hospital. The injection of BIOPEX is usually performed through a direct laryngoscopy under general anesthesia, and no adverse effects were observed in any of the cases. A postoperative three-dimensional CT revealed successful injection of the BIOPEX into the paraglottic space in all cases. BIOPEX is minimally absorbed over long time periods, and this procedure results in a dramatic improvement of glottic function immediately after surgery. We consider this operative technique, which aims at medialization of the vocal fold by injection of a sclerotic agent into the lateral side of the vocal fold, as 'type I thyroplasty from inside the laryngeal framework.' (author)

  12. Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.

    Science.gov (United States)

    Verma, Amol A; Guo, Yishan; Kwan, Janice L; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A; Hwang, Stephen W; Laupacis, Andreas; Mamdani, Muhammad M; Shadowitz, Steven; Upshur, Ross; Reid, Robert J; Razak, Fahad

    2017-12-11

    The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. Copyright 2017

  13. Medical psychology services in dutch general hospitals: