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Sample records for large teaching hospitals

  1. Large Variability in the Diversity of Physiologically Complex Surgical Procedures Exists Nationwide Among All Hospitals Including Among Large Teaching Hospitals.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H; Thenuwara, Kokila; Lubarsky, David A

    2017-11-22

    Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment. What is unknown is whether large diversity is a feature of only a few very unique set of hospitals nationwide (eg, the largest hospitals in each state or province). The 2013 United States Nationwide Readmissions Database was used to study heterogeneity among 1981 hospitals in their diversities of physiologically complex surgical procedures (ie, the procedure codes). The diversity of surgical procedures performed at each hospital was quantified using a summary measure, the number of different physiologically complex surgical procedures commonly performed at the hospital (ie, 1/Herfindahl). A total of 53.9% of all hospitals commonly performed 3-fold larger diversity (ie, >30 commonly performed physiologically complex procedures). Larger hospitals had greater diversity than the small- and medium-sized hospitals (P 30 procedures (lower 99% CL, 71.9% of hospitals). However, there was considerable variability among the large teaching hospitals in their diversity (interquartile range of the numbers of commonly performed physiologically complex procedures = 19.3; lower 99% CL, 12.8 procedures). The diversity of procedures represents a substantive differentiator among hospitals. Thus, the usefulness of statistical methods for operating room management should be expected to be heterogeneous among hospitals. Our results also show that "large teaching hospital" alone is an insufficient description for accurate prediction of the extent to which a hospital sustains the

  2. Nurses exposure to workplace violence in a large teaching hospital in Iran

    OpenAIRE

    Teymourzadeh, Ehsan; Rashidian, Arash; Arab, Mohammad; Akbari-Sari, Ali; Hakimzadeh, Seyyed Mostafa

    2014-01-01

    Background Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses’ exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010. Methods We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO), the Inter...

  3. Nurses exposure to workplace violence in a large teaching hospital in Iran.

    Science.gov (United States)

    Teymourzadeh, Ehsan; Rashidian, Arash; Arab, Mohammad; Akbari-Sari, Ali; Hakimzadeh, Seyyed Mostafa

    2014-11-01

    Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses' exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010. We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO), the International Health Organization (IHO), the International Council of Nurses (ICN), and the Public Services International (PSI). Finally, in order to analyze the relationships among different variables in the study, T-test and Chi-Square test were used. Three hundred and one nurses responded to the questionnaire (a response rate of 73%). Over 70% of the nurses felt worried about workplace violence. The participants reported exposure to verbal abuse (64% CI: 59-70%), bullying-mobbing (29% CI: 24-34%) and physical violence (12% CI: 9-16%) at least once during the previous year. Relatives of hospital patients were responsible for most of the violence. Nurses working in the emergency department and outpatient clinics were more likely to report having experienced violence. Nurses were unlikely to report violence to hospital managers, and 40% of nurses were unaware of any existing policies within the hospital for reducing violence. We observed a considerable level of nurse exposure to workplace violence. The high rate of reported workplace violence demonstrates that the existing safeguards that aim to protect the staff from abusive patients and relatives are inadequate.

  4. Nurses Exposure to Workplace Violence in a Large Teaching Hospital in Iran

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    Ehsan Teymourzadeh

    2014-11-01

    Full Text Available Background Workplace violence is one of the factors which can strongly reduce job satisfaction and the quality of working life of nurses. The aim of this study was to measure nurses’ exposure to workplace violence in one of the major teaching hospitals in Tehran in 2010. Methods We surveyed the nurses in a cross-sectional design in 2010. The questionnaire was adapted from a standardized questionnaire designed collaboratively by the International Labor Office (ILO, the International Health Organization (IHO, the International Council of Nurses (ICN, and the Public Services International (PSI. Finally, in order to analyze the relationships among different variables in the study, T-test and Chi-Square test were used. Results Three hundred and one nurses responded to the questionnaire (a response rate of 73%. Over 70% of the nurses felt worried about workplace violence. The participants reported exposure to verbal abuse (64% CI: 59-70%, bullying-mobbing (29% CI: 24-34% and physical violence (12% CI: 9-16% at least once during the previous year. Relatives of hospital patients were responsible for most of the violence. Nurses working in the emergency department and outpatient clinics were more likely to report having experienced violence. Nurses were unlikely to report violence to hospital managers, and 40% of nurses were unaware of any existing policies within the hospital for reducing violence. Conclusion We observed a considerable level of nurse exposure to workplace violence. The high rate of reported workplace violence demonstrates that the existing safeguards that aim to protect the staff from abusive patients and relatives are inadequate.

  5. Comparing Outcomes of Coronary Artery Bypass Grafting Among Large Teaching and Urban Hospitals in China and the United States.

    Science.gov (United States)

    Zheng, Zhe; Zhang, Heng; Yuan, Xin; Rao, Chenfei; Zhao, Yan; Wang, Yun; Normand, Sharon-Lise; Krumholz, Harlan M; Hu, Shengshou

    2017-06-01

    Coronary artery disease is prevalent in China, with concomitant increases in the volume of coronary artery bypass grafting (CABG). The present study aims to compare CABG-related outcomes between China and the United States among large teaching and urban hospitals. Observational analysis of patients aged ≥18 years, discharged from acute-care, large teaching and urban hospitals in China and the United States after hospitalization for an isolated CABG surgery. Data were obtained from the Chinese Cardiac Surgery Registry in China and the National Inpatient Sample in the United States. Analysis was stratified by 2 periods: 2007, 2008, and 2010; and 2011 to 2013 periods. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay. The sample included 51 408 patients: 32 040 from 77 hospitals in the China-CABG group and 19 368 from 303 hospitals in the US-CABG group. In the 2007 to 2008, 2010 period and for all-age and aged ≥65 years, the China-CABG group had higher mortality than the US-CABG group (1.91% versus 1.58%, P =0.059; and 3.12% versus 2.20%, P =0.004) and significantly higher age-, sex-, and comorbidity-adjusted odds of death (odds ratio, 1.58; 95% confidential interval, 1.22-2.04; and odds ratio, 1.73; 95% confidential interval, 1.24-2.40). There were no significant mortality differences in the 2011 to 2013 period. For preoperative, postoperative, and total hospital stay, respectively, the median (interquartile range) length of stay across the entire study period between China-CABG and US-CABG groups were 9 (8) versus 1 (3), 9 (6) versus 6 (3), and 20 (12) versus 7 (5) days (all P China and the United States. The longer length of stay in China may represent an opportunity for improvement. © 2017 The Authors.

  6. Importation, Mitigation, and Genomic Epidemiology of Candida auris at a Large Teaching Hospital.

    Science.gov (United States)

    Lesho, Emil P; Bronstein, Melissa Z; McGann, Patrick; Stam, Jason; Kwak, Yoon; Maybank, Rosslyn; McNamara, Jodi; Callahan, Megan; Campbell, Jean; Hinkle, Mary K; Walsh, Edward E

    2018-01-01

    OBJECTIVE Candida auris (CA) is an emerging multidrug-resistant pathogen associated with increased mortality. The environment may play a role, but transmission dynamics remain poorly understood. We sought to limit environmental and patient CA contamination following a sustained unsuspected exposure. DESIGN Quasi-experimental observation. SETTING A 528-bed teaching hospital. PATIENTS The index case patient and 17 collocated ward mates. INTERVENTION Immediately after confirmation of CA in the bloodstream and urine of a patient admitted 6 days previously, active surveillance, enhanced transmission-based precautions, environmental cleaning with peracetic acid-hydrogen peroxide and ultraviolet light, and patient relocation were undertaken. Pre-existing agreements and foundational relationships among internal multidisciplinary teams and external partners were leveraged to bolster detection and mitigation efforts and to provide genomic epidemiology. RESULTS Candida auris was isolated from 3 of 132 surface samples on days 8, 9, and 15 of ward occupancy, and from no patient samples (0 of 48). Environmental and patient isolates were genetically identical (4-8 single-nucleotide polymorphisms [SNPs]) and most closely related to the 2013 India CA-6684 strain (~200 SNPs), supporting the epidemiological hypothesis that the source of environmental contamination was the index case patient, who probably acquired the South Asian strain from another New York hospital. All isolates contained a mutation associated with azole resistance (K163R) found in the India 2105 VPCI strain but not in CA-6684. The index patient remained colonized until death. No surfaces were CA-positive 1 month later. CONCLUSION Compared to previous descriptions, CA dissemination was minimal. Immediate access to rapid CA diagnostics facilitates early containment strategies and outbreak investigations. Infect Control Hosp Epidemiol 2018;39:53-57.

  7. Frequency of medication errors in an emergency department of a large teaching hospital in southern Iran

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    Vazin A

    2014-12-01

    Full Text Available Afsaneh Vazin,1 Zahra Zamani,1 Nahid Hatam2 1Department of Clinical Pharmacy, Faculty of Pharmacy, 2School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Abstract: This study was conducted with the purpose of determining the frequency of medication errors (MEs occurring in tertiary care emergency department (ED of a large academic hospital in Iran. The incidence of MEs was determined through the disguised direct observation method conducted by a trained observer. A total of 1,031 medication doses administered to 202 patients admitted to the tertiary care ED were observed over a course of 54 6-hour shifts. Following collection of the data and analysis of the errors with the assistance of a clinical pharmacist, frequency of errors in the different stages was reported and analyzed in SPSS-21 software. For the 202 patients and the 1,031 medication doses evaluated in the present study, 707 (68.5% MEs were recorded in total. In other words, 3.5 errors per patient and almost 0.69 errors per medication are reported to have occurred, with the highest frequency of errors pertaining to cardiovascular (27.2% and antimicrobial (23.6% medications. The highest rate of errors occurred during the administration phase of the medication use process with a share of 37.6%, followed by errors of prescription and transcription with a share of 21.1% and 10% of errors, respectively. Omission (7.6% and wrong time error (4.4% were the most frequent administration errors. The less-experienced nurses (P=0.04, higher patient-to-nurse ratio (P=0.017, and the morning shifts (P=0.035 were positively related to administration errors. Administration errors marked the highest share of MEs occurring in the different medication use processes. Increasing the number of nurses and employing the more experienced of them in EDs can help reduce nursing errors. Addressing the shortcomings with further research should result in reduction

  8. Bedside practice of blood transfusion in a large teaching hospital in Uganda : an observational study

    NARCIS (Netherlands)

    de Graaf, J D; Kajja, I; Bimenya, G S; Postma, Maarten; Smit Sibinga, C.Th.

    BACKGROUND: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. MATERIALS AND

  9. Through the lens of the clinician: autopsy services and utilization in a large teaching hospital in Ghana.

    Science.gov (United States)

    Yawson, Alfred E; Tette, Edem; Tettey, Yao

    2014-12-23

    Declining hospital autopsy rates in many countries have generated considerable concern. The survey determined challenges of the autopsy service in a large Teaching Hospital in Ghana, from the perspective of clinicians. This was a cross-sectional study of doctors at the Korle-Bu Teaching Hospital (KBTH) over in 2012. The data was collected using a 69 item self-administered structured questionnaire. In all a total of 215 questionnaires were sent out and 119 doctors responded. Data was collected on the challenges of the autopsy services and barriers to autopsy request from the perspectives of clinicians. Survey data were analyzed by simple descriptive statistics (i.e. proportions, ratios and percentages. Data from survey was analyzed with SPSS version 21. The most common reasons for requesting autopsies were to answer clinical questions, 55 (46.2%) and in cases of uncertain diagnosis, 54 (45.4%). Main demand side barriers to the use of autopsy services by clinicians were reluctance of family to give consent for autopsy 100 (84%), due to cultural and religious objections 89 (74.8%), extra funeral cost to family53 (44.5%) and increased duration of stay of body in the morgue 19 (16%). Health system barriers included delayed feedback from autopsy service 54 (45.4%), difficulties following up the autopsy process 40 (33.6%) due to uncertainties in the timing of particular events in the autopsy process, and long waiting time for autopsy reports 81 (68.1%). More than a third of clinicians 43 (36.2%), received full autopsy report beyond three weeks and 75 (63.1%) clinicians had concerns with the validity of reports issued by the autopsy service (i.e. reports lack specificity or at variance with clinical diagnosis, no toxicological, histological or tissue diagnoses are performed). The autopsy service should restructure itself efficiently and management should support the provision of histological and toxicological services. Strengthening internal and external quality

  10. Bedside practice of blood transfusion in a large teaching hospital in Uganda: An observational study

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    de Graaf J

    2009-01-01

    Full Text Available Background: Adverse transfusion reactions can cause morbidity and death to patients who receive a blood transfusion. Blood transfusion practice in Mulago Hospital, Kampala, Uganda is analyzed to see if and when these practices play a role in the morbidity and mortality of patients. Materials and Methods: An observational study on three wards of Mulago Hospital. Physicians, paramedics, nurses, medical students and nurse students were observed using two questionnaires. For comparison, a limited observational study was performed in the University Medical Centre Groningen (UMCG in Groningen, The Netherlands. Results: In Mulago Hospital guidelines for blood transfusion practice were not easily available. Medical staff members work on individual professional levels. Students perform poorly due to inconsistency in their supervision. Documentation of blood transfusion in patient files is scarce. There is no immediate bedside observation, so transfusion reactions and obstructions in the blood transfusion flow are not observed. Conclusion: The poor blood transfusion practice is likely to play a role in the morbidity and mortality of patients who receive a blood transfusion. There is a need for a blood transfusion policy and current practical guidelines.

  11. Medication Errors in an Internal Intensive Care Unit of a Large Teaching Hospital: A Direct Observation Study

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    Saadat Delfani

    2012-06-01

    Full Text Available Medication errors account for about 78% of serious medical errors in intensive care unit (ICU. So far no study has been performed in Iran to evaluate all type of possible medication errors in ICU. Therefore the objective of this study was to reveal the frequency, type and consequences of all type of errors in an ICU of a large teaching hospital. The prospective observational study was conducted in an 11 bed internal ICU of a university hospital in Shiraz. In each shift all processes that were performed on one selected patient was observed and recorded by a trained pharmacist. Observer would intervene only if medication error would cause substantial harm. The data was evaluated and then were entered in a form that was designed for this purpose. The study continued for 38 shifts. During this period, a total of 442 errors per 5785 opportunities for errors (7.6% occurred. Of those, there were 9.8% administration errors, 6.8% prescribing errors, 3.3% transcription errors and, 2.3% dispensing errors. Totally 45 interventions were made, 40% of interventions result in the correction of errors. The most common causes of errors were observed to be: rule violations, slip and memory lapses and lack of drug knowledge. According to our results, the rate of errors is alarming and requires implementation of a serious solution. Since our system lacks a well-organize detection and reporting mechanism, there is no means for preventing errors in the first place. Hence, as the first step we must implement a system where errors are routinely detected and reported.

  12. A survey of the prevalence of smoking and smoking cessation advice received by inpatients in a large teaching hospital in Ireland.

    LENUS (Irish Health Repository)

    Bartels, C

    2012-01-06

    BACKGROUND: The adverse effects of smoking are well documented and it is crucial that this modifiable risk factor is addressed routinely. Professional advice can be effective at reducing smoking amongst patients, yet it is not clear if all hospital in-patient smokers receive advice to quit. AIMS: To explore smoking prevalence amongst hospital in-patients and smoking cessation advice given by health professionals in a large university teaching hospital. METHODS: Interviews were carried out over 2 weeks in February 2011 with all eligible in-patients in Beaumont Hospital. RESULTS: Of the 205 patients who completed the survey, 61% stated they had been asked about smoking by a healthcare professional in the past year. Only 44% of current\\/recent smokers stated they had received smoking cessation advice from a health professional within the same timeframe. CONCLUSIONS: Interventions to increase rates of healthcare professional-provided smoking cessation advice are urgently needed.

  13. 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)

  14. Development and Implementation of a Combined Master of Science and PGY1/PGY2 Health-System Pharmacy Administration Residency Program at a Large Community Teaching Hospital.

    Science.gov (United States)

    Gazda, Nicholas P; Griffin, Emily; Hamrick, Kasey; Baskett, Jordan; Mellon, Meghan M; Eckel, Stephen F; Granko, Robert P

    2018-04-01

    Purpose: The purpose of this article is to share experiences after the development of a health-system pharmacy administration residency with a MS degree and express the need for additional programs in nonacademic medical center health-system settings. Summary: Experiences with the development and implementation of a health-system pharmacy administration residency at a large community teaching hospital are described. Resident candidates benefit from collaborations with other health-systems through master's degree programs and visibility to leaders at your health-system. Programs benefit from building a pipeline of future pharmacy administrators and by leveraging the skills of residents to contribute to projects and department-wide initiatives. Tools to assist in the implementation of a new pharmacy administration program are also described and include rotation and preceptor development, marketing and recruiting, financial evaluation, and steps to prepare for accreditation. Conclusion: Health-system pharmacy administration residents provide the opportunity to build a pipeline of high-quality leaders, provide high-level project involvement, and produce a positive return on investment (ROI) for health-systems. These programs should be explored in academic and nonacademic-based health-systems.

  15. Large Outbreak Caused by Methicillin Resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital – From Outbreak Control to Outbreak Prevention

    Science.gov (United States)

    Grönthal, Thomas; Moodley, Arshnee; Nykäsenoja, Suvi; Junnila, Jouni; Guardabassi, Luca; Thomson, Katariina; Rantala, Merja

    2014-01-01

    Introduction The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP) ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 – January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. Methods Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. Results Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3–17.0, P = 0.0003), antimicrobial treatment (OR = 3.8, CI95% 1.0–13.9, P = 0.0442), cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1–1.6, P = 0.0007) or in the surgery ward (OR = 1.1, CI95% 1.0–1.3, P = 0.0401). Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. Conclusion Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring

  16. Large outbreak caused by methicillin resistant Staphylococcus pseudintermedius ST71 in a Finnish Veterinary Teaching Hospital--from outbreak control to outbreak prevention.

    Directory of Open Access Journals (Sweden)

    Thomas Grönthal

    Full Text Available INTRODUCTION: The purpose of this study was to describe a nosocomial outbreak caused by methicillin resistant Staphylococcus pseudintermedius (MRSP ST71 SCCmec II-III in dogs and cats at the Veterinary Teaching Hospital of the University of Helsinki in November 2010 - January 2012, and to determine the risk factors for acquiring MRSP. In addition, measures to control the outbreak and current policy for MRSP prevention are presented. METHODS: Data of patients were collected from the hospital patient record software. MRSP surveillance data were acquired from the laboratory information system. Risk factors for MRSP acquisition were analyzed from 55 cases and 213 controls using multivariable logistic regression in a case-control study design. Forty-seven MRSP isolates were analyzed by pulsed field gel electrophoresis and three were further analyzed with multi-locus sequence and SCCmec typing. RESULTS: Sixty-three MRSP cases were identified, including 27 infections. MRSPs from the cases shared a specific multi-drug resistant antibiogram and PFGE-pattern indicated clonal spread. Four risk factors were identified; skin lesion (OR = 6.2; CI95% 2.3-17.0, P = 0.0003, antimicrobial treatment (OR = 3.8, CI95% 1.0-13.9, P = 0.0442, cumulative number of days in the intensive care unit (OR = 1.3, CI95% 1.1-1.6, P = 0.0007 or in the surgery ward (OR = 1.1, CI95% 1.0-1.3, P = 0.0401. Tracing and screening of contact patients, enhanced hand hygiene, cohorting and barrier nursing, as well as cleaning and disinfection were used to control the outbreak. To avoid future outbreaks and spread of MRSP a search-and-isolate policy was implemented. Currently nearly all new MRSP findings are detected in screening targeted to risk patients on admission. CONCLUSION: Multidrug resistant MRSP is capable of causing a large outbreak difficult to control. Skin lesions, antimicrobial treatment and prolonged hospital stay increase the probability of acquiring MRSP. Rigorous control

  17. Indirect costs of teaching in Canadian hospitals.

    Science.gov (United States)

    MacKenzie, T A; Willan, A R; Cox, M A; Green, A

    1991-01-01

    We sought to determine whether there are indirect costs of teaching in Canadian hospitals. To examine cost differences between teaching and nonteaching hospitals we estimated two cost functions: cost per case and cost per patient-day (dependent variables). The independent variables were number of beds, occupancy rate, teaching ratio (number of residents and interns per 100 beds), province, urbanicity (the population density of the county in which the hospital was situated) and wage index. Within each hospital we categorized a random sample of patient discharges according to case mix and severity of illness using age and standard diagnosis and procedure codes. Teaching ratio and case severity were each highly correlated positively with the dependent variables. The other variables that led to higher costs in teaching hospitals were wage rates and number of beds. Our regression model could serve as the basis of a reimbursement system, adjusted for severity and teaching status, particularly in provinces moving toward introducing case-weighting mechanisms into their payment model. Even if teaching hospitals were paid more than nonteaching hospitals because of the difference in the severity of illness there should be an additional allowance to cover the indirect costs of teaching. PMID:1898870

  18. Developing marketing strategies for university teaching hospitals.

    Science.gov (United States)

    Fink, D J

    1980-07-01

    University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, a rising tide of consumerism, and in many cases a declining urban population base. These problems, which may threaten the teaching hospital's ability to continue tertiary care, teaching, and research functions, may be solved with the aid of new marketing strategies. In developing its marketing strategy, a hospital must assess its strengths and weaknesses, specify its goals in measurable terms, implement tactics to achieve these goals, and evaluate its marketing program. The strategies should be directed toward achieving better relationships with institutions, practitioners, and surrounding communities and increasing patient, visitor, and employee satisfaction. A wide variety of programs can be used to reach these goals and to help teaching hospitals meet the competitive challenges of this decade.

  19. Reflections on Teaching a Large Class.

    Science.gov (United States)

    Miner, Rick

    1992-01-01

    Uses an analysis of small- and large-class differences as a framework for planning for and teaching a large class. Analyzes the process of developing and offering an organizational behavior class to 141 college students. Suggests ways to improve teaching effectiveness by minimizing psychological and physical distances, redistributing resources,…

  20. Did recent changes in Medicare reimbursement hit teaching hospitals harder?

    Science.gov (United States)

    Konetzka, R Tamara; Zhu, Jingsan; Volpp, Kevin G

    2005-11-01

    To inform the policy debate on Medicare reimbursement by examining the financial effects of the Balanced Budget Act of 1997 (BBA) and subsequent adjustments on major academic medical centers, minor teaching hospitals, and nonteaching hospitals. The authors simulated the impacts of BBA and subsequent BBA adjustments to predict the independent effects of changes in Medicare reimbursement on hospital revenues using 1997-2001 Medicare Cost Reports for all short-term acute-care hospitals in the United States. The authors also calculated actual (nonsimulated) operating and total margins among major teaching, minor teaching, and nonteaching hospitals to account for hospital response to the changes. The BBA and subsequent refinements reduced Medicare revenues to a greater degree in major teaching hospitals, but the fact that such hospitals had a smaller proportion of Medicare patients meant that the BBA reduced overall revenues by similar percentages across major, minor, and nonteaching hospitals. Consistently lower margins may have made teaching hospitals more vulnerable to cuts in Medicare support. Recent Medicare changes affected revenues at teaching and nonteaching hospitals more similarly than is commonly believed. However, the Medicare cuts under the BBA probably exacerbated preexisting financial strain on major teaching hospitals, and increased Medicare funding may not suffice to eliminate the strain. This report's findings are consistent with recent calls to support needed services of teaching hospitals through all-payer or general funds.

  1. Evaluation of Data Recording at Teaching Hospitals

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    Hasan Karbasi

    2009-02-01

    Full Text Available Background and purpose: Medical records of patients have an undeniable role on education, research and evaluation of health care delivery, and also could be used as reliable documents of past in casesof patients’ legal complains. This study was done to evaluate medical data recording at teaching hospital of Birjand University of Medical Sciences in 2004.Methods: In this descriptive-analytic study, 527 patients’ records of patients who had been discharged from general wards of the hospitals after 24 hours of hospitalization were randomly selected. 18 standard titles of records include in each patient’s record were evaluated using checklists. Data were analyzed using frequency distribution tables, independent t-test and Chi-square test.Results: Items on records’ titles were completed in a range of 0-100%. Titles of neonates and nursing care with 96% completeness were the most completed ones~ Titles of recovery, pre-delivery care, medical history, summary, and progress notes with 50% to 74% completeness were categorized as moderately completed titles; and titles of vital signs, pre-operation care and operation report were weak. Records of the infectious diseases ward were the most completed records (68% and the least completed were from ophthmology ward (35.8%. There were significant differences between the hospitals and between different wards.Conclusion: Results of this study show the need for further education on record writing, taking medical history, and order writing and more importantly the need for a system of continuous monitoringof the records.Keywords: MEDICAL RECORD, TEACHING HOSPITAL, EVALUATION

  2. Case Mix Complexity Differences between Teaching and Nonteaching Hospitals.

    Science.gov (United States)

    Ament, Richard P.; And Others

    1981-01-01

    The differences between teaching and nonteaching hospitals in complexity and variety of cases seen are described. The results show that teaching hospitals could be expected to cost somewhat more per patient even if case mix were the only factor. (Author/MLW)

  3. Childhood intussusception at the Moi teaching and referral hospital ...

    African Journals Online (AJOL)

    Objective: To review the management of childhood intussusception at the Moi Teaching and Referral Hospital, Eldoret and identify factors that require attention for improved outcome. Design: A retrospective descriptive study covering the period January 2000 to December 2003. Setting: Moi Teaching and Referral Hospital, ...

  4. Hospital management principles applicable to the veterinary teaching hospital.

    Science.gov (United States)

    Harris, Donna L; Lloyd, James W; Marrinan, Mike

    2004-01-01

    The Skills, Knowledge, Aptitude, and Attitude (SKA) Subcommittee of the National Commission on Veterinary Economic Issues (NCVEI) has identified the need for veterinary teaching hospitals (VTH) to be at the forefront of progressive business management to serve as a model for both students and practitioners to emulate. To provide a foundation for developing a model, this study reviewed pertinent literature applicable to the management of a VTH. Much of the literature relevant to VTH management relates to work completed for the human side of medicine (academic health centers, or AHCs) or to the private sector. This review explores management practices in strategic planning, financial management, human resource management, marketing, pricing, operations, and legal issues. It is concluded that strategic management is important to provide the foundation for success in the VTH. In addition, periodic financial reports are recommended, as are the development and use of benchmarks for financial management. Establishing positive, motivating human resource practices is also suggested, along with development of a marketing plan based on a clear understanding of VTH core competencies and the market's specific needs.

  5. Is the Current Management of Patients Presenting With Spinal Trauma to District General Hospitals Fit for Purpose? Our Experience of Delivering a Spinal Service Using an Electronic Referral Platform in a Large District General Teaching Hospital Without Onsite Spinal Services.

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    Hill, Daniel S; Marynissen, Hans

    2018-04-12

    A retrospective cross-sectional analysis. To describe the provision of a spinal service using an electronic platform to direct management from an external spinal unit, and quantify time taken to obtain definitive management plans whilst under prescribed spinal immobilization. Most attending district general hospitals following spinal trauma will have stable injuries and normal neurology, with only a small proportion requiring urgent transfer to a specialist centre. A retrospective review of 104 patients admitted following vertebral during a 12-month period. The British Orthopaedic Association Standards for Trauma consensus that "spinal immobilisation is not recommended for more than 48 hours" was the standard of care measured against. 100 patients occupied a total of 975 hospital inpatient bed days. 117 radiological investigations were requested after the point of external referral (47 CT-scans, 37 MRI-scans, and 33 weight bearing radiographs). The period between initial referral to the regional spinal service and then receiving a definitive final management had a median value of 72 hours and a range of 0 - 33 days. Patients will have been under some form of prescribed spinal immobilisation until the definitive management plan was communicated. 34 patients (34% of the overall cohort) had a definitive management plan in place within 48 hours. 80 patients had vertebral injuries (73 stable, 6 unstable), 3 patients had prolapsed intervertebral disks, 1 had metastatic disease, and 17 had not evidence of an acute injury following evaluation. Patients are being placed under prescribed immobilisation for longer than is recommended. Delays in obtaining radiological imaging were an important factor, together with the time taken to receive a definitive management plan. Limitations in social care provision and delays in arranging this were additional barriers to hospital discharge following the final management plan. 4.

  6. Management of malaria at Juba Teaching Hospital: a clinical audit

    African Journals Online (AJOL)

    2012-08-03

    Aug 3, 2012 ... Medical Department of Juba Teaching Hospital (JTH). The World ... Assess vital signs: • temperature .... March 2012. NICE 2002 Principles for best practice in Clinical Audit. 4. ... A clinical audit cycle has a number of phases: 1.

  7. Risk factors for stillbirths at Universty of Maiduguri teaching hospital ...

    African Journals Online (AJOL)

    Risk factors for stillbirths at Universty of Maiduguri teaching hospital, ... Background:Stillbirth rate is an important indicator of access to and quality of antenatal and delivery care. ... Key words: stillbirth, prevalence, aetiologic determinants ...

  8. Ischaemic heart disease in Aminu Kano Teaching Hospital, Kano ...

    African Journals Online (AJOL)

    Ischaemic heart disease in Aminu Kano Teaching Hospital, Kano, Nigeria: a 5 ... Nigerian Journal of Medicine ... Open Access DOWNLOAD FULL TEXT ... it a prevalence of 0.9% of medical conditions and 3.4% of all cardiovascular cases.

  9. Childhood pneumonia at the University of Ilorin Teaching Hospital ...

    African Journals Online (AJOL)

    owner

    2013-01-09

    Jan 9, 2013 ... which was significantly higher ... University of Ilorin Teaching Hospital between 1st July ..... two organisms formed more than 40% of the isolates. ... Educational Services; 2007:425-. 41. 3. ... Brazilian children in a metropoli-.

  10. Abdominal Injuries in University of Port Harcourt Teaching Hospital

    African Journals Online (AJOL)

    operative findings, postoperative complications, and outcome of management. Data analysis was performed using the Statistical Package for Social Sciences version 16. Abdominal Injuries in University of Port Harcourt. Teaching Hospital. Amabra ...

  11. The Hospitalist Huddle: a 1-year experience of teaching Hospital Medicine utilizing the concept of peer teaching in medical education.

    Science.gov (United States)

    Elhassan, Mohammed

    2017-01-01

    The relatively new specialty of Hospital Medicine in the USA is one of the fastest growing fields in internal medicine. Academic hospitalists are largely involved in the medical education of postgraduate residents and medical students. Little is known about the effectiveness of peer-to-peer teaching in internal medicine residency training programs and how the medical residents perceive its educational value in learning Hospital Medicine. The Hospitalist Huddle is a weekly educational activity newly established by our Hospitalist Division to facilitate the concept of peer-to-peer teaching. It requires medical residents to teach and educate their peers about the clinical topics related to Hospital Medicine. Faculty hospitalists serve as facilitators during the teaching sessions. A survey disseminated at the end of the first year of its implementation examined the residents' perception of the educational value of this new teaching activity. Most residents reported that they see the Huddle as a useful educational forum which may improve their skills in teaching, create a better educational and learning environment during their inpatient rotation, and improve their understanding of Hospital Medicine. Most residents also prefer that their peers, rather than faculty hospitalists, run the activity and do the teaching. The survey results support the notion that teaching and learning with flat hierarchies can be an appealing educational method to medical residents to help them understand Hospital Medicine during their medical wards rotation. Some areas need to be improved and others need to be continued and emphasized in order to make this novel educational activity grow and flourish in terms of its educational value and residents' satisfaction.

  12. Creative payment strategy helps ensure a future for teaching hospitals.

    Science.gov (United States)

    Vancil, D R; Shroyer, A L

    1998-11-01

    The Colorado Medicaid Program in years past relied on disproportionate share hospital (DSH) payment programs to increase access to hospital care for Colorado citizens, ensure the future financial viability of key safety-net hospitals, and partially offset the state's cost of funding the Medicaid program. The options to finance Medicaid care using DSH payments, however, recently have been severely limited by legislative and regulatory changes. Between 1991 and 1997, a creative Medicaid refinancing strategy called the major teaching hospital (MTH) payment program enabled $131 million in net payments to be distributed to the two major teaching hospitals in Colorado to provide enhanced funding related to their teaching programs and to address the ever-expanding healthcare needs of their low-income patients. This new Medicaid payment mechanism brought the state $69.5 million in Federal funding that otherwise would not have been received.

  13. Stroke Among Young Adults at the LAUTECH Teaching Hospital ...

    African Journals Online (AJOL)

    Stroke Among Young Adults at the LAUTECH Teaching Hospital, Osogbo, Nigeria. AF Mustapha, EO Sanya, TO Bello. Abstract. Background: Stroke in young adults is relatively rare and there are very few hospital reports about it in Nigeria. The aetiologic mechanisms of stoke among young adults are quite distinct from ...

  14. 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.

  15. Candiduria in hospitalized patients in teaching hospitals of Ahvaz.

    Science.gov (United States)

    Zarei-Mahmoudabadi, A; Zarrin, M; Ghanatir, F; Vazirianzadeh, B

    2012-12-01

    Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran. During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten µl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80. In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male). The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%), followed by C. glabrata (24.4%), C. tropicalis (3.7%), C. krusei (2.2%), and Geotrichum spp. (0.7%) Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%). Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.

  16. Teaching Writing and Critical Thinking in Large Political Science Classes

    Science.gov (United States)

    Franklin, Daniel; Weinberg, Joseph; Reifler, Jason

    2014-01-01

    In the interest of developing a combination of teaching techniques designed to maximize efficiency "and" quality of instruction, we have experimentally tested three separate and relatively common teaching techniques in three large introductory political science classes at a large urban public university. Our results indicate that the…

  17. Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital

    Directory of Open Access Journals (Sweden)

    Colin Lee

    2015-06-01

    Conclusion: This prospective point prevalence survey provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship initiatives. A multi-center point prevalence survey should be considered to identify patterns of antimicrobial use in Canada and to establish the first steps toward international antimicrobial surveillance.

  18. NICU OUTCOME IN A LOW RESOURCE TEACHING HOSPITAL SETTING

    OpenAIRE

    Sunil; Adarsh; Sahana; Prema; Tamil; Purushotham; Rajanish; Sebastain

    2013-01-01

    OBJECTIVE : To study the mortality pattern in a level III neonatal intensive care unit (NICU)in a low resource teaching hospital. METHODS : A retrospective study was conducted over a period of three years from January 2011 to December 2013. The medical records of all babies who died after being admitte d to the NICU were reviewed. Survival was defined as the discharge of a live infant from the hospital. Data regarding...

  19. Acute appendicitis in Olabisi Onabanjo University Teaching Hospital ...

    African Journals Online (AJOL)

    The hospital is a tertiary care facility in competition with a large number of private hospitals with different levels of competence. Objective: The objective of the study is to review the outcome of the surgical management of acute appendicitis in our hospital. Method: A retrospective study of subjects who had appendectomy for ...

  20. Incidence of iatrogenic pneumothorax in the United States in teaching vs. non-teaching hospitals from 2000 to 2012.

    Science.gov (United States)

    John, Jason; Seifi, Ali

    2016-08-01

    Iatrogenic pneumothorax is a patient safety indicator (PSI) representing a complication of procedures such as transthoracic needle aspiration, subclavicular needle stick, thoracentesis, transbronchial biopsy, pleural biopsy, and positive pressure ventilation. This study examined whether there was a significant difference in rate of iatrogenic pneumothorax in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. We performed a retrospective cohort study on iatrogenic pneumothorax incidence from 2000 to 2012 using the Healthcare Cost and Utilization Project (HCUP) database. Pairwise t tests were performed. Odds ratios and P values were calculated, using a Bonferroni-adjusted α threshold, to examine differences in iatrogenic pneumothorax incidence in teaching vs. non-teaching hospitals. Our study revealed that after the year 2000, teaching hospitals had significantly greater iatrogenic pneumothorax incidence compared to non-teaching hospitals in every year of the study period (Ppneumothorax occurred with significantly greater incidence in teaching hospitals compared to non-teaching hospitals from 2000 to 2012. This trend may have been enhanced by the residency duty-hour regulations implemented in 2003 in teaching institutions, or due to higher rates of procedures in teaching institutions due to the nature of a tertiary center. Iatrogenic pneumothorax was more prevalent in teaching hospitals compared to non-teaching hospitals after the year 2000. Further randomized control studies are warranted to evaluate the etiology of this finding. Published by Elsevier Inc.

  1. Are medical students accepted by patients in teaching hospitals?

    Directory of Open Access Journals (Sweden)

    Yousef Marwan

    2012-04-01

    Full Text Available Background: Worldwide, patients are the cornerstone of bedside teaching of medical students. In this study, the authors aimed to assess patients’ acceptability toward medical students in teaching hospitals of the Faculty of Medicine of Kuwait University. Methods: Ninehundred and ninety five patients were approached in 14 teaching hospitals; 932 patients agreed to participate (refusal rate is 6.3%. A self-administered questionnaire was used to collect data. Results: In general, higher acceptance of students by patients was found when there is no direct contact between the patient and the student (e.g., reading patients’ files, presenting in outpatient clinic, observing doctors performing examination or procedures compared to other situations (e.g., performing physical examination or procedures. Pediatrics patients showed higher acceptance of students compared to patients in other specialties, while Obstetrics/Gynecology patients showed the highest refusal of students. Gender of patients (especially females and students appeared to affect the degree of acceptance of medical students by patients. Majority of the patients (436; 46.8% believed that the presence of medical students in hospitals improves the quality of health care. Conclusion: Patients are an important factor of bedside teaching. Clinical tutors must take advantage of patients who accept medical students. Clinical tutors and medical students should master essential communication skills to convince patients in accepting students, thus improving bedside teaching. Also, using simulation and standardization should be considered to address scenarios that most patients are unwilling to allow students to participate.

  2. Burkholderia cepacia infection at A university Teaching Hospital in ...

    African Journals Online (AJOL)

    Twenty five isolates of B. cepacia, representing 1.4% of all isolates, were obtained at the Microbiology Laboratory of a University Teaching Hospital in Lagos between January 1996 and December 1997. Identification of isolates was done using analytical profile index systems (Biomerieux, France) and sensitivity testing was ...

  3. Endometrial pathology in a teaching hospital in North Central ...

    African Journals Online (AJOL)

    The study was a 5 year histopathological survey of endometrial biopsies seen at the University of Ilorin Teaching Hospital , Ilorin, North Central Nigeria from January 1st 1997 to December 31st 2001. It aimed at identifying the morphological patterns of endometrial disorders, prevalence of these disorders and the ...

  4. Childhood Nephrotic Syndrome in Aminu Kano Teaching Hospital ...

    African Journals Online (AJOL)

    Methods: A prospective study spanning two years (July 2002 – August 2004). Twenty two children with nephrotic syndrome were seen ate the Aminu Kano Teaching Hospital, Kano. The demographic, clinical and laboratory features and response to treatment were documented. Results: Nephritic syndrome made up of 1.2% ...

  5. Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin ...

    African Journals Online (AJOL)

    Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin. AAG Jimoh, OR Balogun, Abubakar Danladi. Abstract. During a five-year period between 1st January 1995 to 31st December 1999, three hundred and twenty eight cases of obstructed labour were encountered out of a total of 12,614 deliveries managed ...

  6. Audit of day case surgery in LAUTECH teaching hospital, Osogbo ...

    African Journals Online (AJOL)

    Background/ method: A retrospective study of all patients operated as day-case at the Ladoke Akintola University Teaching Hospital Osogbo over a period of 14 months (October 2000 to November 2001) was carried out. Results: Seventy-six patients were operated as day-cases within the study period, but 74 case notes ...

  7. Medical Audit: A Nigerian Teaching Hospital's Preliminary Experience

    African Journals Online (AJOL)

    The definition, historical background, aims dimensions and the characteristics of medical audit as well as the indices to be measured in a medical audit exercise are highlighted. The preliminary experience of the University of Ilorin Teaching Hospital (UITH) in the planning, implementation and monitoring of a viable medical ...

  8. Ectopic Pregnancy in Lagos State University Teaching Hospital ...

    African Journals Online (AJOL)

    We set out to determine the socio-demographic factors,pattern of presentation and management of ectopic pregnancy in a University Teaching Hospital in Lagos, Nigeria. A retrospective descriptive analysis of all cases of ectopic pregnancy over a 2-year period was carried out. The case notes were retrieved from the ...

  9. Uniocular blindness in Delta State Teaching Hospital, Oghara, Nigeria

    African Journals Online (AJOL)

    Background: Uniocular blindness causes loss of binocular single vision. People with uniocular blindness are potentially at risk of developing binocular blindness. Aim: To determine the prevalence rate, causes and risk factors for uniocular blindness in a teaching hospital in southern Nigeria over a one-year period. Methods: ...

  10. Epidemiology of open tibial fractures in a teaching hospital ...

    African Journals Online (AJOL)

    Methods: This is a prospective observational study of all open tibial fractures seen at the Accident and Emergency department of the University of Port Harcourt Teaching Hospital (UPTH) over a twelve- month period (July 2002- June 2003). Data from a pre-designed proforma for the study was analyzed and descriptive ...

  11. Anaemia in Pregnancy in Abia State University Teaching Hospital, Aba

    African Journals Online (AJOL)

    A prospective study of incidence of anaemia in pregnancy at Abia state University Teaching Hospital, Aba was conducted over a six-month period spanning from 31st January 2000 to 31st July 2000. The incidence of anaemia in pregnancy was 29%. The vast majority (97.6%) had mild anaemia. The result showed that most ...

  12. Overviewof Contraceptive Use In Jos University Teaching Hospital ...

    African Journals Online (AJOL)

    Background: Modern contraceptive methods accepted by 17,846 new clients in Jos University Teaching Hospital, a tertiary health institution, over two decades are presented. Methods: This was a review of the contraceptive trend in new clients who used the various methods of contraception over an 18-year period, ...

  13. Introduction of bubble CPAP in a teaching hospital in Malawi

    NARCIS (Netherlands)

    Van den Heuvel, M.; Blencowe, H.; Mittermayer, K.; Rylance, S.; Couperus, A.; Heikens, G. T.; Bandsma, R. H. J.

    Background: Continuous positive airway pressure (CPAP) is relatively inexpensive and can be easily taught; it therefore has the potential to be the optimal respiratory support device for neonates in developing countries. Objective: The possibility of implementing bubble CPAP in a teaching hospital

  14. Health workers' ICT literacy in a Nigerian University Teaching Hospital

    African Journals Online (AJOL)

    This study investigated the ICT literacy among the health workers of Igbinedion University Teaching Hospital. The emergence of Internet for Telemedicine and health information revolution necessitates that issue of computer and other communication technology literacy among the health workers of Igbinedion University ...

  15. Vacuum Delivery in Jos University Teaching Hospital, Jos, Nigeria ...

    African Journals Online (AJOL)

    Obstetric practice continues to change, particularly assisted vaginal delivery. Vacuum delivery is a mode of delivery technique in Jos University Teaching Hospital (JUTH) in the maternity unit. The objective of the study was to determine the rate of ventouse delivery, its indications, and maternal and fetal morbidity in our ...

  16. Outpatient waiting time in Jos University Teaching Hospital ...

    African Journals Online (AJOL)

    Problem Long waiting time for services has been identified as a reason people avoid presenting to for care in African countries. Design Examination of causes for long outpatient waiting time and the effect of measures to reduce waiting time. Setting Outpatient department of the Jos University Teaching Hospital.

  17. Racial Disparity in Duration of Patient Visits to the Emergency Department: Teaching Versus Non-teaching Hospitals

    Directory of Open Access Journals (Sweden)

    Zynal Karaca

    2013-09-01

    Full Text Available Introduction: The sources of racial disparity in duration of patients’ visits to emergency departments (EDs have not been documented well enough for policymakers to distinguish patient-related factors from hospital- or area-related factors. This study explores the racial disparity in duration of routine visits to EDs at teaching and non-teaching hospitals.Methods: We performed retrospective data analyses and multivariate regression analyses to investigate the racial disparity in duration of routine ED visits at teaching and non-teaching hospitals. The Healthcare Cost and Utilization Project (HCUP State Emergency Department Databases (SEDD were used in the analyses. The data include 4.3 million routine ED visits encountered in Arizona, Massachusetts, and Utah during 2008. We computed duration for each visit by taking the difference between admission and discharge times.Results: The mean duration for a routine ED visit was 238 minutes at teaching hospitals and 175 minutes at non-teaching hospitals. There were significant variations in duration of routine ED visits across race groups at teaching and non-teaching hospitals. The risk-adjusted results show that the mean duration of routine ED visits for Black/African American and Asian patients when compared to visits for white patients was shorter by 10.0 and 3.4%, respectively, at teaching hospitals; and longer by 3.6 and 13.8%, respectively, at non-teaching hospitals. Hispanic patients, on average, experienced 8.7% longer ED stays when compared to white patients at non-teaching hospitals.Conclusion: There is significant racial disparity in the duration of routine ED visits, especially in non-teaching hospitals where non-White patients experience longer ED stays compared to white patients. The variation in duration of routine ED visits at teaching hospitals when compared to non-teaching hospitals was smaller across race groups. [West J Emerg Med. 2013;14(5:529–541.

  18. 42 CFR 415.190 - Conditions of payment: Assistants at surgery in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... teaching hospitals. 415.190 Section 415.190 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.190 Conditions of payment: Assistants at surgery in teaching hospitals. (a...

  19. Introduction of bubble CPAP in a teaching hospital in Malawi.

    Science.gov (United States)

    van den Heuvel, M; Blencowe, H; Mittermayer, K; Rylance, S; Couperus, A; Heikens, G T; Bandsma, R H J

    2011-01-01

    Continuous positive airway pressure (CPAP) is relatively inexpensive and can be easily taught; it therefore has the potential to be the optimal respiratory support device for neonates in developing countries. The possibility of implementing bubble CPAP in a teaching hospital with a large neonatology unit but very limited resources was investigated. A CPAP system was developed consisting of a compressor, oxygen concentrator, water bottle to control the pressure and binasal prongs. Neonates with birthweights between 1 and 2·5 kg with persistent respiratory distress 4 hours after birth were eligible for bubble CPAP. In the 7-week introduction period from 11 March until 27 April 2008, 11 neonates were treated with CPAP. Five of these neonates met the inclusion criteria and six neonates did not meet these criteria. Of the five neonates who received CPAP and met the inclusion criteria, three survived. The six infants who did not meet the inclusion criteria included three preterm infants with apnoea (all died), two with birthweights CPAP occurred. Bubble CPAP could be used independently by nurses after a short training period. Successful long-term implementation of CPAP depends on the availability of sufficient trained nursing staff.

  20. [Costs of serious adverse events in a community teaching hospital, in Mexico].

    Science.gov (United States)

    Gutiérrez-Mendoza, Luis Meave; Torres-Montes, Abraham; Soria-Orozco, Manuel; Padrón-Salas, Aldanely; Ramírez-Hernández, María Elizabeth

    2015-01-01

    Serious adverse events during hospital care are a worldwide reality and threaten the safety of the hospitalised patient. To identify serious adverse events related to healthcare and direct hospital costs in a Teaching Hospital in México. A study was conducted in a 250-bed Teaching Hospital in San Luis Potosi, Mexico. Data were obtained from the Quality and Patient Safety Department based on 2012 incidents report. Every event was reviewed and analysed by an expert team using the "fish bone" tool. The costs were calculated since the event took place until discharge or death of the patient. A total of 34 serious adverse events were identified. The average cost was $117,440.89 Mexican pesos (approx. €7,000). The great majority (82.35%) were largely preventable and related to the process of care. Undergraduate medical staff were involved in 58.82%, and 14.7% of patients had suffered adverse events in other hospitals. Serious adverse events in a Teaching Hospital setting need to be analysed to learn and deploy interventions to prevent and improve patient safety. The direct costs of these events are similar to those reported in developed countries. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  1. Drug-food interaction counseling programs in teaching hospitals.

    Science.gov (United States)

    Wix, A R; Doering, P L; Hatton, R C

    1992-04-01

    The results of a survey to characterize drug-food interaction counseling programs in teaching hospitals and solicit opinions on these programs from pharmacists and dietitians are reported. A questionnaire was mailed to the pharmacy director and the director of dietary services at teaching hospitals nationwide. The questionnaire contained 33 questions relating to hospital characteristics, drug-food interaction counseling programs, and the standard calling for such programs issued by the Joint Commission on Accreditation of Healthcare Organizations. Of 792 questionnaires mailed, 425 were returned (response rate, 53.7). A majority of the pharmacists and dietitians (51.2%) did not consider their drug-food interaction counseling program to be formal; some had no program. The pharmacy department was involved more in program development than in the daily operation of such programs. The most frequent methods of identifying patients for counseling were using lists of patients' drugs and using physicians' orders. A mean of only five drugs were targeted per program. Slightly over half the respondents rated the Joint Commission standard less effective than other standards in its ability to improve patient care. A majority of teaching hospitals did not have formal drug-food interaction counseling programs. Pharmacists and dietitians did not view these programs as greatly beneficial and did not believe that the Joint Commission has clearly delineated the requirements for meeting its standard.

  2. [Impact of the funding reform of teaching hospitals in Brazil].

    Science.gov (United States)

    Lobo, M S C; Silva, A C M; Lins, M P E; Fiszman, R

    2009-06-01

    To assess the impact of funding reform on the productivity of teaching hospitals. Based on the Information System of Federal University Hospitals of Brazil, 2003 and 2006 efficiency and productivity were measured using frontier methods with a linear programming technique, data envelopment analysis, and input-oriented variable returns to scale model. The Malmquist index was calculated to detect changes during the study period: 'technical efficiency change,' or the relative variation of the efficiency of each unit; and 'technological change' after frontier shift. There was 51% mean budget increase and improvement of technical efficiency of teaching hospitals (previously 11, 17 hospitals reached the empirical efficiency frontier) but the same was not seen for the technology frontier. Data envelopment analysis set benchmark scores for each inefficient unit (before and after reform) and there was a positive correlation between technical efficiency and teaching intensity and dedication. The reform promoted management improvements but there is a need of further follow-up to assess the effectiveness of funding changes.

  3. [Noise level in a care and teaching hospital institution].

    Science.gov (United States)

    Mendoza-Sánchez, R S; Roque-Sánchez, R H; Moncada-González, B

    1996-01-01

    Noise in the environment is increasing over the years. Disturbances produced by noise are varied, some lead to serious health consequences. Noise level was registered in a teaching hospital. Levels in the wards were between 50 and 59 dB. In the Intensive Care Unit, main hallways and outpatients department levels were higher than 59 dB. Isolated peaks up to 90.0 dB (Pediatrics) were detected. The noise level recommended for a hospital is under 50.0 dB. We found that the principal source of noise came from the medical and nursing staff.

  4. Evaluation of drug administration errors in a teaching hospital

    OpenAIRE

    Berdot, Sarah; Sabatier, Brigitte; Gillaizeau, Florence; Caruba, Thibaut; Prognon, Patrice; Durieux, Pierre

    2012-01-01

    Abstract Background Medication errors can occur at any of the three steps of the medication use process: prescribing, dispensing and administration. We aimed to determine the incidence, type and clinical importance of drug administration errors and to identify risk factors. Methods Prospective study based on disguised observation technique in four wards in a teaching hospital in Paris, France (800 beds). A pharmacist accompanied nurses and witnessed the preparation and administration of drugs...

  5. Occupational exposures among healthcare workers: A teaching hospital sample

    OpenAIRE

    Derya Öztürk Engin; Asuman İnan; Nurgül Ceran; Zeynel Abiddin Demir; Özgür Dağli; Emin Karagül; Seyfi Özyürek

    2014-01-01

    Objective: Healthcare workers (HCWs) are at risk for occupational injury associated with contaminated blood and body fluids. This study aims to examine the frequency and type of occupational injuries and to determine best practices after exposure. Methods: A cross-sectional study was conducted in Haydarpaşa Teaching Hospital in December 2010. The questionnaires were completed by healthcare workers with face-to-face interviews. The questionnaire was evaluated occupational injuries in the ho...

  6. Teaching hospital performance: towards a community of shared values?

    Science.gov (United States)

    Mauro, Marianna; Cardamone, Emma; Cavallaro, Giusy; Minvielle, Etienne; Rania, Francesco; Sicotte, Claude; Trotta, Annarita

    2014-01-01

    This paper explores the performance dimensions of Italian teaching hospitals (THs) by considering the multiple constituent model approach, using measures that are subjective and based on individual ideals and preferences. Our research replicates a study of a French TH and deepens it by adjusting it to the context of an Italian TH. The purposes of this research were as follows: to identify emerging views on the performance of teaching hospitals and to analyze how these views vary among hospital stakeholders. We conducted an in-depth case study of a TH using a quantitative survey method. The survey uses a questionnaire based on Parsons' social system action theory, which embraces the major models of organizational performance and covers three groups of internal stakeholders: physicians, caregivers and administrative staff. The questionnaires were distributed between April and September 2011. The results confirm that hospital performance is multifaceted and includes the dimensions of efficiency, effectiveness and quality of care, as well as organizational and human features. There is a high degree of consensus among all observed stakeholder groups about these values, and a shared view of performance is emerging. Our research provides useful information for defining management priorities to improve the performance of THs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Relationship between organizational structure and creativity in teaching hospitals.

    Science.gov (United States)

    Rezaee, Rita; Marhamati, Saadat; Nabeiei, Parisa; Marhamati, Raheleh

    2014-07-01

    Organization structure and manpower constitute two basic components of anorganization and both are necessary for stablishing an organization. The aim of this survey was to investigate the type of the organization structure (mechanic and organic) from viewpoint of senior and junior managers in Shiraz teaching hospitals and creativity in each of these two structures. In this cross-sectional and descriptive-analytic study, organization structure and organizational creation questionnaires were filled out by hospital managers. According to the statistical consultation and due to limited target population, the entire study population was considered as sample. Thus, the sample size in this study was 84 (12 hospitals and every hospital, n = 7). For data analysis, SPSS 14 was used and Spearman correlation coefficient and t-test were used. RESULTS showed that there is a negative association between centralization and complexity with organizational creation and its dimensions. Also there was a negative association between formalization and 4 organizational creation dimensions: reception change, accepting ambiguity, abet new view and less control outside (p=0.001). The results of this study showed that the creation in hospitals with organic structure is more than that in hospitals with mechanic structure.

  8. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  9. Maternity and parental leave policies at COTH hospitals: an update. Council of Teaching Hospitals.

    Science.gov (United States)

    Philibert, I; Bickel, J

    1995-11-01

    Because residents' demands for parental leave are increasing, updated information about maternity and paternity leave policies was solicited from hospitals that are members of the Council of Teaching Hospitals (COTH) of the AAMC. A 20-item questionnaire, combining forced-choice categories and open-ended questions, was faxed to 405 COTH hospitals in October 1994; 45% responded. A total of 77% of the respondents reported having written policies for maternity and/or parental leave; in 1989, only 52% of COTH hospitals had reported having such policies. Forty-one percent of the 1994 responding hospitals offered dedicated paid maternity leave, with a mean of 42 days allowed. Twenty-five percent of the respondents offered paternity leave, and 15% offered adoption leave. It is encouraging that the majority of the teaching hospitals that responded to the survey had adopted written policies, but the 23% without written policies remain a source of concern. Well-defined policies for maternity, paternity, and adoption leave can reduce stress and foster equity both for trainees requiring leave and for their colleagues.

  10. Cataract surgery audit at an Australian urban teaching hospital.

    Science.gov (United States)

    Kahawita, Shyalle K; Goggin, Michael

    2015-08-01

    To provide local data on visual acuity and surgical outcomes for cataract surgery performed in an Australian teaching hospital. Continuous audit over 7 years in a public teaching hospital. A total of 3740 eyes had cataract surgery performed at The Queen Elizabeth Hospital, South Australia, from May 2006 to September 2013. Visual acuity and complication rates were recorded for cataract surgery cases operated on between May 2006 and September 2013 on a digital database with data entry contemporaneous with final follow-up. Visual acuity and surgical complications. Of the patients, 91.4% achieved postoperative best-measured vision better than preoperative best-measured vision. The rate of posterior capsular tear was 2.59%, endophthalmitis was 0.11% and the overall complication rate was 11.7%. This audit is the first to document modern cataract surgery, overwhelmingly dominated by phacoemulsification in an Australian population and can be used to benchmark cataract surgery outcome in an urban Australian population. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

  11. Do guidelines influence results in inguinal hernia treatment? A descriptive study of 2,535 hernia repairs in one teaching hospital from 1994 to 2004

    NARCIS (Netherlands)

    Aufenacker, T. J.; Schmits, S. P.; Gouma, D. J.; Simons, M. P.

    2009-01-01

    BACKGROUND: The Onze Lieve Vrouwe Gasthuis (OLVG) hospital is a large district teaching hospital with a residency programme for general surgery. Since 1998, inguinal hernia (IH) repairs in this hospital were performed according to the preliminary "evidence-based guidelines" concerning IH repair. The

  12. 78 FR 32663 - Medicare Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for...

    Science.gov (United States)

    2013-05-31

    ...] Medicare Program; Notification of Closure of Teaching Hospitals and Opportunity To Apply for Available... announces the closure of two teaching hospitals and the initiation of an application process where hospitals... modifying language at section 1886(d)(5)(B)(v) of the Act, to instruct the Secretary to establish a process...

  13. Advanced Hysteroscopic Surgery: Quality Assurance in Teaching Hospitals.

    Science.gov (United States)

    Erian, Mark M S; McLaren, Glenda R; Erian, Anna-Marie

    2017-01-01

    Advanced hysteroscopic surgery (AHS) is a vitally important technique in the armamentarium for the management of many day-to-day clinical problems, such as menorrhagia, surgical excision of uterine myomata and septa in the management of female infertility, hysteroscopic excision of chronically retained products of conception (placenta accreta), and surgical removal of intramural ectopic pregnancy. In today's climate of accountability, it is necessary that gynecologists take a more active role in assuring the quality of their work. In this article, we discuss the quality assurance system from the point of view of the surgical audit meetings in some of the major teaching hospitals affiliated with the University of Queensland (Brisbane, Queensland, Australia).

  14. Faculty Perceptions of Multicultural Teaching in a Large Urban University

    Science.gov (United States)

    Bigatti, Sylvia M.; Gibau, Gina Sanchez; Boys, Stephanie; Grove, Kathy; Ashburn-Nardo, Leslie; Khaja, Khadiji; Springer, Jennifer Thorington

    2012-01-01

    As college graduates face an increasingly globalized world, it is imperative to consider issues of multicultural instruction in higher education. This study presents qualitative and quantitative findings from a survey of faculty at a large, urban, midwestern university regarding perceptions of multicultural teaching. Faculty were asked how they…

  15. Universal Design for Learning in Teaching Large Lecture Classes

    Science.gov (United States)

    Dean, Tereza; Lee-Post, Anita; Hapke, Holly

    2017-01-01

    To augment traditional lecture with instructional tools that provide options for content representation, learner engagement, and learning expression, we followed the Universal Design for Learning (UDL) principles to design and implement a learning environment for teaching and learning in large lecture classes. To this end, we incorporated four…

  16. Teaching Multiplication of Large Positive Whole Numbers Using ...

    African Journals Online (AJOL)

    This study investigated the teaching of multiplication of large positive whole numbers using the grating method and the effect of this method on students' performance in junior secondary schools. The study was conducted in Obio Akpor Local Government Area of Rivers state. It was quasi- experimental. Two research ...

  17. Strategies for Teaching and Managing Large Classes in University ...

    African Journals Online (AJOL)

    Followed by 'automate assessment tasks where possible (e.g. online quizzes)' with (Mean 3.0, SD = .899) (effective assessment practices) and 'evaluating student understanding regularly through Mini quizzes, short test, class work or True/False responses' with (Mean 2.8, SD = .752) (managing and teaching large classes).

  18. Changing Beliefs about Teaching in Large Undergraduate Mathematics Classes

    Science.gov (United States)

    Kensington-Miller, Barbara; Sneddon, Jamie; Yoon, Caroline; Stewart, Sepideh

    2013-01-01

    Many lecturers use teacher-centred styles of teaching in large undergraduate mathematics classes, often believing in the effectiveness of such pedagogy. Changing these beliefs about how mathematics should be taught is not a simple process and many academic staff are reluctant to change their ways of lecturing due to tradition and ease. This study…

  19. Technical Efficiency of Teaching Hospitals in Iran: The Use of Stochastic Frontier Analysis, 1999–2011

    Directory of Open Access Journals (Sweden)

    Reza Goudarzi

    2014-07-01

    Full Text Available Background Hospitals are highly resource-dependent settings, which spend a large proportion of healthcare financial resources. The analysis of hospital efficiency can provide insight into how scarce resources are used to create health values. This study examines the Technical Efficiency (TE of 12 teaching hospitals affiliated with Tehran University of Medical Sciences (TUMS between 1999 and 2011. Methods The Stochastic Frontier Analysis (SFA method was applied to estimate the efficiency of TUMS hospitals. A best function, referred to as output and input parameters, was calculated for the hospitals. Number of medical doctors, nurses, and other personnel, active beds, and outpatient admissions were considered as the input variables and number of inpatient admissions as an output variable. Results The mean level of TE was 59% (ranging from 22 to 81%. During the study period the efficiency increased from 61 to 71%. Outpatient admission, other personnel and medical doctors significantly and positively affected the production (P< 0.05. Concerning the Constant Return to Scale (CRS, an optimal production scale was found, implying that the productions of the hospitals were approximately constant. Conclusion Findings of this study show a remarkable waste of resources in the TUMS hospital during the decade considered. This warrants policy-makers and top management in TUMS to consider steps to improve the financial management of the university hospitals.

  20. Nutritional Assessment in Elderly Hospitalized Patients in Qazvin Teaching Hospitals in 2011

    Directory of Open Access Journals (Sweden)

    Azam Ghorbani

    2013-04-01

    Full Text Available Objectives: Nutritional status in the elderly is an important issue in developing countries has been little attention to it. It results from complex interaction between personal and environmental factors that have a considerable effect on mortality, morbidity and quality of life of elderly people especially the hospitalized ones. The aim of this study was to investigate nutritional status in elderly hospitalized patients in Qazvin Teaching Hospitals and know Influential factors to plan appropriate programs for improving their health. Methods & Materials: In this cross-sectional study 233 elderly (151 women and 171 men aging more than 60 years, hospitalized in two hospitals in Qazvin city were studied. Nutritional status were evaluated using Mini Nutritional Assessment, The nutritional status was classified into: malnourished, risk of malnutrition and without malnutrition (adequate. Results: Among the assessed elderly 29.8% were well nourish, 13.4% malnourished and 42.95 at risk of malnutrition. There was more malnutrition in females compared to males (25.8% vs 7.2 P=23(62.5% vs. 12.6% P<0.001, Statistical analysis of the studied variables showed that nutritional status were significantly associated with Age, BMI, WC and WHR Conclusion: This study confirms a high prevalence of malnutrition risk in hospitalized elderly patients. The assessment of nutritional status with MNA that can facilitate evaluation of the nutritional status of elderly individuals in hospitals

  1. Point prevalence of hospital-acquired infections in two teaching hospitals of Amhara region in Ethiopia

    Directory of Open Access Journals (Sweden)

    Yallew WW

    2016-08-01

    Full Text Available Walelegn Worku Yallew,1 Abera Kumie,2 Feleke Moges Yehuala3 1Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, 2School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, 3Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Purpose: Hospital-acquired infection (HAI is a major safety issue affecting the quality of care of hundreds of millions of patients every year, in both developed and developing countries, including Ethiopia. In Ethiopia, there is no comprehensive research that presents the whole picture of HAIs in hospitals. The objective of this study was to examine the nature and extent of HAIs in Ethiopia. Methods: A repeated cross-sectional study was conducted in two teaching hospitals. All eligible inpatients admitted for at least 48 hours on the day of the survey were included. The survey was conducted in dry and wet seasons of Ethiopia, that is, in March to April and July 2015. Physicians and nurses collected the data according to the Centers for Disease Control and Prevention definition of HAIs. Coded and cleaned data were transferred to SPSS 21 and STATA 13 for analysis. Univariate and multivariable logistic regression analyses were used to examine the prevalence of HAIs and relationship between explanatory and outcome variables. Results: A total of 908 patients were included in this survey, the median age of the patients was 27 years (interquartile range: 16–40 years. A total of 650 (71.6% patients received antimicrobials during the survey. There were 135 patients with HAI, with a mean prevalence of 14.9% (95% confidence interval 12.7–17.1. Culture results showed that Klebsiella spp. (22.44% and Staphylococcus aureus (20.4% were the most commonly isolated HAI-causing pathogens in these hospitals. The association of patient age and hospital type with the occurrence of HAI was

  2. Nursing Care Systematization: A Study At A Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Louise Passos Vigolvino Macêdo

    2017-03-01

    Full Text Available Objective: Investigate the understanding of nurses who work at a teaching hospital, in relation to NCS and the nursing process; ascertain facilities/difficulties related to the applicability of the nursing process in that service; and verify the opinions of those professionals for the improvement and/or effectiveness of the nursing process at the hospitalization units of the hospital. Method: Exploratory, descriptive study, with a qualitative approach. The sample consisted of 42 nurses who answered a questionnaire. The empirical material was analyzed and categorized based on the content analysis technique and discussed in the light of the literature. Results: From the participants' discourses, two categories of analysis emerged: 1 understanding of NCS as a tool to organize the Nursing work process and improve the quality of care; and 2 applicability of the nursing process at the various hospitalization units of the institution. Conclusion: The implementation and applicability of that method depend on not only the knowledge and motivation of the nursing professionals, but also on a strategic planning involving management and staff, from the recognition of their importance in order to obtain adherence and effective operationalization in practice. Descriptors: Nursing; Nursing Process; Professional Practice.

  3. Laryngeal cancer at the Korle Bu Teaching Hospital Accra Ghana

    International Nuclear Information System (INIS)

    Kitcher, E.D.; Cheyuo, C.; Yarney, J.; Gyasi, R. K.

    2006-01-01

    Laryngeal cancer is the commonest head and neck cancer seen at the Ear Nose and Throat (ENT) Unit Korle Bu Teaching Hospital. The aim of this study was to determine the number of cases of laryngeal cancer seen at the Korle Bu Teaching Hospital, establish epidemiological parameters of the disease and to outline preventive measures. One hundred and fifteen (115) patients who were managed for laryngeal cancer from 1st January 1998 to 31st December 2003 were studied retrospectively with respect to age, sex, duration of symptoms at presentation, risk factors, symptoms complex, histopathology, stage of tumor, details of treatment offered and follow up. The age range was 17-85 years with a mean of 55.5 years (SD10.7). Majority of the patients (90.4%) were above 40 years. The commonest symptom at presentation was dysphonia. A significant proportion of cases (37.3%) presented with locally advanced disease. The commonest histological type of laryngeal tumour seen was squamous cell carcinoma. The treatment offered consisted of radiotherapy for 83 (79.8%) patients and total laryngectomy with neck dissection when necessary for 17 (16.3%) patients who also had postoperative radiotherapy. Only 58 (69.9%) patients completed radiotherapy treatment and in all 32 (24.3 %) patients did not report for any treatment. Majority of patients failed to report for post treatment follow-up. We conclude that significant number of patients with laryngeal cancer presented with locally advanced disease and dysphonia was the commonest symptom. (au)

  4. Pattern of heart failure in a Nigerian teaching hospital

    Directory of Open Access Journals (Sweden)

    Arthur C Onwuchekwa

    2009-09-01

    Full Text Available Arthur C Onwuchekwa, Godspower E AsekomehDepartment of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, NigeriaBackground: Congestive cardiac failure (CCF has emerged as a major public health problem worldwide and imposes an escalating burden on the health care system. Objective: To determine the causes and mortality rate of CCF in the University of Port Harcourt Teaching Hospital (UPTH, south Nigeria, over a five-year period from January 2001 to December 2005.Methods: A retrospective study of CCF cases were identified from the admission and discharge register of the medical wards of UPTH and the case notes were retrieved from the medical records department and analyzed.Results: There were 423 patients: 242 males and 181 females. Their ages ranged from 18 to 100 years with a mean of 54.4 ± 17.3. The commonest causes of CCF were hypertension (56.3% and cardiomyopathy (12.3%. Chronic renal failure, rheumatic heart disease, and ischemic heart disease accounted for 7.8%, 4.3%, and 0.2% of CCF, respectively. Peripartum heart disease was rare despite being commonly reported in northern Nigerian females. Eighteen patients died from various complications with a mortality rate of 4.3%.Conclusion: The burden of CCF in the Niger Delta is mainly attributed to hypertension. Efforts should be geared towards hypertension awareness, detection, treatment, and prevention in the region.Keywords: pattern, cardiac failure, Nigeria, etiological factors

  5. Hospital pharmacy services in teaching hospitals in Nepal: Challenges and the way forward

    Directory of Open Access Journals (Sweden)

    P Ravi Shankar

    2016-01-01

    Full Text Available In Nepal, a developing country in South Asia, hospital pharmacies in teaching hospitals faces a number of challenges. Design and location of the pharmacy is inadequate, the pharmacy is often rented out to private parties, there may be a lack of separation of outpatient and inpatient pharmacy services, medicines are not selected based on objective criteria, too many brands are stocked, pharmaceutical care services are not provided, and pharmaceutical promotion is not regulated within the hospital premises. Furthermore, there is often a lack of pharmacy management software to help dispensing, continuing pharmacy education is not provided, medicines are not compounded or packaged in house, there are problems with medicines availability and medicine quality, and drug utilization studies are not linked with initiatives to promote the rational use of medicines. In this article, the authors examine these challenges and put forward possible solutions.

  6. A survey of radiology reporting practices in veterinary teaching hospitals

    International Nuclear Information System (INIS)

    Adams, W.M.

    1998-01-01

    Radiologists from 28 veterinary schools and one private teaching hospital responded to a survey questionnaire focused on diagnostic image reporting. Radiologists at 26 hospitals generated a hard copy report on essentially all imaging studies performed. At 25 hospitals, radiologists dictated and transcriptionists typed all or most reports; radiologists at two institutions typed all or some of their reports. At five hospitals, preliminary and/or final handwritten reports were generated. The range of reports generated per day was <10 to 40 per radiologist on duty. Seven respondents generated reports as films came from the processor and another 12 routinely generated reports the day the studies were completed. Clinician access to a processed report averaged 2 to 4 days after study was completed (reported range: several hours to 7 or more days). Fifteen responding radiologists personally mounted films from storage jackets for a majority of their reporting. Fourteen respondents generated reports from films mounted on motorized or stationary viewers. Nineteen respondents generated reports in a busy viewing area where they were frequently interrupted. Radiologists' impression of clinician and resident satisfaction regarding availability of radiology reports was that they were satisfied or very satisfied at 15 of the 29 hospitals. Five respondents reported that clinicians and residents were not concerned about availability of processed radiology reports. Thirteen radiologists were planning to change their reporting method within the next 2 years. The change most frequently sought (12 respondents) was to decrease turn-around time of reports. Ten radiologists indicated an interest in trying a voice recognition dictation system. The most common reasons given for not planning any changes in radiology reporting in the next 2 years were: limited number of radiologists (8) and 1 ''satisfied as is'' (7). Turn-around of radiology reports at these veterinary institutions averaged 2

  7. Competitive strategy in turbulent healthcare markets: an analysis of financially effective teaching hospitals.

    Science.gov (United States)

    Langabeer, J

    1998-01-01

    As the healthcare marketplace, characterized by declining revenues and heavy price competition, continues to evolve toward managed care, teaching hospitals are being forced to act more like traditional industrial organizations. Profit-oriented behavior, including emphases on market strategies and competitive advantage, is now a necessity if these hospitals are going to survive the transition to managed care. To help teaching hospitals evaluate strategic options that maximize financial effectiveness, this study examined the financial and operating data for 100 major U.S. teaching hospitals to determine relationships among competitive strategy, market environment, and financial return on invested capital. Results should help major hospitals formulate more effective strategies to combat environmental turbulence.

  8. Undergraduate radiology education in private and public teaching hospitals in Karachi, Pakistan: teaching duties, methodologies, and rewards

    Science.gov (United States)

    Nadeem, Naila; Khawaja, Ranish Deedar Ali; Beg, Madiha; Naeem, Muhammad; Majid, Zain

    2013-01-01

    Background In an integrated method of education, medical students are introduced to radiology in their preclinical years. However, no study has been conducted in Pakistan to demonstrate an academic framework of medical radiology education at an undergraduate level. Therefore, we aimed to document and compare the current level of teaching duties, teaching methodologies, and teaching rewards among radiologists and residents in private and public teaching hospitals in Karachi, Pakistan. Methods A survey was conducted among 121 radiologists and residents in two private and two public teaching hospitals in Karachi, Pakistan. Radiologists who were nationally registered with the Pakistan Medical and Dental Council either part-time or full-time were included. Radiology residents and fellows who were nationally registered with the Pakistan Medical and Dental Council were also included. Self-administered questionnaires addressing teaching duties, methods, and rewards were collected from 95 participants. Results The overall response rate was 78.51% (95/121). All of the radiologists were involved in teaching residents and medical students, but only 36% reported formal training in teaching skills. Although most of the respondents (76%) agreed that medical students appeared enthusiastic about learning radiology, the time spent on teaching medical students was less than five hours per week annually (82%). Only 37% of the respondents preferred dedicated clerkships over distributed clerkships (41%). The most common preferred teaching methodology overall was one-on-one interaction. Tutorials, teaching rounds, and problem-based learning sessions were less favored by radiologists than by residents. Teaching via radiology films (86%) was the most frequent mode of instruction. Salary (59%) was the most commonly cited teaching reward. The majority of respondents (88%) were not satisfied with their current level of teaching rewards. Conclusion All radiologists and residents working in an

  9. Overdosed prescription of paracetamol (acetaminophen) in a teaching hospital.

    Science.gov (United States)

    Charpiat, B; Henry, A; Leboucher, G; Tod, M; Allenet, B

    2012-07-01

    Paracetamol is the most commonly used analgesic and antipyretic. Reviews of hospital use of paracetamol are scarce. Little is known about the appropriateness of the dose of paracetamol prescribed for hospitalized adults. The aim of this study was to report on the nature and the frequency of the overdosed prescription of paracetamol observed in adult patients over a 4.5-year period in a teaching hospital. Prescription analysis by pharmacists was performed once a week in six medical and three surgical departments and daily in a post-emergency unit. In cases of prescription error, the pharmacist notified the physician through an electronic alert when a computerized prescription order entry system was available or otherwise by face-to-face discussion. For each drug-related problem detected, the pharmacists recorded relevant details in a database. From October 2006 to April 2011, 44,404 prescriptions were reviewed and 480 alerts related to the overdosed prescription of paracetamol were made (1% of analyzed prescriptions). The extent of errors of dosage was within the intervals [90-120 mg/kg/d] and greater than 120 mg/kg/d for 87 and 11 patients respectively, who were prescribed a single non-combination paracetamol containing product. Sixty alerts concerned co-prescription of at least two paracetamol containing products with similar frequency for computerized (1.4/1000) or handwritten (1.2/1000) prescriptions. Prescriptions of paracetamol for hospitalized adults frequently exceed the recommended dosage. These results highlight the need for increased awareness of unintentional paracetamol overdose and support the initiation of an educational program aimed at physicians and nurses. Copyright © 2012. Published by Elsevier Masson SAS.

  10. Physician leadership is essential to the survival of teaching hospitals.

    Science.gov (United States)

    Schwartz, R W; Pogge, C

    2000-06-01

    Academic medical centers (AMCs) face severe financial constraints because they must now compete directly with private providers that focus exclusively on cost-effective healthcare delivery. Educational and research capacities developed at AMCs have been supported by government and third party payers, but government support is diminishing. Physicians are ill-equipped to respond to market pressures. Analyses of cultural change and restructuring in corporate giants such as Greyhound, IBM and FedEx are relevant to teaching hospitals. To succeed, organizations must flatten hierarchy, empower staff, train leaders, and mobilize intellectual capital. Effective leadership is essential. Physicians must educate themselves on forces impacting the AMC, understand changes needed in the structure and processes of AMC governance and acquire competencies for leadership and management if AMCs are to survive and thrive. Surgeons should acquire competencies that will enable them to become leaders in the process of AMC transformation.

  11. Depression in myocardial infarction patients at Ayub Teaching Hospital Abbottabad

    International Nuclear Information System (INIS)

    Maqsood, S.; Khan, M.N.; Hayat, U.

    2017-01-01

    There is a considerably high prevalence of depression in post myocardial infarction (MI) patients. This study was designed with an aim to detect depression in patients with acute MI admitted to the CCU at Ayub Teaching Hospital Abbottabad. Methods: This descriptive cross-sectional study enrolled 246 male and female patients with acute MI. The patients were interviewed on the 3rd day of admission and their answers were marked according to the HADS-D scale. Results: With a cut-off score of 11, the frequency of depression in study participants was 27.24% (n=67). No statistically significant association was found between the age and sex of patients and depression. Conclusion: Depression is fairly common following acute MI and the management plans should include a consultation with psychiatric for individualized management of depression in post myocardial infarction patients. (author)

  12. The practice of reporting adverse events in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Andréia Guerra Siman

    2017-10-01

    Full Text Available Abstract OBJECTIVE Understanding the practice of reporting adverse events by health professionals. METHOD A qualitative case study carried out in a teaching hospital with participants of the Patient Safety Center and the nursing team. The collection took place from May to December 2015, and was conducted through interviews, observation and documentary research to treat the data using Content Analysis. RESULTS 31 professionals participated in the study. Three categories were elaborated: The practice of reporting adverse events; Barriers in the effective practice of notifications; The importance of reporting adverse events. CONCLUSION Notification was permeated by gaps in knowledge, fear of punishment and informal communication, generating underreporting. It is necessary to improve the interaction between leaders and professionals, with an emphasis on communication and educational practice.

  13. Pattern of Leukaemia Patients Admitted in Ayub Teaching Hospital Abbottabad

    International Nuclear Information System (INIS)

    Khan, T. M.

    2016-01-01

    Background: Any tissue of the body can give rise to cancer. However, those tissues which multiply rapidly are at high risk of developing cancer and haematopoietic system is one of them. Neoplasms of this system are known as leukaemia and lymphoma, according to the types of white cells involved.Study of cancer patterns in different societies, however can contribute a substantial knowledge about the aetiology of cancer. The present Study was designed and aimed to estimate the frequency of different types of leukaemia in patients admitted in Ayub Teaching hospital Abbottabad. Methods: Data from the patients admitted at oncology Department of Ayub Teaching Hospital Abbottabad from 2010 to 2015 was collected and analysed to calculate cumulative and year-wise frequency of leukaemia and its major types. Frequency distribution with reference to gender and age was also calculated. Results: In our analysis about 16 percent patients had acute myelocytic leukaemia and 32 percent patients had acute lymphocytic leukaemia; while chronic myeloid leukaemia outnumbered chronic lymphocytic leukaemia (11 percent and 3 percent); Hodgkin lymphoma was seen in 18 percent cases while Non Hodgkin lymphoma (NHL) was present in 20 percent cases. Out of the total, 150 cases (75 percent) belonged to mountainous areas of Hazara, i.e., 40 cases belonged to Kohistan, another 40 cases were residents of Battagram, 45 cases belonged to hilly areas of Mansehra and 25 cases to Kaghan valley, while only 50 (25 percent) cases were from the plain areas of Abbottabad and Haripur districts, i.e., 20 and 30 cases respectively. Conclusion: Leukaemia is more common in hilly areas of Hazara, since majority of the cases belonged to well-known mountainous regions of Kohistan, Battagram, Kaghan or Mansehra and only few cases belonged to the plain areas of Abbottabad and Haripur districts. (author)

  14. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment for physician services...

  15. The Relationship Between Strategic Thinking and Hospital Managers’ Productivity in Teaching Hospitals of Shiraz

    Directory of Open Access Journals (Sweden)

    Kiaei

    2016-02-01

    Full Text Available Background Using different methods of strategic thinking is essential for organizations such as hospitals; without them, many organizations will not survive. The aim of the present study is to evaluate the relationship between strategic thinking and management productivity in teaching hospitals of Shiraz. Objectives Because of the importance of strategic management in organizational productivity, the present study is conducted with the goal of assessing the relationship between strategic thinking and hospital managers’ productivity. Patients and Methods This descriptive-correlational study was conducted in 2015. The statistical population included all managers in different levels in the teaching hospitals of Shiraz (170 persons. Among these, 119 participants were selected through Cochran’s formula and a simple random sampling method. Data were collected by a questionnaire addressing strategic thinking based on Liedtka’s model and Hersey and Blanchard’s theory. Its validity was verified by a panel of experts and its reliability was measured in previous studies. Data analysis was performed in SPSS version 20 using descriptive and analytic statistics (analysis of variance (ANOVA, Pearson’s correlation test and t-test. Results The average and Standard Deviation of strategic thinking managers was (2.2 ± 0.04, and productivity of management (2.32 ± 0.37 was estimated on the average level. There was a direct meaningful relationship between strategically thinking managers and productivity (r = 0.387, P < 0.001. The results also showed that there is a meaningful correlation between strategic thinking and sustainability, organizational support and understanding of the job. Conclusions Due to the correlation between strategic thinking and productivity, we recommend educating and training managers in the use of strategic thinking, and that they understand its importance to productivity. Managers should understand that increasing efficiency in a

  16. Congenital club foot in a teaching hospital in Lagos, Nigeria.

    Science.gov (United States)

    Adewole, O A; Giwa, S O; Kayode, M O; Shoga, M O; Balogun, R A

    2009-06-01

    Congenital club foot has been sparsely reported in literature in Nigeria, although it has been reported as the commonest congenital musculoskeletal abnormality. This study enumerates the point prevalence of this disease in a university teaching hospital in Lagos. Better understanding of the epidemiology in our community should improve awareness, and influence management. Between June 2005 and July 2006, 72 consecutive patients with congenital club feet were seen in the orthopaedic clinic of our Hospital. Demographic data, birth weight, family history, birth facility, maternal age and associated congenital anomalies were recorded and analysed using Statistical Programme for Social Sciences (SPSS) version 15. A total of 72 patients were seen, 28 of whom had bilateral club feet resulting in a total of 100 feet. There were 38 males and 34 females. Only 29% presented in the first month of life and 28% in the second month. Maternal ages ranged between 19 and 38 years and no family history of congenital club foot was given,. Babies delivered outside the orthodox medical system (churches, traditional healers, home etc) constituted 28%. The commonest associated congenital anomalies were tibia hemimelia, hydrocephalus, inguinal hernia and umbilical hernia. A default rate of 28% was observed during treatment. Congenital club foot may not be uncommon in Nigeria. Late presentation and high default rate before correction of the deformity were observed. Establishment of special club foot clinics should reduce the default rate. Training of healthcare workers in maternity units as well as Public awareness should encourage early referral to specialists.

  17. A large-scale peer teaching programme - acceptance and benefit.

    Science.gov (United States)

    Schuetz, Elisabeth; Obirei, Barbara; Salat, Daniela; Scholz, Julia; Hann, Dagmar; Dethleffsen, Kathrin

    2017-08-01

    The involvement of students in the embodiment of university teaching through peer-assisted learning formats is commonly applied. Publications on this topic exclusively focus on strictly defined situations within the curriculum and selected target groups. This study, in contrast, presents and evaluates a large-scale structured and quality-assured peer teaching programme, which offers diverse and targeted courses throughout the preclinical part of the medical curriculum. The large-scale peer teaching programme consists of subject specific and interdisciplinary tutorials that address all scientific, physiological and anatomic subjects of the preclinical curriculum as well as tutorials with contents exceeding the formal curriculum. In the study year 2013/14 a total of 1,420 lessons were offered as part of the programme. Paper-based evaluations were conducted over the full range of courses. Acceptance and benefit of this peer teaching programme were evaluated in a retrospective study covering the period 2012 to 2014. Usage of tutorials by students who commenced their studies in 2012/13 (n=959) was analysed from 2012 till 2014. Based on the results of 13 first assessments in the preclinical subjects anatomy, biochemistry and physiology, the students were assigned to one of five groups. These groups were compared according to participation in the tutorials. To investigate the benefit of tutorials of the peer teaching programme, the results of biochemistry re-assessments of participants and non-participants of tutorials in the years 2012 till 2014 (n=188, 172 and 204, respectively) were compared using Kolmogorov-Smirnov- and Chi-square tests as well as the effect size Cohen's d. Almost 70 % of the students attended the voluntary additional programme during their preclinical studies. The students participating in the tutorials had achieved different levels of proficiency in first assessments. The acceptance of different kinds of tutorials appears to correlate with their

  18. Teaching hospital planning: a case study and the need for reform.

    Science.gov (United States)

    Davis, Christopher K; Smith, Harry

    2010-08-16

    Academic teaching hospitals and their networks can best serve patients and other stakeholders by achieving critical mass and scope of clinical services, teaching and research. Successful hospital reconfigurations are associated with a convincing case and majority clinician buy-in. The inscrutable political decision to relocate services away from a major teaching hospital campus and into a merged Queensland Children's Hospital was determined without broad stakeholder consultation or a transparent and accountable business case. This compromised process poses a significant and enduring risk to patient care and Queensland's paediatric, perinatal, adolescent and obstetric academic teaching hospital services. As the proposed major stakeholder in Australia's public hospitals and medical workforce training, the federal government should review this decision using an effective methodology incorporating relevant criteria. National guidelines are needed to ensure best practice in the future planning and auditing of major health care projects. The medical profession is responsible for ensuring that health care policy complies with reliable evidence and good practice.

  19. Improvement of hospital processes through business process management in Qaem Teaching Hospital: A work in progress.

    Science.gov (United States)

    Yarmohammadian, Mohammad H; Ebrahimipour, Hossein; Doosty, Farzaneh

    2014-01-01

    In a world of continuously changing business environments, organizations have no option; however, to deal with such a big level of transformation in order to adjust the consequential demands. Therefore, many companies need to continually improve and review their processes to maintain their competitive advantages in an uncertain environment. Meeting these challenges requires implementing the most efficient possible business processes, geared to the needs of the industry and market segments that the organization serves globally. In the last 10 years, total quality management, business process reengineering, and business process management (BPM) have been some of the management tools applied by organizations to increase business competiveness. This paper is an original article that presents implementation of "BPM" approach in the healthcare domain that allows an organization to improve and review its critical business processes. This project was performed in "Qaem Teaching Hospital" in Mashhad city, Iran and consists of four distinct steps; (1) identify business processes, (2) document the process, (3) analyze and measure the process, and (4) improve the process. Implementing BPM in Qaem Teaching Hospital changed the nature of management by allowing the organization to avoid the complexity of disparate, soloed systems. BPM instead enabled the organization to focus on business processes at a higher level.

  20. Parental responses to involvement in rounds on a pediatric inpatient unit at a teaching hospital: a qualitative study.

    Science.gov (United States)

    Latta, Linda C; Dick, Ronald; Parry, Carol; Tamura, Glen S

    2008-03-01

    In pediatric teaching hospitals, medical decisions are traditionally made by the attending and resident physicians during rounds that do not include parents. This structure limits the ability of the medical team to provide "family-centered care" and the attending physician to model communication skills. The authors thus set out to identify how parents responded to participation in interdisciplinary teaching rounds conducted in a large tertiary care children's teaching hospital. A qualitative descriptive study was conducted using data from semistructured interviews of parents who had participated in rounds on the inpatient medical unit of a large academic children's hospital. From December 2004 to April 2005, 18 parents were interviewed after their participation in rounds. Questions assessed their experiences, expectations, preferred communication styles, and suggestions for improvement. Transcripts of the interviews were analyzed using qualitative content analysis. Being able to communicate, understand the plan, and participate with the team in decision making about their child's care were the most frequently cited outcomes of importance to parents. All 18 participants described the overall experience as positive, and 17 of 18 described themselves as "comfortable" with inclusion in rounds. Use of lay terminology and inclusion of nurses in rounds were preferred. Including parents on ward rounds at a teaching hospital was viewed positively by parents. Specific themes of particular importance to parents were identified. Further study is needed to assess the impact of inclusion of parents on rounds on patient outcomes and the resident experience.

  1. Self-Efficacy and Postpartum Depression Teaching Behaviors of Hospital-Based Perinatal Nurses

    OpenAIRE

    Logsdon, M. Cynthia; Foltz, Melissa Pinto; Scheetz, James; Myers, John A.

    2010-01-01

    Based upon the Self-Efficacy Theory, this study examined the relationship between self-efficacy, self-efficacy-related variables, and postpartum depression teaching behaviors of hospital-based perinatal nurses. Findings revealed that teaching new mothers about postpartum depression is related to a perinatal nurse's self-efficacy in postpartum-depression teaching, self-esteem, and the following self-efficacy-related variables: social persuasion (supervisor's expectations for teaching); mastery...

  2. Outcome of a ceftriaxone/cefotaxime interchange programme in a major teaching hospital.

    Science.gov (United States)

    Gutensohn, A; Bunz, D; Frighetto, L; Jewesson, P

    1991-01-01

    A two-stage intervention programme was performed to enable the effective substitution of ceftriaxone for cefotaxime in a teaching hospital with large numbers of transient prescribers. One hundred and sixteen patients with a variety of bacterial infections were randomized to an open, historical control comparative study to determine if ceftriaxone was an acceptable replacement for cefotaxime. For 6 months prior to the intervention, both cephalosporins were available on formulary. Following an initial informational stage, a therapeutic interchange programme was implemented to convert prescriptions for cefotaxime to ceftriaxone. Ceftriaxone and cefotaxime were equivalent in terms of microbiological and clinical efficacy and patient tolerance in 77 evaluable patients. No changes in prescriber service occurred after the changeover. Post-intervention treatment courses required a ceftriaxone/cefotaxime interchange in 28% of the cases. Ceftriaxone appeared to be a suitable and cost-effective alternative to cefotaxime in this hospital. The intervention programme successfully invoked the formulary change with minimal expense and prescriber opposition.

  3. Evaluation of environmental sampling methods for detection of Salmonella enterica in a large animal veterinary hospital.

    Science.gov (United States)

    Goeman, Valerie R; Tinkler, Stacy H; Hammac, G Kenitra; Ruple, Audrey

    2018-04-01

    Environmental surveillance for Salmonella enterica can be used for early detection of contamination; thus routine sampling is an integral component of infection control programs in hospital environments. At the Purdue University Veterinary Teaching Hospital (PUVTH), the technique regularly employed in the large animal hospital for sample collection uses sterile gauze sponges for environmental sampling, which has proven labor-intensive and time-consuming. Alternative sampling methods use Swiffer brand electrostatic wipes for environmental sample collection, which are reportedly effective and efficient. It was hypothesized that use of Swiffer wipes for sample collection would be more efficient and less costly than the use of gauze sponges. A head-to-head comparison between the 2 sampling methods was conducted in the PUVTH large animal hospital and relative agreement, cost-effectiveness, and sampling efficiency were compared. There was fair agreement in culture results between the 2 sampling methods, but Swiffer wipes required less time and less physical effort to collect samples and were more cost-effective.

  4. A Brief Analysis of Large Classroom’s English Teaching Management Skills

    Directory of Open Access Journals (Sweden)

    Weixuan Zhong

    2014-05-01

    Full Text Available Classroom is the basic place of teaching, where intertwined with a variety of teaching factors, and all these factors forms various kinds of connections. Scientific and effective class teaching management is the necessary and powerful measure of improving the teaching quality. Effective English teaching management skills are parts of the elements of successful large classroom teaching. Under the new educational situation, how to organize, regulate, manage large classrooms in order to train the students' English proficiency within certain time, which is very important to improve English classes management efficiency and teaching quality.

  5. PRESENT SCENARIO OF NON TRAUMATIC QUADRIPARESIS IN A TEACHING HOSPITAL

    Directory of Open Access Journals (Sweden)

    Radha Krishnan

    2015-04-01

    Full Text Available AIMS & OBJECTIVES: Patients presenting with acute quadriparesis may pose therapeutic challenge to the treating physician especially the development of bulbar palsy and respiratory paralysis and require intensive monitoring and treatment in acute clinical and respiratory care units. So this study was conducted to know the etiology of cases of non - traumatic Quadriparesis and its outcome. MATERIALS AND METHODS: 50 adult patients admitted in medical and neurology wards with non - traumatic quadriparesis were prospectively studied b etween October ’2012 to September ’2014at Government General Hospital, Kakinada, a teaching hospital with rural referrals. OBSERVATIONS AND RESULTS: In the study cohort of 50 cases the age of patients ranged from 13 to 80 years with more number of male patients. 29 patients (58% presented with flaccid and 21 cases (42% with spastic quadriparesis. Guillian barre syndrome with 18 (36% cases was the most common cause of quadriparesis followed by Spondylotic myelopathy 11 cases ( 22% and Hypokalemic perio dic paralysis in 8 cases (16%. Transverse Myelitis. Caries spine. Secondaries cervical spine, spinal epidural abscess were in other cases.7 (14% patients had cranial nerve dysfunction. 4(8% patients had facial nerve palsy . CONCLUSION: Guillian barre syn drome constituted the most common cause of nontraumatic quadriparesis, followed by Spondylotic myelopathy, Transverse Myelitis. Caries spine. S econdaries cervical spine, spinal epidural abscess . AIDP and Hypokalemic periodic paralysis were the most frequen t causes of flaccid quadriparesis while Spondylotic myelopathy was the most common cause of spastic quadriparesis . M.R.I was the most useful and appropriate investigation . Severity of paralysis and need for ventilator support were associated with poor prog nosis in patients with acute flaccid quadriparesis . Decompressive surgery in spondylotic myelopathy had good recovery after surgery. Patient recovery was

  6. [Cost of nursing turnover in a Teaching Hospital].

    Science.gov (United States)

    Ruiz, Paula Buck de Oliveira; Perroca, Marcia Galan; Jericó, Marli de Carvalho

    2016-02-01

    To map the sub processes related to turnover of nursing staff and to investigate and measure the nursing turnover cost. This is a descriptive-exploratory study, classified as case study, conducted in a teaching hospital in the southeastern, Brazil, in the period from May to November 2013. The population was composed by the nursing staff, using Nursing Turnover Cost Calculation Methodology. The total cost of turnover was R$314.605,62, and ranged from R$2.221,42 to R$3.073,23 per employee. The costs of pre-hire totaled R$101.004,60 (32,1%), and the hiring process consumed R$92.743,60 (91.8%) The costs of post-hire totaled R$213.601,02 (67,9%), for the sub process decreased productivity, R$199.982,40 (93.6%). The study identified the importance of managing the cost of staff turnover and the financial impact of the cost of the employee termination, which represented three times the average salary of the nursing staff.

  7. Teaching obstetric ultrasound at Mulago Hospital - Kampala, Uganda

    African Journals Online (AJOL)

    ... basic obstetric ultrasound. Keywords: Ultrasound; obstetric; teaching; Uganda; low-resource; curriculum. .... tic and hands-on training were provided by one trainer. (HKA) who at the time .... any formal teaching session. Additionally, the study ...

  8. Teaching obstetric ultrasound at Mulago Hospital - Kampala, Uganda

    African Journals Online (AJOL)

    Conclusion: This original teaching intervention is an effective method to improve ... In ad- dition, no teaching or testing material is available in the literature that can be used to carry ..... trasound in rural areas using a tablet platform and mobile.

  9. Large Hospital 50% Energy Savings: Technical Support Document

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, E.; Studer, D.; Parker, A.; Pless, S.; Torcellini, P.

    2010-09-01

    This Technical Support Document documents the technical analysis and design guidance for large hospitals to achieve whole-building energy savings of at least 50% over ANSI/ASHRAE/IESNA Standard 90.1-2004 and represents a step toward determining how to provide design guidance for aggressive energy savings targets. This report documents the modeling methods used to demonstrate that the design recommendations meet or exceed the 50% goal. EnergyPlus was used to model the predicted energy performance of the baseline and low-energy buildings to verify that 50% energy savings are achievable. Percent energy savings are based on a nominal minimally code-compliant building and whole-building, net site energy use intensity. The report defines architectural-program characteristics for typical large hospitals, thereby defining a prototype model; creates baseline energy models for each climate zone that are elaborations of the prototype models and are minimally compliant with Standard 90.1-2004; creates a list of energy design measures that can be applied to the prototype model to create low-energy models; uses industry feedback to strengthen inputs for baseline energy models and energy design measures; and simulates low-energy models for each climate zone to show that when the energy design measures are applied to the prototype model, 50% energy savings (or more) are achieved.

  10. 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.

  11. Case study: improving efficiency in a large hospital laboratory.

    Science.gov (United States)

    Bartel, Marilynn

    2004-01-01

    Saint Francis Health System (SFHS) consists of three hospitals and one clinic: Saint Francis Hospital (SFH); Broken Arrow Medical Center; Laureate Psychiatric Hospital; and Warren Clinic. SFHS has 670 physicians on staff and serves medical (oncology, orthopedic, neurology, and renal), surgical, cardiac, women and infant, pediatric, transplant, and trauma patients in Tulsa County, Oklahoma, which has a population of 660,000. SFH incorporates 706 staffed beds, including 126 pediatric beds and 119 critical care beds. Each year, the health system averages 38,000 admissions, 70,000 emergency department visits, 25,000 surgeries, and 3,500 births. Saint Francis Laboratory is located within the main hospital facility (SFH) and functions as a core lab for the health system. The lab also coordinates lab services with Saint Francis Heart Hospital, a physician-system joint venture. The Optimal Equipment Configuration (OEC) Project was designed by the Clinical Laboratory Services division of Premier, a group purchasing organization, with the goal of determining whether laboratories could improve efficiency and decrease unit cost by using a single-source vendor. Participants included seven business partners (Abbott, Bayer, Beckman/Coulter, Dade/Behring, J&J/ Ortho, Olympus, and Roche) and 21 laboratory sites (a small, mid-sized, and large site for each vendor). SFH laboratory staff embraced Premier's concept and viewed the OEC project as an opportunity to "energize" laboratory operations. SFH partnered with Abbott, their primary equipment vendor, for the project. Using resources and tools made available through the project, the laboratory was re-engineered to simplify workflow, increase productivity, and decrease costs by adding automation and changing to centralized specimen processing. Abbott and SFH shared a common vision for the project and enhanced their partnership through increased communication and problem solving. Abbott's area representatives provided for third

  12. Medication error detection in two major teaching hospitals: What are the types of errors?

    Directory of Open Access Journals (Sweden)

    Fatemeh Saghafi

    2014-01-01

    Full Text Available Background: Increasing number of reports on medication errors and relevant subsequent damages, especially in medical centers has become a growing concern for patient safety in recent decades. Patient safety and in particular, medication safety is a major concern and challenge for health care professionals around the world. Our prospective study was designed to detect prescribing, transcribing, dispensing, and administering medication errors in two major university hospitals. Materials and Methods: After choosing 20 similar hospital wards in two large teaching hospitals in the city of Isfahan, Iran, the sequence was randomly selected. Diagrams for drug distribution were drawn by the help of pharmacy directors. Direct observation technique was chosen as the method for detecting the errors. A total of 50 doses were studied in each ward to detect prescribing, transcribing and administering errors in each ward. The dispensing error was studied on 1000 doses dispensed in each hospital pharmacy. Results: A total of 8162 number of doses of medications were studied during the four stages, of which 8000 were complete data to be analyzed. 73% of prescribing orders were incomplete and did not have all six parameters (name, dosage form, dose and measuring unit, administration route, and intervals of administration. We found 15% transcribing errors. One-third of administration of medications on average was erroneous in both hospitals. Dispensing errors ranged between 1.4% and 2.2%. Conclusion: Although prescribing and administrating compromise most of the medication errors, improvements are needed in all four stages with regard to medication errors. Clear guidelines must be written and executed in both hospitals to reduce the incidence of medication errors.

  13. Evaluation of drug administration errors in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Berdot Sarah

    2012-03-01

    Full Text Available Abstract Background Medication errors can occur at any of the three steps of the medication use process: prescribing, dispensing and administration. We aimed to determine the incidence, type and clinical importance of drug administration errors and to identify risk factors. Methods Prospective study based on disguised observation technique in four wards in a teaching hospital in Paris, France (800 beds. A pharmacist accompanied nurses and witnessed the preparation and administration of drugs to all patients during the three drug rounds on each of six days per ward. Main outcomes were number, type and clinical importance of errors and associated risk factors. Drug administration error rate was calculated with and without wrong time errors. Relationship between the occurrence of errors and potential risk factors were investigated using logistic regression models with random effects. Results Twenty-eight nurses caring for 108 patients were observed. Among 1501 opportunities for error, 415 administrations (430 errors with one or more errors were detected (27.6%. There were 312 wrong time errors, ten simultaneously with another type of error, resulting in an error rate without wrong time error of 7.5% (113/1501. The most frequently administered drugs were the cardiovascular drugs (425/1501, 28.3%. The highest risks of error in a drug administration were for dermatological drugs. No potentially life-threatening errors were witnessed and 6% of errors were classified as having a serious or significant impact on patients (mainly omission. In multivariate analysis, the occurrence of errors was associated with drug administration route, drug classification (ATC and the number of patient under the nurse's care. Conclusion Medication administration errors are frequent. The identification of its determinants helps to undertake designed interventions.

  14. Evaluation of Pralidoxime Use in an Iranian Teaching Referral Hospital

    Directory of Open Access Journals (Sweden)

    Ali Banagozar Mohammadi

    2018-03-01

    Full Text Available Background: Organophosphorus (OP poisonings, a common source of pesticide poisoning, are an important cause of morbidity and mortality in the developing countries. Combination therapy with atropine and oxime is a common practice in the management of OP poisoning. However, the additive benefit of using pralidoxime in addition to atropine remains controversial. Due to inappropriate and widespread use of this relatively expensive and low available antidote, we aimed to evaluate its usage in an Iranian teaching hospital. Methods: Medical files of patients with pesticide poisoning who had been admitted to the poisoning ward between September 2013 and September 2014 were reviewed. Patients with definite diagnosis of OPs poisoning were selected to evaluate rational use of pralidoxime in their treatment regimen. Data were collected using a checklist containing demographic, clinical, and para clinical characteristics, as well as the type of pesticide poisoning. Appropriateness of the pralidoxime therapy was determined based on clinical practice guideline and endorsed by an attending medical toxicologist. Results: 68.8% of patients had been poisoned with insecticides, 27.1% with aluminum phosphide, 2.1% with herbicides, and 2% with rodenticides, respectively. OPs were responsible for 43.8% of all poisoning. All patients with OPs poisoning received pralidoxime after they had been admitted to emergency department, while only 55% of them were eligible to receive pralidoxime. Moreover, pralidoxime had been administered for 59% of patients with non-OPs poisoning, which all of them were clinically inappropriate. Conclusion: The use of pralidoxime in the northwest of Iran is not appropriate and thus, it is highly recommended that a patient-tailored treatment guideline be provided and implemented regionally.

  15. Pediatric pain: prevalence, assessment, and management in a teaching hospital

    Directory of Open Access Journals (Sweden)

    M.B.M. Linhares

    2012-12-01

    Full Text Available The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents, their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients’ pain symptoms during the 24 h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28% answered the questionnaire and for the other 72% (unable to communicate, the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49% had observed their child’s pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals.

  16. [Clinical research outside of teaching hospitals: Current situation in north-eastern France].

    Science.gov (United States)

    Goetz, C; Dupoux, A; Déloy, L; Hertz, C; Jeanmaire, T; Parneix, N

    2015-04-01

    Most clinical research in France takes place in teaching hospitals. There are, however, many advantages to developing it in other hospitals: access to innovative treatments, improvement in healthcare quality, attractiveness of hospitals, increased trial inclusion rates and reduced selection bias. The objectives of our study were to report on the current situation of clinical research outside teaching hospitals. A three-stage survey was conducted between January 2012 and May 2013 in non-teaching hospitals of north-eastern France. First, questionnaires were sent to administrative and medical boards of all hospitals with more than 100 beds, then to head doctors of every department in hospitals with more than 300 beds and finally meetings were organized with members of 20 selected hospitals. The administrative and medical boards of 85 hospitals participated in the first stage of the survey; half of these hospitals were engaged in clinical research activities and for 10 the internal structuring was cross-disciplinary. Answers from 178 departments were obtained during the second stage; 47% reported a clinical research activity. Meetings with research teams in 20 hospitals allowed us to identify difficulties concerning research funding, transversal organization and sponsoring. Clinical research existed in more than half of the respondent non-teaching hospitals. Obstacles to its development can be grouped in three categories: 1) internal structuring of clinical research, 2) access to information and knowledge of how clinical research functions and to interlocutors outside the hospital and 3) access to skills necessary to sponsor clinical research. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  17. Teaching Quality, Learning Satisfaction, and Academic Performance among Hospitality Students in Taiwan

    Science.gov (United States)

    Ko, Wen-Hwa; Chung, Feng-Ming

    2014-01-01

    The purpose of this study is to examine the effect of the teaching quality of culinary arts teachers and student learning satisfaction on the academic performance of hospitality students. This study surveys the students in hospitality departments at universities in Taiwan. A total of 406 (81.2%) valid questionnaires were received. Research results…

  18. A prospective audit of emergency urology activity in a university teaching hospital

    LENUS (Irish Health Repository)

    2014-06-01

    Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period.

  19. Culture of Safety among Nurses in a Tertiary Teaching Hospital in ...

    African Journals Online (AJOL)

    Purpose: To assess the culture of safety among nurses in a tertiary teaching hospital in Saudi Arabia. Methods: A cross-sectional survey was conducted in King Khaled University Hospital in Riyadh, Saudi Arabia. A random sample of 492 nurses was included in the survey using a pre-validated instrument, Safety Attitudes ...

  20. Patient safety: the experience of an Italian teaching hospital

    Directory of Open Access Journals (Sweden)

    Marco Marchetti

    2005-12-01

    considers the organisation of a complex clinical risk management system within a large university hospital. An information flow that examines and identifies risks from surveying the data has been created. Preventative activities have been planned in the laboratories, transfusion and pharmacotherapy sectors as outlined in the risk map, together with clinical audit activities. Furthermore, all of these issues have been highlighted across all sectors with the creation of an accredited ECM training program as well as the implementation of an anonymous survey. These initiatives have not only increased the interest in Risk Management issues, but have also fostered the integration of different groups and their working methods.

    Conclusions Introducing risk management processes to A. Gemelli University Hospital represents a step from the promotion and dissemination phase to that of a formal organic risk management system in medicine. This initiative, involving the participation of all personnel, has produced a measurable improvement in safety of both patients and staff.

  1. Antimicrobial resistance among nosocomial isolates in a teaching hospital in Goa

    Directory of Open Access Journals (Sweden)

    Kamat U

    2008-01-01

    Full Text Available Background: Emergence of polyantimicrobial resistant strains of hospital pathogens has presented a challenge in the provision of good quality in-patient care. Inappropriate use of antibiotics in the hospital is largely responsible for this catastrophe. Bacteriological surveillance of the cases of nosocomial infections is crucial for framing an evidence-based antimicrobial policy for a hospital. Materials and Methods: A prospective study was undertaken among 498 patients from medicine and surgery wards in a tertiary teaching hospital in Goa. The patients were followed up clinico-bacteriologically for the occurrence of nosocomial infections (NI. Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method. Results: The overall infection rate was 33.93 ± 4.16 infections per 100 patients. Urinary tract infection was the most common NI (26.63%, followed by surgical site infection (23.67%, wound infection (23% and nosocomial pneumonia (18.34%. Ninety-seven percent of the isolates were bacterial, while the others were fungal. More than 80% of the NIs were caused by Gram-negative bacteria, predominantly Pseudomonas aeruginosa, Escherichia coli and Aceinetobacter baumanii . Almost 70% of the isolates were resistant to all the antibiotics for which susceptibility was tested; the rest were sensitive to amikacin, cefoperazone-sulbactam and other antibiotics including methicillin, co-trimoxazole, teicoplenin, vancomycin and rifampicin, either singly or in combination. The proportion of MRSA was 71.4%. Resistance to a particular antibiotic was found to be directly proportional to the antibiotic usage in the study setting. Conclusion: Surveillance of nosocomial infections with emphasis on the microbiologic surveillance and frequent antimicrobial audit are critical towards curbing the evil of polyantimicrobial resistant nosocomial infections in a hospital.

  2. Factors associated with Salmonella shedding among equine colic patients at a veterinary teaching hospital.

    Science.gov (United States)

    Kim, L M; Morley, P S; Traub-Dargatz, J L; Salman, M D; Gentry-Weeks, C

    2001-03-01

    To evaluate factors potentially associated with fecal Salmonella shedding among equine patients hospitalized for colic at a veterinary teaching hospital and to determine the effects of probiotic treatment on fecal Salmonella shedding and clinical signs. Longitudinal study and controlled trial. 246 equine colic patients. History and medical information were obtained from patient records. Fecal and environmental samples were submitted for aerobic bacterial culture for Salmonella enterica. Fifty-one patients were treated with a commercially available probiotic; 46 were treated with a placebo. Logistic regression was used to evaluate data. Salmonella organisms were detected in feces from 23 (9%) patients at least once during hospitalization. Patients were more likely to shed Salmonella organisms if diarrhea was evident equine patients hospitalized at a veterinary teaching hospital because of colic and that pathogen monitoring in patients and the hospital environment and use of barrier nursing precautions for equine colic patients are beneficial.

  3. Ambulatory surgery and anaesthesia in HUKM, a teaching hospital in Malaysia: the first two years experience.

    Science.gov (United States)

    Norsidah, A M; Yahya, N; Adeeb, N; Lim, A L

    2001-03-01

    Ambulatory or day care surgery is still in its infancy in this part of the world. Our newly built university affiliated hospital started its Day Surgery Centre in February 1998. It is the first multidisciplinary ambulatory surgery centre in a teaching hospital in the country. It caters for Orthopaedic surgery, Urology, Plastic surgery, Otorhinolaryngology, General surgery, Paediatric surgery and Ophthalmology. We have done 2,604 cases and our unanticipated admission rate is less than 2%. There has been no major morbidity or mortality. The problems of setting up a multidisciplinary ambulatory centre in a teaching hospital are discussed.

  4. Experiences of clinical teaching for dental core trainees working in hospital.

    Science.gov (United States)

    Mannion, C J; Brotherton, P

    2014-07-11

    There is recognition that the provision of excellence in education and training results in a skilled and competent workforce. However, the educational experiences of dental core trainees (DCT's) working in the hospital oral and maxillofacial surgery (OMFS) setting have not been previously investigated. In this paper, we examine DCT's learning experiences both 'formal' and 'non-formal' within the hospital setting of ward and clinic-based teaching. Are hospital dental core trainees receiving a meaningful educational experience? To conclude this paper, the authors recommend methods, based upon sound educational principles, to maximise the value of clinical sessions for teaching.

  5. A comparative study of collimation in bedside chest radiography for preterm infants in two teaching hospitals

    International Nuclear Information System (INIS)

    Stollfuss, J.; Schneider, K.; Krüger-Stollfuss, I.

    2015-01-01

    •Potential factors influencing non-optimal image collimation in the setting of bedside chest X-ray in preterm infants were investigated.•A comparable rate of optimal images was observed in two hospitals.•Size, weight or disease severity had no influence on collimation quality.•Unrelated to the years of experience a large variation of the technician in correct collimation was noted (18–86%).•Individualized quality control and education is necessary. Potential factors influencing non-optimal image collimation in the setting of bedside chest X-ray in preterm infants were investigated. A comparable rate of optimal images was observed in two hospitals. Size, weight or disease severity had no influence on collimation quality. Unrelated to the years of experience a large variation of the technician in correct collimation was noted (18–86%). Individualized quality control and education is necessary. Unnecessary exposure of the abdomen, arms or head may lead to a substantial increase of the radiation dose in portable chest X-rays on the neonatal intensive care unit. The objective was to identify potential factors influencing inappropriate exposure of non-thoracic structures in two teaching hospitals. The study analysed 200 consecutive digital chest radiographs in 20 preterm neonates (mean gestation 25 ± 1 weeks). Demographical data, tube settings and exposure parameters were recorded. To grade the collimation, we used a scoring system with a maximum of 12 exposed non-thoracic structures. Length of gestation, age, the radiographer, years of experience in performing X-rays and the number of in situ catheters or lines, were correlated with collimation quality. There was no significant difference between the rates of optimal images obtained in the two hospitals (0.32 vs 0.39, n.s.). Scores showed that most suboptimal images had only mildly reduced image quality (1.40 ± 1.38 vs 1.20 ± 1.43, n.s.). Length of gestation or presence of surgical drains, catheters and

  6. Some correlates of electronic health information management system success in nigerian teaching hospitals.

    Science.gov (United States)

    Ojo, Adebowale I; Popoola, Sunday O

    2015-01-01

    Nowadays, an electronic health information management system (EHIMS) is crucial for patient care in hospitals. This paper explores the aspects and elements that contribute to the success of EHIMS in Nigerian teaching hospitals. The study adopted a survey research design. The population of study comprised 442 health information management personnel in five teaching hospitals that had implemented EHIMS in Nigeria. A self-developed questionnaire was used as an instrument for data collection. The findings revealed that there is a positive, close relationship between all the identified factors and EHIMS's success: technical factors (r = 0.564, P < 0.05); social factors (r = 0.616, P < 0.05); organizational factors (r = 0.621, P < 0.05); financial factors (r = 0.705, P < 0.05); and political factors (r = 0.589, P < 0.05). We conclude that consideration of all the identified factors was highly significant for the success of EHIMS in Nigerian teaching hospitals.

  7. Profilaxia para tromboembolismo venoso em um hospital de ensino Venous thromboembolism prophylaxis at a teaching hospital

    Directory of Open Access Journals (Sweden)

    Rafael de Melo Franco

    2006-06-01

    Full Text Available OBJETIVO: Verificar se a profilaxia da trombose venosa profunda está sendo utilizada de maneira correta e rotineira em um hospital de ensino. MÉTODOS E CASUÍSTICA: Foi realizado um estudo transversal de pacientes internados em sete setores (enfermarias do Conjunto Hospitalar de Sorocaba (Hospital de Ensino, no período de agosto de 2004 a agosto de 2005. Para estratificação do risco de trombose venosa profunda de cada paciente, foram pesquisados fatores clínicos e cirúrgicos, segundo o protocolo preconizado pela Sociedade Brasileira de Angiologia e Cirurgia Vascular. No período estudado, foram analisados 216 prontuários, dos quais 30 eram da cirurgia abdominal, 30 da cirurgia vascular, 30 da urologia, 31 da clínica médica, 31 da unidade de terapia intensiva, 31 da ortopedia e 33 da ginecologia/obstetrícia. RESULTADOS: Do total de pacientes, foi efetuada profilaxia para trombose venosa profunda em 57 (26%, sendo que, em 51 (89%, a execução foi de maneira correta e, em 6 (11%, não-preconizada. O método profilático mais utilizado foi o medicamentoso; 49 de 57 pacientes fizeram uso de heparina de baixo peso molecular. Também foi verificada a utilização de meias elásticas em cinco pacientes e deambulação precoce em sete. Já a compressão pneumática intermitente não foi utilizada em nenhum deles. CONCLUSÃO: De acordo com os resultados e com base no protocolo, concluiu-se que, no período da pesquisa, a profilaxia para trombose venosa profunda, no Conjunto Hospitalar de Sorocaba, foi executada rotineiramente e de forma adequada em apenas 23,6% (51 do total de 216 pacientes.OBJECTIVE: To verify whether deep venous thrombosis prophylaxis is being correctly and routinely used at a teaching hospital. METHODS: A cross-sectional study of hospitalized patients on seven sectors at Conjunto Hospitalar de Sorocaba (Hospital de Ensino was performed from August 2004 to August 2005. For the deep venous thrombosis risk stratification of

  8. Examining the effectiveness of experiential teaching in small and large OM modules

    OpenAIRE

    Piercy, N.; Brandon-Jones, A.; Brandon-Jones, E.; Campbell, C.

    2012-01-01

    Purpose – This paper aims to examine the preferences of students towards different teaching methods and the perceived effectiveness of experiential teaching methods in different operations management (OM) modules.Design/methodology/approach – Student perceptions of different teaching methods and various aspects of an experiential teaching method, in the form of a business simulation game, are examined using survey data from 274 respondents in four small post-experience and two large pre-exper...

  9. Developing 21st century accreditation standards for teaching hospitals: the Taiwan experience.

    Science.gov (United States)

    Huang, Chung-I; Wung, Cathy; Yang, Che-Ming

    2009-12-15

    The purpose of this study is to establish teaching hospital accreditation standards anew with the hope that Taiwan's teaching hospitals can live up to the expectations of our society and ensure quality teaching. The development process lasted two years, 2005-2006, and was separated into three stages. The first stage centered on leadership meetings and consensus building, the second on drafting the new standards with expert focus groups, and the third on a pilot study and subsequent revision. Our new teaching hospital accreditation standards have six categories and 95 standards as follows: educational resources (20 items), teaching and training plans and outcomes (42 items), research and results (9 items), development of clinical faculty and continuing education (8 items), academic exchanges and community education (8 items), and administration (8 items). The new standards have proven feasible and posed reasonable challenges in the pilot study. We hope the new standards will strengthen teaching and research, and improve the quality of hospital services at the same time.

  10. Developing 21st century accreditation standards for teaching hospitals: the Taiwan experience

    Directory of Open Access Journals (Sweden)

    Wung Cathy

    2009-12-01

    Full Text Available Abstract Background The purpose of this study is to establish teaching hospital accreditation standards anew with the hope that Taiwan's teaching hospitals can live up to the expectations of our society and ensure quality teaching. Methods The development process lasted two years, 2005-2006, and was separated into three stages. The first stage centered on leadership meetings and consensus building, the second on drafting the new standards with expert focus groups, and the third on a pilot study and subsequent revision. Results Our new teaching hospital accreditation standards have six categories and 95 standards as follows: educational resources (20 items, teaching and training plans and outcomes (42 items, research and results (9 items, development of clinical faculty and continuing education (8 items, academic exchanges and community education (8 items, and administration (8 items. Conclusions The new standards have proven feasible and posed reasonable challenges in the pilot study. We hope the new standards will strengthen teaching and research, and improve the quality of hospital services at the same time.

  11. Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

    Science.gov (United States)

    Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

    2016-01-01

    Background: There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. Methods: This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. Results: No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Conclusion: Based on the students’ perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered. PMID:27683645

  12. Does outsourcing paramedical departments of teaching hospitals affect educational status of the students?

    Science.gov (United States)

    Moslehi, Shandiz; Atefimanesh, Pezhman; Sarabi Asiabar, Ali; Ahmadzadeh, Nahal; Kafaeimehr, Mohamadhosein; Emamgholizadeh, Saeid

    2016-01-01

    There is an increasing trend of outsourcing public departments. Teaching hospitals also outsourced some of their departments to private sectors. The aim of this study was to investigate and compare the educational status of students in public and outsourced departments of teaching hospitals affiliated to Iran University of Medical Sciences. This study was conducted in six teaching hospitals of Iran University of Medical Sciences, which had public and outsourced teaching departments in 2015. One hundred fifty students from the departments of radiology, physiotherapy and laboratory participated in this study and their perceptions about their educational status were assessed. A valid and reliable questionnaire was used; participation in the study was voluntary. Descriptive statistics such as mean (SD), t-test and Kolmogorov-Smirnov were used. No difference was detected between the educational status of students in public and outsourced departments of radiology, physiotherapy and laboratory (p>0.05). Based on the students' perception, the private sectors could maintain the educational level of the teaching departments similar to the public departments. It is recommended to involve all the stakeholders such as hospital administrators, academic staff and students in the decision- making process when changes in teaching environments are being considered.

  13. A Model for Teaching Large Classes: Facilitating a "Small Class Feel"

    Science.gov (United States)

    Lynch, Rosealie P.; Pappas, Eric

    2017-01-01

    This paper presents a model for teaching large classes that facilitates a "small class feel" to counteract the distance, anonymity, and formality that often characterize large lecture-style courses in higher education. One author (E. P.) has been teaching a 300-student general education critical thinking course for ten years, and the…

  14. Hospital waste management status in Iran: a case study in the teaching hospitals of Iran University of Medical Sciences.

    Science.gov (United States)

    Farzadkia, Mahdi; Moradi, Arash; Mohammadi, Mojtaba Shah; Jorfi, Sahand

    2009-06-01

    Hospital waste materials pose a wide variety of health and safety hazards for patients and healthcare workers. Many of hospitals in Iran have neither a satisfactory waste disposal system nor a waste management and disposal policy. The main objective of this research was to investigate the solid waste management in the eight teaching hospitals of Iran University of Medical Sciences. In this cross-sectional study, the main stages of hospital waste management including generation, separation, collection, storage, and disposal of waste materials were assessed in these hospitals, located in Tehran city. The measurement was conducted through a questionnaire and direct observation by researchers. The data obtained was converted to a quantitative measure to evaluate the different management components. The results showed that the waste generation rate was 2.5 to 3.01 kg bed(-1) day(-1), which included 85 to 90% of domestic waste and 10 to 15% of infectious waste. The lack of separation between hazardous and non-hazardous waste, an absence of the necessary rules and regulations applying to the collection of waste from hospital wards and on-site transport to a temporary storage location, a lack of proper waste treatment, and disposal of hospital waste along with municipal garbage, were the main findings. In order to improve the existing conditions, some extensive research to assess the present situation in the hospitals of Iran, the compilation of rules and establishment of standards and effective training for the personnel are actions that are recommended.

  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. Bridging the Gap: A Framework and Strategies for Integrating the Quality and Safety Mission of Teaching Hospitals and Graduate Medical Education.

    Science.gov (United States)

    Tess, Anjala; Vidyarthi, Arpana; Yang, Julius; Myers, Jennifer S

    2015-09-01

    Integrating the quality and safety mission of teaching hospitals and graduate medical education (GME) is a necessary step to provide the next generation of physicians with the knowledge, skills, and attitudes they need to participate in health system improvement. Although many teaching hospital and health system leaders have made substantial efforts to improve the quality of patient care, few have fully included residents and fellows, who deliver a large portion of that care, in their efforts. Despite expectations related to the engagement of these trainees in health care quality improvement and patient safety outlined by the Accreditation Council for Graduate Medical Education in the Clinical Learning Environment Review program, a structure for approaching this integration has not been described.In this article, the authors present a framework that they hope will assist teaching hospitals in integrating residents and fellows into their quality and safety efforts and in fostering a positive clinical learning environment for education and patient care. The authors define the six essential elements of this framework-organizational culture, teaching hospital-GME alignment, infrastructure, curricular resources, faculty development, and interprofessional collaboration. They then describe the organizational characteristics required for each element and offer concrete strategies to achieve integration. This framework is meant to be a starting point for the development of robust national models of infrastructure, alignment, and collaboration between GME and health care quality and safety leaders at teaching hospitals.

  17. appendicitis in university of port harcourt teaching hospital, nigeria

    African Journals Online (AJOL)

    2012-10-01

    Oct 1, 2012 ... Design: Hospital based retrospective study. Setting: Department ... studies have supported the clinical findings with the ... diagnosis in 90-95% of cases (3). ... Generalised abdominal pain. 14 (10.8). Fever. 47 (36.2). Anorexia.

  18. Utilization Pattern of Vancomycin in a University Teaching Hospital ...

    African Journals Online (AJOL)

    HP

    vis a vis to the Hospital Infection Control Practices Advisory Committee (HICPAC) guidelines and the ... effective against most Gram-positive bacteria ... Proper use of TDM procedures along ..... between antecedent vancomycin treatment and.

  19. Video‑assisted thoracic surgery in a Nigerian teaching hospital ...

    African Journals Online (AJOL)

    2015-05-20

    May 20, 2015 ... minimally invasive surgery of the chest where a thoracotomy is avoided, access .... 6 patients (24%), spontaneous pneumothorax in. 5 patients (20%) ... involves less surgical trauma and results in a reduction in hospital stay.[1].

  20. Trials of large group teaching in Malaysian private universities: a cross sectional study of teaching medicine and other disciplines

    Science.gov (United States)

    2011-01-01

    Background This is a pilot cross sectional study using both quantitative and qualitative approach towards tutors teaching large classes in private universities in the Klang Valley (comprising Kuala Lumpur, its suburbs, adjoining towns in the State of Selangor) and the State of Negeri Sembilan, Malaysia. The general aim of this study is to determine the difficulties faced by tutors when teaching large group of students and to outline appropriate recommendations in overcoming them. Findings Thirty-two academics from six private universities from different faculties such as Medical Sciences, Business, Information Technology, and Engineering disciplines participated in this study. SPSS software was used to analyse the data. The results in general indicate that the conventional instructor-student approach has its shortcoming and requires changes. Interestingly, tutors from Medicine and IT less often faced difficulties and had positive experience in teaching large group of students. Conclusion However several suggestions were proposed to overcome these difficulties ranging from breaking into smaller classes, adopting innovative teaching, use of interactive learning methods incorporating interactive assessment and creative technology which enhanced students learning. Furthermore the study provides insights on the trials of large group teaching which are clearly identified to help tutors realise its impact on teaching. The suggestions to overcome these difficulties and to maximize student learning can serve as a guideline for tutors who face these challenges. PMID:21902839

  1. Development of an effective risk management system in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Adibi Hossein

    2012-09-01

    Full Text Available Abstract Background Unsafe health care provision is a main cause of increased mortality rate amongst hospitalized patients all over the world. A system approach to medical error and its reduction is crucial that is defined by clinical and administrative activities undertaken to identify, evaluate, and reduce the risk of injury. The aim of this study was to develop and implement a risk management system in a large teaching hospital in Iran, especially of the basis of WHO guidelines and patient safety context. Methods WHO draft guideline and patient safety reports from different countries were reviewed for defining acceptable framework of risk management system. Also current situation of mentioned hospital in safety matter and dimensions of patient safety culture was evaluated using HSOPSC questionnaire of AHRQ. With adjustment of guidelines and hospital status, the conceptual framework was developed and next it was validated in expert panel. The members of expert panel were selected according to their role and functions and also their experiences in risk management and patient safety issues. The validated framework consisted of designating a leader and coordinator core, defining communications, and preparing the infrastructure for patient safety education and culture-building. That was developed on the basis of some values and commitments and included reactive and proactive approaches. Results The findings of reporting activities demonstrated that at least 3.6 percent of hospitalized patients have experienced adverse events and 5.3 percent of all deaths in the hospital related with patient safety problems. Beside the average score of 12 dimensions of patient safety culture was 46.2 percent that was considerably low. The “non-punitive responses to error” had lowest positive score with 21.2 percent. Conclusion It is of paramount importance for all health organizations to lay necessary foundations in order to identify safety risks and improve

  2. Development of an effective risk management system in a teaching hospital.

    Science.gov (United States)

    Adibi, Hossein; Khalesi, Nader; Ravaghi, Hamid; Jafari, Mahdi; Jeddian, Ali Reza

    2012-09-21

    Unsafe health care provision is a main cause of increased mortality rate amongst hospitalized patients all over the world. A system approach to medical error and its reduction is crucial that is defined by clinical and administrative activities undertaken to identify, evaluate, and reduce the risk of injury. The aim of this study was to develop and implement a risk management system in a large teaching hospital in Iran, especially of the basis of WHO guidelines and patient safety context. WHO draft guideline and patient safety reports from different countries were reviewed for defining acceptable framework of risk management system. Also current situation of mentioned hospital in safety matter and dimensions of patient safety culture was evaluated using HSOPSC questionnaire of AHRQ. With adjustment of guidelines and hospital status, the conceptual framework was developed and next it was validated in expert panel. The members of expert panel were selected according to their role and functions and also their experiences in risk management and patient safety issues. The validated framework consisted of designating a leader and coordinator core, defining communications, and preparing the infrastructure for patient safety education and culture-building. That was developed on the basis of some values and commitments and included reactive and proactive approaches. The findings of reporting activities demonstrated that at least 3.6 percent of hospitalized patients have experienced adverse events and 5.3 percent of all deaths in the hospital related with patient safety problems. Beside the average score of 12 dimensions of patient safety culture was 46.2 percent that was considerably low. The "non-punitive responses to error" had lowest positive score with 21.2 percent. It is of paramount importance for all health organizations to lay necessary foundations in order to identify safety risks and improve the quality of care. Inadequate participation of staff in education

  3. Understanding end water quality in hospitals and other large buildings

    Science.gov (United States)

    Local hospitals are depending on the use of copper silver ionization treatment to control Legionella in premise plumbing. Discussion will show some results that speak to the effectiveness of this treatment to control opportunistic pathogens.

  4. TEACHING BUSINESS CORRESPONDENCE FOR TOURISM AND HOSPITALITY THROUGH COLLABORATIVE WRITING APPROACH

    OpenAIRE

    Budi Purnomo

    2017-01-01

    This research aims at answering problems: (1) ―How to teach business correspondence for tourism and hospitality (BCTH) through collaborative writing approach (CWA)?‖ (2) ―What are the advantages of teaching BCTH through CWA?‖ and (3) ―What are the disadvantages of teaching BCHT through CWA?‖ This study is a descriptive and qualitative research. It uses three techniques for collecting data: observation and field notes, questionnaire and in-depth interviewing. It was undertaken in a Business Co...

  5. Hospital Accreditation: What is its Effect on Quality and Safety Indicators? Experience of an Iranian teaching hospital

    Directory of Open Access Journals (Sweden)

    Ali Janati

    2016-07-01

    Full Text Available Background: program evaluation is an integral and expected component in the development of any healthcare program. It helps decision-makers to base their decisions on facts. Objective: This paper analyzes the effect of accreditation on three indicators related to patient safety and hospital care quality in ICU wards of an Iranian teaching hospital. Methods: This interventional study was accomplished based on executive management and scientific methods such as plan-do-check-act (PDCA cycle and audit to improve quality and safety. We used data reported from ICU wards of the hospital to analyze the effect of accreditation on the three selected indicators. (SPSS version 22.00 was used for the statistical analysis. Results: In total, 6997 patients were analyzed. The accreditation interventions appeared to be effective at reducing pressure ulcer incidence average (from an average of 6.8 percent to 4.1 percent (p=0.045. The accreditation also. The average stay of the patients during the study also positively changed from an average of 1.58 days to 10.13 days (1.45 improvements(p=0.0303. In relation to hospital acquired infection but, unexpectedly, its effect on hospital was negative, then it considerably increased and rose from 1.5 percent to 8.1 percent (p=0.001. However this increasing was due to enhanced infection incident report system. Conclusion: hospital accreditation has presented ample opportunity a significant positive effect on hospitals

  6. Evaluation of the medical records system in an upcoming teaching hospital-a project for improvisation.

    Science.gov (United States)

    Kumar, B Deepak; Kumari, C M Vinaya; Sharada, M S; Mangala, M S

    2012-08-01

    The medical records system of an upcoming teaching hospital in a developing nation was evaluated for its accessibility, completeness, physician satisfaction, presence of any lacunae, suggestion of necessary steps for improvisation and to emphasize the importance of Medical records system in education and research work. The salient aspects of the medical records department were evaluated based on a questionnaire which was evaluated by a team of 40 participants-30 doctors, 5 personnel from Medical Records Department and 5 from staff of Hospital administration. Most of the physicians (65%) were partly satisfied with the existing medical record system. 92.5% were of the opinion that upgradation of the present system is necessary. The need of the hour in the present teaching hospital is the implementation of a hospital-wide patient registration and medical records re-engineering process in the form of electronic medical records system and regular review by the audit commission.

  7. Economic burden of managing Type 2 diabetes mellitus: Analysis from a Teaching Hospital in Malaysia.

    Science.gov (United States)

    Ismail, Aniza; Suddin, Leny Suzana; Sulong, Saperi; Ahmed, Zafar; Kamaruddin, Nor Azmi; Sukor, Norlela

    2017-01-01

    Type 2 diabetes mellitus (T2DM) is a chronic disease that consumes a large amount of health-care resources. It is essential to estimate the cost of managing T2DM to the society, especially in developing countries. Economic studies of T2DM as a primary diagnosis would assist efficient health-care resource allocation for disease management. This study aims to measure the economic burden of T2DM as the primary diagnosis for hospitalization from provider's perspective. A retrospective prevalence-based costing study was conducted in a teaching hospital. Financial administrative data and inpatient medical records of patients with primary diagnosis (International Classification Disease-10 coding) E11 in the year 2013 were included in costing analysis. Average cost per episode of care and average cost per outpatient visit were calculated using gross direct costing allocation approach. Total admissions for T2DM as primary diagnosis in 2013 were 217 with total outpatient visits of 3214. Average cost per episode of care was RM 901.51 (US$ 286.20) and the average cost per outpatient visit was RM 641.02 (US$ 203.50) from provider's perspective. The annual economic burden of T2DM for hospitalized patients was RM 195,627.67 (US$ 62,104) and RM 2,061,520.32 (US$ 654,450) for those being treated in the outpatient setting. Economic burden to provide T2DM care was higher in the outpatient setting due to the higher utilization of the health-care service in this setting. Thus, more focus toward improving T2DM outpatient service could mitigate further increase in health-care cost from this chronic disease.

  8. Factors affecting the informal payments in public and teaching hospitals.

    Science.gov (United States)

    Aboutorabi, Ali; Ghiasipour, Maryam; Rezapour, Aziz; Pourreza, Abolghasem; Sarabi Asiabar, Ali; Tanoomand, Asghar

    2016-01-01

    Informal payments in the health sector of many developing countries are considered as a major impediment to health care reforms. Informal payments are a form of systemic fraud and have adverse effects on the performance of the health system. In this study, the frequency and extent of informal payments as well as the determinants of these payments were investigated in general hospitals affiliated to Tehran University of Medical Sciences. In this cross-sectional study, 300 discharged patients were selected using multi-stage random sampling method. First, three hospitals were selected randomly; then, through a simple random sampling, we recruited 300 discharged patients from internal, surgery, emergency, ICU & CCU wards. All data were collected by structured telephone interviews and questionnaire. We analyzed data using Chi- square, Kruskal-Wallis and Mann-Whitney tests. The results indicated that 21% (n=63) of individuals paid informally to the staff. About 4% (n=12) of the participants were faced with informal payment requests from hospital staff. There was a significant relationship between frequency of informal payments with marital status of participants and type of hospitals. According to our findings, none of the respondents had informal payments to physicians. The most frequent informal payments were in cash and were made to the hospitals' housekeeping staff to ensure more and better services. There was no significant relationship between the informal payments with socio-demographic characteristics, residential area and insurance status. Our findings revealed that many strategies can be used for both controlling and reducing informal payments. These include training patients and hospitals' staff, increasing income levels of employees, improving the quantity and quality of health services and changing the entrenched beliefs that necessitate informal payments.

  9. 15 Pattern of bladder cancer at University Teaching Hospital, Lusaka,

    African Journals Online (AJOL)

    Esem

    bladder cancer who presented to the hospital during this period were recruited .... malignant tissues. Table 2: Distribution of variables among patients. Gender number. Percentage .... cancer of the cervix, cancer of the eye, breast cancer,. Kaposi's sarcoma .... as a result of national wide roll out of anti retroviral treatment in ...

  10. Culinary and hospitality teaching as a research-based profession

    African Journals Online (AJOL)

    Research in Hospitality Management is co-published by NISC (Pty) Ltd and Routledge, Taylor & Francis Group. Copyright © NISC (Pty) .... in medical cases, law cases, or in the physical models of of ... provide teachers with the sort of concepts and insights that .... creation of strategic research plans, the selection of research.

  11. Microbiological assessment of indoor air of teaching hospital wards ...

    African Journals Online (AJOL)

    Thus, the objective of this study is to provide fundamental data related to the microbial quality of indoor air of Jimma University Specialized Hospital wards, to estimate the health hazard and to create standards for indoor air quality control. METHODS: The microbial quality of indoor air of seven wards of Jimma University ...

  12. Triple Gestations in Two University Teaching Hospitals in Yaounde ...

    African Journals Online (AJOL)

    3Department of Obstetrics & Gynecology, Central Hospital Yaounde/Faculty of Medicine and Biomedical Sciences,. University of Yaounde I, BP 337, Yaounde, Cameroon. Address correspondence to E. Nkwabong, enkwabong@yahoo.fr. Received 27 November 2010; Accepted 19 January 2011. Abstract The frequency of ...

  13. Paediatric utilisation of a teaching hospital and a community health ...

    African Journals Online (AJOL)

    to Red Cross Children's Hospital (RXH) that could be more ... better access and perceived quality. S Atr Med ... tertiary resources, low levels of efficiency and staff ... However, central to improved patterns of utilisation is the .... the modei were: (/) age of the child; (it) duration of residence ... There was no significant association.

  14. Hydatidiform mole in university of Calabar teaching hospital, Nigeria ...

    African Journals Online (AJOL)

    Suction evacuation was done in all the cases. About 63% of patients had 1-3 months follow up, while 2.9% continued beyond 1 year. The case fatality was 1.47%. However. 12 patients never came back to the hospital after evacuation. Conclusion : Molar pregnancy is a common cause of first trimester miscarriages and ...

  15. Prevalence of malnutrition in hospital children in federal teaching ...

    African Journals Online (AJOL)

    Background: Malnutrition is a state of excess or deficiency in energy, protein and or other nutrients which causes measurable adverse effects on body forms and function. A holistic approach is required in the management of hospitalized pediatric patients and includes the assessment and management of nutritional ...

  16. Teaching to the Test: A Very Large Red Herring

    Science.gov (United States)

    Phelps, Richard P.

    2016-01-01

    Elevating teaching-to-the-test to dogma, from the beginning with the distortion of J.J. Cannell's 1980s "Lake Wobegon" findings, has served to divert attention from scandals that should have threatened US educators' almost complete control of their own evaluation. Had the test cheating scandal Dr. Cannell uncovered been portrayed…

  17. A study on job satisfaction among clinical and non-clinical hospital staff in a teaching hospital in Lagos, Nigeria.

    Science.gov (United States)

    Coker, O O; Coker, A O; Onuoha, B

    2011-12-01

    Previous studies had demonstrated that continuous and effective productivity of hospital staff are linked to job satisfaction and only those who are satisfied with their job can be maximally effective and productive. This cross-sectional descriptive survey was designed to determine the levels of job satisfaction among various groups of health care professionals working in a teaching hospital in Lagos, Nigeria. Two hundred clinical and non-clinical hospital staff were invited to take part in the study. They completed a sociodemographic questionnaire and the Job Descriptive Index (JDI). The results indicated that majority clinical and non-clinical staff were satisfied with their jobs as regards the parameters of the JDI compared with those not satisfied with their jobs. The government and health policy makers should continue to pay attention to boost job morale and satisfaction of medical health workers to continue to make them to be satisfied with their job.

  18. Multimorbidity in a large district hospital: A descriptive cross ...

    African Journals Online (AJOL)

    Mitchell's Plain District Hospital, Western Cape Department of Health, Cape Town, South Africa. Corresponding author: E de .... group as a whole, 6.3% of patients had mental illness. .... be investigated, research can also be focused specifically on reducing .... strongly affected by social stigma, particularly in the case of illicit.

  19. Traffic flow and microbial air contamination in operating rooms at a major teaching hospital in Ghana

    DEFF Research Database (Denmark)

    Stauning, M. T.; Bediako-Bowan, A.; Andersen, L. P.

    2018-01-01

    . Aim: To assess microbial air contamination in operating rooms at a Ghanaian teaching hospital and the association with door-openings and number of people present. Moreover, we aimed to document reasons for door-opening. Methods: We conducted active air-sampling using an MAS 100® portable impactor...

  20. THE EFFECT OF OUTPATIENT SERVICE QUALITY ON PATIENT SATISFACTION IN TEACHING HOSPITALS IN IRAN.

    Science.gov (United States)

    Pouragha, Behrouz; Zarei, Ehsan

    2016-02-01

    The quality of services plays a primary role in achieving patient satisfaction. The main purpose of this study was to explore the effect of outpatient service quality on patient satisfaction in teaching hospitals in Iran. this cross-sectional study was conducted in 2014. The study sample included 500 patients were selected with systematic random method from the outpatient departments (clinics) of four teaching hospitals in Tehran. The survey instrument was a questionnaire consisted of 44 items, which were confirmed its reliability and validity. The data were analyzed by using descriptive statistics, Pearson's correlation, and multivariate regression methods with the SPSS.18 software. According to the findings of this study, the majority of patients had a positive experience in the outpatient departments of the teaching hospitals and thus evaluated the services as good. Perceived service costs, physician consultation, physical environment, and information to patient were found to be the most important determinants of outpatient satisfaction. The results suggest that improving the quality of consultation, providing information to the patients during examination and consultation, creating value for patients by reducing costs or improving service quality, and enhancing the physical environment quality of the clinic can be regarded as effective strategies for the management of teaching hospitals toward increasing outpatient satisfaction.

  1. Positioning academic medical centers and teaching hospitals to thrive in the next decade.

    Science.gov (United States)

    Morris, D E

    1985-06-01

    Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification.

  2. Factors Associated with Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana

    Science.gov (United States)

    Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A.; Akingbola, Titilola S.; Hewlett, Sandra A.; Tayo, Bamidele O.; Cole, Helen V.; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

    2016-01-01

    Background: Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study…

  3. Radiodiagnosis in the Plzen teaching hospital in the last 15 years (1961 to 1976)

    International Nuclear Information System (INIS)

    Chudacek, Z.

    1978-01-01

    The development is shown of radiodiagnosis at the Teaching Hospital in Plzen and in the West Bohemian region in the period 1961 to 1976. Quantitative and qualitative increase radiodiagnosis is analysed. The introduction of new diagnostic methods and equipment is discussed. (author)

  4. Hospitality and tourism management professor receives Fulbright to teach in India

    OpenAIRE

    Ho, Sookhan

    2009-01-01

    Mahmood A. Khan, professor of hospitality and tourism management at Virginia Tech's Pamplin College of Business, has been awarded a Fulbright-Nehru Scholar grant to teach at the Indian Institute of Technology in New Delhi during the 2009-10 academic year.

  5. A "Prepaid Package" for Obstetrics: Effect on Teaching and Patient Care in a University Hospital

    Science.gov (United States)

    Young, Philip E.

    1976-01-01

    The changing social milieu has removed the charity patient but not the need for a teaching population. The University Hospital's program is described, in which patients prepaid a fixed, single fee for all obstetrics-related care through the third post partum day. (LBH)

  6. Preventing nosocomial infections: improving compliance with standard precautions in an Indonesian teaching hospital.

    NARCIS (Netherlands)

    Duerink, D.O.; Farida, H.; Nagelkerke, N.J.; Wahyono, H.; Keuter, M.; Lestari, E.S.; Hadi, U.; Broek, P.J.J.A. van den

    2006-01-01

    Standard precautions can prevent transmission of micro-organisms. This study investigated hand hygiene, handling of needles and use of personal protective equipment in an Indonesian teaching hospital, and performed a multi-faceted intervention study to improve compliance. An intervention was

  7. Resident training in a teaching hospital: How do attendings teach in the real operative environment?

    Science.gov (United States)

    Glarner, Carly E; Law, Katherine E; Zelenski, Amy B; McDonald, Robert J; Greenberg, Jacob A; Foley, Eugene F; Wiegmann, Douglas A; Greenberg, Caprice C

    2017-07-01

    The study aim was to explore the nature of intraoperative education and its interaction with the environment where surgical education occurs. Video and audio recording captured teaching interactions between colorectal surgeons and general surgery residents during laparoscopic segmental colectomies. Cases and collected data were analyzed for teaching behaviors and workflow disruptions. Flow disruptions (FDs) are considered deviations from natural case progression. Across 10 cases (20.4 operative hours), attendings spent 11.2 hours (54.7%) teaching, using directing (M = 250.1), and confirming (M = 236.1) most. FDs occurred 410 times, accounting for 4.4 hours of case time (21.57%). Teaching occurred with FD events for 2.4 hours (22.2%), whereas 77.8% of teaching happened outside FD occurrence. Teaching methods shifted from active to passive during FD events to compensate for patient safety. Understanding how FDs impact operative learning will inform faculty development in managing interruptions and improve its integration into resident education. Copyright © 2016. Published by Elsevier Inc.

  8. The relationship between employees’ continuing education and performance in Tehran’s teaching hospitals

    Directory of Open Access Journals (Sweden)

    Mohsen Ghobadi Tara

    2016-01-01

    Full Text Available Introduction: Continuing education and training of employees significantly affect a hospital’s performance and efficiency, and learning organizations usually exhibit higher efficiency. Hence, the objective of this study was to evaluate the correlation between the hospital employees’ continuing education and performance indicators in the teaching hospitals affiliated to Tehran’s Azad University. Method: A cross-sectional study was conducted in the teaching hospitals affiliated to Tehran’s Azad University in 2014. The subjects consisted of 70 professional hospital employees, including physicians, nurses, midwives and other personnel who had attended continuing education courses. A data collection form was used to collect the data. The data were analyzed with SPSSW-20 software. Pearson correlation coefficient was used at a significance level of 0.05. Results:The number of continuing education courses held for physicians and nurses was equal five courses, while fewer courses were held for the remaining personnel. There were significant associations between the employees’ continuing education and bed occupancy rate (p=0.009 and bed turnover interval (p=0.01. There was no significant association between the employees’ continuing education and hospital death rate (p=0.19. Conclusion: Training employees ultimately affects their performance in the hospital. Hence, a deeper insight into the significance of hospital training is needed for decision-making policy-makers and for hospitals’ executive managers to efficiently use the limited therapeutic resources and eventually achieve optimum effectiveness.

  9. Self-Concept, Values Orientation, and Teaching Performance Among Hospitality Educators

    Directory of Open Access Journals (Sweden)

    Joy D. Jocson

    2014-02-01

    Full Text Available This survey-correlational study aimed to investigate the self-concept, values orientation, and teaching performance among hospitality educators of the West Visayas State University System. The study was conducted in January 2013 and utilized 42 randomly selected hospitality educators as participants. The simple random sampling method was used in the selection of the participants. Three (3 standardized and published datagathering instruments were adapted to obtain the data for the study. To ascertain the degree of self-concept, Girdano and Everly’s (1979 Self-perception Test instrument was used. In determining the pre-dominant values orientation, Rokeach’s (1973 Value Survey Form used by Rabago (1988 was utilized. To ascertain the level of teaching performance, the WVSU F-PES was employed. Frequency counts, rank, percentage analyses, mean scores, and standard deviations were employed as descriptive statistics; while t-test for independent samples, one-way ANOVA, and Pearson’s Product Moment Coefficient of Correlation (Pearson’s r were employed as inferential statistics. The criterion for the acceptance or rejection of the null hypotheses was set at .05 alpha level. The results of the study revealed that, generally, the hospitality educators had outstanding teaching performance and strong self-concept. Family security, salvation, and happiness were their most important terminal values while social recognition, a world of beauty and pleasure were their least important values. Loving, responsible, and honest were their most important instrumental values and imaginative, ambitious, and clean were their least important values. In terms of teaching performance, no significant differences existed when hospitality educators were classified according sex, age, civil status, educational attainment, status of employment and number of years in teaching. Significant differences existed in the degree of self-concept among hospitality educators grouped

  10. Prevalence of auditory changes in newborns in a teaching hospital

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    Guimarães, Valeriana de Castro

    2012-01-01

    Full Text Available Introduction: The precocious diagnosis and the intervention in the deafness are of basic importance in the infantile development. The loss auditory and more prevalent than other joined riots to the birth. Objective: Esteem the prevalence of auditory alterations in just-born in a hospital school. Method: Prospective transversal study that evaluated 226 just-been born, been born in a public hospital, between May of 2008 the May of 2009. Results: Of the 226 screened, 46 (20.4% had presented absence of emissions, having been directed for the second emission. Of the 26 (56.5% children who had appeared in the retest, 8 (30.8% had remained with absence and had been directed to the Otolaryngologist. Five (55.5% had appeared and had been examined by the doctor. Of these, 3 (75.0% had presented normal otoscopy, being directed for evaluation of the Evoked Potential Auditory of Brainstem (PEATE. Of the total of studied children, 198 (87.6% had had presence of emissions in one of the tests and, 2 (0.9% with deafness diagnosis. Conclusion: The prevalence of auditory alterations in the studied population was of 0,9%. The study it offers given excellent epidemiologists and it presents the first report on the subject, supplying resulted preliminary future implantation and development of a program of neonatal auditory selection.

  11. Title: Evaluation of Organizational Intelligence , Organizational learning and Organizational Agility in Teaching Hospitals of Yazd City: A Case Study at Teaching Hospitals of Yazd City in 2015

    Directory of Open Access Journals (Sweden)

    MA Kiani

    2017-01-01

    Full Text Available Background: Organizational intelligence has been defined as the capacity of an organization to direct its mental abilities and use these capabilities to achieve its mission and agility means ability to react quickly to environmental changes and it is an important factor for hospital effectiveness. This study was aimed to Evaluate Organizational Intelligence and Organizational learning and Organizational Agility in Teaching Hospitals of Yazd City. Methods: this descriptive, analytical, cross-sectional study was conducted in 2015 .the study population included administrative and medical staff in Shahid Sadoughi,, Shahid Rahnemoon,, Afshar and burning hospital. A total of 370 administrative and medical staff were contributed in the study.  We used stratified-random method for sampling. The required data were gathered using 3 valid questionnaires including Albrecht- Organizational Intelligence (2002, organizational learning (neefe2001 and  organizational agility questionnaire according to theory Sharifi & Zhang (1999  . data was analyzed by descriptive and inferential statistical methods in SPSS18 . Results: mean Organizational Intelligence scores hospital was 2.29, organizational learning scores hospital was 1.48 and organizational agility scores hospital was 1.52. as well as , hospital variable and Education  affect on Organizational Intelligence, organizational learning and organizational agility. Conclusion: Based on the findings it can be concluded that the implementation of appropriate strategies for improving the organizational capacity to direct its employees’ mental abilities, can also improve the ability of organization’s rapid response to surrounding issues which is crucial for its survival and dynamics in today’s changing world

  12. Applying the Balanced Scorecard approach in teaching hospitals: a literature review and conceptual framework.

    Science.gov (United States)

    Trotta, Annarita; Cardamone, Emma; Cavallaro, Giusy; Mauro, Marianna

    2013-01-01

    Teaching hospitals (THs) simultaneously serve three different roles: offering medical treatment, teaching future doctors and promoting research. The international literature recognises such organisations as 'peaks of excellence' and highlights their economic function in the health system. In addition, the literature describes the urgent need to manage the complex dynamics and inefficiency issues that threaten the survival of teaching hospitals worldwide. In this context, traditional performance measurement systems that focus only on accounting and financial measures appear to be inadequate. Given that THs are highly specific and complex, a multidimensional system of performance measurement, such as the Balanced Scorecard (BSC), may be more appropriate because of the multitude of stakeholders, each of whom seek a specific type of accountability. The aim of the paper was twofold: (i) to review the literature on the BSC and its applications in teaching hospitals and (ii) to propose a scorecard framework that is suitable for assessing the performance of THs and serving as a guide for scholars and practitioners. In addition, this research will contribute to the ongoing debate on performance evaluation systems by suggesting a revised BSC framework and proposing specific performance indicators for THs. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Multiple challenges of antibiotic use in a large hospital in Ethiopia - a ward-specific study showing high rates of hospital-acquired infections and ineffective prophylaxis.

    Science.gov (United States)

    Gutema, Girma; Håkonsen, Helle; Engidawork, Ephrem; Toverud, Else-Lydia

    2018-05-03

    This project aims to study the use of antibiotics in three clinical wards in the largest tertiary teaching hospital in Ethiopia for a period of 1 year. The specific aims were to assess the prevalence of patients on antibiotics, quantify the antibiotic consumption and identify the main indications of use. The material was all the medical charts (n = 2231) retrieved from three clinical wards (internal medicine, gynecology/obstetrics and surgery) in Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa between September 2013 and September 2014. Data collection was performed manually by four pharmacists. Each medical chart represented one patient. About 60% of the patients were admitted to internal medicine, 20% to each of the other two wards. The number of bed days (BD) was on average 16.5. Antibiotics for systemic use were prescribed to 73.7% of the patients (on average: 2.1 antibiotics/patient) of whom 86.6% got a third or fourth generation cephalosporin (mainly ceftriaxone). The average consumption of antibiotics was 81.6 DDD/100BD, varying from 91.8 in internal medicine and 71.6 in surgery to 47.6 in gynecology/obstetrics. The five most frequently occurring infections were pneumonia (26.6%), surgical site infections (21.5%), neutropenic fever (6.9%), sepsis (6.4%) and urinary tract infections (4.7%). About one fourth of the prescriptions were for prophylactic purposes. Hospital acquired infections occurred in 23.5% of the patients (353 cases of surgical site infection). The prescribing was based on empirical treatment and sensitivity testing was reported in only 3.8% of the cases. In the present study from three wards in the largest tertiary teaching hospital in Ethiopia, three out of four patients were prescribed antibiotics, primarily empirically. The mean antibiotic consumption was 81.6 DDD/100BD. Surgical site infections constituted a large burden of the infections treated in the hospital, despite extensive prescribing of prophylaxis. The findings show

  14. Liver scanning using indium-113m at the University Teaching Hospital, Lusaka, Zambia

    Energy Technology Data Exchange (ETDEWEB)

    Mulaisho, C [Nuclear Medicine Unit, Department of Medicine, University of Zambia, Lusaka, Zambia; Mumba, K N [Radio-isotope Research Unit, National Council for Scientific Research, Lusaka, Zambia

    1981-11-21

    Liver scanning using the radio-isotope indium-113m, can now be routinely perfomed at the University Teaching Hospital, Lusaka, Zambia. The dose used is 1 - 4 mCi. Liver scans have been performed on 48 subjects, including 10 healthy individuals 16 patients with histologically proven hepatocellular carcinoma, 11 with clinical and laboratory evidence of portal hypertension and 11 with miscellaneous illnesses. Seven representative scans are illustrated. The procedure is easy, and gives a fairly accurate functional estimate of Kupffer cell mass. In hepatoma the scan may be either larger than or smaller than normal and reflects more accurately the residual function of the Kupffer cells. In cirrhosis of the liver with portal hypertention, residual Kupffer cell mass is small. Consequently, most of the indium-113m is taken up by the splenic reticulo-endothelial system, resulting in a large spleen scan. This technique, although fraught with major limitations, is a useful additional diagnostic tool in the management of chronic liver disease.

  15. Teaching hospital financial status and patient outcomes following ACGME duty hour reform.

    Science.gov (United States)

    Navathe, Amol S; Silber, Jeffrey H; Small, Dylan S; Rosen, Amy K; Romano, Patrick S; Even-Shoshan, Orit; Wang, Yanli; Zhu, Jingsan; Halenar, Michael J; Volpp, Kevin G

    2013-04-01

    To examine whether hospital financial health was associated with differential changes in outcomes after implementation of 2003 ACGME duty hour regulations. Observational study of 3,614,174 Medicare patients admitted to 869 teaching hospitals from July 1, 2000 to June 30, 2005. Interrupted time series analysis using logistic regression to adjust for patient comorbidities, secular trends, and hospital site. Outcomes included 30-day mortality, AHRQ Patient Safety Indicators (PSIs), failure-to-rescue (FTR) rates, and prolonged length of stay (PLOS). All eight analyses measuring the impact of duty hour reform on mortality by hospital financial health quartile, in postreform year 1 ("Post 1") or year 2 ("Post 2") versus the prereform period, were insignificant: Post 1 OR range 1.00-1.02 and Post 2 OR range 0.99-1.02. For PSIs, all six tests showed clinically insignificant effect sizes. The FTR rate analysis demonstrated nonsignificance in both postreform years (OR 1.00 for both). The PLOS outcomes varied significantly only for the combined surgical sample in Post 2, but this effect was very small, OR 1.03 (95% CI 1.02, 1.04). The impact of 2003 ACGME duty hour reform on patient outcomes did not differ by hospital financial health. This finding is somewhat reassuring, given additional financial pressure on teaching hospitals from 2011 duty hour regulations. © Health Research and Educational Trust.

  16. [A Survey of the Perception of Nurses Toward the Practice Environment at a Regional Teaching Hospital in Central Taiwan].

    Science.gov (United States)

    Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan

    2015-08-01

    The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.

  17. Effects of implementing time-variable postgraduate training programmes on the organization of teaching hospital departments.

    Science.gov (United States)

    van Rossum, Tiuri R; Scheele, Fedde; Sluiter, Henk E; Paternotte, Emma; Heyligers, Ide C

    2018-01-31

    As competency-based education has gained currency in postgraduate medical education, it is acknowledged that trainees, having individual learning curves, acquire the desired competencies at different paces. To accommodate their different learning needs, time-variable curricula have been introduced making training no longer time-bound. This paradigm has many consequences and will, predictably, impact the organization of teaching hospitals. The purpose of this study was to determine the effects of time-variable postgraduate education on the organization of teaching hospital departments. We undertook exploratory case studies into the effects of time-variable training on teaching departments' organization. We held semi-structured interviews with clinical teachers and managers from various hospital departments. The analysis yielded six effects: (1) time-variable training requires flexible and individual planning, (2) learners must be active and engaged, (3) accelerated learning sometimes comes at the expense of clinical expertise, (4) fast-track training for gifted learners jeopardizes the continuity of care, (5) time-variable training demands more of supervisors, and hence, they need protected time for supervision, and (6) hospital boards should support time-variable training. Implementing time-variable education affects various levels within healthcare organizations, including stakeholders not directly involved in medical education. These effects must be considered when implementing time-variable curricula.

  18. Defining teaching hospitals' GME strategy in response to new financial and market challenges.

    Science.gov (United States)

    Wray, J L; Sadowski, S M

    1998-04-01

    The authors present an overview of current graduate medical education (GME) issues, particularly the financial challenges to teaching hospitals resulting from the Balanced Budget and Tax Payer Relief Acts of 1997 and other recent market-driven factors. They describe in detail the nature of Medicare GME payments before and after the 1997 legislation, with specific examples, and explain the negative financial impact of the legislation and aspects of the legislation that are designed to alleviate that impact. Other factors influencing GME program size and composition are also discussed, including oversupplies or shortages of physicians, the concern that teaching hospitals are using public funds to train international medical graduates, changing training requirements, etc. The authors also describe a recent consulting assignment during which they assisted a major teaching hospital to develop a GME strategy that was responsive to the organization's mission and patients and that took into account future GME financing challenges. Detailed explanations are given of how the consultants analyzed the hospital's GME programs and finances, developed and ranked key institution-specific program criteria (strategic, organizational and operational, and financial), and, in consultation with all key stakeholders, formulated a GME strategy specific to the institution's needs. The authors conclude by cautioning that each institution's GME strategy will be different, but that it is important for institutions to develop such strategies to better face future challenges.

  19. Pharmacoepidemiology of antiretroviral drugs in a teaching hospital ...

    African Journals Online (AJOL)

    Objective: Prescribing, adherence, and adverse drug events to HAART in a large antiretroviral programme in Lagos was evaluated. Design: A retrospective 5 year open cohort study. Setting: The AIDS Prevention Initiative in Nigeria (APIN) clinic at LUTH is one of the United States Presidential Emergency Plan for AIDS ...

  20. Cancer Mortality Pattern in Lagos University Teaching Hospital, Lagos, Nigeria

    International Nuclear Information System (INIS)

    Akinde, O. R.; Phillips, A. A.; Oguntunde, O. A.; Afolayan, O. M.

    2014-01-01

    Cancer is a leading cause of death worldwide and about 70% of all cancer deaths occurred in low- and middle-income countries. The cancer mortality pattern is quite different in Africa compared to other parts of the world. Extensive literature research showed little or no information about the overall deaths attributable to cancer in Nigeria. Aims and Objectives. This study aims at providing data on the patterns of cancer deaths in our center using the hospital and autopsy death registers. Methodology. Demographic, clinical data of patients who died of cancer were extracted from death registers in the wards and mortuary over a period of 14 years (2000-2013). Results. A total of 1436 (4.74%) cancer deaths out of 30287 deaths recorded during the period. The male to female ratio was 1:2.2 and the peak age of death was between 51 and 60 years. Overall, breast cancer was responsible for most of the deaths. Conclusion. The study shows that the cancers that accounted for majority of death occurred in organs that were accessible to screening procedures and not necessary for survival. We advise regular screening for precancerous lesions in these organs so as to reduce the mortality rate and burden of cancer.Cancer is a leading cause of death worldwide and about 70% of all cancer deaths occurred in low- and middle-income countries. The cancer mortality pattern is quite different in Africa compared to other parts of the world. Extensive literature research showed little or no information about the overall deaths attributable to cancer in Nigeria. Aims and Objectives. This study aims at providing data on the patterns of cancer deaths in our center using the hospital and autopsy death registers. Methodology. Demographic, clinical data of patients who died of cancer were extracted from death registers in the wards and mortuary over a period of 14 years (2000-2013). Results. A total of 1436 (4.74%) cancer deaths out of 30287 deaths recorded during the period. The male to female

  1. Pattern of sudden death at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South West Nigeria

    Directory of Open Access Journals (Sweden)

    Akinwusi PO

    2013-06-01

    Full Text Available Patience Olayinka Akinwusi,1,2 Akinwumi Oluwole Komolafe,3 Olanrewaju Olayinka Olayemi,2 Adeleye Abiodun Adeomi41Department of Medicine, College of Health Sciences, Osun State University, 2Department of Medicine, LAUTECH Teaching Hospital, Osogbo, 3Department of Morbid Anatomy, Obafemi Awolowo University Teaching, Hospitals Complex, Ile-Ife, Osun State, 4Department of Community Medicine, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, NigeriaBackground: The purpose of this study was to determine the etiology and epidemiologic characteristics of sudden death at Ladoke Akintola University of Technology (LAUTECH Teaching Hospital, South West Nigeria.Methods: This was a retrospective descriptive study of all cases of natural unexpected death, either occurring out of hospital or less than 24 hours after admission to LAUTECH Teaching Hospital, over a nine-year period from January 2003 to December 2011. Data were generated from information in the case notes and autopsy reports for these cases.Results: Sudden death accounted for 29 (4.0% of 718 adult medical deaths and 1.0% of all adult medical admissions. Out-of-hospital deaths occurred in 72.4% of cases. The mean age of the patients was 46.8 ± 11.5 (range 25–74 years. The male to female ratio was 6.25:1. Cardiovascular disease were the most common cause of death (51.7%, followed by respiratory disease (20.7%, pulmonary thromboembolism (10.4%, central nervous system disease (13.8%, gastrointestinal disorders (13.8%, severe chemical/drug poisoning (13.8%, and combined cardiovascular and central nervous system disease (13.8%. Hypertension-related causes were responsible for 14/29 (48.3% of the sudden deaths. Hypertensive heart disease accounted for 86.7% of the cardiovascular deaths, hypertensive heart failure accounted for 73.3%, whilst all heart failure cases accounted for 80.0%. Left ventricular hypertrophy was present in 69.2% of the patients with hypertensive heart disease. Moderate to severe

  2. Assessment of preoperative exams request in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Eduardo Toshiyuki Moro

    2014-04-01

    Background: preoperative exams aim to identify disorders that may compromise the patient´s perioperative care. However, unnecessary tests rarely change the outcome, and are expensive to institution. The aim of this study was to evaluate the preoperative tests ordered in Santa Lucinda hospital, Sorocaba - SP. Methods: after approval by the Ethics Committee of PUC-SP University, we assessed pre-anesthetic evaluation of patients undergoing elective surgery from march to August, 2011. We recorded: age, sex, ASA physical status, the presence of coexisting diseases, medication use, type of surgery and preoperative tests. They were classified as sufficient, sufficient with unnecessary tests, insufficient, or insufficient with unnecessary tests. Results: two hundred and nineteen records were evaluated, of which 52% were considered sufficient, but with unnecessary tests. For 24% of patients, the tests were insufficient, with some ordered unnecessarily. To 8% of patients, the tests were insufficient, and only 16% didn´t have insufficient and unnecessary tests. The most frequently ordered tests were hematocrit and hemoglobin. The exams most unnecessarily ordered were coagulation tests and dosage of serum urea. Among the necessary examinations, but unsolicited, there were ECG (27%, electrolytes (13% and creatinine (11%. Seventy-nine tests showed some kind of problem, but they didn´t change in behavior. Conclusions: preoperative tests unnecessarily ordered are frequent, which do not guarantee that some patients present to surgery without fundamental exams according to their risk group.

  3. Methicillin-resistant staphylococcal contamination of cellular phones of personnel in a veterinary teaching hospital

    Directory of Open Access Journals (Sweden)

    Julian Timothy

    2012-07-01

    Full Text Available Abstract Background Hospital-associated infections are an increasing cause of morbidity and mortality in veterinary patients. With the emergence of multi-drug resistant bacteria, these infections can be particularly difficult to eradicate. Sources of hospital-associated infections can include the patients own flora, medical staff and inanimate hospital objects. Cellular phones are becoming an invaluable feature of communication within hospitals, and since they are frequently handled by healthcare personnel, there may be a potential for contamination with various pathogens. The objective of this study was to determine the prevalence of contamination of cellular phones (hospital issued and personal carried by personnel at the Ontario Veterinary College Health Sciences Centre with methicillin-resistant Staphylococcus pseudintermedius (MRSP and methicillin-resistant Staphylococcus aureus (MRSA. Results MRSP was isolated from 1.6% (2/123 and MRSA was isolated from 0.8% (1/123 of cellular phones. Only 21.9% (27/123 of participants in the study indicated that they routinely cleaned their cellular phone. Conclusions Cellular phones in a veterinary teaching hospital can harbour MRSP and MRSA, two opportunistic pathogens of significant concern. While the contamination rate was low, cellular phones could represent a potential source for infection of patients as well as infection of veterinary personnel and other people that might have contact with them. Regardless of the low incidence of contamination of cellular phones found in this study, a disinfection protocol for hospital-issued and personal cellular phones used in veterinary teaching hospitals should be in place to reduce the potential of cross-contamination.

  4. Evaluation of Patient-Oriented Standards of Joint Commission International in Gilan and Mazandaran Teaching Hospitals

    Directory of Open Access Journals (Sweden)

    Ghaseminejhad

    2016-08-01

    Full Text Available Background Medical tourism, a multi-million-dollar industry, has had a significant effect in economic flourishing, creating jobs, and preventing the outflow of currency. Objectives The aim of this study was to evaluate teaching hospitals affiliated to Gilan and Mazandaran University of Medical Sciences, according to joint commission international (JCI standards. Methods This was a descriptive cross sectional study conducted among teaching hospitals affiliated to Gilan and Mazandaran University of Medical Sciences during year 2015. To collect data and evaluate the hospitals, patient-oriented standards of JCI was applied. Results Amongst the eight standards, international patient safety goals (IPSG (with a score of 87.5% had the highest, and patient and family education (PFE (with a score of 53.75% had the lowest score. Hospital “4” with a score of 90.41%, had the highest, and hospital “7” with 58.90%, had the lowest rate of compliance to the standards. According to the Mann-Whitney test, the observed statistics considering a P value of ≤ 0.05 level, was not significant, therefore on a 95% certainty level, there was no significant difference between hospitals in Gilan and Mazandaran, regarding compliance with standards. Overall, the hospitals under study were relatively prepared for attracting medical tourists. Conclusions According to the results, it seems that more planning and implementation of projects is required to strengthen the axes of the joint commission regarding accreditation of hospitals and attraction of medical tourists to these centers, especially foreign tourists. Researchers are recommended to pay special attention to the university of medical sciences of two provinces for the establishment of standards and utilization of professional consultants.

  5. Muddy puddles - the microbiology of puddles located outside tertiary university teaching hospitals.

    Science.gov (United States)

    Furukawa, M; McCaughan, J; Stirling, J; Millar, B C; Bell, J; Goldsmith, C E; Reid, A; Misawa, N; Moore, J E

    2018-04-01

    In the British Isles, the frequency of rain results in the formation of puddles on footpaths and roads in/around hospitals. No data are available demonstrating the microbiological composition of such puddles and therefore a study was undertaken to examine the microbiology of puddles in the grounds of two tertiary university-teaching hospitals (18 sites) and compared with control puddles from non-hospital rural environments (eight sites), estimating (i) total viable count; (ii) identification of organisms in puddles; (iii) enumeration of Escherichia coli: (iv) detection of Extended Spectrum β-Lactamase producing organisms and (v) direct antimicrobial susceptibility testing. A mean count of 2·3 × 10 3  CFU per ml and 1·0 × 10 9  CFU per ml was obtained for hospital and non-hospital puddles respectively. Isolates (n = 77; 54 hospital and 23 non-hospital) were isolated comprising of 23 species among 17 genera (hospital sites), where the majority (10/16; 62·5%) of genera identified were Gram-negative approximately, a fifth (20·6%) were shared by hospital and non-hospital rural samples. Escherichia coli was detected in half of the hospital puddles and under-half (37·5%) of the rural puddles extended spectrum β-lactamase organisms were not detected in any samples examined. Rainwater puddles from the hospital and non-hospital environments contain a diverse range of bacteria, which are capable of causing infections. This study demonstrated the presence of a wide diversity of bacterial taxa associated with rainwater puddles around hospitals, many of which are capable of causing human disease. Of clinical significance is the presence of Pseudomonas aeruginosa isolated from a hospital puddle, particularly for patients with cystic fibrosis. The presence of potentially disease-causing bacteria in puddles in and around hospitals identifies a new potential environmental reservoir of bacteria. Furthermore work is now needed to define their potential of entering or

  6. Malpractice awareness among surgeons at a teaching hospital in Pakistan

    Directory of Open Access Journals (Sweden)

    Sheikh Asfandyar

    2012-11-01

    Full Text Available Abstract Background The duty of a doctor to take care presumes the person who offers medical advice and treatment to unequivocally possess the skills and knowledge to do so. However, a sense of responsibility cannot be guaranteed in the absence of accountability, which in turn requires a comprehensive medical law system to be in place. Such a system is almost non-existent in Pakistan. Keeping the above in mind, we designed this study to assess the knowledge, attitudes and practices of surgeons regarding malpractice at a tertiary care center in Pakistan. Methods This was an observational, cross-sectional, questionnaire-based study conducted during a three month period from 31st March, 2012 to 30th June, 2012 at Civil Hospital, Karachi. Surgeons who were available during the period of our study and had been working in the hospital for at least 6 months were included. Self-administered questionnaires were distributed after seeking informed, written consent. The specialties included were general surgery, cardiothoracic surgery, neurosurgery, ophthalmology, otolaryngology, plastic surgery, pediatric surgery, orthopedic surgery, oral and maxillofacial surgery and gynecology and obstetrics. The study questionnaire comprised of four sections. The first section was concerned with the demographics of the surgeons. The second section analyzed the knowledge of the respondents regarding professional negligence and malpractice. The third section assessed the attitudes surgeons with regard to malpractice. The last section dealt with the general and specific practices and experiences of surgeons regarding malpractice. Results Of the 319 surgeons interviewed, 68.7% were oblivious of the complete definition of malpractice. Leaving foreign objects inside the patient (79.6% was the most commonly agreed upon form of malpractice, whereas failure to break news in entirety (43.9% was most frequently disagreed. In the event of a medical error, majority (67.7% were ready

  7. Malpractice awareness among surgeons at a teaching hospital in Pakistan.

    Science.gov (United States)

    Sheikh, Asfandyar; Ali, Sajid; Ejaz, Sadaf; Farooqi, Marium; Ahmed, Syed Salman; Jawaid, Imran

    2012-11-06

    The duty of a doctor to take care presumes the person who offers medical advice and treatment to unequivocally possess the skills and knowledge to do so. However, a sense of responsibility cannot be guaranteed in the absence of accountability, which in turn requires a comprehensive medical law system to be in place. Such a system is almost non-existent in Pakistan. Keeping the above in mind, we designed this study to assess the knowledge, attitudes and practices of surgeons regarding malpractice at a tertiary care center in Pakistan. This was an observational, cross-sectional, questionnaire-based study conducted during a three month period from 31st March, 2012 to 30th June, 2012 at Civil Hospital, Karachi. Surgeons who were available during the period of our study and had been working in the hospital for at least 6 months were included. Self-administered questionnaires were distributed after seeking informed, written consent. The specialties included were general surgery, cardiothoracic surgery, neurosurgery, ophthalmology, otolaryngology, plastic surgery, pediatric surgery, orthopedic surgery, oral and maxillofacial surgery and gynecology and obstetrics. The study questionnaire comprised of four sections. The first section was concerned with the demographics of the surgeons. The second section analyzed the knowledge of the respondents regarding professional negligence and malpractice. The third section assessed the attitudes surgeons with regard to malpractice. The last section dealt with the general and specific practices and experiences of surgeons regarding malpractice. Of the 319 surgeons interviewed, 68.7% were oblivious of the complete definition of malpractice. Leaving foreign objects inside the patient (79.6%) was the most commonly agreed upon form of malpractice, whereas failure to break news in entirety (43.9%) was most frequently disagreed. In the event of a medical error, majority (67.7%) were ready to disclose their error to the patient. The most

  8. Malpractice awareness among surgeons at a teaching hospital in Pakistan

    Science.gov (United States)

    2012-01-01

    Background The duty of a doctor to take care presumes the person who offers medical advice and treatment to unequivocally possess the skills and knowledge to do so. However, a sense of responsibility cannot be guaranteed in the absence of accountability, which in turn requires a comprehensive medical law system to be in place. Such a system is almost non-existent in Pakistan. Keeping the above in mind, we designed this study to assess the knowledge, attitudes and practices of surgeons regarding malpractice at a tertiary care center in Pakistan. Methods This was an observational, cross-sectional, questionnaire-based study conducted during a three month period from 31st March, 2012 to 30th June, 2012 at Civil Hospital, Karachi. Surgeons who were available during the period of our study and had been working in the hospital for at least 6 months were included. Self-administered questionnaires were distributed after seeking informed, written consent. The specialties included were general surgery, cardiothoracic surgery, neurosurgery, ophthalmology, otolaryngology, plastic surgery, pediatric surgery, orthopedic surgery, oral and maxillofacial surgery and gynecology and obstetrics. The study questionnaire comprised of four sections. The first section was concerned with the demographics of the surgeons. The second section analyzed the knowledge of the respondents regarding professional negligence and malpractice. The third section assessed the attitudes surgeons with regard to malpractice. The last section dealt with the general and specific practices and experiences of surgeons regarding malpractice. Results Of the 319 surgeons interviewed, 68.7% were oblivious of the complete definition of malpractice. Leaving foreign objects inside the patient (79.6%) was the most commonly agreed upon form of malpractice, whereas failure to break news in entirety (43.9%) was most frequently disagreed. In the event of a medical error, majority (67.7%) were ready to disclose their error

  9. PREVALENCE OF THYROID DISORDERS IN PREGNANCY AT A TEACHING HOSPITAL

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    Guntoory Indira

    2017-01-01

    Full Text Available BACKGROUND Thyroid disorders are the second most common endocrinological disorders seen in pregnant women. Thyroid hormone plays a crucial role in pregnancy both in the development of a healthy baby and in maintaining the health of the mother. Several studies have shown a rising prevalence of thyroid disease in India and in South Asian countries. The diagnosis of thyroid disease in pregnancy is difficult as many of the signs and symptoms of thyroid disease are also common to pregnancy. The aim of the study is to determine the prevalence of thyroid disease in pregnant women. MATERIALS AND METHODS This is a hospital-based cross-sectional study. 333 antenatal women were screened in their first visit to the antenatal clinic by serum TSH, fT3, fT4. Statistical analysis of the results was done. RESULTS 283 women out of 333 antenatal women screened were found to be euthyroid. 50 women were detected to be having thyroid disorder. 45 women had subclinical hypothyroidism, one woman had overt hypothyroidism and four women had subclinical hyperthyroidism. 4 women had hypothyroidism prior to pregnancy. The overall prevalence of thyroid disorders in pregnancy in our study was found to be 16.21%. CONCLUSION The prevalence was found to be high in our study and in several studies from India and in its neighbouring countries. This is probably due to iodine deficiency being prevalent in several areas in our country. The prevalence of subclinical hypothyroidism is high. This all the more stresses the need for universal screening of pregnant women for thyroid disease in our country.

  10. Audit of colonoscopy practice in Lagos University Teaching Hospital

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    Adedapo Osinowo

    2016-01-01

    Full Text Available Introduction: Recent procurement of new endoscopies and accessories led to the reactivation of diagnostic and therapeutic colonoscopy services at our center. A preliminary audit is deemed necessary after a 2-year period of open access colonoscopy. Objective: To assess the pattern of indications, diagnostic yield, and selected key performance indicators in the practice of colonoscopy at our tertiary hospital. Patients and Methods: The endoscopy reports of all patients that underwent colonoscopy from January 2012 to April 2014 were reviewed. The demographic data, indications, and endoscopic findings were recorded. Information on cecal intubation, colonoscopy withdrawal time, polyp detection, adverse events, and bowel preparation quality were also extracted and analyzed. Results: Colonoscopy was performed in 149 patients. They were 81 males and 68 females, aged between 18 and 101 years with a mean of 46.9 ± 22.7 years. 126 (84.5% patients had a colonoscopy for symptomatic conditions while 5 (4% were for screening. Bowel preparation was assessed to be excellent in 81 (54.4%, adequate in 42 (28.2%, and inadequate in 26 (17.4% patients, respectively. The cecal intubation rate (CIR was 80.2%, polyp detection rate 7.4%, average colonoscopy withdrawal time was 6 min 53 s, overall diagnostic yield 55.9% and there were no adverse events. Tumors were seen in 19 patients (10.1%; 13 were located in the rectum, three in the sigmoid and three in the descending colon. Conclusion: The audit revealed that our CIR could be improved by a more effective bowel preparation, increased expertise, and procedure volume of endoscopists. Tumors of the colorectum were detected in 10.1% of patients.

  11. Gender inequality in acute coronary syndrome patients at Omdurman Teaching Hospital, Sudan

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    Hyder O Mirghani

    2016-01-01

    Full Text Available Background: Gender differences among patients with the acute coronary syndrome is still being debated, no research has been done on gender inequality among coronary syndrome patients in Sudan. Objectives: To study gender differences in presentation, management, and outcomes of acute coronary syndrome in Sudan. Subjects and Methods: This cross-sectional descriptive longitudinal study was conducted in Omdurman Teaching Hospital between July 2014 and August 2015. Patients were invited to sign a written informed consent form, were interviewed and examined by a physician, and then followed during their hospital stay. Information collected includes coronary risk factors, vital signs, echocardiography findings, arrhythmias, heart failure, cardiogenic shock, and death. The Ethical Committee of Omdurman Teaching Hospital approved the research. Results: A total of 197 consecutive acute coronary syndrome patients were included, 43.1% were females. A significant statistical difference was evident between males and females regarding the type of acute coronary syndrome, its presentation, and time of presentation to the hospital, smoking, and receipt of thrombolysis (P 0.05. Conclusion: Women were less likely to receive thrombolytic therapy, present with chest pain, and diagnosed with ST-segment elevation myocardial infarction. No gender differences were found in acute coronary syndrome risk factors apart from smoking, which was more common in males, and there were no differences between males and females as regards in-hospital complications.

  12. Gender inequality in acute coronary syndrome patients at Omdurman Teaching Hospital, Sudan.

    Science.gov (United States)

    Mirghani, Hyder O; Elnour, Mohammed A; Taha, Akasha M; Elbadawi, Abdulateef S

    2016-01-01

    Gender differences among patients with the acute coronary syndrome is still being debated, no research has been done on gender inequality among coronary syndrome patients in Sudan. To study gender differences in presentation, management, and outcomes of acute coronary syndrome in Sudan. This cross-sectional descriptive longitudinal study was conducted in Omdurman Teaching Hospital between July 2014 and August 2015. Patients were invited to sign a written informed consent form, were interviewed and examined by a physician, and then followed during their hospital stay. Information collected includes coronary risk factors, vital signs, echocardiography findings, arrhythmias, heart failure, cardiogenic shock, and death. The Ethical Committee of Omdurman Teaching Hospital approved the research. A total of 197 consecutive acute coronary syndrome patients were included, 43.1% were females. A significant statistical difference was evident between males and females regarding the type of acute coronary syndrome, its presentation, and time of presentation to the hospital, smoking, and receipt of thrombolysis (P 0.05). Women were less likely to receive thrombolytic therapy, present with chest pain, and diagnosed with ST-segment elevation myocardial infarction. No gender differences were found in acute coronary syndrome risk factors apart from smoking, which was more common in males, and there were no differences between males and females as regards in-hospital complications.

  13. The design of diagnostic imaging and nuclear medicine facilities in a major new teaching hospital

    International Nuclear Information System (INIS)

    Causer, D.A.

    2010-01-01

    Full text: The design of the layout and radiation shielding for diagnostic imaging and nuclear medicine facilities in a modern teaching hospital requires the collaboration of persons from a number of professions including architects, engineers, radiologists, nuclear medicine physi cians, medical imaging technologists and medical physicists. This paper discusses the design of such facilities, including PET/CT and T-131 ablation therapy suites for a major new tertiary hospital in Perth. The importance of involving physicists on the planning team from the earliest stages of the design process is stressed, design plans presented, and some of the problems which may present themselves and their solutions are illustrated.

  14. Proton Beam Radiotherapy for Uveal Melanomas at Nice Teaching Hospital: 16 Years' Experience

    International Nuclear Information System (INIS)

    Caujolle, Jean-Pierre; Mammar, Hamid; Chamorey, Emmanuel Phar; Pinon, Fabien; Herault, Joel; Gastaud, Pierre

    2010-01-01

    Purpose: To present the results of uveal melanomas treated at Nice Teaching Hospital. Methods and Materials: This retrospective study included 886 consecutive patients referred to our clinic for the treatment of uveal melanomas by proton beam radiotherapy from June 1991 to December 2007. Survival rates were determined by using Kaplan-Meier estimates, and prognostic factors were evaluated using the log-rank test or Cox model. Results: The number (percent total) of subjects staged according to the TNM classification system (6th edition) of malignant tumors included 39 stage T1 (4.4%), 420 stage T2 (47.40%), 409 stage T3 (46.16%), and 18 stage T4 (2.03%) patients. The median follow-up was 63.7 months. The Kaplan-Meier overall survival rate at 5 years according to the sixth edition TNM classification was 92% for T1, 89% for T2, 67% for T3, and 62% for T4; and at 10 years, 86% for T1, 78% for T2, 43% for T3, and 41% for T4. Five factors were found to be associated with an increased death rate: advanced age, tumor thickness, largest tumor basal diameter, tumor volume, and tumor volume-to-eyeball volume ratio. The metastasis-free survival rates were 88.3 % at 5 years and 76.4 % at 10 years. The local control rates were 93.9% at 5 years and 92.1% at 10 years. The ocular conservation rates were 91.1% at 5 years and 87.3% at 10 years. Conclusions: We report the results of a large series of patients treated for uveal melanomas with a very long follow-up. Despite the large tumor volume treated, our results were similar to previously published findings relating to proton beam therapy.

  15. Patients’ Perception on Hospital Quality in a Teaching Hospital of Tehran

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    Samad Azari

    2016-01-01

    Full Text Available ​Background and Objectives : Due to unique characteristics of the health sector, measuring the efficiency and quality of services provided are the top priorities of the Ministry of Health and Medical Education. In health systems, an appropriate response to the needs and demands of patients is a priority. This study was conducted to assess hospital’s services quality using logit model for prioritizing service attributes based on patients’ perception in 2012. Material and Methods : In this descriptive cross-sectional study, 330 patients in Imam Khomeini Hospital in Tehran were entered into the study based on Cochran method. Data were gathered using questionnaire in 5 dimensions and 10 scenarios. Reliability and validity of the questionnaire were approved. Data were input into STATA software 10th edition and utility function was estimated to calculate the marginal utility specifications. Results : According to the patients’ perception, type of examination and treatment was ranked as the first and cleaning services of the departments and toilets was ranked as the last priority. The results about waiting time between hospital arrival until admission was negative which means reverse influence on patient perception of quality. Except cleaning services of the departments and toilets and handling patients, other features had significant relationship with patient preferences. Conclusion : In order to increase the desirability of visiting patients in hospitals and delivering high quality services and considering patient preferences; hospital administrators need to be focused on improving the quality of the programs.

  16. 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.

  17. Technical Support Document: Development of the Advanced Energy Design Guide for Large Hospitals - 50% Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, E.; Leach, M.; Pless, S.

    2013-06-01

    This Technical Support Document describes the process and methodology for the development of the Advanced Energy Design Guide for Large Hospitals: Achieving 50% Energy Savings Toward a Net Zero Energy Building (AEDG-LH) ASHRAE et al. (2011b). The AEDG-LH is intended to provide recommendations for achieving 50% whole-building energy savings in large hospitals over levels achieved by following Standard 90.1-2004. The AEDG-LH was created for a 'standard' mid- to large-size hospital, typically at least 100,000 ft2, but the strategies apply to all sizes and classifications of new construction hospital buildings. Its primary focus is new construction, but recommendations may be applicable to facilities undergoing total renovation, and in part to many other hospital renovation, addition, remodeling, and modernization projects (including changes to one or more systems in existing buildings).

  18. The profile of infertility in a teaching Hospital in North West Nigeria

    OpenAIRE

    Abubakar A Panti; Yusuf T Sununu

    2014-01-01

    Background: Infertility is a global health problem and a socially destabilizing condition for couples carrying several stigmas and a cause of marital disharmony. We determined the prevalence, causes, and clinical pattern of infertility at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto. Materials and Methods: This was a prospective study conducted at the Gynecological Department of UDUTH Sokoto between 1 st January, 2011 and 31 st July, 2011. All the patients that presented with...

  19. Physician Acceptance of a Computerized Outpatient Medication System in a Teaching Hospital Group Practice

    OpenAIRE

    Blish, Christi; Proctor, Rita; Fletcher, Suzanne W.; O'Malley, Michael

    1983-01-01

    As part of a new automated ambulatory medical record, a computerized outpatient medication system was developed for a teaching hospital general medicine group practice. Seven months after its implementation, the system was evaluated to determine physician acceptance and approval. Practice physicians were surveyed, and 94% of the respondents approved of the system. Over 90% thought that the computerized system had improved the completeness and accuracy of medication information as well as thei...

  20. Computer literacy enhancement in the Teaching Hospital Olomouc. Part I: project management techniques. Short communication.

    Science.gov (United States)

    Sedlár, Drahomír; Potomková, Jarmila; Rehorová, Jarmila; Seckár, Pavel; Sukopová, Vera

    2003-11-01

    Information explosion and globalization make great demands on keeping pace with the new trends in the healthcare sector. The contemporary level of computer and information literacy among most health care professionals in the Teaching Hospital Olomouc (Czech Republic) is not satisfactory for efficient exploitation of modern information technology in diagnostics, therapy and nursing. The present contribution describes the application of two basic problem solving techniques (brainstorming, SWOT analysis) to develop a project aimed at information literacy enhancement.

  1. Pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South East Nigeria

    OpenAIRE

    Osuji, Charles Ukachukwu; Onwubuya, Emmanuel Ikechukwu; Ahaneku, Gladys Ifesinachi; Omejua, Emeka Godwin

    2014-01-01

    Introduction Cardiovascular disease (CVD) is one of the top killer diseases in the world sparing neither developed or developing countries. The study was carried out to determine the pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi South East Nigeria. Methods The study was a retrospective study covering the period January 2007 to December 2009. SPSS version 13 software was used to analyze data. Results 537 (15%) patients were admitted into the study ou...

  2. Medical and surgical ward rounds in teaching hospitals of Kuwait University: students’ perceptions

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    AlMutar S

    2013-09-01

    Full Text Available Sara AlMutar,1 Lulwa AlTourah,1 Hussain Sadeq,2 Jumanah Karim,2 Yousef Marwan3 1Department of Medicine, 2Department of Pediatrics, Mubarak Al-Kabeer Hospital, 3Department of Orthopedic Surgery, Al-Razi Orthopedic Hospital, Kuwait City, Kuwait Background: Teaching sessions for medical students during ward rounds are an essential component of bedside teaching, providing students with the opportunity to regard patients as actual people, and to observe their physical conditions directly, allowing a better understanding of illnesses to be developed. We aim to explore medical students’ perceptions regarding medical and surgical ward rounds within the Faculty of Medicine at Kuwait University, and to evaluate whether this teaching activity is meeting the expectation of learners. Methods: A pretested questionnaire was used to collect data from 141 medical students during the 2012–2013 academic year. They were asked to provide their current and expected ratings about competencies that were supposed to be gained during ward rounds, on a scale from 1 (lowest to 5 (highest. Mean scores were calculated, and the Student t-test was used to compare results. P < 0.05 was the cut-off level for significance. Results: Only 17 students (12.1% declined to participate in the study. The students' current competency scores (for competencies taught within both disciplines – medical and surgical were significantly lower than the scores indicating students’ expectations (P < 0.001. The best-taught competency was bedside examination, in both medical (mean: 3.45 and surgical (mean: 3.05 ward rounds. However, medical ward rounds were better than surgical rounds in covering some competencies, especially the teaching of professional attitude and approach towards patients (P < 0.001. Conclusion: Both medical and surgical ward rounds were deficient in meeting the students’ expectations. Medical educators should utilize the available literature to improve the bedside

  3. Profile of Under-Five Malnourished Children Admitted in a Tertiary Care Teaching Hospital in Pune, India

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    Dhrubajyoti J Debnath

    2014-01-01

    Full Text Available Background: Malnutrition is a major public health problem in a developing country like India. Keeping this in mind a study was carried out to find the proportion of under-five children suffering from malnutrition among the under-five hospitalized children and to study co-morbid illnesses and epidemiological factors associated with malnutrition. Methods: This was a hospital-based cross sectional study carried out in the pediatric ward of a tertiary care teaching hospital in Pune, India. All under-five children suffering from malnutrition were studied over a period of 1 month. Results: Total number of under five children diagnosed as malnourished were 47 (39.83%. Moderate and severe/very severe malnutrition was statistically significantly higher in a girl child. The proportion of moderate and severe/very severe malnutrition was higher in low birth weight babies, children who were incompletely immunized for age. Faulty infant feeding practice was observed in 28 (59.6% children. Some of the co-morbid illnesses contributing to morbidity in the malnourished child were acute diarrheal diseases, acute respiratory infection, anemia, and septicemia. Conclusion: A large proportion of hospitalized children were malnourished. Girl child suffered from moderate to severe forms of malnutrition as compared to male child and this was the only statistically significant association. This may be due to neglect of girl child.

  4. PERCEPTION OF INTERN TEACHERS’ USE OF INTERACTIVE STRATEGIES IN TEACHING LARGE CLASSES IN ONLINE ENVIRONMENT

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    Carol Adaku Obiefuna

    2015-07-01

    Full Text Available Higher education institutions experience large classes despite the National Universities’ Commission’s (NUC and other supervisory agencies emphasis on carrying capacity of the institutions in Nigeria. The overpopulation affects effective teaching and learning and quality assurance. This study focused on perception of intern teachers of the use of interactive strategies in teaching Curriculum Studies in an online environment in a College of Education. 200 computer science students (intern teachers in a Curriculum Studies class formed the study sample. Three research questions guided the study. A structured and validated questionnaire with reliability index of 0.79, made up of 25 items constructed on a four-point Likert-type scale was administered on the students for data collection. The data were analysed using simple mean and the results showed that the intern teachers supported the use of the teaching strategies in an online class as a complement to the face to face method of teaching. They are also recommended as alternative strategies to reduce the problems associated with large classes. However, the research subjects were sceptical about the implementation of online teaching as a result of power supply and access to internet facilities. The findings have a far reaching implication for the 21st Century teaching and learning. Suggestions towards effective online teaching and learning were made especially with theGovernment’s reiteration of the need for Information and Communication Technology (ICT in the schools in Nigeria.

  5. Effect of teaching and checklist implementation on accuracy of medication history recording at hospital admission.

    Science.gov (United States)

    Lea, Marianne; Barstad, Ingeborg; Mathiesen, Liv; Mowe, Morten; Molden, Espen

    2016-02-01

    Medication discrepancies at hospital admission is an extensive problem and knowledge is limited regarding improvement strategies. To investigate the effect of teaching and checklist implementation on accuracy of medication history recording during hospitalization. Patients admitted to an internal medicine ward were prospectively included in two consecutive periods. Between the periods, non-mandatory teaching lessons were provided and a checklist assisting medication history recording implemented. Discrepancies between the recorded medications at admission and the patient's actual drug use, as revealed by pharmacist-conducted medication reconciliation, were compared between the periods. The primary endpoint was difference between the periods in proportion of patients with minimum one discrepancy. Difference in median number of discrepancies was included as a secondary endpoint. 56 and 119 patients were included in period 1 (P1) and period 2 (P2), respectively. There was no significant difference in proportion of patients with minimum one discrepancy in P2 (68.9 %) versus P1 (76.8 %, p = 0.36), but a tendency of lower median number of discrepancies was observed in P2 than P1, i.e. 1 and 2, respectively (p = 0.087). More powerful strategies than non-mandatory teaching activities and checklist implementation are required to achieve sufficient improvements in medication history recording during hospitalization.

  6. Patients’ experiences of being nursed by student nurses at a teaching hospital

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    Ferdinand C. Mukumbang

    2014-02-01

    Full Text Available Background: Teaching hospitals are medical institutes at which most nursing education institutions provide their students with practical nursing experience. Although the focus of care is the patient, attention is sometimes focused more on the nursing students rather than on the patients who are undergoing care at the hands of both the nursing professionals and students. However, proper nursing care should also take into account the experiences of patients during the care process in the health facility.Objectives: The study had three objectives: to describe the experiences of patients nursed by student nurses in a teaching hospital in the Western Cape; to identify patterns in the experiences of patients receiving patient care from student nurses; and to analyse aspects of the experiences that may need further attention for the training of student nurses.Method: A descriptive phenomenological approach was used to explore the experiences of patients nursed by student nurses. Participant selection took place purposively from different wards of the identified teaching hospital, and thematic saturation was achieved at 10 participants. The data were collected through in-depth interviews and analysed using thematic content analysis.Results: Three main themes were discovered after data analysis: methods of identification of student nurses by patients; positive perceptions of student nurses by patients; and negative perceptions of student nurses by patients.Conclusion: The findings will inform the clinical supervisors and educational institutions of aspects of the nursing training of student nurses that need improvement and those that require enforcement. 

  7. Anesthesia Capacity in Ghana: A Teaching Hospital's Resources, and the National Workforce and Education.

    Science.gov (United States)

    Brouillette, Mark A; Aidoo, Alfred J; Hondras, Maria A; Boateng, Nana A; Antwi-Kusi, Akwasi; Addison, William; Hermanson, Alec R

    2017-12-01

    Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016. Teaching hospital data were generated from observations of hospital facilities and patient care, review of archival records, and interviews with KATH personnel. National data were obtained from interviews with KATH personnel, correspondence with Ghana's anesthesia society, and review of public records. The practice of anesthesia at KATH incorporated preanesthesia clinics, intraoperative management, and critical care. However, there were not enough physicians to consistently supervise care, especially in postanesthesia care units (PACUs) and the critical care unit (CCU). Clean water and electricity were usually reliable in all 16 operating rooms (ORs) and throughout the hospital. Equipment and drugs were inventoried in detail. While much basic infrastructure, equipment, and medications were present in ORs, patient safety was hindered by hospital-wide oxygen supply failures and shortage of vital signs monitors and working ventilators in PACUs and the CCU. In 2015, there were 10,319 anesthetics administered, with obstetric and gynecologic, general, and orthopedic procedures comprising 62% of surgeries. From 2011 to 2015, all-cause perioperative mortality rate in ORs and PACUs was 0.65% or 1 death per 154 anesthetics, with 99% of deaths occurring in PACUs. Workforce and education data at KATH revealed 10 anesthesia attending physicians, 61 nurse anesthetists (NAs), and 7 anesthesia resident physicians in training. At the national level, 70 anesthesia attending physicians and 565 NAs cared for Ghana's population

  8. A flipped mode teaching approach for large and advanced electrical engineering courses

    Science.gov (United States)

    Ravishankar, Jayashri; Epps, Julien; Ambikairajah, Eliathamby

    2018-05-01

    A fully flipped mode teaching approach is challenging for students in advanced engineering courses, because of demanding pre-class preparation load, due to the complex and analytical nature of the topics. When this is applied to large classes, it brings an additional complexity in terms of promoting the intended active learning. This paper presents a novel selective flipped mode teaching approach designed for large and advanced courses that has two aspects: (i) it provides selective flipping of a few topics, while delivering others in traditional face-to-face teaching, to provide an effective trade-off between the two approaches according to the demands of individual topics and (ii) it introduces technology-enabled live in-class quizzes to obtain instant feedback and facilitate collaborative problem-solving exercises. The proposed approach was implemented for a large fourth year course in electrical power engineering over three successive years and the criteria for selecting between the flipped mode teaching and traditional teaching modes are outlined. Results confirmed that the proposed approach improved both students' academic achievements and their engagement in the course, without overloading them during the teaching period.

  9. The Effect of Job Demand-Control-Social Support Model on Nurses' Job Satisfaction in Specialized Teaching Hospitals, Ethiopia

    OpenAIRE

    Negussie, Nebiat; Kaur, Geetinder

    2016-01-01

    Background The job demand-control-social support model has been widely studied in western countries but has not been theoretically addressed on health workers of sub-Saharan African countries. Therefore, this study investigates the relationship between Job Demand-Control-Support Model and job satisfaction in specialized teaching hospitals in Ethiopia. Method A cross-sectional survey was conducted from September 2014 to May 2015 in three public specialized teaching hospitals in Ethiopia. Among...

  10. The Effect of Service Compact (SERVICOM) on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    OpenAIRE

    Jude Kennedy Emejulu; M. C. Muo; E. E.O. Chukwuemeka

    2014-01-01

    This study examined the effect of service compact (Servicom Service delivery) in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that requir...

  11. Teaching to the test: A very large red herring

    Directory of Open Access Journals (Sweden)

    Richard P. Phelps

    2016-05-01

    Full Text Available Elevating teaching-to-the-test to dogma, from the beginning with the distortion of Dr. Cannell’s findings, has served to divert attention from scandals that should have threatened US educators’ almost complete control of their own evaluation.[10] Had the scandal Dr. Cannell uncovered been portrayed honestly to the public—educators cheat on tests administered internally with lax security—the obvious solution would have been to externally manage all assessments (Oliphant, 2011. Recent test cheating scandals in Atlanta, Washington, DC, and elsewhere once again drew attention to a serious problem. But, instead of blaming lax security and internally managed test administration, most educators blamed the stakes and alleged undue pressure that ensues (Phelps 2011a. Their recommendation, as usual: drop the stakes and reduce the amount of testing. Never mind the ironies: they want oversight lifted so they may operate with none, and they admit that they cannot be trusted to administer tests to our children properly, but we should trust them to educate our children properly if we leave them alone. Perhaps the most profound factoids revealed by the more recent scandals were, first, that the cheating had continued for ten years in Atlanta before any responsible person attempted to stop it and, even then, it required authorities outside the education industry to report the situation honestly. Second, in both Atlanta and Washington, DC, education industry test security consultants repeatedly declared the systems free of wrongdoing (Phelps 2011b. Meanwhile, thirty years after J. J. Cannell first showed us how lax security leads to corrupted test scores, regardless the stakes, test security remains cavalierly loose. We have teachers administering state tests in their own classrooms to their own students, principals distributing and collecting test forms in their own schools. Security may be high outside the schoolhouse door, but inside, too much is left

  12. Job satisfaction of nurses in Jimma University Specialized Teaching Hospital, Ethiopia.

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    Negussie, Nebiat

    2016-03-01

    In Ethiopia nurses have played a very important role in providing timely and quality health service in healthcare organizations. However, there is a limited literature in the area of nurses' job satisfaction in Ethiopian public hospitals. The objective of this research is to measure job satisfaction of nurses in Jimma University Specialized Teaching Hospital and to determine the influencing factors. A cross-sectional survey was conducted from January 2012 to June 2012 in Jimma University Specialized Teaching Hospital. All full-time nurses with nonsupervisory management position and more than 1 year of work experience were invited to participate in the study. Minnesota Satisfaction Questionnaire was used to collect the data. A total of 175 copies of the questionnaires were returned out of 186 copies distributed to the respondents. The results indicated that nurses were not satisfied by their job (mean=2.21, SD=0.52). Remuneration (r=0.71, Pjob advancement (r=0.69, Pjob satisfaction. Job security was associated with highest satisfaction (r=0.41, Pjob advancement were the most important factors for nurses' job satisfaction. Hospital administrators as well as health policy makers need to address the two major identified sources of nurses' job dissatisfaction in the study (i.e. remuneration and narrow opportunity of job advancement) and take appropriate measures to overcome their consequences.

  13. Patient Satisfaction with Food Services in Teaching Hospitals of Tabriz; 2012

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    Massumeh gholizadeh

    2015-08-01

    Full Text Available Background and Objectives : Results of the previous studies indicate that nutrition as one of the basic elements in patient safety is neglected or plays a minor role in treatment process. This study aimed to assess patient satisfaction with food services in teaching hospitals of Tabriz University of medical sciences. Materials and Methods : This cross-sectional study was conducted in teaching hospitals of Tabriz University of medical sciences. A total 314 number of available beds were selected. Data gathering tool was a LIKERT-based researcher–made questionnaire with 15 questions. Validity and reliability of the tool were verified by Delphi method and Cronbach’s alpha test of 0.91. Sample t-test and ANOVA were used to analyze data. Results: This study’s findings declared the minimum satisfaction about hospitals’ food services include: patients’ demands, assistance while eating, the effect of food on improving health conditions, clean appearance of meal services, observing health standards and respect by distributors .The findings revealed a significant difference among different nutritional services in studied hospitals. However, there was not a meaningful relationship between the level of satisfaction and gender, occupation, education and place of residence.  Conclusion : Based on the results of this study, hospital managers are recommended to carry out activities to promote awareness of food services staff regarding food safety programs, employing more nutritionists and their active presence at the patient’s bedside and providing freedom of choice for patients. ​

  14. Computer-assisted instruction: a library service for the community teaching hospital.

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    McCorkel, J; Cook, V

    1986-04-01

    This paper reports on five years of experience with computer-assisted instruction (CAI) at Winthrop-University Hospital, a major affiliate of the SUNY at Stony Brook School of Medicine. It compares CAI programs available from Ohio State University and Massachusetts General Hospital (accessed by telephone and modem), and software packages purchased from the Health Sciences Consortium (MED-CAPS) and Scientific American (DISCOTEST). The comparison documents one library's experience of the cost of these programs and the use made of them by medical students, house staff, and attending physicians. It describes the space allocated for necessary equipment, as well as the marketing of CAI. Finally, in view of the decision of the National Board of Medical Examiners to administer the Part III examination on computer (the so-called CBX) starting in 1988, the paper speculates on the future importance of CAI in the community teaching hospital.

  15. HEALTH WORKERS' PERCEPTIONON THE QUALITY OF SERVICE AND CORPORATE CULTURE OF A TEACHING HOSPITAL IN NIGERIA.

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    Akpan, Etukumana Etiobong; Bassey, Orie Jacob

    2015-01-01

    Quality of service delivery remains the most important issue in hospitals since patients expect higher standard care and services. This quality service is rooted in the culture of the health care organization. Therefore,this study seeks to determine health workers' perception on the quality of service and corporate culture at University of Uyo Teaching hospital, Uyo, Nigeria. A cross-sectional descriptive study was carried out. Using structured questionnaire and convenient sampling technique, data were collected from 250 hospital workers.The responses on questions to elicit the hospital's quality of service and corporate culture were rated on a five-point Likert Scale as follows; Strongly Agree (SA), Agree (A), Neutral(N), Disagree (D) and Strongly Disagree (SD). Data entry and analysis were performed using Epi Info 3.2.2 (CDC, Atlanta, Georgia, USA). The minimum and maximum ages of the respondents were 21 years and 60 years respectively. The mean, median and mode ages in the respondents were 34.6 (± 7.88) years, 33 years, and 30 years respectively. Majority of the study respondents were in the age group of 31-40 years (30%), female (56.8%) and Doctors (36%). The respondents' positive perception on quality of service offered by the hospital was 69.2% (OR 5.05, 95% CI 3.39-7.52, P quality services as obtained in other hospitals. Majority of the workers in all the professions except Medical Doctors accepted that the hospital values the individual workers. Majority of the Pharmacists and Non-clinical staff accepted that the hospital management was flexible and understands the importance of balancing their work and personal life. Majority of the Doctors, Pharmacists and laboratory/image scientists did not accept that top management communicates changes in decisions that affect employees. The perception of health workers on the quality of service rendered by the University of Uyo Teaching Hospital was satisfactory. However, the hospital needs to improve on its

  16. Evaluation of chest and abdominal injuries in trauma patients hospitalized in the surgery ward of poursina teaching hospital, guilan, iran.

    Science.gov (United States)

    Hemmati, Hossein; Kazemnezhad-Leili, Ehsan; Mohtasham-Amiri, Zahra; Darzi, Ali Asghar; Davoudi-Kiakalayeh, Ali; Dehnadi-Moghaddam, Anoush; Kouchakinejad-Eramsadati, Leila

    2013-01-01

    Trauma, especially chest and abdominal trauma are increasing due to the growing number of vehicles on the roads, which leads to an increased incidence of road accidents. Urbanization, industrialization and additional problems are the other associated factors which accelerate this phenomenon. A better understanding of the etiology and pattern of such injuries can help to improve the management and ultimate the outcomes of these patients. This study aimed to evaluate the patients with chest and abdominal trauma hospitalized in the surgery ward of Poursina teaching hospital, Guilan, Iran. In this cross-sectional study, the data of all chest and abdominal trauma patients hospitalized in the surgery ward of Poursina teaching hospital were collected from March 2011 to March 2012. Information about age, gender, injured areas, type of injury (penetrating or blunt), etiology of the injury, accident location (urban or rural) and patients' discharge outcomes were collected by a questionnaire. In total, 211 patients with a mean age of 34.1 ± 1.68 years was entered into the study. The most common cause of trauma was traffic accidents (51.7%). Among patients with chest trauma, 45 cases (35.4%) had penetrating injuries and 82 cases (64.6%) blunt lesions. The prevalence of chest injuries was 35.5% and rib fractures 26.5%. In chest injuries, the prevalence of hemothorax was 65.3%, pneumothorax 2.7%, lung contusion 4% and emphysema 1.3%, respectively. There were 24 cases (27.9%) with abdominal trauma which had penetrating lesions and 62 cases (72.1%) with blunt lesions. The most common lesions in patients with penetrating abdominal injuries were spleen (24.2%) and liver (12.1%) lesions. The outcomes of the patients were as follow: 95.7% recovery and 4.3% death. The majority of deaths were observed among road traffic victims (77.7%). Considering the fact that road-related accidents are quite predictable and controllable; therefore, the quality promotion of traumatic patients' care

  17. Job satisfaction among hospital staff working in a Government teaching hospital of India

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    Poonam Jaiswal

    2015-01-01

    Full Text Available Background: In a resource-limited and high burden disease setting, satisfied human resource is an asset in terms of high productivity, efficiency and quality care. Aim: To assess job satisfaction among permanent employees working in a government hospital. Materials and Methods: A sample of 200 staff members was interviewed using 34-item, Likert response based, modified job satisfaction scale. Key factors for job satisfaction were identified after subjecting data to principal component analysis, varimax rotation and multivariate analysis using step-wise regression procedure. Results: The mean job satisfaction index was computed to be in a similar range, but was found to be highest for nurses (0.68, followed by doctors (0.66, support staff (0.63 and technicians (0.62. Nine uncorrelated and critical factors related to job satisfaction that explained 68.09% of the variability was identified, that is, communication, pay/salary, working conditions, organization supervision system, co-workers, workload, benefits, career aspects and rewards. A positive association was reported between job satisfaction score and factor scores (units of communication (0.133, benefits (0.110, working condition (0.027 and co-workers (0.032 and a negative relation with organizational supervision system (0.118, workload (0.093, rewards (0.035, pay/salary (0.034 and career prospects (0.017 respectively for all categories of respondents. However in case of doctors, co-workers (0.023 units showed a negative relation. Conclusion: There is scope for interventions to enhance job satisfaction and concomitant continuous monitoring can be useful in determining various service aspects that necessitate improvement. By enhancing job satisfaction, hospital administrator can improve not only the mental, psychological and social well-being of work-force, but also the financial health of an organization.

  18. Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education.

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    Ratelle, John T; Wittich, Christopher M; Yu, Roger C; Newman, James S; Jenkins, Sarah M; Beckman, Thomas J

    2015-09-01

    There is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM. This was a cross-sectional study of participants and didactic presentations from a national HM CME course in 2014. Participants provided CME teaching effectiveness (CMETE) ratings using an instrument with known validity evidence. Overall CMETE scores (5-point scale: 1 = strongly disagree; 5 = strongly agree) were averaged for each presentation, and associations between scores and presentation characteristics were determined using the Kruskal-Wallis test. The threshold for statistical significance was set at P teaching effectiveness scores and characteristics of effective CME presentations in HM. Our findings, which support previous research in other fields, indicate that CME presentations may be improved by increasing interactivity through the use of audience response systems and allowing longer presentations. © 2015 Society of Hospital Medicine.

  19. Assessment of Midwives’ Communication Skills at the Maternity Wards of Teaching Hospitals in Mashhad in 2014

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    Talate Khadivzadeh

    2015-06-01

    Full Text Available Background & aim:The quality of communication between midwives and parturient women is a determinant of maternal satisfaction with midwifery care. Therefore, this study was conducted to determine the communication skills of midwives at maternity wards of Mashhad teaching hospitals in 2014.   Methods:In this descriptive study, 49 midwives, working at Mashhad teaching hospitals, were randomly selected. All midwives worked rotating shifts at the wards. The midwives’ communication skills were assessed by the researcher, using the self-structured  observation checklist of communicative performance.   Results: The mean age of midwives was 39.11±9.66 years and their mean work experience was 15.9±8.77 years. In total, 68.3% of the participants experienced childbirth themselves. 66.7% of midwives were moderately  keen on midwifery as a profession. The mean score of the checklist obtained by midwives was 67.9±10.7. There was no relationship between midwives’ communication skills and work experience, childbirth experience, age or interest in midwifery. Conclusion:Considering the inadequacy of midwives’ communication skills, which could be the major cause of maternal dissatisfaction with delivery care, it is recommended that in-service training courses be held by applying new teaching methods. Moreover, the educational needs of midwives, including communication skills, should be considered in these training programs .

  20. Teaching Business Law to Non-Law Students, Culturally and Linguistically Diverse ("CaLD") Students, and Large Classes

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    Kariyawasam, Kanchana; Low, Hang Yen

    2014-01-01

    This paper is largely based on the experience of teaching law to students with non-legal background in business schools, with a focus on internationalisation and the large class lecture format. Business schools often consist of large classes which include a significant proportion of Culturally and Linguistically Diverse (CaLD) students. Teaching a…

  1. 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.

  2. Patient education process in teaching hospitals of Tehran University of Medical Sciences.

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    Seyedin, Hesam; Goharinezhad, Salime; Vatankhah, Soodabeh; Azmal, Mohammad

    2015-01-01

    Patient education is widely recognized as a core component of nursing. Patient education can lead to quality outcomes including adherence, quality of life, patients' knowledge of their illness and self-management. This study aimed to clarify patient education process in teaching hospitals affiliated to Tehran University of Medical Sciences (TUMS) in Iran. This cross-sectional study was conducted in 2013. In this descriptive quantitative study, the sample covered 187 head nurses selected from ten teaching hospitals through convenience sampling. Data were collected with a questionnaire developed specifically for this study. The questionnaire measured patient education process in four dimensions: need assessment, planning, implementing and evaluating. The overall mean score of patient education was 3.326±0.0524. Among the four dimensions of the patient education process, planning was in the highest level (3.570±0.0591) and the lowest score belonged to the evaluation of patient education (2.840 ±0.0628). Clarifying patient education steps, developing standardized framework and providing easily understandable tool-kit of the patient education program will improve the ability of nurses in delivering effective patient education in general and specialized hospitals.

  3. Adherence to oral anti-diabetic drugs among patients attending a Ghanaian teaching hospital

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    Bruce SP

    2015-03-01

    Full Text Available Background: The burden of diabetes mellitus, especially Type-2, continues to increase across the world. Medication adherence is considered an integral component in its management. Poor glycemic controls due to medication nonadherence accelerates the development of long-term complications which consequently leads to increased hospitalization and mortality. Objective: This study examined the level of adherence to oral antidiabetic drugs among patients who visited the teaching hospital and explored the probable contributory factors to non-adherence. Methods: A cross-sectional descriptive study using systematic sampling to collect quantitative data was undertaken. Questionnaires were administered to out-patients of the medical department of a teaching hospital in Ghana. Logistic regression was performed with statistical significance determined at p<0.05. Results: A total of 200 diabetic patients participated in the study. Using the Morisky Medication Adherence scale, the level of adherence determined was 38.5%. There were significant correlations between level of adherence and educational level [(OR=1.508; (CI 0.805- 2.825, P=0.019, and mode of payment [(OR=1.631; (CI 0.997- 2.669, P=0.05. Conclusion: Adherence in diabetic patients was low among respondents and this can be improved through education, counseling and reinforcement of self-care. There were several possible factors that contributed to the low adherence rate which could benefit from further studies.

  4. STANDARD PRECAUTIONS: AN ASSESSMENT OF AWARENESS AMONG HEALTH CARE PERSONNEL IN A TEACHING HOSPITAL, SOUTH INDIA.

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    Sangeetha

    2015-02-01

    Full Text Available BACKGROUND : Standard precautions ar e crucial in the prevention and transmission of Healthcare associated infections ( HAI and transmission of blood - borne pathogens like Hepatitis B, Human Immunodeficiency Virus & Hepatitis C. They are not well u nderstood or implemented by health care practitioners. Hence this study was taken up to determine and compare knowledge, attitude of standard precautions among health care personnel at a teaching hospital, Bangalore. OBJECTIVE : To assess knowledge, attitud e, practices and compliance of Standard precautions among health care workers at a teaching hospital. METHODOLOGY : One hundred and fifty seven health care personnel participated in this study. A pretest and post test was administered to the study group. A pre - structured questionnaire on standard precautions was prepared which included knowledge, attitude and practices. RESULTS : 116 ( 73.88% nurses had knowledge about hand hygiene, but only 82 ( 52.2% nurses practiced hand hygiene before and after patient care. Knowledge about PPE measures like gloves, face mask & goggles, gowns were known to 101(64.33%, 56 ( 35.66% & 69 ( 43.94% nurses respectively. 117 ( 74.52% nurses discarded needles & sharps in correct puncture proof containers, but their correct knowled ge regarding colour coding of hospital waste segregation was comparatively less i.e. 104 ( 66.24%. 119 ( 75.79% of the nurses had practice of recapping the needles after use. CONCLUSION : There was significant improvement in the knowledge and practice of stan dard precautions in the present study after incorporating good training practices

  5. Assessment of Safety Condition in One of the Teaching Hospitals in Kermanshah (2015: A Case Study

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    Masod Ghanbari Kakavand

    2016-09-01

    Full Text Available Background & Aims of the Study: Many working conditions-related stress factors that can produce injuries and illnesses are important in hospital environments. So, the health and safety of nurses and patients from workplace-induced injuries and illnesses is important. In this study, we have assessed the safety condition of one of the teaching hospitals in Kermanshah (2015. Materials and Methods: This descriptive and cross-sectional study was conducted in one of the teaching hospital of Kermanshah University of medical sciences. For this aim a checklist was prepared based on the Occupational Safety and Health Administration's standards and Part 3 of the manual of National Building Regulations. These checklists comprised (The final checklist had 239 questions of 9 dimensions various sections of safety including; fire safety, building safety, electrical safety, emergency exit routes safety, heating and cooling equipment safety, operating room and laundry room and salty home safety. Eventually, using SPSS 16 and descriptive statistics, data were analyzed. Results: According to the results of this study, 66.6% of the units had poor safety and 33.4% of them were moderately safe. As well as, only ICU and CCU unit, heating and cooling equipment and operational room showed moderate compliance with safety requirements and other sections were poorly complied. Conclusion: The results of this study showed that safety conditions of hospital were not at favorable level. These poor safety statues can jeopardize patients and hospital personnel. Thus some interventions such as improvement of working conditions, compliance with safety acts and implementation of health, safety and environmental management system would be necessary.

  6. Standards for gene therapy clinical trials based on pro-active risk assessment in a London NHS Teaching Hospital Trust.

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    Bamford, K B; Wood, S; Shaw, R J

    2005-02-01

    Conducting gene therapy clinical trials with genetically modified organisms as the vectors presents unique safety and infection control issues. The area is governed by a range of legislation and guidelines, some unique to this field, as well as those pertinent to any area of clinical work. The relevant regulations covering gene therapy using genetically modified vectors are reviewed and illustrated with the approach taken by a large teaching hospital NHS Trust. Key elements were Trust-wide communication and involvement of staff in a pro-active approach to risk management, with specific emphasis on staff training and engagement, waste management, audit and record keeping. This process has led to the development of proposed standards for clinical trials involving genetically modified micro-organisms.

  7. Sexuality after hysterectomy at University of Jordan Hospital: a teaching hospital experience.

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    Fram, Kamil Mosa; Saleh, Shawqi S; Sumrein, Issa A

    2013-04-01

    This research concentrates on evaluating the sexual activity of the patients after having hysterectomy for benign disorders. This analysis took place at the University of Jordan hospital. The retrospective record was reviewed for over 2 years (from January 2008 to January 2010). The sample of study included a total number of 124 patients with benign disorders who underwent hysterectomy. The sexual life parameters indicate that 93 patients (75 %) felt general improvement in their performance, while 14 patients (11.3 %) complained of having suffered bad performance, 6 patients (4.8 %) noticed no changes, and 11 patients (8.9 %) did not provide any comment. As for the partner's sexual function (as relayed by the patients themselves), 69 patients (55.6 %) felt improvements in their performance and 23 (18.5 %) commented that their partners had bad performance, while 18 patients (14.5 %) noticed no changes and 14 (11.3 %) did not provide any comment. Patients were interviewed by the operating physician each of whom was subjected to an average of half an hour verbal interview after obtaining the prior written consent of the patient. Questionnaire forms were used to record the answers given by each patient. The interview data recorded in the questionnaires were analyzed. The result of these analyses significantly indicated that sexual function is a major cause of women's concern for scheduled hysterectomy. That is because they were influenced by both physiological and psychological factors. Even though the analysis results implied that there was a sizeable minority who evidently suffered a considerably worse outcome, it was recognized that hysterectomy leads to improvement in sexual function and health for the majority of women. Therefore, it is important to spread awareness among women and let them know that most probably they will neither lose their sexual desire after hysterectomy, nor they will lose their feminine shape or style.

  8. A Flipped Mode Teaching Approach for Large and Advanced Electrical Engineering Courses

    Science.gov (United States)

    Ravishankar, Jayashri; Epps, Julien; Ambikairajah, Eliathamby

    2018-01-01

    A fully flipped mode teaching approach is challenging for students in advanced engineering courses, because of demanding pre-class preparation load, due to the complex and analytical nature of the topics. When this is applied to large classes, it brings an additional complexity in terms of promoting the intended active learning. This paper…

  9. Teaching Children to Organise and Represent Large Data Sets in a Histogram

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    Nisbet, Steven; Putt, Ian

    2004-01-01

    Although some bright students in primary school are able to organise numerical data into classes, most attend to the characteristics of individuals rather than the group, and "see the trees rather than the forest". How can teachers in upper primary and early high school teach students to organise large sets of data with widely varying…

  10. Teaching the Assessment of Normality Using Large Easily-Generated Real Data Sets

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    Kulp, Christopher W.; Sprechini, Gene D.

    2016-01-01

    A classroom activity is presented, which can be used in teaching students statistics with an easily generated, large, real world data set. The activity consists of analyzing a video recording of an object. The colour data of the recorded object can then be used as a data set to explore variation in the data using graphs including histograms,…

  11. A survey of digital radiography practice in four South African teaching hospitals: an illuminative study.

    Science.gov (United States)

    Nyathi, T; Chirwa, Tf; van der Merwe, Dg

    2010-01-01

    The purpose of this study was to assess radiographer familiarity and preferences with digital radiography in four teaching hospitals and thereafter make recommendations in line with the migration from screen film to digital radiography. A questionnaire was designed to collect data from either qualified or student radiographers from four teaching hospitals. From the four teaching hospitals, there were a total of 205 potential respondents. Among other things, responses regarding experiences and preferences with digital radiography, quality control procedures, patient dose, advantages and disadvantages of digital radiography were sought. The information collected was based on self-reporting by the participants. The study is exploratory in nature and descriptive statistics were generated from the collected data using Microsoft Excel 2007 and StatsDirect software. Sixty-three out of 205 (31%) radiographers from all the four radiology centers responded to the circulated questionnaire. Only 15% (8) of the qualified radiographers had 4 or more years of experience with digital radiography compared to 68% (36) for the same amount of experience with screen-film radiography. Sixty-one percent (38) of the participants had been exposed to digital radiography during their lectures while at university. A small proportion, 16% (10) of the respondents underwent formal training in quality control procedures on the digital X-ray units they were using. Slightly more than half (55%) of the participants felt it was easier for them to retake an image in digital radiography than in screen film radiography. The results of this survey showed that the participants are familiar with digital radiography and have embraced this relatively new technology as shown by the fact that they can identify both its advantages and disadvantages as applied to clinical practice. However, there are minimal quality control procedures specific to digital radiography being undertaken as such there is need for

  12. Clinical profile of hypertension at a University Teaching Hospital in Nigeria

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    Arthur C Onwuchekwa

    2010-07-01

    Full Text Available Arthur C Onwuchekwa, Sunday ChinenyeDepartment of Internal Medicine, University of Port Harcourt Teaching Hospital, NigeriaBackground: Hypertension in Nigeria is a widespread problem of immense social and economic importance because of its high prevalence and the severity of its complications.Aim: To define the morbidity and mortality pattern of hypertension at the University of Port Harcourt Teaching Hospital (UPTH.Method: Records of all patients admitted to the medical wards of the UPTH over a 5-year period with essential hypertension or any of its complications were retrieved from the ward and medical records and reviewed.Result: A total of 780 hypertensive patients were reviewed, constituting 28.2% of all ­medical admissions. Only 424 (15.2% had complete records and were analyzed. Record keeping was poor. There were 173 (41% males and 251 (59% females with a male to female ratio of 1:1.5. The ages ranged from 18 years to 100 years with a mean of 56.5 ± 16.2. Stroke was responsible for 169 (39.9% hypertensive complications. Heart failure occurred in 97 (22% cases while renal failure and encephalopathy accounted for 40 (9.4% and 7 (1.7% hypertensive complications respectively. There were 99 deaths out of which 51 (51.5% were due to stroke, 14 (14.12% were due to heart failure, and 12 (12.1% were due to renal failure.Conclusion: The contribution of systemic hypertension to the morbidity and mortality of adults at UPTH is quite significant.Keywords: clinical profile, hypertension, University of Port Harcourt Teaching Hospital

  13. Tetanus immunization: perception of residents in a tertiary care teaching hospital in Western India

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    Dhande Priti P, Beri Shirish G, Patel Hardik R

    2013-04-01

    Full Text Available Background: Prevention of tetanus is far easier than its treatment where mortality is very high. Most cases of tetanus occur due to lack of proper vaccination against the disease and incomplete immunization on exposure. Residents in a tertiary care teaching hospital constitute the first contact physicians for patients. Aim: To assess the perception about Tetanus immunization among residents in a tertiary care teaching hospital of Pune city. Methodology: A pre tested questionnaire was used to assess the knowledge & recommendations about tetanus immunization among randomly selected 157 residents. Results: 73.25% residents were not aware of the number of doses of tetanus vaccine recommended for children under the age of 16 years. Around 50% residents were not aware of the recommended number of doses of tetanus vaccine for adults over the age of 16 years and during pregnancy. Nearly 60% of the residents considered the wound after every injury to be tetanus prone. 75.8% of residents thought burn injuries to be prone to the development of tetanus while 13.4% and 36.9% of the residents did not consider animal bite and human bite to be tetanus prone respectively. 99.4% residents considered tetanus toxoid administration in wound with rusted iron. The knowledge regarding tetanus immunization in relation to the wound categories depending on the immunization status of the patients was very poor amongst the residents. Conclusion: Better awareness and adherence of tetanus prophylaxis recommendations is needed in residents who are the first tier of health care providers in teaching hospitals.

  14. Quality assessment of clinical education services in teaching hospitals located in Kerman, Iran.

    Science.gov (United States)

    Yazdi-Feyzabadi, Vahid; Gozashti, Mohammad Hossein; Komsari, Samane; Mohammadtaghizadeh, Sedigheh; Amiresmaili, Mohammadreza

    2015-11-01

    Clinical education is one of the most important components of the resource generation function of health systems, and it has a very important role in graduates' competency with respect to effective, practical education. This study aimed to assess the quality of clinical services in Kerman's teaching hospitals located in southeastern Iran. This cross-sectional study was conducted in 2011 on 303 medical students at different levels of medical education at Kerman's teaching hospitals. A modified SERVQUAL instrument was used to collect the data after its validity and reliability were checked. The data were analyzed by SPSS 18.0 using the paired t-test, Kruskal-Wallis, and post hoc tests, when appropriate. In all five dimensions of quality, gaps were observed between students' perceptions and expectations as follows: Assurance (mean = -1.18), Responsiveness (-1.56), Empathy (-1.4), Reliability (-1.27), and Tangibles (-1.21). There was a significant difference between the quality perceptions and expectations of the medical students (p < 0.001). A significant difference was observed between three educational levels, including externships, internships, and assistantships regarding the dimensions of the quality gaps (p < 0.001). The clinical services provided by teaching hospitals in the study did not meet the students' expectations at any of the three educational levels. As we precisely assessed the dimensions and items that had the higher quality gaps, it was apparent that, for most part, clinical education officials could improve the quality by designing interventions, which would not be very difficult to do.

  15. Maternofetal outcome of asymptomatic bacteriuria among pregnant women in a Nigerian Teaching Hospital.

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    Izuchukwu, Kenneth Ebele; Oranu, Emmanuel Okwudili; Bassey, Goddy; Orazulike, Ngozi Clare

    2017-01-01

    Asymptomatic bacteriuria has been reported to be associated with adverse pregnancy outcome. This study sought to determine the prevalence and complications of asymptomatic bacteriuria amongst parturient in the University of Port Harcourt Teaching Hospital (UPTH). The study was a prospective cohort study involving 220 eligible antenatal attendees. Urine culture and sensitivity was conducted for each participant and the fetomaternal outcome between affected and unaffected women were compared and p value women. Contrary to widely held view, there was no significant increase in adverse pregnancy outcome amongst affected women.

  16. Fibreoptic gastro-intestinal endoscopy at the Korle Bu Teaching Hospital, Accra, Ghana: a historical perspective.

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    Nkrumah, Kofi N; Archampong, Emmanuel Q

    2017-12-01

    Fibreoptic (or Flexible) endoscopy has revolutionized and completely transformed practice of gastroenterology, and many other medical specialties, over the past half century or so. At the Korle Bu Teaching Hospital, Accra the development of this facility has evolved gradually, especially involving specialists from the Departments of Medicine and Surgery since the 1970s. This article is an attempt to trace and record this journey and to highlight some of the problems and challenges yet to be overcome. It is an anecdotal account based on the authors' recollection with attempts at verification of important dates.

  17. Pediatric disaster preparedness of a hospital network in a large metropolitan region.

    Science.gov (United States)

    Ferrer, Rizaldy R; Balasuriya, Darshi; Iverson, Ellen; Upperman, Jeffrey S

    2010-01-01

    We describe pediatric-related emergency experiences and responses, disaster preparation and planning, emergency plan execution and evaluation, and hospital pediatric capabilities and vulnerabilities among a disaster response network in a large urban county in the West Coast of the United States. Using semistructured key informant interviews, the authors conducted qualitative research between March and April 2008. Eleven hospitals and a representative from the community clinic association agreed to participate (86 percent response rate) and a total of 22 key informant interviews were completed. Data were analyzed using ATLAS.ti.v.5.0, a qualitative analytical software program. Although hospitals have infrastructure to respond in the event of a large-scale disaster, well-established disaster preparedness plans have not fully accounted for the needs of children. The general hospitals do not anticipate a surge of pediatric victims in the event of a disaster, and they expect that children will be transported to a children's hospital as their conditions become stable. Even hospitals with well-established disaster preparedness plans have not fully accounted for the needs of children during a disaster. Improved communication between disaster network hospitals is necessary as incorrect information still persists.

  18. Infection after open heart surgery in Golestan teaching hospital of Ahvaz, Iran.

    Science.gov (United States)

    Nashibi, Roohangiz; Mohammadi, Mohammad Javad; Alavi, Seyed Mohammad; Yousefi, Farid; Salmanzadeh, Shokrolah; Ahmadi, Fatemeh; Varnaseri, Mehran; Ramazani, Asghar; Moogahi, Sasan

    2018-02-01

    The present study surveyed demographic and infection data which were obtained after open heart surgery (OHS) through patient's admission in Golestan teaching hospital, Ahvaz metropolitan city of Iran, taking into account the confirmed location of the infection, microorganism and antibiotic susceptibility. The occurrence of infection among patients during 48 to 72 h after surgery and hospital admission is the definition of Nosocomial infections (NIs) (Salmanzadeh et al., 2015) [1]. All of them after OHS were chosen for this study. In this paper, type of catheter, fever, type of microorganism, antibiotic susceptibility, location of the infection and outcome (live or death) were studied (Juhl et al., 2017; Salsano et al., 2017) [2], [3]. After the completion of the observations and recording patients' medical records, the coded data were fed into EXCELL. Data analysis was performed using SPSS 16.

  19. Clinical audit on documentation of anticipatory "Not for Resuscitation" orders in a tertiary australian teaching hospital

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    Naveen Sulakshan Salins

    2011-01-01

    Full Text Available Aim: The purpose of this clinical audit was to determine how accurately documentation of anticipatory Not for Resuscitation (NFR orders takes place in a major metropolitan teaching hospital of Australia. Materials and Methods: Retrospective hospital-based study. Independent case reviewers using a questionnaire designed to study NFR documentation reviewed documentation of NFR in 88 case records. Results: Prognosis was documented in only 40% of cases and palliative care was offered to two-third of patients with documented NFR. There was no documentation of the cardiopulmonary resuscitation (CPR process or outcomes of CPR in most of the cases. Only in less than 50% of cases studied there was documented evidence to suggest that the reason for NFR documentation was consistent with patient′s choices. Conclusion: Good discussion, unambiguous documentation and clinical supervision of NFR order ensure dignified and quality care to the dying.

  20. Knowledge and power necessary to reconstruct nursing after management changes at a teaching hospital.

    Science.gov (United States)

    Bernardino, Elizabeth; Felli, Vanda Elisa Andres

    2008-01-01

    This study was carried out at a teaching hospital in Southern Brazil, which adopted a management model that provoked the dismantling of the nursing service and the disbandment of nursing professionals. Its general goal was to promote changes that would be implemented in the re-organization of nursing work. It is a case study with a historical-dialectic approach, whose data were collected in March and April 2005 through the focal group technique. The study subjects were eight nurses, two technicians and two nursing auxiliaries. Data were analyzed through thematic content analysis. Results evidenced that the greatest challenges nursing faced at this hospital were: to construct a new identity, carry out teamwork while maintaining its professional identity, acquire visibility in the institution, change care and expand management.

  1. Epidemiological Study of Poisoning in Teaching Hospitals in Shiraz in 1387

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    M. Aryaie

    2012-04-01

    Full Text Available Background/Objective: Poisoning is One common cause of referred cases , especially in the adolescent and young group to hospital emergency department. This study was designed to determine Epidemiologic of poisoning in teaching hospitals, shiraz in 1387 Methods: This is a cross-sectional study that 266 sample via random sampling with 95% confidence interval and α 0.05 were considered. Results: There were 47% female and 53% male. 67.2 percent of poisoned patient were single and 32.8% were married. This study showed, highest rate of poisoning was between the age of 20-35 years. Most common season of poisoning was in spring. Overall mortality of our study was 1.6 percent. Conclusions: Regional epidemiological information, make rational use of resources in order to prevention and control of poisoning and with using analysis of effective factors will be reduced poisoning by policymakers and planners.

  2. Challenges of Clinical Governance in Risk Management: A Qualitative Study of Teaching Hospitals

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    Mohammad Keshvari

    2017-01-01

    Full Text Available Background: Clinical Governance is a Framework in which health care provider will be responsible for continuous quality improvement. This study aimed to identify implementation challenges of Clinical Governance in the area of risk management. Methods: This is a descriptive-qualitative study. We used Content Analysis method for data analysis. Study environment contained 7 teaching hospitals, and the study population included the hospitals staff engaged in Clinical Governance implementation. Using purposive non-randomised sampling, 18 participants were selected. A semi-structured face-to-face interview was used for data collection. Content Analysis method was used to conceptualize, interpret and analyze the texts and maxQDA software for data analysis. Results: Our research findings presented two main themes as cultural factors and lack of resources. Conclusion: Promoting management as well as empowering health care providers could act as a key factor in addressing problems related to the implementation of risk management in health care environments.

  3. Comparison of patient doses in interventional radiology procedures performed in two large hospitals in Greece

    International Nuclear Information System (INIS)

    Papageorgiou, E.; Tsapaki, V.; Tsalafoutas, I. A.; Maurikou, E.; Kottou, S.; Orfanos, A.; Karidas, G.; Fidanis, T.; Zafiriadou, E.; Neofotistou, V.

    2007-01-01

    Purpose of the study was to determine patient doses in the most common interventional radiology (IR) procedures performed in two large Greek hospitals. A total of 164 patients who underwent 4 types of IR procedures were studied. Fluoroscopy time, total exposure time, number of frames, number of runs, radiation field size, and cumulative dose-area product (DAP) were recorded. The median DAP values for carotid arteriography and lower limb arteriography were 66 and 123 Gy cm 2 for hospital 'A' and 21 and 49 Gy cm 2 for hospital 'B'. For the cerebral arteriographies performed in hospital 'A', the median DAP was 116 Gy cm 2 while for the hepatic embolizations performed in hospital 'B', it was 104 Gy cm 2 . The DAP values observed in hospital 'A' for carotid arteriography and lower limb arteriography were almost three times than those of hospital 'B'. From the data analysis, it is evident that dose optimization in hospital 'A' should be pursued through revision of the techniques used. (authors)

  4. Paradigms and nursing management, analysis of the current organizational structure in a large hospital.

    Science.gov (United States)

    Wilson, D

    1992-01-01

    Hospitals developed over the period of time when positivism become a predominant world view. Positivism was founded by four Western trends: preponderance of hierarchy and autocracy, popularization of bureaucracy, extensive application of a machine orientation to work and predominance of "scientific" inquiry. Organizational theory developed largely from quantitative research findings arising from a positivistic world view. A case study, analyzing a current nursing organizational structure at one large hospital, is presented. Nursing management was found to be based upon the positivistic paradigm. The predominance of a machine orientation, and an autocratic and bureaucratic structure are evidence of this. A change to shared governance had been attempted, indicating a shift to a more modern organizational structure based on a different paradigm. The article concludes by emphasizing that managers are largely responsible for facilitating change; change that will meet internal human resource needs and the cost-effectiveness crises of hospitals today through more effective use of human resources.

  5. Prevalence of pressure ulcers in three university teaching hospitals in Ireland.

    LENUS (Irish Health Repository)

    Gallagher, Paul

    2012-02-03

    AIM: Pressure ulceration is a significant, but preventable, cause of morbidity and resource utilisation in hospital populations. Data on pressure ulcer prevalence in Ireland are limited. This study aims to determine (i) the point-prevalence of pressure ulcers in three teaching hospitals in Ireland and (ii) risk factors for their development. METHODS: Eight teams of one doctor and one nurse visited 672 adult patients over a 2-day period in three teaching hospitals. Each patient was examined and pressure ulcers graded with the European Pressure Ulcer Advisory Panel system. Mental test score, Barthel index, type of support surface, length of stay, documentation of risk assessment and serum albumin were recorded. RESULTS: Point-prevalence of pressure ulceration was 18.5%. Seventy-seven percent of pressure ulcers were hospital-acquired, 49% grade 1, 37% grade 2, 11% grade 3 and 3% grade 4. Reduced mobility, urinary incontinence, cognitive impairment, low serum albumin and length of stay were significantly associated with pressure ulcers. Multivariate logistic regression analysis found reduced mobility (odds ratio 8.84; 95% CI 5.04-15.48, p<0.0001) and length of stay (odds ratio 1.02; 95% CI 1.01-1.02, p<0.0001) to be predictive of the presence of pressure ulcers. Age, gender and risk assessment documentation were not associated with pressure ulcers. Sixty-five percent of patients with pressure ulcers were positioned on appropriate support surfaces. DISCUSSION: Point-prevalence of pressure ulceration was 18.5%, similar to international data. Regular audit of prevalence, prevention and management strategies may raise awareness, influence resource allocation and ultimately improve patient care.

  6. The readmission rates in patients with versus those without diabetes mellitus at an urban teaching hospital.

    Science.gov (United States)

    Sonmez, Halis; Kambo, Varinder; Avtanski, Dimiter; Lutsky, Larry; Poretsky, Leonid

    2017-12-01

    We examined the 30-day hospital readmission rates and their association with the admission diagnosis and the length of stay (LOS) in patients with diabetes versus those without diabetes mellitus (DM) in an urban teaching hospital. In this retrospective study, we compared the 30-day readmission rates in patients with DM (n=16,266) versus those without DM (n=86,428) at an urban teaching hospital between January 1, 2013, and September 30, 2015. In individuals with a secondary diagnosis of DM, we analyzed the relationship between readmission rates and the ten most common Medicare Severity Diagnosis Related Groups (MS-DRGs). Additionally, we examined the relationship between the LOS and readmission rates in patients with diabetes and those without DM. The 30-day readmission rates adjusted for age and gender were higher in patients with DM compared to those without DM (15.3% vs. 8.4%, respectively, readmissions was present both in patients with a primary or a secondary diagnosis of DM. For the secondary diagnosis of DM, statistically significant difference was present for two out of the ten most common DRGs (DRG # 313 [chest pain], and # 392 [esophagitis, gastroenteritis, and miscellaneous digestive disorders], p=0.045 and 0.009, respectively). There was a direct correlation between LOS and readmission rates in both patients with diabetes and those without DM (preadmission rates are higher in patients with DM compared to patients without DM. DM is an independent risk factor for hospital readmissions. The readmission rates correlate directly with LOS in both patients with diabetes and those without DM. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Microbiological assessment of indoor air of a teaching hospital in Nigeria.

    Science.gov (United States)

    Awosika, S A; Olajubu, F A; Amusa, N A

    2012-06-01

    To investigate the quality of indoor air of different wards and units of Olabisi Onabanjo University Teaching Hospital, Sagamu, to ascertain their contribution to infection rate in the hospital. The microbial quality of indoor air of nine wards/units of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria was conducted. Sedimentation technique using open Petri-dishes containing different culture media was employed and samplings were done twice daily, one in the morning shortly after cleaning and before influx of people/patients into the wards/units and the other in the evening when a lot of activities would have taken place in these wards. Isolates were identified according to standard methods. Results showed that there was a statistically significant difference (χ(2) = 6.016 7) in the bacteria population of the different sampling time whereas it was not so for fungi population (χ(2) = 0.285 7). Male medical ward (MMW) and male surgical general (MSG) recorded the highest bacterial and fungal growth while the operating theatre (OT) was almost free of microbial burden. The bacteria isolates were Staphylococcus aureus, Klebsiella sp., Bacillus cereus, Bacillus subtilis, Streptococcus pyogenes and Serratia marscences while the fungi isolates included Aspergillus flavus, Penicillium sp., Fusarium sp., Candida albicans and Alternaria sp. Staphylococcus aureus was the predominantly isolated bacterium while Penicillium sp. was the most isolated fungus. Though most of the microbial isolates were potential and or opportunistic pathogens, there was no correlation between the isolates in this study and the surveillance report of nosocomial infection during the period of study, hence the contribution of the indoor air cannot be established. From the reduction noticed in the morning samples, stringent measures such as proper disinfection and regular cleaning, restriction of patient relatives' movement in and out of the wards/units need to be enforced so as to

  8. Prescription Pattern of Analgesic Drugs for Patients Receiving Palliative Care in a Teaching Hospital in India.

    Science.gov (United States)

    Menezes, Vishma Hydie; Nair, Shoba N; Soumya, M S; Tarey, S D

    2016-01-01

    Drugs used in the palliative care unit for managing symptoms are major contributors toward the expenditure occurring in palliative care. This study was conducted to understand the prescription pattern of analgesic drugs in the patients who are receiving palliative care in a teaching hospital in India by a retrospective study of case records. Case record based, retrospective, descriptive study was conducted at the Pain and Palliative Care Department of St. John's Medical College Hospital, Bengaluru. Case record files of all patients referred to Pain and Palliative Care Department for the treatment of pain in the year of 2012 were studied. Patients' age, gender, diagnoses, numerical pain rating scale (0-10), drugs prescribed, dosage, frequency, route of administration were recorded. The difference in drug utilization between the genders was done using Chi-square test. Data were collected from 502 patients of which 280 (56%) were males and 222 (44%) were females. Twelve percent of patients had mild pain (1-3), 34% had moderate pain (4-6), and 54% had severe pain (7-10). The most commonly used analgesic drugs were opioids (47%), followed by nonsteroidal anti-inflammatory drugs (36%). The opioids used were tramadol (56%), and morphine (38%). Ninety percent of patients with numerical pain scale more than 6 received morphine. There was no difference in analgesic drug utilization with regards to gender. Prescription pattern differed depending on the severity of pain. Opioids were the most commonly used drugs for pain management. The study shows that prescription pattern in palliative care unit of this hospital was in accordance with WHO pain management guidelines. The study showed the current trend in prescription of analgesic drugs in the teaching hospital where the study was conducted.

  9. Chi-Square Test of Word of Mouth Marketing with Impact on the Evaluation of Patients' Hospital and Services: An Application in Teaching and Research Hospital

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    Yelda ŞENER

    2014-12-01

    Full Text Available The purpose of this study, using data provided from 223 inpatients in a teaching and research hospital, hospital’s preference is to explain the effect of word of mouth marketing. For this purpose, word of mouth marketing process is evaluated in terms of providing information about the hospital and the patient’s level of intimacy, both of patients and information provider’s level of expertise with related to hospital and services, the patient’s perceived level of risk for hospitals and services and providing information’s level of impact on patient being treated in hospital. The obtain data, after evaluation by frequency distributions these factors impact on word of mouth marketing is demonstrated by descriptive statistics, chi-square analysis and pearson’s correlation analysis. As a result of this study is concluded word of mouth marketing on the training and research hospital is preferred by the patints to have a significant impact.

  10. An individual-based model of transmission of resistant bacteria in a veterinary teaching hospital.

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    Neeraj Suthar

    Full Text Available Veterinary nosocomial infections caused by antibiotic resistant bacteria cause increased morbidity, higher cost and length of treatment and increased zoonotic risk because of the difficulty in treating them. In this study, an individual-based model was developed to investigate the effects of movements of canine patients among ten areas (transmission points within a veterinary teaching hospital, and the effects of these movements on transmission of antibiotic susceptible and resistant pathogens. The model simulates contamination of transmission points, healthcare workers, and patients as well as the effects of decontamination of transmission points, disinfection of healthcare workers, and antibiotic treatments of canine patients. The model was parameterized using data obtained from hospital records, information obtained by interviews with hospital staff, and the published literature. The model suggested that transmission resulting from contact with healthcare workers was common, and that certain transmission points (housing wards, diagnostics room, and the intensive care unit presented higher risk for transmission than others (lobby and surgery. Sensitivity analyses using a range of parameter values demonstrated that the risk of acquisition of colonization by resistant pathogens decreased with shorter patient hospital stays (P<0.0001, more frequent decontamination of transmission points and disinfection of healthcare workers (P<0.0001 and better compliance of healthcare workers with hygiene practices (P<0.0001. More frequent decontamination of heavily trafficked transmission points was especially effective at reducing transmission of the model pathogen.

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

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    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.

  12. Serum magnesium and calcium in preeclampsia: a comparative study at the Korle-Bu Teaching Hospital, Ghana

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    Owusu Darkwa E

    2017-08-01

    Full Text Available Ebenezer Owusu Darkwa,1 Charles Antwi-Boasiako,2 Robert Djagbletey,1 Christian Owoo,1 Samuel Obed,3,† Daniel Sottie4 1Department of Anaesthesia, University of Ghana School of Medicine and Dentistry, 2Department of Physiology, University of Ghana School of Biomedical and Allied Health Sciences, 3Department of Obstetrics and Gynaecology, University of Ghana School of Medicine and Dentistry, College of Health Sciences, 4Department of Anaesthesia, Korle-Bu Teaching Hospital, Accra, Ghana †Samuel Obed passed away on May 12, 2017 Background: A large percentage (16% of maternal mortality in developed countries, compared to 9% in developing countries, is due to hypertensive disorders in pregnancy. The etiology of preeclampsia remains unknown, with poorly understood pathophysiology. Magnesium and calcium play an important role in vascular smooth muscle function and therefore a possible role in the development of preeclampsia.Aim: We aimed to compare serum magnesium and total calcium levels of preeclamptic and normal pregnant women at the Korle-Bu Teaching Hospital in Ghana.Patients and methods: A comparative cross-sectional study involving 30 normal pregnant and 30 preeclamptic women with >30 weeks gestation and aged 18–35 years, was conducted at the Korle-Bu Teaching Hospital. Magnesium and calcium were determined using a flame atomic absorption spectrometer.Results: Mean serum magnesium and total calcium levels in preeclamptic women were 0.70±0.15 and 2.13±0.30 mmol/L, respectively. Mean serum magnesium and total calcium levels in normal pregnant women were 0.76±0.14 and 2.13±0.35 mmol/L, respectively. There was a statistically nonsignificant difference in serum magnesium and total calcium in preeclamptic women compared to normal pregnant women, with p-values of 0.092 and 0.972, respectively.Conclusion: Serum magnesium and total calcium, therefore, seem not to differ in preeclamptic women compared to normal pregnant women in Ghana

  13. The prevalence of HIV among blood donors at Juba Teaching Hospital Blood Bank, South Sudan

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    Kenneth L L Sube

    2014-11-01

    Full Text Available Objectives The aim of this study is to determine the prevalence of HIV among blood donors in Juba Teaching Hospital Blood Bank, South Sudan in 2013. Method and Materials This is a retrospective study that involved the abstraction of data from registers at the blood bank. Data were collected onto data sheets and entered into a computer database. Statistical analysis was performed using SPSS Version 20 Software. A p value of <0.05 was considered statistically significant. Results Out of 1095 blood donors, 1074 (98.1% were males and 21 (1.9% were females. The mean age and the range for the whole group was 29+7.16 (15-69 yrs. The prevalence of HIV was higher among males than females 85 (7.9% vs 1 (4.8% respectively but this was not statistical significant (p=0.6. The 20 to 29 year age group had the highest prevalence of 49 (57% with no statistical significance (p=0.3.The prevalence of HIV was 7.0 % (86 and there were co-infections between HIV and HBV, HCV and syphilis of 14 (50%, 5 (18%, 9 (32% with p=0.7, p=0.1, p=0.8 respectively. Blood group O positive had the highest percentage 58.1 % (n=50 and was the commonest group. Conclusion In this study, HIV prevalence is very high among blood donors at the Juba Teaching Hospital blood bank.

  14. Patients’ experiences of being nursed by student nurses at a teaching hospital

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    Ferdinand C. Mukumbang

    2014-09-01

    Objectives: The study had three objectives: to describe the experiences of patients nursed by student nurses in a teaching hospital in the Western Cape; to identify patterns in the experiences of patients receiving patient care from student nurses; and to analyse aspects of the experiences that may need further attention for the training of student nurses. Method: A descriptive phenomenological approach was used to explore the experiences of patients nursed by student nurses. Participant selection took place purposively from different wards of the identified teaching hospital, and thematic saturation was achieved at 10 participants. The data were collected through in-depth interviews and analysed using thematic content analysis. Results: Three main themes were discovered after data analysis: methods of identification of student nurses by patients; positive perceptions of student nurses by patients; and negative perceptions of student nurses by patients. Conclusion: The findings will inform the clinical supervisors and educational institutions of aspects of the nursing training of student nurses that need improvement and those that require enforcement.

  15. Evaluating the Rate of Compliance with Radiation Protection Standards in Shohada Teaching Hospital -Tabriz

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    Faramarz Pourasghar

    2016-01-01

    Full Text Available ​ Background and Objectives : If proper diagnosis is regarded as the basis of modern medicine, medical radiography is the foundation of medical diagnosis. Properly applied radiography helps physicians to diagnose problems. On one side, using it to improve quality of life is essential but on the other hand, its hazards are obvious. A reasonable usage and according to protection standards are the best way to benefit its advantages and reduce the hazards. Material and Methods : This cross-sectional study was conducted by a researcher-made check list that its validity and reliability were confirmed by experts. It was performed as direct observation in Shohada teaching hospital. Collected data were entered into Excel software and analyzed applying descriptive statistics. Results : The results indicated that compliance with protection standards regarding staff protection ranged from 73.6 to 100 percent and it ranged from 0 to 99.2 percent regarding patient protection. Compliance with protection standards concerning the availability of the devices was lower than average but it was rated higher than average regarding environmental protection. Conclusion : In general, not all protection standards for radiological diagnostic tests are followed at the radiology ward in the shohada teaching hospital. Continuous training courses and increasing staff and patients' awareness might resolve this problem.

  16. FACTORS AFFECTING IMPLEMENTATION OF EVIDENCE BASED PRACTICE AMONG PHYSIOTHERAPISTS IN MOI TEACHING REFFERAL HOSPITAL KENYA

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    Naomi Wanjiru

    2016-06-01

    Full Text Available Background: The application of the concept of Evidenced Based Practice into clinical decision-making and practicehas outstanding benefits both to clinicians and the patient. However, the utilization of this concept has not been copiously utilized in most health facilities by the physiotherapists in Kenya. Therefore, the objectives for this study was to determine the level of awareness of evidence based practice among Physiotherapist, establish the availability of resource for Evidence Based Practice and to assess the challenges encountered by physiotherapist in engaging in evidence based practice at Moi Teaching and Referral Hospital. Methods: All physiotherapists working in Moi Teaching and Referral Hospital (42 took part in a cross-sectional descriptive survey. Questionnaires were used for data collection and analyzed by SPSS version 22. Results: there was high level of awareness on Evidence Based Practice (95 % and confidence in EBP (72.5 %. However, lack of information resources, poor skills to implement EBP, poor organization support 90%, insufficient authority to induct change in the practice setting 85%, inadequate facilities 74% and lack of time were identified as the major challenges in implementation of EBP Conclusion: Strategies should be developed to provide PTs with EBP resources, such as access to databases or links to guidelines, and continuous education regarding specific topics. Professional organizations and Associations should aim at changing the current practice to ensure full utilization of EBP.

  17. Night shift fatigue among anaesthesia trainees at a major metropolitan teaching hospital.

    Science.gov (United States)

    Lancman, B M

    2016-05-01

    Night shifts expose anaesthesia trainees to the risk of fatigue and, potentially, fatigue-related performance impairment. This study examined the workload, fatigue and coping strategies of anaesthesia trainees during night shifts. A blinded survey-based study was undertaken at a major single centre metropolitan teaching hospital in Australia. All ten anaesthesia trainees who worked night shifts participated. The survey collected data on duration of night shifts, workload, and sleep patterns. Fatigue was assessed using the Karolinska Sleepiness Scale (KSS). There were 93 night shifts generating data out of a potential 165. Trainees tended to sleep an increasing amount before their shift as the nights progressed from 1 to 5. Night 1 was identified as an 'at risk' night due to the amount of time spent awake before arriving at work (32% awake for U+003E8 hours); on all other nights trainees were most likely to have slept 6-8 hours. The KSS demonstrated an increase in sleepiness of 3 to 4 points on the scale from commencement to conclusion of a night shift. The Night 1 conclusion sleepiness was markedly worse than any other night with 42% falling into an 'at-risk' category. The findings demonstrate fatigue and inadequate sleep in anaesthesia trainees during night shifts in a major metropolitan teaching hospital. The data obtained may help administrators prepare safer rosters, and junior staff develop improved strategies to reduce the likelihood of fatigue.

  18. Relationship between Organizational Learning and Organizational Agility in Teaching Hospitals of Yazd

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    Mohammad Amin Bahrami

    2016-10-01

    Full Text Available Background: In organizational learning theory, organization is defined as an open system that has the ability to anticipate, identify, define, design, and solve its problems. This study was aimed to examine the relationship between organizational learning and organizational agility in the teaching hospitals of the city of Yazd. Methods: This analytical and cross-sectional study was conducted in 2015 in four teaching hospitals of the city of Yazd. A total of 370 administrative and medical staff contributed in the study. We used stratified-random method for sampling. The required data were gathered using two valid questionnaires including organizational learning questionnaire (Neefe 2001 and organizational agility questionnaire according to the theory of Sharifi & Zhang (1999 being analyzed trough statistical softwares of R and lavaan package, semPlot and semtool for structural equation model and SPSS18 for descriptive statistics. Results: Our results showed a positive significant relationship between organizational learning and organizational agility (0.521. Conclusion: Based on the findings it can be concluded that the implementation of appropriate strategies for improving the organizational capacity to direct its employees’ mental abilities, can improve the ability of organization’s rapid response to surrounding issues which is crucial for its survival and dynamics in today’s changing world.

  19. Profile of neurological admissions at the University of Nigeria Teaching Hospital Enugu.

    Science.gov (United States)

    Ekenze, O S; Onwuekwe, I O; Ezeala Adikaibe, B A

    2010-01-01

    The burden of Neurological diseases may be on the increase especially in developing countries. Improved outcome in these settings may require appreciation of the spectrum of Neurological diseases and the impediments to their management. We aim to determine the profile of neurological admissions and the challenges of managing these diseases at the University of Nigeria Teaching Hospital Enugu South East Nigeria. Analysis of Neurological admissions into the medical wards of the University of Nigeria Teaching Hospital Enugu from January 2003 to December 2007. Neurological admissions comprise about 14.8% of medical admissions. There were 640 (51%) males and 609 (49%) females. The spectrum of neurological diseases were stroke 64.9%, central nervous system infections (21.8% ), HIV related neurological diseases 3.5%, hypertensive encephalopathy (3.4%), dementia (3%), subarachnoid haemorrhage (2.2%), Guillian Barre syndrome (1.2%), Parkinson's disease (1.1%), myasthenia gravis (1.0%), motor neurone disease and peripheral neuropathy and accounted for 0.8% and 0.6% respectively. Overall, noninfectious disease accounted for 78.2% of neurological admissions while infectious diseases accounted for 11.8%. A wide spectrum of neurological diseases occurs in our setting. The high incidence of CNS infections indicates that efforts should be geared towards preventive measures. A major challenge to be addressed in the management of neurological diseases in our setting is the lack of specialized facilities.

  20. Contraceptive choices among women attending the fertility research unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto

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    Constance E Shehu

    2013-01-01

    Full Text Available Background: One of the most sensitive and intimate decisions made by any individual or couple is that of fertility control . The knowledge of the factors which influence contraceptive choices may increase its acceptance and uptake. This study determines the choice and reason for contraception among new clients attending the Fertility Research Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto. Materials and Methods: In this prospective study a structured questionnaire was administered to 251 consecutive clients, who attended the Fertility Research Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto between 1 July 2008 and 31 December 2008. Results: Most (58.2% of the clients were between 21 and 30 years of age. Many (42.6% were grand multipara. Majority (76.9% of the clients were married. The main source of knowledge of contraception and referral (45.8% was the physicians. Child spacing (87.7% was the most common reason given for contraceptive use. Majority (55.8% of the clients chose Implanon and the least preferred method of contraception was the condom (2.0%. Conclusion: Our data shows that the most commonly chosen contraceptive method in the study population was the Implanon. Child spacing was the main reason for seeking family planning while the source of contraceptive knowledge was the physicians.

  1. When the globe is your classroom: teaching and learning about large-scale environmental change online

    Science.gov (United States)

    Howard, E. A.; Coleman, K. J.; Barford, C. L.; Kucharik, C.; Foley, J. A.

    2005-12-01

    Understanding environmental problems that cross physical and disciplinary boundaries requires a more holistic view of the world - a "systems" approach. Yet it is a challenge for many learners to start thinking this way, particularly when the problems are large in scale and not easily visible. We will describe our online university course, "Humans and the Changing Biosphere," which takes a whole-systems perspective for teaching regional to global-scale environmental science concepts, including climate, hydrology, ecology, and human demographics. We will share our syllabus and learning objectives and summarize our efforts to incorporate "best" practices for online teaching. We will describe challenges we have faced, and our efforts to reach different learner types. Our goals for this presentation are: (1) to communicate how a systems approach ties together environmental sciences (including climate, hydrology, ecology, biogeochemistry, and demography) that are often taught as separate disciplines; (2) to generate discussion about challenges of teaching large-scale environmental processes; (3) to share our experiences in teaching these topics online; (4) to receive ideas and feedback on future teaching strategies. We will explain why we developed this course online, and share our experiences about benefits and challenges of teaching over the web - including some suggestions about how to use technology to supplement face-to-face learning experiences (and vice versa). We will summarize assessment data about what students learned during the course, and discuss key misconceptions and barriers to learning. We will highlight the role of an online discussion board in creating classroom community, identifying misconceptions, and engaging different types of learners.

  2. The real world of blood glucose point-of-care testing (POCT) system running in China teaching hospital.

    Science.gov (United States)

    Li, Feng-Fei; Xie, Yun; Shi, Bing-Yin; Niu, Min; Guo, Hui; Cao, Yan; Liu, Bing-Li; Yan, Reng-Na; Su, Xiao-Fei; Wu, Jin-Dan; Zhang, Dan-Feng; Chen, Li-Ming; Ma, Jian-Hua

    2018-06-01

     The blood glucose point-of-care testing (POCT) system is important in the decision-making process involving patients suspected of having hypoglycemia. To investigate the real world of the POCT system being used in teaching hospitals in China. The survey was conducted by Hisend Research Group from May 2015 to July 2015 in four teaching hospitals in China. The survey questions were referred to the ISO 15197:2013 standard requirements for the use of the POCT system in a hospital setting. A total of 170 subjects were included from 4 hospitals, which included nursing staff, nurse unit managers, employees from the department of medical instruments, and staff members employed by the clinical laboratories in the Tianjin Metabolism Hospital, Nanjing First Hospital, First Affiliated Hospital of Dalian Medical University, and the First hospital affiliated with the Xi'an Transportation University. The average score for the four hospitals surveyed in this study was 66.6, which varied from 46.1 to 79.7. The main factors influencing the scores were the multiple choices of blood-glucose meters, and the quality control assessment. Our data indicates that the real world use of the POCT system in hospital settings in China needs more closer adherence to a quality management framework.

  3. Dermatology in Ghana: a retrospective review of skin disease at the Korle Bu Teaching Hospital Dermatology Clinic.

    Science.gov (United States)

    Rosenbaum, Brooke E; Klein, Rebecca; Hagan, Paa Gyasi; Seadey, Mark-Young; Quarcoo, Naa Larteley; Hoffmann, Rachel; Robinson, Maria; Lartey, Margaret; Leger, Marie C

    2017-01-01

    Ghana is currently developing its provision of dermatology services. Epidemiologic studies of the skin diseases seen by Ghanaian dermatologists are needed to guide these efforts. We aimed to describe the skin conditions seen by and management practices of Ghanaian dermatologists in a specialized clinic. We conducted a chart review of new patients presenting to the Korle Bu Teaching Hospital dermatology clinic during 2014. Among the 529 patients studied, 700 discrete diagnoses were made. The most commonly diagnosed skin conditions were infections (24.6%) and dermatitis (24.6%); atopic dermatitis (8.4%), acne vulgaris (5.3%) and scabies (5.1%) were the most common specific diagnoses. Among infants, children, and adolescents, the most common diagnosis was atopic dermatitis (31.7%, 30.0%, and 14.9%, respectively). Acne vulgaris (12.0%) was the most common skin condition diagnosed in young adults. Irritant contact dermatitis (6.9%) was most common among adults. Lichen planus (9.9%) was the most commonly diagnosed skin condition in the senior population. Diagnoses made by dermatologists differed from the referral diagnosis documented by primary care providers for 65.8% of patients. The most frequently recommended treatments were antihistamines (47.8%) and topical steroids (38.4%). Only 18 diagnostic biopsies were performed. Our study summarizes the skin diseases seen and management practices of Ghanaian dermatologists in a specialized clinic at a large public teaching hospital. The results of this study can help to guide future dermatology education and development efforts in Ghana.

  4. Budget impact analysis of pemetrexed introduction: case study from a teaching hospital perspective, Thailand.

    Science.gov (United States)

    Chanjaruporn, Farsai; Roughead, Elizabeth E; Sooksriwong, Cha-oncin; Kaojarern, Sming

    2011-09-01

    Thailand does not currently require Budget Impact Analysis (BIA) assessment. The present study aimed to estimate the annual drug cost and the incremental impact on the hospital pharmaceutical budget of the introduction of pemetrexed to a Thai teaching hospital. The budget impact model was conducted in accordance with the Guidelines for preparing submissions to the Pharmaceutical Benefits Advisory Committee (PBAC). The model variables consisted of number of patients, growth rate of lung cancer, uptake rate of pemetrexed over time, unit prices of drugs, and the length and cost of treatment. Sensitivity analysis was performed to determine changes in budgetary impact due to variation of parameters or assumptions in the model. The introduction of pemetrexed was estimated to cause considerable costs for the teaching hospital. In the base-case analysis, the incremental costs were estimated at 8,553,984 Baht in the first year increasing to 12, 118, 144 Baht, 17,820,800 Baht and 17,820,800 Baht in the following years. The 4-year net budgetary impact was 20,154,480 Baht or approximately 127,560 Baht per patient. Sensitivity analyses found that number of treatment cycles andproportion of patients assumed to be treated with pemetrexed were the two most important influencing factors in the model. New costly innovative interventions should be evaluated using the BIA model to determine whether they are affordable. The Thai government should consider requiring the BIA study as one of the requirements for drug submission to assist in the determination of listing and subsidizing decision for medicines.

  5. Stroke among young adults at the LAUTECH Teaching Hospital, Osogbo, Nigeria.

    Science.gov (United States)

    Mustapha, A F; Sanya, E O; Bello, T O

    2012-01-01

    Stroke in young adults is relatively rare and there are very few hospital reports about it in Nigeria. The aetiologic mechanisms of stoke among young adults are quite distinct from those of the adults' populations. The purpose of this retrospective study was to determine the frequency, aetiologic mechanisms and prognosis of stroke among young adults at the LAUTECH Teaching Hospital Osogbo Nigeria. The study was both retrospective and descriptive. Case notes of stroke patients aged 16-45 years managed at the LAUTECH Teaching Hospital Osogbo from June 2005 till February 2008 were retrieved. Demographic data, clinical profile of stroke, laboratory investigation results and treatment outcomes were collated. Clinical diagnosis and classification of stroke was mainly clinical using the WHO clinical criteria. Only 3 patients had cranial CT scan. Out of the total number of 208 stroke patients managed during this period, 27(12.9%) were aged 45 years and below. This comprised of 17 males and 10 females. The age range was between 23-45 years. Using the WHO clinical criteria, there were 14 cases of heamorrhagic CVD and 13 cases of ischaemic CVD. The three cranial CT scan that were done revealed cerebral infarction which was consistent with the clinical diagnosis. Severe hypertension was found in 16 (59.2%) patients on admission. 3 patients had clinical and electrocardiographic evidence of rheumatic heart disease with infective endocarditis. Other risk factors included Sickle cell disease, cardiac arrhythmias etc. 8 out of the 27 patients died giving a percentage mortality of 29.6% and 7 patients were discharged against medical advice. Heamorrhagic stroke was slightly more frequent than ischaemic CVD. Systemic hypertension was also found to be prevalent among these young Nigerian adults with stroke. However, it was difficult to unravel the aetiologic mechanisms of stroke in this study because of paucity of investigations.

  6. Intraoperative complications of outpatient interval tubal sterilization at a teaching hospital in Turkey

    International Nuclear Information System (INIS)

    Dilbaz, B.; Akdag, D.; Cengiz, H.; Akyunak, A.; Dilbaz, S.; Haberal, A.

    2008-01-01

    Objective was to evaluate the intra-operative complications of outpatient interval tubal sterilization at a teaching hospital. The data of 461 patients who underwent interval tubal ligation ITL at the Family Planning Clinic of Ankara Etlik Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey between January 2002 and December 2005 were reviewed from a computerized database. The demographic characteristics, operative technique and intra- and early postoperative complications of patients were evaluated. Only 11 patients had minilaparotomy for ITL. Laparoscopic ITL was performed using bipolar cautery. The cases who were hospitalized or had a complication and/or an unplanned laparotomy were analyzed. The mean age of patients was 35.1 range: 21-51, gravidity was 4.6 range: 2-9, parity was 3.2 range: 2-7 and number of living children was 3.1 range 2-6. Out of 461 patients, only 20.4% had complications related with general anesthesia. Two cases 0.4% had bleeding from the port-site, 3 cases 0.6% had meso-salpingeal and meso-ovarian bleeding, one had omental bleeding 0.2% from vagina wall. There was only one 0.2% intestinal burn that required a laparotomy and segmental resection followed by end-to-end anastomosis. The mortality was nil, whilst the morbidity was found to be 2.1% and all the complications were encountered in patients who had laparoscopic surgery. Outpatient tubal ligation is a convenient and safe procedure and implementing endoscopic surgical techniques is necessary for correction of the complications. (author)

  7. TEACHING BUSINESS CORRESPONDENCE FOR TOURISM AND HOSPITALITY THROUGH COLLABORATIVE WRITING APPROACH

    Directory of Open Access Journals (Sweden)

    Budi Purnomo

    2017-04-01

    Full Text Available This research aims at answering problems: (1 ―How to teach business correspondence for tourism and hospitality (BCTH through collaborative writing approach (CWA?‖ (2 ―What are the advantages of teaching BCTH through CWA?‖ and (3 ―What are the disadvantages of teaching BCHT through CWA?‖ This study is a descriptive and qualitative research. It uses three techniques for collecting data: observation and field notes, questionnaire and in-depth interviewing. It was undertaken in a Business Correspondence class at Sahid Tourism Institute of Surakarta from July to December 2013. There are 28 undergraduate students of semester five and one English lecturer as research subjects. Through CWA students in pairs were given tasks to compose (1 introduction letter, (2 letter of inquiry and offer, (3 reservation letter, (4 letter of collection, (5 letter of changes and cancelation, (6 letter of complaint, (7 letter of joint venture, (8 invitation letter, (9 application letter, (10 letter of resignation, (11 letter of recommendation and (12 business report. The research findings show that procedures to teach BCTH through CWA are: teacher explains a BCTH topic and shows a model of letter; students choose their partners themselves; teacher gives a writing task to students; student A writes a letter and student B writes a reply letter; pairs exchange information during the process of writing; students submit their products of writing; teacher makes a correction for their products outside of class. The advantages of teaching BCTH through CWA are: CWA helps students work together to reach the best products of writing; CWA improves the content of writing; CWA develops grammatical and structural proficiency and CWA reduces stress and saves time. The disadvantages of teaching BCTH through CWA are: CWA affects a conflict related to personal learning style; CWA improves the use of unexpected spoken Indonesian and Javanese languages during doing the tasks and

  8. Surveillance of ESBL producing multidrug resistant Escherichia coli in a teaching hospital in India

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    Shakti Rath

    2014-04-01

    Full Text Available Objective: To record nosocomial and community-acquired accounts of antibiotic resistance in Escherichia coli (E. coli strains, isolated from clinical samples of a teaching hospital by surveillance, over a period of 39 months (November 2009-January 2013. Methods: Clinical samples from nosocomial sources, i.e., wards and cabins, intensive care unit (ICU and neonatal intensive care unit (NICU, and community (outpatient department, OPD sources of the hospital, were used for isolating strains of E. coli, which were subjected for testing for production of ‘extended spectrum beta-lactamase’-(ESBL enzyme as well as determining antibiotic sensitivity pattern with 23 antibiotics. Results: Of the total 1642 (100% isolates, 810 (49.33% strains were from OPD and 832 (50.66% were from hospital settings. Occurrence of infectious E. coli strains increased in a mathematical progression in community sources, but in nosocomial infections, such values remained almost constant in each quarter. A total of 395 (24.05% ESBL strains were isolated from the total 810 isolates of community; of the total of 464 (28.25% isolates of wards and cabins, 199 (12.11% were ESBL strains; and among the total of 368 (22.41% isolates of ICU and NICU, ESBLs were 170 (10.35%; the total nosocomial ESBL isolates, 369 (22.47% were from the nosocomial total of 832 (50.66% isolates. Statistically, it was confirmed that ESBL strains were equally distributed in community or hospital units. Antibiogram of 23 antibiotics revealed progressive increases of drug-resistance against each antibiotic with the maximum resistance values were recorded against gentamicin: 92% and 79%, oxacillin: 94% and 69%, ceftriaxone: 85% and 58%, and norfloxacin 97% and 69% resistance, in nosocomial and community isolates, respectively. Conclusions: This study revealed the daunting state of occurrence of multidrug resistant E. coli and its infection dynamics in both community and hospital settings.

  9. Impact of a smoke-free policy in a large psychiatric hospital on staff attitudes and patient behavior.

    Science.gov (United States)

    Voci, Sabrina; Bondy, Susan; Zawertailo, Laurie; Walker, Louise; George, Tony P; Selby, Peter

    2010-01-01

    The objectives of this work were to examine changes over time in degree of staff support for the implementation of a smoke-free policy in Canada's largest public mental health and addiction teaching hospital and to assess the impact of the policy on patient behavior. Staff completed an anonymous survey, which assessed views toward the smoke-free policy and perceived change in patient behavior, 2-7 and 31-33 months after an indoor smoke-free policy was implemented (September 21, 2005). Objective indicators of patient behavior were also collected in the form of number of emergency code whites (aggressive behavior) and that of code reds (fire) called 1 year prior to and 2 years following policy implementation. Survey response rates were 19.0% (n=481) and 18.1% (n=500) at 2-7 and 31-33 months, respectively. The proportion of staff who supported the policy increased from pre-implementation (82.6%) to post-implementation (89.1%), and a high level of support was maintained 2 years after policy enactment (90.1%). The number of emergency codes did not significantly change after policy implementation, and staff did not perceive a change in most forms of patient behavior. A smoke-free policy can be implemented in a large psychiatric hospital with a high degree of support from staff and no substantial negative impact on patient behavior. Copyright © 2010 Elsevier Inc. All rights reserved.

  10. Diagnostic outcome of patients presenting with severe thunderclap headache at saidu teaching hospital

    International Nuclear Information System (INIS)

    Ahmad, A.; Khan, P.; Ahmad, K.; Syed, A.

    2008-01-01

    To find out the frequency of patients attending Casualty department of a Teaching Hospital with sudden severe thunderclap headache, their diagnostic out-come and follow up. The study was conducted in Casualty and Medical, Departments of Saidu Teaching Hospital, Saidu Sharif, from January 2006 to December 2006. Out of 22,000 patients with different Medical problems attended Casualty department during study period of which 128 cases had acute severe thunderclap headache. Age range was 15 to 80 years with mean age of 46+-10 years. Seventy eight patients (61%) were female and fifty (39%) were male. Protocol included proper clinical examination, basic laboratory investigations, admission to the General medical ward / Intensive care unit for observation, treatment and follow-up. CT scan of brain and or lumber puncture was performed in all the studied patients. The in-hospital follow up period was from two to fourteen days. The patients were reviewed one month later after discharge from hospital. Out of 120 patients twenty cases (15.6%) had Subarachnoid haemorrhage (SAH) seven patients (5.4%) had Cerebral infarction, five patients (3.9%) had an Intracerebral Haematoma. Five patients (3.9%) had aseptic meningitis. Two cases (1.5%) were reported as cerebral edema. One case (0.8%) had venous sinus thrombosis. As there was no specific finding on investigations and follow up of 88 cases (69%): these were labeled as idiopathic thunder-clap headache. Past history of not more than three similar episodes was present in 33 cases (25.78%). Out of these 33 cases, thirty belonged to the benign group of 88; other three cases had organic causes. Clinical diagnosis of Migraine was made in 37 cases out of these 88 cases. Attack of severe thunderclap headache is not an un-common emergency. Attack due to Subarachnoid haemorrhage (SAH) or other serious underlying disease cannot be distinguished from non specific headaches on clinical grounds alone. It is recommended that all such patients be

  11. Trends in maternal mortality at the University of Calabar Teaching Hospital, Nigeria, 1999–2009

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    TU Agan

    2010-08-01

    Full Text Available TU Agan1, EI Archibong1, JE Ekabua1, EI Ekanem1, S E Abeshi1, TA Edentekhe2, EE Bassey21Department of Obstetrics and Gynecology and 2Department of Anesthesia, College of Medical Sciences, University of Calabar Teaching Hospital, NigeriaBackground: Maternal mortality remains a major public health challenge, not only at the University of Calabar Teaching Hospital, but in the developing world in general.Objective: The objective of this study was to assess trends in maternal mortality in a tertiary health facility, the maternal mortality ratio, the impact of sociodemographic factors in the deaths, and common medical and social causes of these deaths at the hospital.Methodology: This was a retrospective review of obstetric service delivery records of all maternal deaths over an 11-year period (01 January 1999 to 31 December 2009. All pregnancy-related deaths of patients managed at the hospital were included in the study.Results: A total of 15,264 live births and 231 maternal deaths were recorded during the period under review, giving a maternal mortality ratio of 1513.4 per 100,000 live births. In the last two years, there was a downward trend in maternal deaths of about 69.0% from the 1999 value. Most (63.3% of the deaths were in women aged 20–34 years, 33.33% had completed at least primary education, and about 55.41% were unemployed. Eight had tertiary education. Two-thirds of the women were married. Obstetric hemorrhage was the leading cause of death (32.23%, followed by hypertensive disorders of pregnancy. Type III delay accounted for 48.48% of the deaths, followed by Type I delay (35.5%. About 69.26% of these women had no antenatal care. The majority (61.04% died within the first 48 hours of admission.Conclusion: Although there was a downward trend in maternal mortality over the study period, the extent of the reduction is deemed inadequate. The medical and social causes of maternal deaths identified in this study are preventable, especially

  12. Role of Organizational Climate in Organizational Commitment: The Case of Teaching Hospitals.

    Science.gov (United States)

    Bahrami, Mohammad Amin; Barati, Omid; Ghoroghchian, Malake-Sadat; Montazer-Alfaraj, Razieh; Ranjbar Ezzatabadi, Mohammad

    2016-04-01

    The commitment of employees is affected by several factors, including factors related to the organizational climate. The aim of this study was to investigate the relationship between organizational commitment of nurses and the organizational climate in hospital settings. A cross-sectional study was conducted in 2014 at two teaching hospitals in Yazd, Iran. A total of 90 nurses in these hospitals participated. We used stratified random sampling of the nursing population. The required data were gathered using two valid questionnaires: Allen and Meyer's organizational commitment standard questionnaire and Halpin and Croft's Organizational Climate Description Questionnaire. Data analysis was done through SPSS 20 statistical software (IBM Corp., Armonk, NY, USA). We used descriptive statistics and Pearson's correlation coefficient for the data analysis. The findings indicated a positive and significant correlation between organizational commitment and organizational climate (r = 0.269, p = 0.01). There is also a significant positive relationship between avoidance of organizational climate and affective commitment (r = 0.208, p = 0.049) and between focus on production and normative and continuance commitment (r = 0.308, p = 0.003). Improving the organizational climate could be a valuable strategy for improving organizational commitment.

  13. Medication Reviews by a Clinical Pharmacist at an Irish University Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Alan Kearney

    2017-10-01

    Full Text Available Purpose: Pharmacist-led medication reviews in hospitals have shown improvement in patient outcomes. The aim of this study is to describe the prevalence and nature of pharmacist interventions (PIs following a medication review in an Irish teaching hospital. Methods: PIs were recorded over a six-month period in 2015. PIs were assessed by a panel of healthcare professionals (n = 5 to estimate the potential of adverse drug events (ADEs. Descriptive statistics were used for the variables and the chi square test for independence was used to analyse for any association between the variables. Results: Of the 1216 patients (55.8% female; median age 68 years (interquartile range 24 years who received a medication review, 313 interventions were identified in 213 patients. 412 medicines were associated with PIs, of which drugs for obstructive airway disease (n = 82, analgesics (n = 56, and antibacterial products for systemic use (n = 50 were the most prevalent. A statistically significant association was found between PI and patient’s age ≥65 years (p = 0.000, as well as female gender (p = 0.037. A total of 60.7% of the PIs had a medium or high likelihood of causing an ADE. Conclusion: Pharmacist-led medication review in a hospital setting prevented ADEs. Patients ≥65 years of age and female patients benefited the most from the interventions.

  14. Review of eclampsia at the Nnamdi Azikiwe University teaching hospital, Nnewi (January 1996-December 2000).

    Science.gov (United States)

    Ikechebelu, J I; Okoli, C C

    2002-05-01

    In a retrospective study of 43 cases of eclampsia managed at the Nnamdi Azikiwe University Teaching Hospital Nnewi over a 5-year period, an incidence of 0.75% out of 5750 labour ward admissions was found. Eclampsia was more prevalent in the primigravidae (65%) and unbooked patients (83.7%) than in the multigravidae (35%) and booked (16.3%) patients. The mean age of the patients was 23.5 years. The majority of the eclamptic seizure (55.8%) occurred in the antepartum period. Many unbooked patients presented after more than two seizures. The most frequently used drugs in the management of eclampsia in the hospital were intravenous diazepam and hydralazine. For the 35 cases of antepartum eclampsia, 85.7% had a caesarean section while 14.3% had an operative vaginal delivery; none had a spontaneous vaginal delivery. There were four maternal deaths (9.3% of the cases) and seven perinatal deaths (16.3% of the cases). Clinical causes of death in the women were cardiopulmonary failure (three cases) and coagulation disorders (one case). The total maternal deaths in the hospital during this period was 19 given a maternal mortality rate of 330 per 100 000. Eclampsia, therefore, contributed 21.1% of the maternal deaths. The role of health education and good antenatal, labour and early puerperal supervision is stressed in the reduction of the incidence of eclampsia in the developing countries.

  15. Epidemiology of infective endocarditis in a large Belgian non-referral hospital.

    Science.gov (United States)

    Poesen, K; Pottel, H; Colaert, J; De Niel, C

    2014-06-01

    Guidelines for diagnosis of infective endocarditis are largely based upon epidemiological studies in referral hospitals. Referral bias, however, might impair the validity of guidelines in non-referral hospitals. Recent studies in non-referral care centres on infective endocarditis are sparse. We conducted a retrospective epidemiological study on infective endocarditis in a large non-referral hospital in a Belgian city (Kortrijk). The medical record system was searched for all cases tagged with a putative diagnosis of infective endocarditis in the period 2003-2010. The cases that fulfilled the modified Duke criteria for probable or definite infective endocarditis were included. Compared to referral centres, an older population with infective endocarditis, and fewer predisposing cardiac factors and catheter-related infective endocarditis is seen in our population. Our patients have fewer prosthetic valve endocarditis as well as fewer staphylococcal endocarditis. Our patients undergo less surgery, although mortality rate seems to be highly comparable with referral centres, with nosocomial infective endocarditis as an independent predictor of mortality. The present study suggests that characteristics of infective endocarditis as well as associative factors might differ among non-referral hospitals and referral hospitals.

  16. High rate of burnout among anaesthesiologists in Belgrade teaching hospitals: Results of a cross-sectional survey.

    Science.gov (United States)

    Milenović, Miodrag; Matejić, Bojana; Vasić, Vladimir; Frost, Elizabeth; Petrović, Nataša; Simić, Dušica

    2016-03-01

    Decisions by anaesthesiologists directly impact the treatment, safety, recovery and quality of life of patients. Physical or mental collapse due to overwork or stress (burnout) in anaesthesiologists may, therefore, be expected to negatively affect patients, departments, healthcare facilities and families. To evaluate the prevalence of burnout among anaesthesiologists in Belgrade public teaching hospitals. A cross-sectional survey. Anaesthesiologists in 10 Belgrade teaching hospitals. Burnout was assessed using Maslach Burnout Inventory-Human Services Survey. The response rate was 76.2% (205/272) with the majority of respondents women (70.7%). The prevalence of total burnout among anaesthesiologists in Belgrade teaching hospitals was 6.34%. Measured level of burnout as assessed by high emotional exhaustion, high depersonalisation and low personal accomplishment was 52.7, 12.2 and 28.8%, respectively. More than a quarter of the studied population responded in each category with symptoms of moderate burnout. We detected that sex, additional academic education, marital status and working conditions were risk factors for emotional exhaustion and depersonalisation. Ageing increased the likelihood of burnout by 21.3% with each additional year. Shorter professional experience and increased educational accomplishment increased the risk of total burnout by 272%. Burnout rates in Belgrade teaching hospitals among anaesthesiologists are higher than in foreign hospitals. Emotional and/or physical breakdowns can have serious effects when these individuals care for patients in extremely stressed situations that may occur perioperatively. Causes for burnout should be examined more closely and means implemented to reverse this process.

  17. Application of the ATLAS score for evaluating the severity of Clostridium difficile infection in teaching hospitals in Mexico

    OpenAIRE

    Raúl Hernández-García; Elvira Garza-González; Mark Miller; Giovanna Arteaga-Muller; Alejandra María Galván-de los Santos; Adrián Camacho-Ortiz

    2015-01-01

    Background: For clinicians, a practical bedside tool for severity assessment and prognosis of patients with Clostridium difficile infection is a highly desirable unmet medical need. Setting: Two general teaching hospitals in northeast Mexico. Population: Adult patients with C. difficile infection. Methods: Prospective observational study. Results: Patients included had a median of 48 years of age, 54% of male gender and an average of 24.3 days length of hospital stay. Third genera...

  18. Active case finding for carbapenemase-producing Enterobacteriaceae in a teaching hospital: prevalence and risk factors for colonization.

    Science.gov (United States)

    Poole, K; George, R; Decraene, V; Shankar, K; Cawthorne, J; Savage, N; Welfare, W; Dodgson, A

    2016-10-01

    Over the past decade, the prevalence of carbapenemase-producing Enterobacteriaceae (CPE) has increased. Whilst basic infection prevention and control practices reduce the risk of transmission, cases of unrecognized carriage pose a potential risk of transmission. To estimate the prevalence of CPE and explore risk factors associated with colonization within a large teaching hospital with an established CPE outbreak. All inpatients that had not previously tested positive for CPE were offered testing. Demographic and hospital episode data were also collected, together with antibiotic and proton pump inhibitor (PPI) use in the preceding 24h. This study identified 70 CPE-positive cases (26 newly identified and 44 previously known) and 592 CPE-negative cases, giving a combined prevalence of 11% [95% confidence interval (CI) 8-13]. Medication (antibiotic and PPI use), previous admission, ethnicity and length of stay were assessed as risk factors for colonization, and none were found to be independently associated with CPE colonization. Using logistic regression, age [odds ratio (OR) 1.03, 95% CI 1.01-1.07] and antibiotic use (OR 2.55, 95% CI 1.08-6.03) were the only risk factors significantly associated with CPE colonization. This study has added to the evidence base by estimating the prevalence of CPE among inpatients in an acute hospital with an established CPE outbreak. A case-finding exercise was feasible and identified a number of new cases. Despite a small sample size, increasing age and prescription of an antibiotic on the day of testing were significantly associated with CPE colonization. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  19. The pain experience of inpatients in a teaching hospital: revisiting a strategic priority.

    Science.gov (United States)

    Jabusch, Kimberly M; Lewthwaite, Barbara J; Mandzuk, Lynda L; Schnell-Hoehn, Karen N; Wheeler, Barbara J

    2015-02-01

    For hospital executives and clinicians to improve pain management, organizations must examine the current pain experience of in-patients beyond simply measuring patient satisfaction. The aim of this study was to quantify the prevalence of pain among adult in-patients and the degree of interference pain had on daily activities. A descriptive, cross-sectional study was undertaken in a 530 bed tertiary care, teaching hospital in central Canada. A convenience sample (N = 88) of adult medical-surgical patients completed the Short Form-Brief Pain Inventory survey. Pain prevalence was 70.4%. The mean pain severity score was 3.76 (standard deviation, SD = 2.88) and mean pain interference score on daily activities was 4.56 (SD = 3.93). The most frequently identified site of pain was the lower extremities (n = 15, 28%). Women had higher mean scores on pain "right now" compared to men (p < 0.05). The sample majority (n = 81) indicated hospital staff asked about the presence of pain. Seventy-nine percent (n = 57) reported hospital staff "always" did everything they could to help manage pain. Eighty-four percent (n = 61) selected "always" or "usually" to describe their ability to be involved in deciding pain treatments. The mean pain relief score from treatments was 61% (SD = 34.79). Significant positive correlations were found between pain intensity ratings and pain interference on all daily activities (p < 0.001). Pain prevalence remains high with a significant relationship between pain and activities of daily living. The study provides baseline data to direct future initiatives at improving pain management. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  20. Patients characteristics and perception of quality of care in a teaching hospital in Anambra State, Nigeria.

    Science.gov (United States)

    Emelumadu, O F; Ndulue, C N

    2012-01-01

    Patients' assessment of quality of health care despite its importance in uptake of available services has not been closely examined in developing countries. The main objective of this study was to assess patient's perception of the quality of healthcare services as offered at the General Outpatients Department (GOPD) of a teaching hospital in order to obtain rational information for effective policy formulation on improved patient care in our hospitals. This was a four-week duration descriptive cross-sectional study involving three hundred and ninety (390) new adult patients seen at the General Out-Patients' Department of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Using a self-administered pre-tested, semi-structured questionnaire in English language, relevant information was obtained from the participants. A total of 390 adult new patients with mean age 31.4 years participated in the study of which females 216 (55.5%) were slightly more than males 174 (45.5%). About 225 (57.7%) of the respondents received at most a primary school education. The major reasons for seeking care at the GOPD were expectations of being attended to by qualified doctors and nurses (38%); receiving efficient and quality service (36%) and obtaining cheaper and affordable drugs (14.5%). A quarter ofthe patients (25%) waited for up to one hour to register, while 38% spent more than an hour before being attended to by a doctor. Seventy percent (70%) of thepatients opined that the nurses were friendly, 94.5% of the patients rated the doctors as being friendly while 82.5% expressed satisfaction with the care received from the doctors. The conditions of the waiting hall were deemed very comfortable by 42%,and 42% felt hat it was uncomfortable. In all 79% of the patients felt at the quality of care was good and 82% were willing to return for consultations in future if need be. The waiting time for obtaining the patients card and doctors' consultation appeared to be acceptably long in this

  1. Prevalence of infection in patients with temporary catheter for hemodialysis in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Palmiane de Rezende Ramim Borges

    2017-08-01

    Full Text Available This study aimed to determine the prevalence of infection related to the provisional catheter for hemodialysis in a teaching hospital and evaluate the risk factors associated with these infections.  A cross-sectional study analyzed by descriptive statistics and parametric tests. It was found that out of 129 patients, 48.8 % had catheter-related infection in hemodialysis, 65 % were male, 33.3 % were 60 years old and over, and 88 % of patients were admitted to intensive care unit. The prevalence of infection in this group was high, and the vast majority of diagnoses of infection were empirical. Given this, it is suggested to establish the routine culture of the catheter tip in all cases of suspected catheter infection to improve the quality of patient care, and the relentless pursuit of the causes that trigger the infection process in line with good practice from across the healthcare team.

  2. Radiological shielding of cobalt-60 teletherapy facility at Komfo Anokye Teaching Hospital, Kumasi, Ghana

    International Nuclear Information System (INIS)

    Addison, E.K.T.; Kitcher, H.W.; Kyere, A.W.K.; Nani, E.K.

    2003-01-01

    The radiological shielding of the radiotherapy unit, oncology directorate, Komfo Anokye teaching hospital, has been assessed based on the workload and occupancy factors, in addition to the technical and performance specification of the cirus cobalt-60 equipment. Aspects relating to the design of treatment room were described. Calculations were based on NCRP report 49 and measurements were carried out on the structural shielding design of the cobalt-60 unit by the standard method prescribed in the NCRP report 49. This study was carried out to evaluate the adequacy of the shielding put in place to ensure the safety of the staff, public and oncological patients. The results obtained and measurements made, all fall below the regulatory effective dose limit of 20 mSv per year for staff and 1 mSv per year for the public (author)

  3. Re-evaluation of 60Co treatment facility of Korle-Bu Teaching Hospital

    International Nuclear Information System (INIS)

    Adu, S.

    2008-06-01

    The radiological protection assessment based on the shielding of the Co-60 Radiotherapy facility at the Korle Bu Teaching Hospital after the source replacement has been carried out. The results indicate that the concrete biological shield is adequate to attenuate the gamma photons from the new 222 TBq Co-60 source in use. The dose rates at critical locations of the public access area are within the recommended dose rate limit of O.5J..1Sv/h and 7.5J..1Sv/h for public and staff respectively. Thus the shielding has not deteriorated and still provides adequate protection for members of the public and the operating staff (au).

  4. The pattern of neurological disorders in patients admitted to El shaab teaching hospital

    Energy Technology Data Exchange (ETDEWEB)

    Mohamed, Taj Eldin Hag Osman [Faculty of Medicine, University of Khartoum, Khartoum (Sudan)

    1999-07-01

    This thesis was designed to study the pattern of neurological disorders of admitted patients to the neurology centre at El shaab teaching hospital in the period from january 1997 to december 1998. 402 cases were admitted. (35%) were in the age group 21-40, 30% in 41-60, 20% in 61-80, 14% in 0-20 and 1% in >81 males constituted 72% and females 28%. Cerebrovascular diseases top the list with 18.9%, followed by paraplegia's with 17.4%, peripheral neuropathies 11.7, (guillain barre was the most common). Brain space occupying lesions 10.4% (tumors and tuberculomas was the most common),movement disorders with 10% (Parkinson's disease was the most encountered), muscle disorders 6.2% (myasthenia gravis was the commonest). Ataxias 5.5%, headache and migraine was the least group of disorders.

  5. The pattern of neurological disorders in patients admitted to El shaab teaching hospital

    International Nuclear Information System (INIS)

    Mohamed, Taj Eldin Hag Osman

    1999-01-01

    This thesis was designed to study the pattern of neurological disorders of admitted patients to the neurology centre at El shaab teaching hospital in the period from january 1997 to december 1998. 402 cases were admitted. (35%) were in the age group 21-40, 30% in 41-60, 20% in 61-80, 14% in 0-20 and 1% in >81 males constituted 72% and females 28%. Cerebrovascular diseases top the list with 18.9%, followed by paraplegia's with 17.4%, peripheral neuropathies 11.7, (guillain barre was the most common). Brain space occupying lesions 10.4% (tumors and tuberculomas was the most common),movement disorders with 10% (Parkinson's disease was the most encountered), muscle disorders 6.2% (myasthenia gravis was the commonest). Ataxias 5.5%, headache and migraine was the least group of disorders

  6. Pregnant Women's Knowledge of and Attitudes to HIV Testing at Komfo Anokye Teaching Hospital, Kumasi.

    Science.gov (United States)

    Addo, Vn

    2005-06-01

    SummaryA questionnaire survey on the knowledge about human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and attitudes to voluntary counselling and testing (VCT) in pregnancy of 334 antenatal attendants at Komfo Anokye Teaching Hospital (KATH) was conducted. The survey showed that HIV/AIDS is recognized as a life-threatening condition and is mainly acquired through unprotected sexual intercourse with an infected partner, use of unsterile sharp instruments and blood transfusion. Knowledge about mother to child transmission (MTCT) was lacking.The majority of women who had done the test did so as a pre-requisite for church blessing of their marriage.VCT would be acceptable especially when anonymity is ensured and drug treatment is available for mother and child should the pregnant woman test positive for HIV.

  7. Otolaryngology outreach to Komfo Anokye Teaching Hospital: a medical and educational partnership.

    Science.gov (United States)

    Waller, B; Larsen-Reindorf, R; Duah, M; Opoku-Buabeng, J; Edwards, B M; Brown, D; Moyer, J; Prince, M; Basura, G J

    2017-07-01

    Medical and educational partnerships between high- and low-resourced countries provide opportunities to have a long-term meaningful impact on medical training and healthcare delivery. An otolaryngology partnership between Komfo Anokye Teaching Hospital in Kumasi, Ghana, and the University of Michigan Department of Otolaryngology/Head and Neck Surgery has been undertaken to enhance healthcare delivery at both institutions. A temporal bone dissection laboratory, with the equipment to perform dedicated otological surgery, and academic platforms for clinical and medical education and residency training have been established. This article describes the details of this partnership in otological surgery and hearing health, with an emphasis on creating in-country surgical simulation, training on newly acquired medical equipment and planning regarding the formulation of objectified metrics to gauge progress going forward.

  8. Oral tumours seen at Korle Bu Teaching Hospital: a preliminary report

    International Nuclear Information System (INIS)

    Parkins, G.; Armah, G.E.; Tetteh, Y.

    2002-01-01

    Oral tumours in patients attending the oral Surgery Department of the Korle Bu Teaching Hospital, Accra, during a 12 month period from February 1998 to January 1999 were studied and classified. In all, 50 patients were included in the study out of which 33 were fully characterised and classified historically. Fifteen (45.4%) of the tumours examined were squamous cell carcinoma (SCC), 6(18.2%) ameloblastoma (AME), 3 (9.1%) each of Lympoma (L), adenoid cystic carcinoma (ADC) and pleomorphic adenoma (PA), 2(61.1%) ossifying fibroma (OF) and 1(3.0%) embryonal rhabdomyosar coma (ER). There was significant observed between the prevalence rates in men and women. OSCC was found to occur more frequently in the palate/maxillary sinus and the parotid gland whilst ameloblastoma was the commonest benign neoplasm within the fourth decade. (author)

  9. Will there be room for the teaching of internal medicine in a university hospital?

    Science.gov (United States)

    Junod, Alain F

    2002-01-12

    To answer the question addressed, two working groups, one made of the staff of a University clinic, the other one composed of practising general internists, have discussed the assets and weaknesses of a University service of Internal Medicine for postgraduate training. The groups agreed on a number of points: patients' characteristics (complexity and co-morbidities), quality of teaching, method acquisition for clinical reasoning, as well as absence of exposure to ambulatory patients and of follow-up. The groups differed in their views related to the lack of training in psychiatry and psychosocial problems or to hospital dysfunctions. Opening of internal medicine to primary care appears to be necessary at the same time as individual qualities among the senior staff are to be developed, such as critical analysis and self-questioning.

  10. Factors Influencing Laboratory Information System Effectiveness Through Strategic Planning in Shiraz Teaching Hospitals.

    Science.gov (United States)

    Bahador, Fateme; Sharifian, Roxana; Farhadi, Payam; Jafari, Abdosaleh; Nematolahi, Mohtram; Shokrpour, Nasrin

    This study aimed to develop and test a research model that examined 7effective factors on the effectiveness of laboratory information system (LIS) through strategic planning. This research was carried out on total laboratory staff, information technology staff, and laboratory managers in Shiraz (a city in the south of Iran) teaching hospitals by structural equation modeling approach in 2015. The results revealed that there was no significant positive relationship between decisions based on cost-benefit analysis and LIS functionality with LIS effectiveness, but there was a significant positive relationship between other factors and LIS effectiveness. As expected, high levels of strategic information system planning result in increasing LIS effectiveness. The results also showed that the relationship between cost-benefit analysis, LIS functionality, end-user involvement, and information technology-business alignment with strategic information system planning was significant and positive.

  11. The prevalence of malaria parasitaemia in blood donors in a Nigerian teaching hospital.

    Science.gov (United States)

    Okocha, E C; Ibeh, C C; Ele, P U; Ibeh, N C

    2005-03-01

    The present study was undertaken to assess the prevalence of malaria parasitaemia among blood donors and to determine the possible risk of transmission of malaria parasite to recipients of blood in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State. Four hundred and forty-four subjects were selected randomly and EDTA added blood was collected for screening malaria parasites using Giemsa stain. The data were subjected to chi2 analysis. Prevalence of malaria was 30.2% among blood donors and showed bimodal distribution with significant variation in different months. Due to high prevalence of asymptomatic malaria parasitaemia in this region, all blood samples should be screened for malaria parasites (post-donor screening) and administered with a curative dose of antimalarials prophylactically to all patients transfused with malaria parasite positive blood.

  12. Improving the quality of the order-writing process for inpatient orders in a teaching hospital.

    Science.gov (United States)

    Boehringer, Peter A; Rylander, Jeanette; Dizon, Dominic T; Peterson, Michael W

    2007-01-01

    Physicians' illegible handwriting is a notorious contributing factor to medical errors. Furthermore, an illegible signature or failure to print prescribers' name interferes with the ability of staff to clarify orders. We surveyed support medical staff at a teaching hospital before and 2 months after providing all internal medicine department residents a self-inking stamp with their name and pager number. Responses were received from 51% at the first and 36% at the second survey of 401 eligible staff. Responses to questions regarding illegible or absent signature, illegible or absent pager number, and failure to print prescribers' name showed a significant improvement (P writing process. This kind of signature allows clarification of orders in a timely fashion.

  13. A Generic Discrete-Event Simulation Model for Outpatient Clinics in a Large Public Hospital

    Directory of Open Access Journals (Sweden)

    Waressara Weerawat

    2013-01-01

    Full Text Available The orthopedic outpatient department (OPD ward in a large Thai public hospital is modeled using Discrete-Event Stochastic (DES simulation. Key Performance Indicators (KPIs are used to measure effects across various clinical operations during different shifts throughout the day. By considering various KPIs such as wait times to see doctors, percentage of patients who can see a doctor within a target time frame, and the time that the last patient completes their doctor consultation, bottlenecks are identified and resource-critical clinics can be prioritized. The simulation model quantifies the chronic, high patient congestion that is prevalent amongst Thai public hospitals with very high patient-to-doctor ratios. Our model can be applied across five different OPD wards by modifying the model parameters. Throughout this work, we show how DES models can be used as decision-support tools for hospital management.

  14. Retrospective evaluation of the clinical management of patients with periodontal abscesses attending a teaching hospital

    Directory of Open Access Journals (Sweden)

    Modupeoluwa Omotunde Soroye

    2016-01-01

    Full Text Available Aim: This study aimed to examine the clinical management of patients who attended a Nigerian teaching hospital with periodontal abscesses. Setting and Design: This is a retrospective study among patients who attended the Periodontics Clinic of the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, between January 2008 and December 2015. Patients and Methods: Information about the diagnosis was obtained from the departmental log book, and case notes were retrieved from record department. Data collection elicited information on age, sex, tribe, frequency of tooth brushing, dental attendance, medical history, clinical features, involved tooth/teeth, and treatment received. Statistical Analysis Used: Epi info version 3.5.1 was used for statistical analysis. Results: Patients aged between 15 and 87 years, with a mean age of 35.53 ± 19.30 years. Majority of patients were males, had minor ethnic extractions, had some form of education, first dental clinic attendees, indulged in once-daily toothbrushing, fully dentate, and had fair/poor oral hygiene. A total of 8.8% and 31.6% of the participants smoked cigarettes and consumed alcohol, respectively. A fifth of the participants had systemic diseases such as hypertension, diabetes mellitus, and peptic ulcer disease. Majority of the participants (91.2% had severe pain. About two-fifths had periodontal abscess around the incisors and the molars. The upper right quadrant was mostly involved (31.6%. Two-fifth of the patients had extraction done. Conclusion: Data from this study revealed periodontal abscess as a severely painful condition in naÏve dental patients, successfully treated mainly through extraction of the implicated tooth/teeth. This implies that oral health awareness and regular dental attendance may prevent its occurrence.

  15. Midwives’ knowledge and use of partographs at Juba Teaching Hospital, South Sudan

    Directory of Open Access Journals (Sweden)

    Clara Roba Alfred

    2017-11-01

    Full Text Available Background: Evidence shows that good knowledge of partographs and proper application of this knowledge results in a remarkable reduction in prolonged and obstructed labour and reduces maternal mortality. Obstructed labour can be prevented by a simple and cost-effective health intervention tool, the partograph. A partograph is a graphical record of the progress of labour and salient conditions of the mother and foetus plotted against time in hours. This provides an opportunity for early identification of deviation from normal progress. Early detection of prolonged labour greatly contributes to prevention of obstructed labour and related complications. Objective: To assess midwives’ knowledge and use of partographs in the maternity ward of Juba Teaching Hospital, South Sudan. Methods: A cross-sectional descriptive study was conducted to assess utilisation of partographs among healthcare providers in Juba Teaching Hospital. All providers working at the time of the study were included. An interviewer administered questionnaire prepared in English was used to assess socio-demographic and other related variables of respondents as well as knowledge and practice. Ethical procedures were followed at every step. Results: Only 20% of the 30 respondents were registered midwives, 67% knew the components -of a partograph, and 93% could differentiate between normal and abnormal labour with the use of a partograph. The factors affecting the use of partographs included; shortage of partographs in the ward, lack of protocols on partograph use, understanding semantics of the English language, absence of refresher training, late reporting of mothers to the ward, and a shortage of staff. Conclusions: Despite good knowledge of the partograph, about half of the providers do not use them. We recommend training and recruitment of more qualified midwives, a continuous supply of partographs to improve use of partographs continuous supportive supervision, mentoring of

  16. Case series of child sexual abuse: Abia State University Teaching Hospital experience.

    Science.gov (United States)

    Okoronkwo, N C; Ejike, O

    2014-01-01

    Child sexual abuse remains a serious infringement on the rights of the child. Though it appears to be viewed less seriously among adolescents, the consequences may be more severe and less obvious for the younger child. Age of the child appears notto be a deterrent. There is paucity of local data in the sub-region on this important social problem. The circumstance surrounding child sexual abuse in our environment needs to be reviewed. This study sets out to evaluate the characteristics of victims of child sexual abuse and to proffer solutions on how to stem the tide of the crime. To examine the characteristics of sexually abused children presenting to the paediatrics department of Abia State UniversityTeaching hospital, Aba. The case records of 10 consecutive cases of sexually abused children that presented to the Children Outpatient Department of Abia State University Teaching Hospital (ABSUTH) Aba, from January to June 2006 were prospectively reviewed and the parents/child/abuser interviewed where possible. All the victims were females aged 3-11 yrs, while all the abusers were males 14-29 yrs. Both parties were of low socio-economic class. 50% of the victims reported the incident. Mental and psychological state of the perpetrators appears to be a factor. Physical injuries to the vulva-vaginal areas were common. This study shows that child sexual abuse may not be uncommon in our environment. The exact prevalence remains unknown.The perpetrators of child sexual abuse should be prosecuted as a deterrent and rehabilitated whenever possible.

  17. Appropriateness and diagnostic yield of referrals for oesophagogastroduodenoscopy at the Korle Bu Teaching Hospital.

    Science.gov (United States)

    Tachi, K; Nkrumah, K N

    2011-01-01

    Increasing endoscopy workload in open-access services necessitates adoption of appropriateness criteria to check abuse and improve yield. To assess the appropriateness of referrals for oesophagogastroduodenoscopy (OGD) and its relationship to yield at Korle-Bu Teaching Hospital (KBTH), Accra. Referrals, signs, and symptoms of 375 consecutive patients for diagnostic oesophagogastroduodenoscopy were evaluated over four months. Indications were categorized as appropriate or inappropriate using the American Society of Gastrointestinal Endoscopy (ASGE) guidelines and endoscopic findings (yield) categorized as positive or negative. The relationship between these was analyzed and the diagnostic accuracy of the guidelines determined. There were 209 (55.7%) females, and 316 (84.3%) open-access procedures. Mean age was 46±17 years. Dyspepsia, 272 (72.5%) and epigastric tenderness, 192 (41.4 %) were the commonest symptom and sign respectively. Only 133 (35.5%) reported alarm symptoms. Appropriate referrals constituted 221(58.9%). Inappropriate referral rate was similar for endoscopists and non-endoscopists. Positive yield was 62.7%. Male sex, age > 45 years, haematemesis, persistent vomiting, gastroenterologists' referrals and epigastric tenderness were the best predictors of positive yield. Gastritis, 121 (32.3%), duodenal ulcer, 48 (12.5%) and oesophagitis, 36 (9.6%) were the leading endoscopy diagnoses. Carcinomas were reported only after 45 years and 18 (81.8%) of the cases had alarm symptoms. Inappropriate referral for OGD rate is high in Accra. Yield is improved by adherence to the ASGE guidelines but its accuracy as a screening tool for OGD at Korle- Bu Teaching Hospital is too low to recommend it for adoption.

  18. TEMPOROMANDIBULAR PAIN DYSFUNCTION SYNDROME IN PATIENTS ATTENDING LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS, NIGERIA.

    Science.gov (United States)

    Eweka, O M; Ogundana, O M; Agbelusi, G A

    2016-01-01

    Temporomandibular joint pain dysfunction syndrome (TMJPDS) is the most common temporomandibular disorder. This condition presents with symptoms of pain, restricted jaw movement and joint noise. Other symptoms include otalgia, headache, neck pain and trismus. To determine the pattern of Temporomandibular joint pain dysfunction syndrome patients managed at the Lagos University Teaching Hospital, Lagos, Nigeria. A descriptive study of patients with signs and symptoms of Temporomandibular joint pain dysfunction syndrome attending the Oral Medicine Clinic of Lagos University Teaching Hospital. Twenty-one patients with Temporomandibular joint pain dysfunction syndrome were enrolled into the study, out of which 10(48%) were females and 11(52%) were males. The age range was 23-81years with a mean of 45.2 ± 18.9 years. Majority of the patients 20(95.2%) complained of pain around the joint, in the pre-auricular region, in the muscles of mastication and the ear. While 7(35%) complained of clicking sounds, 10(47.6%) complained of pain on mouth opening and during mastication only. In all 5(23.8%) had impaired movement of the jaws, mouth opening was normal in 18(85.7%) but reduced in 3(14.3%) patients. Over half of patients 12(57%) experienced clicking sounds, there was tenderness around the temporomandibular joint in 16(76.2%) cases, pain in the ear of 7(33.3%) patients and 13(61.9%) people presented with tenderness of the muscles of mastication. Conservative management of all the cases resulted in resolution of the symptoms. Temporomandibular joint pain dysfunction syndrome has diverse clinical presentation and though distressing, it responds to prompt and effective conservative management.

  19. Post-operative pain management in paediatric surgery at Sylvanus Olympio University Teaching Hospital, Togo

    Directory of Open Access Journals (Sweden)

    Hamza Doles Sama

    2014-01-01

    Full Text Available Background: The aim of this study was to evaluate pain management in paediatric surgery at Sylvanus Olympio University Teaching Hospital, Lome. Patients and Methods: A prospective descriptive study was conducted in the Department of Anaesthesiology and Intensive Care at Sylvanus Olympio teaching hospital from 1 January to 30 June 2012. Data collected include: demography, type of surgery, American Society of Anaesthesiologists (ASA classification, anaesthetic protocol, analgesia technique, post-operative complications and cost of analgesia. Results: The study includes 106 post-operative children. Abdominal surgery was performed in 41.5% and orthopaedic surgery in 31.1%. A total of 75% of patients were classified ASA 1. General anaesthesia (GA was performed in 88%. Anaesthetists supervised post-operative care in 21.7% cases. Multimodal analgesia was used in every case and 12% of patients received a regional block. The most frequently unwanted effects of analgesics used were nausea and/or vomiting in 12.3%. At H24, child under 7 years have more pain assessment than those from 7 to 15 years (46% vs 24% and this difference was statistically significant (chi-square = 4.7598; P = 0.0291 < 0.05. The average cost of peri-operative analgesia under loco regional analgesia (LRA versus GA during the first 48 h post-operative was US $23 versus $46. Conclusion: Our study showed that post-operative pain management in paediatric surgery is often not well controlled and paediatric loco regional analgesia technique is under practiced in sub Saharan Africa.

  20. Evaluating Checklist Use in Companion Animal Wellness Visits in a Veterinary Teaching Hospital: A Preliminary Study.

    Science.gov (United States)

    Nappier, Michael T; Corrigan, Virginia K; Bartl-Wilson, Lara E; Freeman, Mark; Werre, Stephen; Tempel, Eric

    2017-01-01

    The number of companion animal wellness visits in private practice has been decreasing, and one important factor cited is the lack of effective communication between veterinarians and pet owners regarding the importance of preventive care. Checklists have been widely used in many fields and are especially useful in areas where a complex task must be completed with multiple small steps, or when cognitive fatigue is evident. The use of checklists in veterinary medical education has not yet been thoroughly evaluated as a potential strategy to improve communication with pet owners regarding preventive care. The authors explored whether the use of a checklist based on the American Animal Hospital Association/American Veterinary Medical Association canine and feline preventive care guidelines would benefit senior veterinary students in accomplishing more complete canine and feline wellness visits. A group of students using provided checklists was compared to a control group of students who did not use checklists on the basis of their medical record notes from the visits. The students using the checklists were routinely more complete in several areas of a wellness visit vs. those who did not use the checklists. However, neither group of students routinely discussed follow-up care recommendations such as frequency or timing of follow-up visits. The study authors recommend considering checklist use for teaching and implementing wellness in companion animal primary care veterinary clinical teaching settings.

  1. Evaluating Checklist Use in Companion Animal Wellness Visits in a Veterinary Teaching Hospital: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Michael T. Nappier

    2017-06-01

    Full Text Available The number of companion animal wellness visits in private practice has been decreasing, and one important factor cited is the lack of effective communication between veterinarians and pet owners regarding the importance of preventive care. Checklists have been widely used in many fields and are especially useful in areas where a complex task must be completed with multiple small steps, or when cognitive fatigue is evident. The use of checklists in veterinary medical education has not yet been thoroughly evaluated as a potential strategy to improve communication with pet owners regarding preventive care. The authors explored whether the use of a checklist based on the American Animal Hospital Association/American Veterinary Medical Association canine and feline preventive care guidelines would benefit senior veterinary students in accomplishing more complete canine and feline wellness visits. A group of students using provided checklists was compared to a control group of students who did not use checklists on the basis of their medical record notes from the visits. The students using the checklists were routinely more complete in several areas of a wellness visit vs. those who did not use the checklists. However, neither group of students routinely discussed follow-up care recommendations such as frequency or timing of follow-up visits. The study authors recommend considering checklist use for teaching and implementing wellness in companion animal primary care veterinary clinical teaching settings.

  2. Implications, large and small, from chemical education research for the teaching of chemistry

    Directory of Open Access Journals (Sweden)

    Peter J. Fensham

    2002-05-01

    Full Text Available Research studies in chemical education pose a communication problem for chemists. Unlike the findings from other specializations in chemistry the findings in chemical education tend to be reported in education journals that are not readily accessible to most chemists or chemistry teachers. This lecture is an attempt to remedy this gap in communication. Research studies fall into three broad categories. (i issues related to the content of chemistry itself, that is, What content to teach? And What meaning of each topic is to be conveyed? (ii issues related to how chemical content is taught, such as, the role of lectures, practical work, particular pedagogies, etc. and (iii issues related to its learning, that is, learning of concepts, conceptual change, motivation, etc. Findings in each of these categories of research over the last twenty years have drawn attention to opportunities for improving the quality of chemical education in each of the levels of formal education where chemistry is taught. Sometimes the research findings seem small since they, in fact, merely diagnose the actual problem in teaching and learning. At other times, the research findings are large because they provide a solution to these problems. What remains to be done is to disseminate the findings so that appropriate teaching occurs more widely, with its consequent gains in the quality of learning. Research findings, of these small and large types will be used to illustrate the potential of research to make the practice of chemical education more effective.

  3. Level of awareness about legalization of abortion in Nepal: a study at Nepal Medical College Teaching Hospital.

    Science.gov (United States)

    Tuladhar, H; Risal, A

    2010-06-01

    World Health Organization (WHO) estimates that about 25.0% of all pregnancies worldwide end in induced abortion, approximately 50 million each year. More than half of these abortions are performed under unsafe conditions resulting in high maternal mortality ratio specially in developing countries like Nepal. Abortion was legalized under specified conditions in March 2002 in Nepal. But still a large proportion of population are unaware of the legalization and the conditions under which it is permitted. Legal reform alone cannot reduce abortion related deaths in our country. This study was undertaken with the main objective to study the level of awareness about legalization of abortion in women attending gyne out patients department of Nepal Medical College Teaching Hospital (NMCTH), which will give a baseline knowledge for further dissemination and advocacy about abortion law. Total 200 women participated in the study. Overall 133 (66.5%) women said they were aware of legalization of abortion in Nepal. Women of age group 20-34 years, urban residents, service holders, Brahmin/Chhetri caste and with higher education were more aware about it. Majority (92.0%) of the women received information from the media. Detail knowledge about legal conditions under which abortion can be performed specially in second trimester was found to be poor. Large proportion (71.0%) of the women were still unaware of the availability of comprehensive abortion care services at our hospital, which is being provided since last seven years. Public education and advocacy campaigns are crucial to create awareness about the new legislation and availability of services. Unless the advocacy and awareness campaign reaches women, they are not likely to benefit from the legal reform and services.

  4. Improving financial performance by modeling and analysis of radiology procedure scheduling at a large community hospital.

    Science.gov (United States)

    Lu, Lingbo; Li, Jingshan; Gisler, Paula

    2011-06-01

    Radiology tests, such as MRI, CT-scan, X-ray and ultrasound, are cost intensive and insurance pre-approvals are necessary to get reimbursement. In some cases, tests may be denied for payments by insurance companies due to lack of pre-approvals, inaccurate or missing necessary information. This can lead to substantial revenue losses for the hospital. In this paper, we present a simulation study of a centralized scheduling process for outpatient radiology tests at a large community hospital (Central Baptist Hospital in Lexington, Kentucky). Based on analysis of the central scheduling process, a simulation model of information flow in the process has been developed. Using such a model, the root causes of financial losses associated with errors and omissions in this process were identified and analyzed, and their impacts were quantified. In addition, "what-if" analysis was conducted to identify potential process improvement strategies in the form of recommendations to the hospital leadership. Such a model provides a quantitative tool for continuous improvement and process control in radiology outpatient test scheduling process to reduce financial losses associated with process error. This method of analysis is also applicable to other departments in the hospital.

  5. Training Spiritual Care in Palliative Care in Teaching Hospitals in the Netherlands (SPIRIT-NL) : A Multicentre Trial

    NARCIS (Netherlands)

    Geer, Joep van de; Zock, Tanja; Leget, Carlo; Veeger, Nic; Prins, Jelle; de Groot, Marieke; Vissers, Kris

    Background: In the Netherlands, the spiritual dimension in healthcare became marginal in the second part of the twentieth century. In the Dutch healthcare sys- tem, palliative care is not a medical specialization and teaching hospitals do not have specialist palliative care units with specialized

  6. Mock Hospital Ethics Committee: An Innovative Simulation to Teach Prelicensure Nursing Students the Complexities of Ethics in Practice.

    Science.gov (United States)

    Hagedorn Wonder, Amy

    Limited opportunities exist for prelicensure nursing students to observe the interprofessional process required to resolve complex ethical cases in practice. Therefore, a mock hospital ethics committee (MHEC) was assembled to teach the application of ethics in practice through simulation. The MHEC meeting is an example of how nursing education and practice can partner to create meaningful learning experiences.

  7. Avoidable iatrogenic complications of urethral catheterization and inadequate intern training in a tertiary-care teaching hospital.

    LENUS (Irish Health Repository)

    Thomas, Arun Z

    2009-10-01

    To examine the magnitude of potentially avoidable iatrogenic complications of male urethral catheterization (UC) within a tertiary-care supra-regional teaching hospital, and to evaluate risk factors and subjective feeling of interns in our institution on the adequacy of training on UC.

  8. Knowledge Practice and Outcome of Quality Nursing Care among Nurses in University of Calabar Teaching Hospital (UCTH)

    Science.gov (United States)

    Oyira, Emilia James; Ella, R. E.; Chukwudi, Usochukwu Easter; Paulina, Akpan Idiok

    2016-01-01

    Objectives: The main purpose of this study was to determine knowledge practice and outcome of quality nursing care among nurses in University of Calabar Teaching Hospital (UCTH). Three research questions and one hypothesis were formulated to guide this study. Literature related to the variables under study was reviewed according to the research…

  9. 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

  10. [The profile urological emergencies at the Conakry University Teaching Hospital, Guinea].

    Science.gov (United States)

    Bobo Diallo, A; Bah, I; Diallo, T M O; Bah, O R; Amougou, B; Bah, M D; Guirassy, S; Bobo Diallo, M

    2010-03-01

    To stick out the profile urological emergencies at the Conakry University Teaching Hospital, Guinea. This retrospective study, carried out over a period of 3 years (January 2005-December 2007), included 757 urological emergencies admitted to the urology department of the university hospital of Conakry, Guinea. The mean age of patients was 56 years. These patients had an age equal to or higher than 60 years in 58% of the cases. The sex ratio (M/F) was 16.6. According to the social profession, the farmer (40,6%) and workers (21%) were the dominant patients. The most frequent illness was vesical urinary retention (73.9%), hematuria (9.6%) and genito-urinary system trauma (7%). The most performed procedures were the installation of a urethral catheter (55.25%) and the installation of a suprapubic catheter (24.14%). The most frequent urological emergency in our country was vesical urinary retention, the hematuria and genito-urinary system trauma are not rare there. Copyright 2009 Elsevier Masson SAS. All rights reserved.

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

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    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. Utilization of potentially inappropriate medications in elderly patients in a tertiary care teaching hospital in India

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    Binit N Jhaveri

    2014-01-01

    Full Text Available Aim: To evaluate the use of potentially inappropriate medicines in elderly inpatients in a tertiary care teaching hospital. Materials and Methods: Retrospective analysis was performed for cases of elderly patients admitted between January 2010 and December 2010. Data on age, gender, diagnosis, duration of hospital stay, treatment, and outcome were collected. Prescriptions were assessed for the use of potentially inappropriate medications in geriatric patients by using American Geriatric Society Beer′s criteria (2012 and PRISCUS list (2010. Results: A total of 676 geriatric patients (52.12% females were admitted in the medicine ward. The average age of geriatric patients was 72.69 years. According to Beer′s criteria, at least one inappropriate medicine was prescribed in 590 (87.3% patients. Metoclopramide (54.3%, alprazolam (9%, diazepam (8%, digoxin > 0.125 mg/day (5%, and diclofenac (3.7% were the commonly used inappropriate medications. Use of nonsteroidal anti-inflammatory drugs (NSAIDs in heart and renal failure patients was the commonly identified drug-disease interaction. According to PRISCUS list, at least one inappropriate medication was prescribed in 210 (31.06% patients. Conclusion: Use of inappropriate medicines is highly prevalent in elderly patients.

  13. Distribution of bacterial contamination in a teaching hospital in Tehran - a special focus on Staphylococcus aureus.

    Science.gov (United States)

    Mirzaii, Mehdi; Emaneini, Mohammad; Maleknejad, Parviz; Jonaidi, Nematollah; Fooladi, Abbas Ali Imani; Aligholi, Marzieh; Jabalameli, Fereshteh; Halimi, Shahnaz; Taherikalani, Morovat; Kasaeian, Amir

    2012-03-01

    There are documents that confirm the cycle of bacterial transmission between patients, staff, and the inanimate environment. The environment may have more effect on intensive care units (ICUs), because the patients who require intensive care have unstable clinical conditions and are more sensitive to infections. The aim of this study was to determine the prevalence of bacteria in air and inanimate surface in the ICUs and to compare the microbial levels to standard levels.Air and inanimate surface in the four ICUs of a teaching hospital underwent weekly surveillance by means of air sampler and swabs for a period of six-month. Total bacterial counts were evaluated onto trypticase soy agar and mannitol salt agar (MSA).A total of 725 samples [air (168) and inanimate surfaces (557)] were collected. The total mean ± SD CFU/m3 of airborne bacteria in all of the ICUs were 115.93 ± 48.04. The most common bacteria in air of the ICUs were Gram-positive cocci (84.2%). The total mean ± SD airborne of Staphylococcus aureus was 12.10±8.11 CFU/m3. The highest levels of S. aureus contamination were found in ventilators and bed ledges. More suitable disinfection of hospital environments and monthly rotation in utilization of the various disinfectant agents are needed for the prevention of airborne and inanimate transmission of S. aureus.

  14. A retrospective study of daptomycin use in a Paris teaching-hospital.

    Science.gov (United States)

    Marc, F; Esquirol, C; Papy, E; Longuet, P; Armand-Lefevre, L; Rioux, C; Diamantis, S; Dumortier, C; Bourgeois-Nicolaos, N; Lucet, J-C; Wolff, M; Arnaud, P

    2014-01-01

    We retrospectively studied daptomycin use during 2010 at the Bichat-Claude-Bernard teaching-hospital (Paris) to observe the evolution of daptomycin prescriptions. Twenty-one patients were included and several parameters were documented: site of infection, bacterial species involved, reason for daptomycin use, dose and clinical outcome. Ninety-five percent of daptomycin prescritions were off-label and most did not comply with local guidelines. Fifteen of the 21 patients were cured (71%), including 9 patients of the 12 with off-label and off-local recommendation prescriptions (75%). Osteitis and Enterococcus spp endocarditis were the new indications. Daptomycin was increasingly used at higher doses: 52% of our patients were given doses above 6mg/kg. Staphylococcus spp. was the most frequent pathogen responsible for infection is our patients, followed by Enterococcus spp. Daptomycin use is likely to evolve because of its effectiveness in the treatment of osteitis, left-sided and Enterococcus spp. infective endocarditis. It is generally used at higher doses, which are well tolerated. However, therapeutic monitoring needs to be developed. The antibiotic commission of our hospital gave new recommendations for daptomycin use in 2011. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  15. Nasal colonization with Staphylococcus aureus in individuals with HIV/ AIDS attended in a Brazilian Teaching Hospital

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    Lilian Andreia Fleck Reinato

    2013-12-01

    Full Text Available OBJECTIVE: to evaluate the prevalence of nasal colonization with Staphylococcus aureus in individuals with HIV/AIDS under inpatient treatment in a teaching hospital in the state of São Paulo (Brazil. METHOD: a cross-sectional study undertaken in two units specialized in attending people living with HIV/AIDS, in the period August 2011 - July 2012. Socio-demographic and clinical data was collected through individual interviews and from the medical records; samples of nasal secretion were collected with Stuart swabs on the first day of inpatient treatment. Ethical aspects were respected. RESULT: of the 229 individuals with HIV/AIDS hospitalized in this period, 169 participated in the study, with Staphylococcus aureus being identified in the culture tests of 46 (27.2% of the individuals, resistance to oxacillin being evidenced in 10 (21.8% participants. CONCLUSION: the results of the research indicate that the prevalence of colonization with Staphylococcus aureus in individuals with HIV/AIDS in the specialized units was considered relevant, possibly contributing to future investigations and, moreover, to the implementation of measures to prevent and control this pathogen in this population.

  16. Nasal colonization with Staphylococcus aureus in individuals with HIV/ AIDS attended in a Brazilian teaching hospital.

    Science.gov (United States)

    Reinato, Lilian Andreia Fleck; Pio, Daiana Patrícia Marchetti; Lopes, Letícia Pimenta; Pereira, Fernanda Maria Vieira; Lopes, Ana Elisa Ricci; Gir, Elucir

    2013-01-01

    to evaluate the prevalence of nasal colonization with Staphylococcus aureus in individuals with HIV/AIDS under inpatient treatment in a teaching hospital in the state of São Paulo (Brazil). a cross-sectional study undertaken in two units specialized in attending people living with HIV/AIDS, in the period August 2011 - July 2012. Socio-demographic and clinical data was collected through individual interviews and from the medical records; samples of nasal secretion were collected with Stuart swabs on the first day of inpatient treatment. Ethical aspects were respected. of the 229 individuals with HIV/AIDS hospitalized in this period, 169 participated in the study, with Staphylococcus aureus being identified in the culture tests of 46 (27.2%) of the individuals, resistance to oxacillin being evidenced in 10 (21.8%) participants. the results of the research indicate that the prevalence of colonization with Staphylococcus aureus in individuals with HIV/AIDS in the specialized units was considered relevant, possibly contributing to future investigations and, moreover, to the implementation of measures to prevent and control this pathogen in this population.

  17. An analysis of uterine rupture at the Nnamdi Azikiwe University Teaching Hospital Nnewi, Southeast Nigeria.

    Science.gov (United States)

    Mbamara, S U; Obiechina, Nja; Eleje, G U

    2012-01-01

    Uterine rupture is a preventable condition which has persistently remained in our environment. The aim of this study therefore is to ascertain the incidence of uterine rupture, examine the predisposing factors and maternal and fetal outcome of patients managed of uterine rupture in a tertiary hospital. This descriptive case series was conducted at the department of Obstetrics and Gynaecology, Nnamdi Azikiwe, University Teaching Hospital Nnewi from March 2004 to February 2009. The incidence of uterine rupture was 6.2 per 1000 deliveries. The commonest age range of occurrence was 30-34 years. Uterine rupture occurred predominantly among women of low parity. Previous caesarean section with concurrent use of oxytocics was the commonest risk factor documented.The maternal and perinatal mortality ratio was 94 per 100,000 deliveries and 6 per 1000 births respectively. Surgery was the main stay of treatment and the commonest procedure carried out was uterine repair only. Rupture of the gravid uterus is still a significant cause of maternal mortality and morbidity in our environment. The causes are commonly preventable. The provision of maternal care by skilled personnel, proper antenatal care, update training programmes for health care providers and appropriate legislation on maternal care will significantly reduce the incidence of uterine rupture and improve its prognosis.

  18. Pattern of clinical presentation of eclampsia at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Southeastern Nigeria.

    Science.gov (United States)

    Adinma, E D; Echendu, D A

    2012-01-01

    Eclampsia contributes significantly to maternal and perinatal mortalities globally. The objective of this study is to review the pattern of Eclampsia in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. A retrospective study that reviewed records from labour ward and the Medical Records Department, of cases of Eclampsia managed at NAUTH over a ten year period 1st January-31st December, 2009. There were 57 cases of Eclampsia out of a total of 6,262 deliveries within the study period, giving a prevalence of 0.91%. The highest prevalence of 0.24% occurred in 2009. It was most common, 14 (30.4%), in the 25-29 year age group. The nulliparous women, 28 (61%) were more commonly affected. The prevalence was higher in the un-booked patients (89%), and antepartum Eclampsia was the commonest type (76%). Twenty one (45.7%) patients had three or more convulsions prior to the institution of therapy. Headache, oedema, and blurring of vision were the commonest symptoms, 74%, 71%, and 65% respectively. Eclampsia occurred mainly in un-booked and primigravid patients in this study. Early registration of pregnant women, especially primigravid, in health facilities for effective antenatal care and supervised hospital delivery will significantly reduce the prevalence and complications of Eclampsia.

  19. Urological injuries following gynecological operations--our experience in a teaching hospital in Nigeria.

    Science.gov (United States)

    Chianakwana, G U; Okafor, P I S; Ikechebelu, J I; Mbonu, Okechukwu O

    2006-01-01

    Various grades of urological injuries occur following gynecological operations. Some are recognized during or after surgery but others pass unnoticed. To study the urological injuries that follow gynecological operations in our centre. Retrospective study. Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria, a third generation tertiary institution serving rural, semi-urban, and urban communities. Searching through the records, all the gynecological operations performed in our centre from 1st July 1998 to 30th June 2003 were reviewed. Those patients in whom there were documented evidences of urological injuries were noted. Similarly, all the urological injuries treated in our institution during the same period but resulting from gynecological operations carried out in peripheral hospitals were also noted. From the relevant medical records, the following data were extracted: type of gynecological operation, nature of urological injury, time when injury was detected, status of the surgeon, management modalities, and outcome. A total of 37 urological injuries occurred but, because of incomplete records in five, only 32 patients were included in this study. Ligation of the ureters following hysterectomy was the most common injury and occurred in 28 (87.5%) of the patients. Ureteric ligation is a common urological injury following gynecological operations in our centre.

  20. Maternal morbidity and mortality due to primary PPH-experience at ayub teaching hospital abbottabad

    International Nuclear Information System (INIS)

    Naz, H.; Sarwar, I.; Nisa, A.U.

    2008-01-01

    Postpartum Haemorrhage (PPH) remains a significant cause of maternal mortality and morbidity like hypovolemic shock, anaemia, multi organ failure, consumptive coagulopathy, disseminated intra vascular coagulation (DIC), blood transfusion related complications and hysterectomy leading to loss of childbearing potential. The present study was conducted to determine the frequency of PPH and the associated maternal morbidity at the Department of Gynaecology Unit B, Ayub Teaching Hospital Abbottabad. The study was carried out in the Department of Obstetrics and Gynaecology Unit B of the Ayub teaching Hospital Abbottabad from 18th April 2006 to 17 July 2006. The study population included all cases admitted with primary PPH during the study period. For calculation of frequencies, the total number of deliveries in the setting during the study period was used. All subjects underwent a complete obstetrical clinical workup comprising of history, general physical examination, abdominal and pelvic examination, relevant laboratory investigations. The maternal condition was assessed and managed according to established hospital protocols which included both pharmacological and surgical intervention. All maternal complications were noted and recorded on pre-designed proformas. Data was entered and analyzed by computer. A total of 50 cases of primary PPH were recorded during the study period. The frequency of PPH was calculated as 7.1%. The major cause of PPH was uterine atony found in 29 (58%) cases, followed by cervical, vaginal and perineal tears in 12 (24%) cases. Initially all patients were managed pharmacologically followed by surgical intervention. Subtotal (haemostatic) hysterectomy was performed in 10 (20%) cases. Maternal morbidity was detected in 31 (62%) of cases; the major morbidities were DIC in 3 (6%) cases. Acute renal failure in 3 (6%) patients and shock in 2 (9.9%) cases and anaemia in 20 (90.1%) cases. The study concludes that the frequency of primary PPH in this

  1. Evaluation of APACHE II system among intensive care patients at a teaching hospital

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    Paulo Antonio Chiavone

    Full Text Available CONTEXT: The high-complexity features of intensive care unit services and the clinical situation of patients themselves render correct prognosis fundamentally important not only for patients, their families and physicians, but also for hospital administrators, fund-providers and controllers. Prognostic indices have been developed for estimating hospital mortality rates for hospitalized patients, based on demographic, physiological and clinical data. OBJECTIVE: The APACHE II system was applied within an intensive care unit to evaluate its ability to predict patient outcome; to compare illness severity with outcomes for clinical and surgical patients; and to compare the recorded result with the predicted death rate. DESIGN: Diagnostic test. SETTING: Clinical and surgical intensive care unit in a tertiary-care teaching hospital. PARTICIPANTS: The study involved 521 consecutive patients admitted to the intensive care unit from July 1998 to June 1999. MAIN MEASUREMENTS: APACHE II score, in-hospital mortality, receiver operating characteristic curve, decision matrices and linear regression analysis. RESULTS: The patients' mean age was 50 ± 19 years and the APACHE II score was 16.7 ± 7.3. There were 166 clinical patients (32%, 173 (33% post-elective surgery patients (33%, and 182 post-emergency surgery patients (35%, thus producing statistically similar proportions. The APACHE II scores for clinical patients (18.5 ± 7.8 were similar to those for non-elective surgery patients (18.6 ± 6.5 and both were greater than for elective surgery patients (13.0 ± 6.3 (p < 0.05. The higher this score was, the higher the mortality rate was (p < 0.05. The predicted death rate was 25.6% and the recorded death rate was 35.5%. Through the use of receiver operating curve analysis, good discrimination was found (area under the curve = 0.80. From the 2 x 2 decision matrix, 72.2% of patients were correctly classified (sensitivity = 35.1%; specificity = 92.6%. Linear

  2. Infection dynamics of vancomycin and inducible clindamycin resistant Enterococcus faecalis in an Indian teaching hospital

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    Debasmita Dubey

    2015-06-01

    Full Text Available Objective: To do surveillance for vancomycin and inducible clindamycin resistance of Enterococcus faecalis (E. faecalis, a Gram-positive bacterium in a teaching hospital. Methods: E. faecalis strains isolated from clinical samples were screened for vancomycin and inducible clindamycin resistance, i.e., D-test positivity, using vancomycin screen agar and blood agar plates, respectively. For the D-test screening, erythromycin resistant (Er-r and clindamycin sensitive (Cd-s strain were used. Results: Of 265 isolated E. faecalis strains, 159 (60% were vancomycin resistant Enterococcus (VRE and 106 were vancomycin sensitive Enterococcus (VSE. Of 265 strains, 42 were constitutively resistant to clindamycin and erythromycin and of 148 Er-r and Cd-s strains, 87 (32.83% had D-test positivity, while the rest 61 strains were D-test negatives. D-test results examined with 6 hospital factors as bivalents, only 2 factors, the VSE/VRE and the presence/absence of prior antibiotic use > 90 days bivalent were statistically significant. A VRE strain with D-test positivity would be picked up 0.570 2 times more frequently than a strain with VSE and D-test positivity. Also, patients with prior antibiotic use > 90 days had 3.737 5 times more chance of picking up D-test positive strains than patients without any prior antibiotic use. Resistance pattern of E. faecalis strains to individual 14 antibiotics were recorded; the maximum values of resistance were against ampicillin 10 μg/disc and linezolid 30 μg/disc. Student’s t-test for hospital acquired and community acquired data revealed that drug resistant strains were equally prevalent in both sources. Conclusions: Prevalence of 60% VRE in both hospital and adjoining community creates consternation. In total 87 (32.83% strains had D-test positivity; patients who had used antibiotics within the last 90 days have got an ample chance of picking of D-test positive E. faecalis. D-test protocol should be followed with

  3. Place and role of multifield hospital in teaching program on surgery for students

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    A. V. Kapshytar

    2013-08-01

    Full Text Available Present time is characterized by increase of dynamics of world and social development, introduction of ECTS (European Credit Transfer System [Andrushchenko V. P. at al. 2007; Pertseva T. O. at al. 2008]. Features of new information technologies and forms of educational process dictate need of active introduction of the principles of evidential medicine [Pidayev A. Century at al. 2004; Pishak at al. 2005; Bereznitsky Y. S. at al. 2006]. Thus the main postulate of the Bologna declaration is providing adequate material level of educational base where the training program is implemented in the hospital [Desyaterik V.I. 2008]. Research objective: to determine place and role of multifield clinical base in student’s teaching “General surgery”. Material and research methods. The chair of the general surgery with care of the patients, located in the Community organization “City clinical hospital urgent and an emergency medical service” based in 3 abdominal surgical departments. The hospital has totally 10 surgical departments of a various profile which are the specialized centers and bases of chairs of urology and medicine of accidents, military medicine, anesthesiology and resuscitation. Results of research. Students under the supervision of the teacher visit departments in the hospital and achieve practical skills according to subject goals, make the acquaintance of structure of surgical departments, desmurgy, an asepsis and antiseptics, anesthesia, participate in primary surgical processing of wounds, a bleeding stop, reposition of changes and dislocations, imposing of plaster bandages, imposing or removal of spoke and rod devices, performance of drainage. Big importance has studying of nosological forms is purulent - septic diseases of skin and hypoderma, chronic specific and nonspecific surgical infection, an necrosis, sepsis, tumors and anomalies of development, etc. Wreath of an educational program, the General surgery is writing of the

  4. Role of transformational leadership on employee productivity of teaching hospitals: using structural equation modeling

    Science.gov (United States)

    Vatankhah, Soudabeh; Alirezaei, Samira; Khosravizadeh, Omid; Mirbahaeddin, Seyyed Elmira; Alikhani, Mahtab; Alipanah, Mobarakeh

    2017-01-01

    Background In today’s transforming world, increased productivity and efficient use of existing facilities are practically beyond a choice and become a necessity. In this line, attention to change and transformation is one of the affecting factors on the growth of productivity in organizations, especially in hospitals. Aim To examine the effect of transformational leadership on the productivity of employees in teaching hospitals affiliated to Iran University of Medical Sciences. Methods This cross-sectional study was conducted on 254 participants from educational and medical centers affiliated to Iran University of Medical Sciences (Tehran, Iran) in 2016. The standard questionnaires of Bass & Avolio and of Hersi & Goldsmith were used to respectively assess transformational leadership and level of productivity. The research assumptions were tested in a significance level of 0.05 by applying descriptive statistics and structural equations modeling (SEM) using SPSS 19 and Amos 24. Results Results of the fitting indicators of the assessing model after amending includes Chi-square two to degrees of freedom of 2.756, CFI indicator 0.95, IFI indicator 0.92, Root mean square error of approximation (RMSEA) indicator 0.10. These results indicate that the assessing model is well fitting after the amendment. Also, analysis of the model’s assumptions and the final model of the research reveals the effect of transformational leadership on employees’ productivity with a significance level of 0.83 (p=0.001). Conclusion This research indicates that the more the leadership and decision-making style in hospitals lean towards transformational mode, the more positive outcomes it brings among employees and the organization due to increased productivity. Therefore, it is essential to pay focused attention to training/educational programs in organizations to create and encourage transformational leadership behaviors which hopefully lead to more productive employees. PMID:28979731

  5. Outcomes of a natural rubber latex control program in an Ontario teaching hospital.

    Science.gov (United States)

    Tarlo, S M; Easty, A; Eubanks, K; Parsons, C R; Min, F; Juvet, S; Liss, G M

    2001-10-01

    Allergy to natural rubber latex (NRL) has been frequently reported in health care workers. However, there is little published evidence of the outcome of hospital intervention programs to reduce exposure and detect cases of sensitization early. This study assesses the effects of intervention to reduce NRL allergy in an Ontario teaching hospital with approximately 8000 employees. A retrospective review assessed annual numbers of employees visiting the occupational health clinic, allergy clinic, or both for manifestations of NRL allergy compared with the timing of introduction of intervention strategies, such as worker education, voluntary medical surveillance, and hospital conversion to low-protein, powder-free NRL gloves. The number of workers identified with NRL allergy rose annually, from 1 in 1988 to 6 in 1993. When worker education and voluntary medical surveillance were introduced in 1994, a further 25 workers were identified. Nonsterile gloves were changed to low-protein, powder-free NRL gloves in 1995: Diagnoses fell to 8 workers that year, and 2 of the 3 nurses who had been off work because of asthma-anaphylaxis were able to return to work with personal avoidance of NRL products. With a change to lower protein, powder-free NRL sterile gloves in 1997, allergy diagnoses fell to 3, and only 1 new case was identified subsequently up to May 1999. No increased glove costs were incurred as a result of consolidated glove purchases. This program to reduce NRL allergy in employees was effectively achieved without additional glove costs while reducing expenses from time off work and workers' compensation claims.

  6. Prevalence and pattern of congenital malformations among neonates in the neonatal unit of a teaching hospital

    International Nuclear Information System (INIS)

    Hussain, S.; Sabir, M.; Tarar, S. H.; Mushtaq, R.; Asghar, I.; Chattha, M. N.

    2014-01-01

    Objective: To determine the prevalence and pattern of congenital malformations among neonates in a teaching hospital. Methods: The prospective hospital-based study was conducted over a period of 18 months in the neonatal unit of Combined Military Hospital, Kharian, from September 2011 to February 2013. All neonates from newborn to 28 days of age admitted to the unit irrespective of their condition comprised the study population. Neonatal examination was done by the Registrar at the time of admission followed by neonatologist/paediatrician. Information regarding gender, weight, gestational age, mode of delivery, consanguinity, maternal age, antenatal visit record and family history were recorded on a predesigned proforma. After clinical examination, if required, relevant investigations like ultrasonography, radiology, echocardiography, laboratory and genetic studies were done to confirm diagnosis. Data was statistically analysed by using SPSS 20. Results: Out of 3,210 total admissions, 226 (7%) neonates were congenitally malformed. Of them, 130 (57.52 %) were male and 96 (42.47 %) females. Among different body systems affected, anomalies related to the central nervous system were 46(20.35%) musculoskeletal 42(18.58%), genitourinary 34 (15.04%), cardiovascular system 30 (13.27%), ear, eye, face, neck 27(11.94%), digestive system 19 (8.40%), syndromes and skin 14 (6.19%) each. Conclusion: Congenital Malformations are not rare in our community and central nervous system is the most commonly affected system. Healthcare managers must stress upon primary prevention in the form of vaccination, nutrition and drugs to decrease preventable share of congenital malformations. (author)

  7. Role of transformational leadership on employee productivity of teaching hospitals: using structural equation modeling.

    Science.gov (United States)

    Vatankhah, Soudabeh; Alirezaei, Samira; Khosravizadeh, Omid; Mirbahaeddin, Seyyed Elmira; Alikhani, Mahtab; Alipanah, Mobarakeh

    2017-08-01

    In today's transforming world, increased productivity and efficient use of existing facilities are practically beyond a choice and become a necessity. In this line, attention to change and transformation is one of the affecting factors on the growth of productivity in organizations, especially in hospitals. To examine the effect of transformational leadership on the productivity of employees in teaching hospitals affiliated to Iran University of Medical Sciences. This cross-sectional study was conducted on 254 participants from educational and medical centers affiliated to Iran University of Medical Sciences (Tehran, Iran) in 2016. The standard questionnaires of Bass & Avolio and of Hersi & Goldsmith were used to respectively assess transformational leadership and level of productivity. The research assumptions were tested in a significance level of 0.05 by applying descriptive statistics and structural equations modeling (SEM) using SPSS 19 and Amos 24. Results of the fitting indicators of the assessing model after amending includes Chi-square two to degrees of freedom of 2.756, CFI indicator 0.95, IFI indicator 0.92, Root mean square error of approximation (RMSEA) indicator 0.10. These results indicate that the assessing model is well fitting after the amendment. Also, analysis of the model's assumptions and the final model of the research reveals the effect of transformational leadership on employees' productivity with a significance level of 0.83 (p=0.001). This research indicates that the more the leadership and decision-making style in hospitals lean towards transformational mode, the more positive outcomes it brings among employees and the organization due to increased productivity. Therefore, it is essential to pay focused attention to training/educational programs in organizations to create and encourage transformational leadership behaviors which hopefully lead to more productive employees.

  8. Drug Use Evaluation of Human Intravenous Immunoglobulin (IVIG in a Teaching Hospital in East of Iran

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    Mandana Moradi

    2018-02-01

    Full Text Available different indications that only a few of them is now approved by the Food and Drug Administration (FDA as primary immunodeficiency, idiopathic thrombocytopenic purpura (ITP. Although it has been approved for selected indications, the list of its clinical indications, particularly off-labels, has grown considerably. Unfortunately, many of these conditions, lack sufficient clinical data of efficacy and might not always be appropriate.Method: It was a cross sectional study performed in Amir-al-momenin teaching hospital affiliated to Zabol University of medical sciences. All hospitalized patients who received IVIG during a 6 month period (autumn and winter 2015 were included in this study. We used predesigned data collection forms for data gathering as patient’s demographics, diagnoses, as well as drug related data, such as dose regimen, duration, rate of infusion, any related lab test.Results: In this study total of 49 patients received IVIG. Only in 25 cases, the mentioned indications were FDA approved (51%.Total of 189 IVIG vials (945 grams that cost 146,475,000 Tomans (39481 USD was administered during this study period, of which 560 grams (112vials (59.2% were used for FDA approved indications. From 19 ITP patients only 6 (12.2% fulfilled the criteria for IVIG therapy. Considering cases of wrong doses and whom were not indicated to receive IVIG therapy, total of (93 vials 465 grams, that cost 72,075,000 Tomans (19427 USD were spent irrationally.Conclusion: We concluded that IVIG was widely used irrationally in our institution and cost of this irrational administration is huge. This fact justifies the need for establishing multidisciplinary supervisory procedure in our hospital.

  9. Medication prescribing errors in a public teaching hospital in India: A prospective study.

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    Pote S

    2007-03-01

    Full Text Available Background: To prevent medication errors in prescribing, one needs to know their types and relative occurrence. Such errors are a great cause of concern as they have the potential to cause patient harm. The aim of this study was to determine the nature and types of medication prescribing errors in an Indian setting.Methods: The medication errors were analyzed in a prospective observational study conducted in 3 medical wards of a public teaching hospital in India. The medication errors were analyzed by means of Micromedex Drug-Reax database.Results: Out of 312 patients, only 304 were included in the study. Of the 304 cases, 103 (34% cases had at least one error. The total number of errors found was 157. The drug-drug interactions were the most frequently (68.2% occurring type of error, which was followed by incorrect dosing interval (12% and dosing errors (9.5%. The medication classes involved most were antimicrobial agents (29.4%, cardiovascular agents (15.4%, GI agents (8.6% and CNS agents (8.2%. The moderate errors contributed maximum (61.8% to the total errors when compared to the major (25.5% and minor (12.7% errors. The results showed that the number of errors increases with age and number of medicines prescribed.Conclusion: The results point to the establishment of medication error reporting at each hospital and to share the data with other hospitals. The role of clinical pharmacist in this situation appears to be a strong intervention; and the clinical pharmacist, initially, could confine to identification of the medication errors.

  10. Management of perforated peptic ulcer in patients at a teaching hospital

    International Nuclear Information System (INIS)

    Bin-Taleb, Ali K.; Razzaq, Riyadh A.; Al-Kathiri, Zaki O.

    2008-01-01

    Objective was to explore and analyze the current status in management of patients with perforated peptic ulcers (PPU). A retrospective study carried out at the Surgical Department, Al-Gamhouria Teaching Hospital, Aden, Yemen. Patients admitted with perforated benign peptic ulcers from January 1997 to December 2006 were included in the study. A total of 156 patients, 138 (88.5%) male and 18 (11.5%) female, with an overall mean age of 39.08 years (range 14-75 years) and a higher frequency of PPU were noted in patients 21-40 years (58.3%). The perforated duodenal ulcer and perforated gastric ulcer ratio was 4.8:1. The mean time of presentation was 16.5 hours, and operative intervention after admission was 5.25 hours. Simple perforation closure was used in 91.7% of the patients. Postoperative complication rate was 41% (statistically significant in cases admitted later than 12 hours) wound sepsis making the majority at 55.2%, 6 deaths (3.9%), the correlation with presentation time was not significant. The overall mean post-operative hospitalization period was 12.76 days; 14.7% of the patients stayed more than 3 weeks. Younger patients (21-40 years) were frequently affected. Emphasis should be placed on shortening the time to surgery. Simple closure remains the selected treatment in the majority of patients. Overall post-operative mortality was low (3.9%). Improving the surgical skills, wound care, administrative regulations, hospital environment and the equipments are needed to reduce the high rate of complications. (author)

  11. Management of perforated peptic ulcer in patients at a teaching hospital.

    Science.gov (United States)

    Bin-Taleb, Ali K; Razzaq, Riyadh A; Al-Kathiri, Zaki O

    2008-02-01

    To explore and analyze the current status in management of patients with perforated peptic ulcers (PPU). A retrospective study carried out at the Surgical Department, Al-Gamhouria Teaching Hospital, Aden, Yemen. Patients admitted with perforated benign peptic ulcers from January 1997 to December 2006 were included in the study. A total of 156 patients, 138 (88.5%) male and 18 (11.5%) female, with an overall mean age of 39.08 years (range 14-75 years) and a higher frequency of PPU was noted in patients 21-40 years (58.3%). The perforated duodenal ulcer and perforated gastric ulcer ratio was 4.38:1. The mean time of presentation was 16.5 hours, and operative intervention after admission was 5.25 hours. Simple perforation closure was used in 91.7% of the patients. Postoperative complication rate was 41% (statistically significant in cases admitted later than 12 hours), wound sepsis making the majority at 55.2%, 6 deaths (3.9%), the correlation with presentation time was not significant. The overall mean post-operative hospitalization period was 12.76 days; 14.7% of the patients stayed more than 3 weeks. Younger patients (21-40 years) were frequently affected. Emphasis should be placed on shortening the time to surgery. Simple closure remains the selected treatment in the majority of patients. Overall post-operative mortality was low (3.9%). Improving the surgical skills, wound care, administrative regulations, hospital environment, and equipment are needed to reduce the high rate of complications.

  12. Clinical nutrition and foodservice personnel in teaching hospitals have different perceptions of total quality management performance.

    Science.gov (United States)

    Chong, Y; Unklesbay, N; Dowdy, R

    2000-09-01

    To investigate the perceived total quality management (TQM) performance of their department by clinical nutrition managers and dietitians, and foodservice managers and supervisors, in hospital food and nutrition service departments. Using a 2-part questionnaire containing items about 3 constructs of TQM performance and demographic characteristics, participants rated their perceptions of TQM performance. Employees in 7 Council of Teaching Hospitals. Of the 128 possible respondents, 73 (57%) completed the study. Correlation analysis to identify relationships between demographic characteristics and TQM performance. Analysis of variance to investigate statistical differences among hospitals and between subject groups and types of employment positions. Three TQM constructs--organization, information, and quality management--were evaluated. The clinical nutrition manager and dietitian group had mean ratings between 3.1 and 4.7 (5-point Likert scale); the foodservice manager and supervisor group had mean ratings from 2.7 to 4.0. Education level was significantly correlated (r = 0.44) to performance of employee training in the clinical nutrition group. The number of employees directly supervised was negatively correlated (r = -0.21) to the performance of employee training in the foodservice group. As the dynamic roles of dietitians change, many dietitians will occupy management positions in organizations such as restaurants, health food stores, food processing/distribution companies, and schools. This study demonstrates how a TQM survey instrument could be applied to clinical nutrition and foodservice settings. Dietitians will need to assess TQM in their workplace facilities, especially because of the direct links of TQM to productivity and client satisfaction.

  13. Nasal Colonization rate of Staphylococcus aureus strains among Health Care Service Employee’s of Teaching University Hospitals in Yazd

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    Khalili Mohammad Bagher

    2009-10-01

    Full Text Available This study was carried out to find the extent of staphylococcal carriages including Methicillin resistant Staphylococcus aureus MRSA in employee's of teaching university hospitals in Yazd. Nasal swabs of 742 employees in four different medical teaching hospitals in Yazd were collected, and tested for detection of staphylococci strains. Out of 742 employees, 94 (12.7% were carrier of staphylococcus aurus and 57 (11.38% for methicillin resistant Staphylococcus aureus (MRSA respectively. Prevalence of Staphylococci aureus and MRSA in individual hospitals and wards were different. In general the highest carriers were personnel of dialysis ward and the lowest pediatrics wards. Resistance rate of MRSA against Ciprofloxacin, Vancomycin, and Rifampin were found to be as 28.1%, 10.5% and 35.1% respectively.

  14. An Examination of Teachers' Perceptions and Practice when Teaching Large and Reduced-Size Classes: Do Teachers Really Teach Them in the Same Way?

    Science.gov (United States)

    Harfitt, Gary James

    2012-01-01

    Class size research suggests that teachers do not vary their teaching strategies when moving from large to smaller classes. This study draws on interviews and classroom observations of three experienced English language teachers working with large and reduced-size classes in Hong Kong secondary schools. Findings from the study point to subtle…

  15. Potentially avoidable inpatient nights among warfarin receiving patients; an audit of a single university teaching hospital.

    LENUS (Irish Health Repository)

    Forde, Dónall

    2009-01-01

    BACKGROUND: Warfarin is an oral anticoagulant (OAT) that needs active management to ensure therapeutic range. Initial management is often carried out as an inpatient, though not requiring inpatient facilities. This mismatch results in financial costs which could be directed more efficaciously. The extent of this has previously been unknown. Here we aim to calculate the potential number of bed nights which may be saved among those being dose optimized as inpatients and examine associated factors. METHODS: A 6 week prospective audit of inpatients receiving OAT, at Cork University Hospital, was carried out. The study period was from 11th June 2007 to 20th July 2007. Data was collected from patient\\'s medications prescription charts, medical record files, and computerised haematology laboratory records. The indications for OAT, the patient laboratory coagulation results and therapeutic intervals along with patient demographics were analysed. The level of potentially avoidable inpatient nights in those receiving OAT in hospital was calculated and the potential cost savings quantified. Potential avoidable bed nights were defined as patients remaining in hospital for the purpose of optimizing OAT dosage, while receiving subtherapeutic or therapeutic OAT (being titred up to therapeutic levels) and co-administered covering low molecular weight heparin, and requiring no other active care. The average cost of euro638 was taken as the per night hospital stay cost for a non-Intensive Care bed. Ethical approval was granted from the Ethical Committee of the Cork Teaching Hospitals, Cork, Ireland. RESULTS: A total of 158 patients were included in the audit. There was 94 men (59.4%) and 64 women (40.6%). The mean age was 67.8 years, with a median age of 70 years.Atrial Fibrillation (43%, n = 70), followed by aortic valve replacement (15%, n = 23) and pulmonary emboli (11%, n = 18) were the commonest reasons for prescribing OAT. 54% had previously been prescribed OAT prior to

  16. Analysis of the quality of hospital information systems in Isfahan teaching hospitals based on the DeLone and McLean model.

    Science.gov (United States)

    Saghaeiannejad-Isfahani, Sakineh; Saeedbakhsh, Saeed; Jahanbakhsh, Maryam; Habibi, Mahboobeh

    2015-01-01

    Quality is one of the most important criteria for the success of an information system, which refers to its desirable features of the processing system itself. The aim of this study was the analysis of system quality of hospital information systems (HIS) in teaching hospitals of Isfahan based on the DeLone and McLean model. This research was an applied and analytical-descriptive study. It was performed in teaching hospitals of Isfahan in 2010. The research population consisted of the HIS's users, system designers and hospital information technology (IT) authorities who were selected by random sampling method from users' group (n = 228), and system designers and IT authorities (n = 52) using census method. The data collection tool was two researcher-designed questionnaires. Questionnaires' reliability was estimated by using Cronbach's alpha was calculated. It was 97.1% for the system designers and IT authorities' questionnaire and 92.3% for system users' questionnaire. Findings showed that the mean of system quality score in a variety of HIS and among different hospitals was significantly different and not the same (P value ≥ 0.05). In general, Kosar (new version) system and Rahavard Rayaneh system have dedicated the highest and the lowest mean scores to themselves. The system quality criterion overall mean was 59.6% for different HIS and 57.5% among different hospitals respectively. According to the results of the research, it can be stated that based on the applied model, the investigated systems were relatively desirable in terms of quality. Thus, in order to achieve a good optimal condition, it is necessary to pay particular attention to the improving factors of system quality, type of activity, type of specialty and hospital ownership type.

  17. Emerging Perils of Extended Spectrum β-Lactamase Producing Enterobacteriaceae Clinical Isolates in a Teaching Hospital of Nepal

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    Narayan Prasad Parajuli

    2016-01-01

    Full Text Available Introduction. Infections due to extended spectrum β-lactamase producing Enterobacteriaceae are on the rise. They pose serious public health problems due to their resistance to large number of antibiotics. However, little is known about the genotypes of ESBL from Nepal. Therefore, the study presents results of phenotypic and molecular characterization of ESBL producing Escherichia coli and Klebsiella spp. isolated from various clinical specimens in a tertiary care teaching hospital of Nepal. Methods. A total of 172 Enterobacteriaceae clinical isolates recovered from various clinical specimens were analyzed for their antibiotic susceptibility test. Detection of ESBLs was carried out using combination disk test and multiplex PCR for their genotypes (CTX-M, SHV, and TEM. Results. Out of 172 clinical isolates, 70 (40.6% of them were found ESBL producers. The major source of ESBL producers was urinary tract samples and the highest ESBL production was observed in Escherichia coli (46.5%. Among ESBL genotypes, CTX-M (91.4% was most predominant, followed by TEM (65.7% and SHV (11.4% in both of the isolates. Conclusions. High level of drug resistance and ESBL production was observed among the clinical isolates. There is a need for longitudinal and nationwide surveillance for drug resistance in clinical isolates and antimicrobial stewardship is necessary to guide the appropriate and judicious antibiotic use.

  18. Emerging Perils of Extended Spectrum β-Lactamase Producing Enterobacteriaceae Clinical Isolates in a Teaching Hospital of Nepal.

    Science.gov (United States)

    Parajuli, Narayan Prasad; Maharjan, Pooja; Joshi, Govardhan; Khanal, Puspa Raj

    2016-01-01

    Introduction . Infections due to extended spectrum β -lactamase producing Enterobacteriaceae are on the rise. They pose serious public health problems due to their resistance to large number of antibiotics. However, little is known about the genotypes of ESBL from Nepal. Therefore, the study presents results of phenotypic and molecular characterization of ESBL producing Escherichia coli and Klebsiella spp. isolated from various clinical specimens in a tertiary care teaching hospital of Nepal. Methods . A total of 172 Enterobacteriaceae clinical isolates recovered from various clinical specimens were analyzed for their antibiotic susceptibility test. Detection of ESBLs was carried out using combination disk test and multiplex PCR for their genotypes (CTX-M, SHV, and TEM). Results . Out of 172 clinical isolates, 70 (40.6%) of them were found ESBL producers. The major source of ESBL producers was urinary tract samples and the highest ESBL production was observed in Escherichia coli (46.5%). Among ESBL genotypes, CTX-M (91.4%) was most predominant, followed by TEM (65.7%) and SHV (11.4%) in both of the isolates. Conclusions . High level of drug resistance and ESBL production was observed among the clinical isolates. There is a need for longitudinal and nationwide surveillance for drug resistance in clinical isolates and antimicrobial stewardship is necessary to guide the appropriate and judicious antibiotic use.

  19. The relationship of centralization, organizational culture and performance indexes in teaching hospitals affiliated to Tehran University of Medical Sciences.

    Science.gov (United States)

    Nasirpour, Amir Ashkan; Gohari, Mahmoud Reza; Moradi, Saied

    2010-01-01

    One of the main problems in the efficiency and efficacy of an organization is its structural issue. Organizational culture is also considered as an effective factor in the performance of many organizations. The main goal of the present study was to determine the relationship of Centralization and organizational culture and performance indexes in Teaching Hospitals affiliated to Tehran University of Medical Sciences. This correlation study was performed in the year 2007. The population studied consisted of 4408 personnel from 13 hospitals among whom 441 subjects were selected and studied via a class sampling method. Data was compiled using a check list concerning the evaluation status of Centralization and another form concerning performance indexes as well as Robbin's organizational culture questionnaire. Data were obtained from the subjects by self answering and analyzed by using descriptive statistical indexes, T- test and Fisher's exact tests. Among the organizational culture indexes of the hospitals studied, control and organizational identity was better as compared to others (mean=3.32 and 3.30). Concerning the extent of Centralization in the hospitals studied, 53.85 % and 46.15 % were reported to have upper and lower organizational Centralization, respectively. Mean ratio of surgical operations to inpatients was 40%, the mean rate of admissions per active bed was 60.83, mean bed occupancy coefficient was 70.79%, average length of stay was 6.96 days, and mean net death rate was 1.41%. No significant correlation was seen between Centralization degree, organizational culture and performance indexes in teaching hospitals Tehran university of medical sciences. (with 95% confidence interval). Due to the fact that first grade Teaching hospitals use board certified members, expert personnel, and advanced equipments and because of the limitation of patients choice and, the extent of Centralization and many organizational culture components have no significant

  20. Utilization of arterial blood gas measurements in a large tertiary care hospital.

    Science.gov (United States)

    Melanson, Stacy E F; Szymanski, Trevor; Rogers, Selwyn O; Jarolim, Petr; Frendl, Gyorgy; Rawn, James D; Cooper, Zara; Ferrigno, Massimo

    2007-04-01

    We describe the patterns of utilization of arterial blood gas (ABG) tests in a large tertiary care hospital. To our knowledge, no hospital-wide analysis of ABG test utilization has been published. We analyzed 491 ABG tests performed during 24 two-hour intervals, representative of different staff shifts throughout the 7-day week. The clinician ordering each ABG test was asked to fill out a utilization survey. The most common reasons for requesting an ABG test were changes in ventilator settings (27.6%), respiratory events (26.4%), and routine (25.7%). Of the results, approximately 79% were expected, and a change in patient management (eg, a change in ventilator settings) occurred in 42% of cases. Many ABG tests were ordered as part of a clinical routine or to monitor parameters that can be assessed clinically or through less invasive testing. Implementation of practice guidelines may prove useful in controlling test utilization and in decreasing costs.

  1. Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration

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    Curtis L. Baysinger

    2017-06-01

    Full Text Available Many low- and middle-income countries (LMICs report low rates of regional anesthesia (RA use for cesarean delivery (CD, despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV, a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV. From late 2011 through 2015, teams from Kybele participated in annual to biannual didactic conferences and week-long bedside teaching efforts involving obstetric and anesthesia staff from CCV and surrounding hospitals. Ongoing contact occurred at least weekly between Kybele and the host to discuss progress. De-identified quality improvement data on total deliveries, numbers of elective and non-elective CDs, number of vaginal deliveries, type of anesthesia for CD, and the number of NALs were collected. RA use for CD increased to 25% in year 2015 versus 14% in base year 2011 [odds ratio (OR: 2.05; 95% confidence interval (CI: 1.73,2.42; p < 0.001]. NAL increased to 10.5% of laboring women in 2015 versus 1.2% in 2011 (OR: 9.6; 95% CI: 7.2, 12.8; p < 0.001. Greater increases for RA use during non-elective CD were observed between 2011 and 2015 (1.4 versus 7.5% of total CD; OR: 5.52; 95% CI: 2.63, 8.41; p < 0.001 relative to elective CD (12.5 versus 17.5% of total CD; OR: 1.48; 95% CI: 1.23, 1.77; p < 0.001. Overall, RA for CD increased during the 4 year collaboration but was not as great as reported in other countries with similar health-care demographics utilizing a similar program. Detailed descriptions of program interventions and barriers to change at CCV are presented.

  2. Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration.

    Science.gov (United States)

    Baysinger, Curtis L; Pujic, Borislava; Velickovic, Ivan; Owen, Medge D; Serafin, Joanna; Shotwell, Matthew S; Braveman, Ferne

    2017-01-01

    Many low- and middle-income countries (LMICs) report low rates of regional anesthesia (RA) use for cesarean delivery (CD), despite its association with lower maternal major morbidity and mortality. Also, the prevalence of neuraxial analgesia for labor (NAL) is often low in LMICs. We report on the results of a collaboration in clinical education over a multi-year period between Kybele Inc., an international non-profit organization, and Klinicki Centar Vojvodine (CCV), a teaching hospital in Novi Sad, Serbia, to increase RA use for CD and NAL at CCV. From late 2011 through 2015, teams from Kybele participated in annual to biannual didactic conferences and week-long bedside teaching efforts involving obstetric and anesthesia staff from CCV and surrounding hospitals. Ongoing contact occurred at least weekly between Kybele and the host to discuss progress. De-identified quality improvement data on total deliveries, numbers of elective and non-elective CDs, number of vaginal deliveries, type of anesthesia for CD, and the number of NALs were collected. RA use for CD increased to 25% in year 2015 versus 14% in base year 2011 [odds ratio (OR): 2.05; 95% confidence interval (CI): 1.73,2.42; p  < 0.001]. NAL increased to 10.5% of laboring women in 2015 versus 1.2% in 2011 (OR: 9.6; 95% CI: 7.2, 12.8; p  < 0.001). Greater increases for RA use during non-elective CD were observed between 2011 and 2015 (1.4 versus 7.5% of total CD; OR: 5.52; 95% CI: 2.63, 8.41; p  < 0.001) relative to elective CD (12.5 versus 17.5% of total CD; OR: 1.48; 95% CI: 1.23, 1.77; p  < 0.001). Overall, RA for CD increased during the 4 year collaboration but was not as great as reported in other countries with similar health-care demographics utilizing a similar program. Detailed descriptions of program interventions and barriers to change at CCV are presented.

  3. The mental health of nurses in acute teaching hospital settings: a cross-sectional survey.

    Science.gov (United States)

    Perry, Lin; Lamont, Scott; Brunero, Scott; Gallagher, Robyn; Duffield, Christine

    2015-01-01

    Nursing is an emotionally demanding profession and deficiencies in nurses' mental wellbeing, characterised by low vitality and common mental disorders, have been linked to low productivity, absenteeism and presenteeism. Part of a larger study of nurses' health, the aim of this paper was to describe the mental health status and related characteristics of nurses working in two acute metropolitan teaching hospitals. A cross sectional survey design was used. The Registered and Enrolled Nurse workforce, employed on any form of contract, at two teaching hospitals in Sydney Australia were invited to participate. The survey tool was compiled of validated tools and questions. Family and medical history and health risk-related characteristics, current psycho-active medications, smoking status, alcohol intake, eating disorders, self-perceived general health, mental health and vitality, demographic, social and occupational details were collected. A total of 1215 surveys were distributed with a usable response rate of 382 (31.4%). Altogether 53 nurses (14%) reported a history of mental health disorders, of which n = 49 (13%) listed diagnoses of anxiety and/or depression; 22 (6%) were currently taking psychoactive medication. Symptoms that could potentially indicate a mental health issue were more common, with 248 (65.1%) reporting they had experienced symptoms sometimes or often in the last 12 month. Nurses had better mental health if they had better general health, lived with a spouse/ partner rather than alone, had fewer symptoms, sleep problems or disordered eating behaviours, were not an informal carer and did not work nights. Nurses had greater vitality if they were male, had better general health, fewer sleep problems or symptoms generally and lived with a spouse/ partner rather than alone; less vitality if they were an informal carer or had disordered eating. Nurses and their managers should strive to create workplaces where working practices promote nurses' health

  4. Fail to prepare and you can prepare to fail: the experience of financing path changes in teaching hospitals in Iran.

    Science.gov (United States)

    Doshmangir, Leila; Rashidian, Arash; Jafari, Mehdi; Ravaghi, Hamid; Takian, Amirhossein

    2016-04-21

    In 1995, teaching and public hospitals that are affiliated with the ministry of health and medical education (MOHME) in Iran were granted financial self-sufficiency to practice contract-based relations with insurance organizations. The so-called "hospital autonomy" policy involved giving authority to the insurance organizations to purchase health services. The policy aimed at improving hospitals' performance, hoping to reduce government's costs. However, the policy was never implemented as intended. This was because most participating hospitals gave up to implement autonomous financing and took other financing pathways. This paper analyses the reasons for the gap between the intended policy and its execution. The lessons learned from this analysis can inform, we envisage, the implementation of similar initiatives in other settings. We conducted semi-structured interviews with 28 national and 13 regional health policy experts. We also gathered a comprehensive and purposeful set of related documents and analyzed their content. The qualitative data were analyzed by thematic inductive-deductive approach. We found a number of prerequisites and requirements that were not prepared prior to the implementing hospital autonomy policy and categorized them into policy content (sources of funds for the policy), implementation context (organization of insurance organizations, medical tariffs, hospitals' organization, feasibility of policy implementation, actors and stakeholders' support), and implementation approach (implementation method, blanket approach to the implementation and timing of implementation). These characteristics resulted in unsuitable platform for policy implementation and eventually led to policy failure. Autonomy of teaching hospitals and their exclusive financing through insurance organizations did not achieve the desired goals of purchaser-provider split in Iran. Unless contextual preparations are in place, hospital autonomy will not succeed and problematic

  5. Pattern and presentation of acute abdomen in a Nigerian teaching hospital.

    Science.gov (United States)

    Agboola, John Owoade; Olatoke, Samuel Adegboyega; Rahman, Ganiyu Abebisi

    2014-05-01

    Abdominal pain of sudden onset is the hallmark of most non-traumatic emergency surgical presentations. This presents a scenario of urgency to the young surgeon who has to determine which of a myriad of disease conditions the patient is presenting with. Such a physician has to rely on experience and a sound knowledge of the local aetiological spectrum in making a clinical diagnosis. To determine the epidemiology and aetiological spectrum of diseases presenting as acute abdomen in the adult population at the hospital surgical emergency unit. Two hundred and seventy-six patients presenting at the University of Ilorin Teaching Hospital emergency unit and managed by the general surgeons between 1(st) of May 2009 and 30(th) of April 2010 were recruited and followed-up throughout the period of admission. The biodata and clinical information inclusive of diagnosis, investigations, treatment modality and outcome were entered in a structured questioner. Standardised treatment was given to all patients and difficulties encountered in their management were also noted. The data collected was evaluated using SPSS16. Acute abdomen constituted 9.6% of total surgical emergency admissions with patients aged 16-45 years constituting 78.3%. The commonest cause of acute abdomen was appendicitis (30.3%) followed by intestinal obstruction (27.9%), perforated typhoid ileitis 14.9% and peptic ulcer disease (7.6%), respectively. The result from the study is similar to what has been reported in other tropical settings with inflammatory lesions being the major problem. There is also a rising incidence of post-operative adhesions and gradual decline in incidence of obstructed hernia.

  6. Process mapping evaluation of medication reconciliation in academic teaching hospitals: a critical step in quality improvement.

    Science.gov (United States)

    Holbrook, Anne; Bowen, James M; Patel, Harsit; O'Brien, Chris; You, John J; Tahavori, Roshan; Doleweerd, Jeff; Berezny, Tim; Perri, Dan; Nieuwstraten, Carmine; Troyan, Sue; Patel, Ameen

    2016-12-30

    Medication reconciliation (MedRec) has been a mandated or recommended activity in Canada, the USA and the UK for nearly 10 years. Accreditation bodies in North America will soon require MedRec for every admission, transfer and discharge of every patient. Studies of MedRec have revealed unintentional discrepancies in prescriptions but no clear evidence that clinically important outcomes are improved, leading to widely variable practices. Our objective was to apply process mapping methodology to MedRec to clarify current processes and resource usage, identify potential efficiencies and gaps in care, and make recommendations for improvement in the light of current literature evidence of effectiveness. Process engineers observed and recorded all MedRec activities at 3 academic teaching hospitals, from initial emergency department triage to patient discharge, for general internal medicine patients. Process maps were validated with frontline staff, then with the study team, managers and patient safety leads to summarise current problems and discuss solutions. Across all of the 3 hospitals, 5 general problem themes were identified: lack of use of all available medication sources, duplication of effort creating inefficiency, lack of timeliness of completion of the Best Possible Medication History, lack of standardisation of the MedRec process, and suboptimal communication of MedRec issues between physicians, pharmacists and nurses. MedRec as practised in this environment requires improvements in quality, timeliness, consistency and dissemination. Further research exploring efficient use of resources, in terms of personnel and costs, is required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Low back pain in pregnant women attending antenatal clinic: The Aminu Kano teaching hospital experience.

    Science.gov (United States)

    Usman, Mustapha Ibrahim; Abubakar, Muhammad Kabir; Muhammad, Shamsuddeen; Rabiu, Ayyuba; Garba, Ibrahim

    2017-01-01

    The profound physiologic effects of pregnancy affect the musculoskeletal system. Pregnant women are at increased risks of low back/pelvic girdle pains. To determine the incidence of low back/pelvic girdle pains among pregnant women. This was a cross-sectional study conducted from May 1 to June 30, 2016, among consenting pregnant women at Aminu Kano Teaching Hospital. Ethical approval was obtained from the Hospital Ethics Committee. Information was obtained in a questionnaire on consecutive pregnant women. Data obtained were analyzed using SPSS version 18 (SPSS Inc., Chicago, Illinois, USA, 2012). Fisher's exact test was used for categorical data, and P ≤ 0.05 was considered statistically significant. A total of 309 pregnant women were recruited from May 1 to June 30, 2016. The mean age ± standard deviation was 28.4 ± 5.86 years. The incidence of low back pains (LBPs) and pelvic girdle pains among the pregnant women was 106 (34.3%) and 178 (57.6%), respectively. The pain was severe among 26 (9.2%) pregnant women, which warranted analgesic usage. Pain radiation was reported in> 50% of cases. There was an incidental finding of urinary incontinence in 36 (12.6%) cases. Low back/pelvic girdle pain was not associated with body mass index (BMI) (P = 0.390). The incidence of LBPs and pelvic girdle pains was high and found to be 34.3% and 57.6%, respectively. Analgesics were used especially among those with severe pains. There was an incidental finding of urinary incontinence among pregnant women with complaints of low back/pelvic girdle pains. There was no statistically significant association between LBPs and maternal BMI.

  8. Compliance With Guideline Statements for Urethral Catheterization in an Iranian Teaching Hospital

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    Negar Taleschian-Tabrizi

    2015-12-01

    Full Text Available Background It is believed that healthcare staff play an important role in minimizing complications related to urethral catheterization. The purpose of this study was to determine whether or not healthcare staff complied with the standards for urethral catheterization. Methods This study was conducted in Imam Reza teaching hospital, Tabriz, Iran, from July to September 2013. A total of 109 catheterized patients were selected randomly from surgical and medical wards and intensive care units (ICUs. A questionnaire was completed by healthcare staff for each patient to assess quality of care provided for catheter insertion, while catheter in situ, draining and changing catheter bags. Items of the questionnaire were obtained from guidelines for the prevention of infection. Data analysis was performed with SPSS 16. Results The mean age of the patients was 50.54 ± 22.13. Of the 109 patients, 56.88% were admitted to ICUs. The mean duration of catheter use was 15.86 days. Among the 25 patients who had a urinalysis test documented in their hospital records, 11 were positive for urinary tract infection (UTI. The lowest rate of hand-washing was reported before bag drainage (49.52%. The closed drainage catheter system was not available at all. Among the cases who had a daily genital area cleansing, in 27.63% cases, the patients or their family members performed the washing. In 66.35% of cases, multiple-use lubricant gel was applied; single-use gel was not available. The rate of documentation for bag change was 79%. Conclusion The majority of the guideline statements was adhered to; however, some essential issues, such as hand hygiene were neglected. And some patients were catheterized routinely without proper indication. Limiting catheter use to mandatory situations and encouraging compliance with guidelines are recommended.

  9. A survey of inpatient practitioner knowledge of penicillin allergy at 2 community teaching hospitals.

    Science.gov (United States)

    Staicu, Mary L; Soni, Dipekka; Conn, Kelly M; Ramsey, Allison

    2017-07-01

    The negative effect of the penicillin allergy label on antibiotic use and patient outcomes has brought to light the need for thorough penicillin allergy assessments and heightened practitioner education. To evaluate practitioner knowledge of penicillin allergy and the clinical approach to the patients with penicillin allergy. An electronic survey was distributed to attending physicians, residents, pharmacists, nurse practitioners, and physician assistants practicing adult inpatient medicine at 2 community-based teaching hospitals from February to April 2016. A total of 276 (39%) of 716 practitioners completed surveys were analyzed. Most respondents were attending physicians (45%) with more than 10 years of experience (53%). Approximately half of the respondents indicated that they were unfamiliar with the rate of cross-reactivity between penicillin and cephalosporin (46%), carbapenem (42%), and monobactam (48%) antibiotics. When evaluating the role of penicillin skin testing and temporary induction of drug tolerance in the case vignettes, only 41% and 19% of respondents appropriately considered these options as the leading antibiotic management plan, respectively. Despite acknowledging the need for allergy/immunology consultation in clinical scenarios, 86% of respondents indicated that they never consult an allergist or immunologist or do so only once per year. Overall, pharmacists had a better understanding of the natural history of penicillin allergy and antibiotic cross-reactivity (P penicillin allergy in the hospital setting, where collaborative efforts between allergy and nonallergy health care practitioners are sparse. The expansion of a multidisciplinary approach may optimize antimicrobial prescribing in this subset of patients. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. Maternal mortality and morbidity of unsafe abortion in a university teaching hospital of Karachi, Pakistan

    International Nuclear Information System (INIS)

    Shah, N.; Hossain, N.; Khan, N.H.

    2011-01-01

    Objective: To study the mortality and morbidity of unsafe abortion in a University Teaching Hospital. Methods: A cross-sectional, descriptive study was conducted in Department of Obstetrics and Gynaecology, Unit III, Dow Medical College and Civil Hospital Karachi from January 2005 to December 2009. Data regarding the socio demographic characteristics, reasons and methods of abortion, nature of provider, complications and treatment were collected for 43 women, who were admitted with complications of unsafe abortion, and an analysis was done. Results: The frequency of unsafe abortion was 1.35% and the case fatality rate was 34.9%. Most of the women belonged to a very poor socioeconomic group (22/43; 51.2%) and were illiterate (27/43; 62.8%). Unsafe abortion followed an induced abortion in 29 women and other miscarriages in 14 women. The majority of women who had an induced abortion were married (19/29, 65.5%). A completed family was the main reason for induced abortion (14/29; 48.2%) followed by being unmarried (8/29, 27.5%) and domestic violence in 5/29 cases (17.2%). Instruments were the commonest method used for unsafe abortion (26/43;68.4%).The most frequent complication was septicaemia (34; 79%) followed by uterine perforation with or without bowel perforation (13, 30.2%) and haemorrhage (9; 20.9%). Majority of induced abortions were performed by untrained providers (22/26; 84.6%) compared to only 3/14 cases (21.4%) of other miscarriages (p=0.0001). Conclusion: The high maternal mortality and morbidity of unsafe abortion in our study highlights the need for improving contraceptive and safe abortion services in Pakistan. (author)

  11. Medicine utilization review at a university teaching hospital in New Delhi

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    M Aqil

    2012-01-01

    Full Text Available Objective: A prospective medicine usage evaluation based on prescription monitoring was conducted in the medicine OPD of our university teaching hospital to know prescribing trends of different categories of medicines. Materials and Methods: A total of 600 patients were included in the study comprising of 339 (56.5% males and 261 (43.5% females. The data were recorded within the OPD by a registered pharmacist on a medicine usage evaluation form, approved by The University Institutional Review Board (IRB. Results: A total of 2365 medicines were prescribed to 600 patients during the 3 months study period. The mean number of medicines per prescription were found to be 3.94. Medicines were most frequently prescribed as solid dosage forms (85.62%, especially tablets (70.82%, and liquid formulations (14.12%. Oral route (96.17% was the most preferred mode of administration, followed by topical (2.11% and parenteral (1.60% routes. Combination therapy (94.33% was more prevalent than monotherapy (5.66%. An overwhelming tendency for prescribing medicines by brand names (99% was observed by the physicians. The most frequently prescribed class of medicines were antimicrobials > analgesics > cardiovascular > gastrointestinal agents. The most prescribed individual medicines among various therapeutic classes included isoniazid (antimicrobial, amlodipine (cardiovascular, metformin (hypoglycemic, cetirizine (antiallergic, rabeprazole (GI medicine, atorvastatin (hypolipidemic, dextromethorphan (respiratory medicine, alprazolam (sedative-hypnotic, paracetamol (analgesic. Conclusions: There is a considerable scope of improvement in the existing prescribing practice, especially prescribing by generic names, needs to be encouraged and a hospital formulary has to be developed for the purpose. The number of medicines to be included per prescription should be judged rationally and polypharmacy ought to be curbed. Use of antimicrobial also needs to be rationalized as over

  12. Pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South East Nigeria.

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    Osuji, Charles Ukachukwu; Onwubuya, Emmanuel Ikechukwu; Ahaneku, Gladys Ifesinachi; Omejua, Emeka Godwin

    2014-01-01

    Cardiovascular disease (CVD) is one of the top killer diseases in the world sparing neither developed or developing countries. The study was carried out to determine the pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi South East Nigeria. The study was a retrospective study covering the period January 2007 to December 2009. SPSS version 13 software was used to analyze data. 537 (15%) patients were admitted into the study out of 3546 patients {females 1756 and 1790} admitted into medical wards. 322 (60%) of study population were males and 215 (40%) females. 359(67.5%) were discharged, 170 (32%) died and 8 (0.5%) were discharged against medical advice. The majority of the deaths 105(61.8%), were in patients with CVA. Most of the deaths (111 or 65.3%) occurred within the first seven days of admission. The mean age of the population was 60.7 years ±15.9 with a range of 18 to 110 years. The length of stay in hospital ranged between 1 and 140 days with a mean of 13.5 ± 13.9 days and a median of 10 days. 33 of the subjects were single, 406 were married, 94 were widowed (11 males and 83 females) and 4 were divorced. 46.7% (251) were admitted for CVA and 30.9% (166) for heart failure. Cardiomyopathy/valvular heart diseases (clinical diagnosis due to absence of echocardiography) constituted 3.9%, hypertension 20.5% and pre-existing hypertension with uremia 1.9%. The study has shown that cardiovascular disease contributed significantly to medical admissions the elderly accounting for a significant proportion. There is thus the need for intensification of primary preventive strategies for cardiovascular diseases.

  13. Placenta praevia: review of clinical presentation and management in a Nigerian teaching hospital.

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    Ikechebelu, J I; Onwusulu, D N

    2007-01-01

    The study aims at reviewing the clinical presentation and management of placenta praevia in a tertiary health facility. This is a retrospective study of 59 cases of placenta praevia managed at the Nnamdi Azikiwe University Teaching Hospital, Nnewi from January 1997 to December 2001. The case records of 44 of the patients were obtained from the hospital medical records department and analysed. During the five year period, there were 3565 deliveries and 59 cases of placenta praevia giving an incidence of 1.65%. Thirty four (77.3%) occurred in women aged 35 years and below. The commonest was type 111 (12 cases; 27.3%) followed by type IV (10 cases; 22.7%). Previous uterine scar was associated with 22 (50.0%) cases. Age had no statistically significant effect on the prevalence. The commonest GA range at presentation (13; 29.6%) and at delivery (18; 40.9%) was 37-40 weeks. The commonest mode of presentation was antepartum haemorrhage (34; 77.3%) followed by abnormal lie and malpresentation (4 each; 9.1%). The average admission delivery interval was one week in 33 (75.0%) cases and only two (4.5%) received blood transfusion. Forty (90.9%) women had caesarean delivery while 12 (27.3%) babies were of low birth weight. There were only 2 (4.5%) fetal deaths and one (2.3%) caesarean hysterectomy. The commonest predisposing factor to placenta praevia in this study is previous uterine scar. Judicious use of caesarean section especially in the primigravida will help reduce the incidence of placenta praevia. Also a screening ultrasonography at 34-36 weeks gestation (especially in women with previously scarred uterus) is recommended.

  14. Family violence among mothers seen at the University of Ilorin Teaching Hospital, Ilorin, Nigeria

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    B A Ayinmode

    2008-08-01

    Full Text Available Objective. The attention given to family violence (FV in primary medical care in Nigeria is still very insufficient in relation to its known adverse medical and psychosocial implications for women’s health. The objective of this preliminary study was to assess the prevalence rate, correlates and effects of FV among mothers attending a primary care facility in Nigeria, with the aim of gaining an understanding of whether screening for FV in the primary care setting in Nigeria would be beneficial. Methodology . A cross-sectional study of FV among 250 mothers attending the General Outpatient Department of the University of Ilorin Teaching Hospital was undertaken over a 5-month period. Data on the mothers’ sociodemographic characteristics, and experience of FV and its psychosocial correlates and effects were collected using a semi-structured questionnaire and a 20-item Self- Reporting Questionnaire (SRQ as instruments. Data analysis . EPI Info version 6 was used to analyse the data. Results. Sixty-nine mothers (28% had experienced FV at the hands of their husbands. Of these women, 49 (71% indicated occurrences within the preceding 2 years; in 17 (25%, the violence was severe enough to warrant a hospital visit or treatment. Mothers who experienced FV were significantly more likely to have had previous experiences of violence by an in-law; to have reported child cruelty by a husband; to have children with difficult behaviour; and to have reported that they were neglected by their husbands and not enjoying their marriages. They were also significantly more likely to have a high score on the SRQ and be identified as probable cases with psychological problems (SRQ score ≥ 5. Conclusion. In view of these findings, screening for FV in the primary care setting would be beneficial. Primary care physicians should therefore increase their interest, improve their skill, and carry out more research in the identification and management of FV.

  15. Characteristics of smokers and their knowledge about smoking at a teaching hospital in Karachi

    International Nuclear Information System (INIS)

    Qidwai, W.; Zahid, N.

    2005-01-01

    Objective: To study the characteristics of smokers and their knowledge about smoking, among Family Practice Patients, at a teaching hospital in Karachi, Pakistan. Main outcome measures: Age at starting smoking, duration and number of cigarettes smoked, started smoking under influence of friends, colleagues, family members or self motivation, number of friends and colleagues who smoked, whether smoking is unhealthy, and actual chance of harm to an individual due to smoking is very rare or not. Results: One hundred patients who visited Family Practice Center were interviewed. Sixty one percent were young married men, well educated and either student, in private service, self employed or unemployed. Eighty-four (84%) smokers started smoking between 16-25 years of age, and smoked 6-20 cigarettes daily for two to twenty five years. Sixty-nine (69%) of them started smoking under the influence of friends and had 3-5 friends and colleagues who smoked. 91% of smokers believed that smoking is unhealthy and were aware that it causes lung cancer and heart disease. Majority of them (69%) believed that the actual harm of smoking to an individual is not very rare. Conclusion: We have documented the characteristics of smokers and their knowledge about smoking among Family Practice patients. Majority of the respondents started smoking at a young age under the influence of friends though they were aware of its harmful effects. Though the sample size is small but it does give an indication about the responsible factors to plan interventional preventive strategies. (author)

  16. Film reject analysis and image quality in diagnostic Radiology Department of a Teaching hospital in Ghana

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    J. Owusu-Banahene

    2014-10-01

    Full Text Available Patients usually undergo repeated X-ray examinations after their initial X-ray radiographs are rejected due to poor image quality. This subjects the patients to an excess radiation exposure and extra cost and necessitates the need to investigate the causes of reject. The use of reject analysis as part of the overall quality assurance programs in clinical radiography and radiology services is vital in the evaluation of image quality of a well-established practice. It is shown that, in spite of good quality control maintained by the Radiology Department of a Teaching hospital in Ghana, reject analysis performed on a number of radiographic films developed indicated 14.1% reject rate against 85.9% accepted films. The highest reject rate was 57.1 ± 0.7% which occurs in cervical spine and the lowest was7.7 ± 0.5% for lumbar spine. The major factors contributing to film rejection were found to be over exposure and patient positioning in cervical spine examinations. The most frequent examination was chest X-ray which accounts for about 42.2% of the total examinations. The results show low reject rates by considering the factors for radiographic rejection analysis in relation to both equipment functionality and film development in the facility.

  17. Awareness and perception of pregnant women about obstetrics ultrasound at Aminu Kano Teaching Hospital

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    A A Saleh

    2017-01-01

    Full Text Available Background: Ultrasonography is firmly embedded in antenatal maternity care around the world. It proves accuracy in calculation of gestational age, earlier identification of multiple pregnancies, and diagnosis of nonviable pregnancies and certain fetal malformations. Objective: The study is aimed to determine the awareness and perception of pregnant women towards obstetric scan, at Aminu Kano Teaching Hospital (AKTH. Materials and Methods: This was a prospective and cross-sectional study conducted among 400 pregnant women that attended antenatal ultrasound scan at AKTH. A pretested and structured questionnaire was used. Only women that agreed to participate were included in the study. Convenience sampling technique was employed for the data collection. Information collected from the participants was: Age, marital status, occupation, level of education, parity, level of awareness and level of perception. The collected data was analyzed using SPSS (16.0 software for windows (SPSS Inc., Chicago, IL, USA to obtain frequency, mean and percentages. Results: A total of 400 women were included in the study, of which most of them were within the age range of 21–30 years. Almost all the participants (97% had ultrasound before, and they believed it is safe. The majority (93.8% believed that ultrasound is necessary during pregnancy. Ninety-seven percent believed it is done to determine fetal viability and wellbeing. Conclusion: The study established that most of the participants are aware of ultrasound scan. The subjects also believed that the procedure is safe, and the main purpose is for fetal wellbeing and viability.

  18. Acceptance testing of Siemens e.cam SPECT system at the Korle-Bu Teaching Hospital

    International Nuclear Information System (INIS)

    Sosu, K. E.

    2006-01-01

    Acceptance testing has been performed on the Siemens e.cam Signature Series (Single Head) Single Photon Emission Computed Tomography (SPECT) system; the first of its kind, at the Nuclear Medicine Department, Korle-Bu Teaching Hospital, Accra. The various tests were performed according to NEMA NU 1 (2001) specifications as far as possible. The most important parameters that characterized the performance of the camera, gantry system, patient bed, collimators, computer system and fundamental software were evaluated based on visual inspection techniques. Various measuring instruments, different kinds of phantoms, point and flood sources containing 99m-Tc were also used for quantitative studies. Tests performed were divided into Physical inspection, intrinsic measurements (without collimator), extrinsic measurements (with collimator) and Single Photon Emission Computed Tomography (SPECT) system measurement. Some results obtained were better than factory specifications, others were within specifications. Other results obtained from this study which did not have factory specifications for comparison can serve as baseline for future measurements and quality control. Although not all the tests originally planned for could be done due to the non-availability of certain phantoms and radionuclide, it had been possible to perform sufficient and relevant tests to ensure that the system had no serious problems and that it can be used for clinical nuclear medicine imaging. (au)

  19. Gestational diabetes mellitus among women attending prenatal care at Korle-Bu Teaching Hospital, Accra, Ghana.

    Science.gov (United States)

    Oppong, Samuel A; Ntumy, Michael Y; Amoakoh-Coleman, Mary; Ogum-Alangea, Deda; Modey-Amoah, Emefa

    2015-12-01

    To determine the burden of gestational diabetes mellitus (GDM) among pregnant women in Accra, Ghana. The present cross-sectional study enrolled women at 20-24 weeks of pregnancy attending their first prenatal clinic at Korle-Bu Teaching Hospital, Accra, between March and November 2013. Participants underwent a 2-hour, 75-g oral glucose tolerance test between 24 and 28 weeks. The odds of GDM among different body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) groupings were calculated in a multiple logistic regression model. Among 399 women screened, 37 (9.3%) had GDM. Compared with women with a BMI in the normal range (18.50-24.99), obese women (BMI >30.0) had an increased risk of GDM (odds ratio [OR] 2.98, 95% confidence interval [CI] 1.08-8.20; P=0.034]; overweight women (BMI 25.00-29.99) had a slightly elevated risk (OR 1.20, 95% CI 0.41-3.55; P=0.742). Maternal age, parity, education, employment status, place of residence, and previous pregnancy complications did not affect the risk of GDM. GDM was found in 10% of pregnant women in Accra. Women who were obese by 20-24 weeks of pregnancy had a significantly increased risk of GDM. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Factors related to in-house agricultural animal caseloads in US veterinary teaching hospitals.

    Science.gov (United States)

    Tyler, Jeff W; Miller, Robert B; Constable, Peter D; Hostetler, Douglas E; Lakritz, Jeff; Hardin, David K; Angel, Kenneth L; Wolfe, Dwight F

    2002-01-01

    A retrospective observational study was conducted to determine whether agricultural animal caseloads at veterinary teaching hospitals declined between 1995 and 1998. Thereafter, the effect of organizational and demographic factors on 1998 in-house agricultural animal caseloads was examined. Caseload data were obtained from the American Association of Veterinary Medical Colleges. Demographic and organizational data were obtained by surveys, telephone interviews, and web-based resources. Complete data were available from 25 veterinary colleges, and data from these schools were used in subsequent analyses. In 1998, in-house food animal caseload decreased relative to 1995 in 17 schools and increased relative to 1995 in 8 schools. This trend was not significant (P = .053); however, the power of the test was limited (.50). Mean 1998 caseload was 886 +/- 504. Among schools with a discipline-based organizational structure, annual mean caseload was 464 +/- 220. Among schools with a species-based organizational structure, mean caseload was 1,167 +/- 463. The regression model that best predicted caseload was a forward-stepping model that included only organizational structure as an independent variable. No additional independent variable was significantly associated with caseload.

  1. Retrospective study of antibiotic resistance among uropathogens from rural teaching hospital, Tamilnadu, India

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    Kasi Murugan

    2012-10-01

    Full Text Available Objective: To determine the community associated urinary tract infection (UTI causing uropathogen's prevalence, antibiotic resistance pattern and the risk factors predisposing infection in Indian rural settings. Methods: A pilot study was conducted between January and December 201 0 among out patients attending rural teaching medical college hospital at Tamilnadu, India. The demographic details, culture, common antibiotic Kirby-Bauer disc diffusion assay susceptibility profiles of the isolates and the resistance analysis by WHONET 5.6 software were performed. Results: During this surveillance study, a total number of 1 359 urinary samples were collected, among which 309 (22.78% gave positive culture. The common uropathogens encountered were Escherichia coli (66.02%, Staphylococcus sp. (12.62%, Klebsiella sp. (5.83%, Streptococcus sp. (5.1 8%, Enterococcus sp. (2.59% and Proteus sp., (2.26%. Antibiotic resistance analysis revealed the multiple drug resistance nature of the isolates to the commonly used antibiotics. It is also found that both genders at the specific age group of 40-50 were more prone to infection and seasonal variations also play an important role in their establishment. Conclusions: The obtained results suggest that antibiotic selection for empirical treatment should be based on individual drug-sensitive test results. There is also an urgent need to develop a new combination of chemotherapeutic agents and awareness on antibiotic use for the effective UTI management in rural settings.

  2. Continuous subcutaneous insulin infusion (CSII) therapy at Derby Teaching Hospitals: sustained benefits in glucose control.

    Science.gov (United States)

    Anyanwagu, U; Olaoye, H; Jennings, P; Ashton-Cleary, S; Sugunendran, S; Hughes, D; Idris, I; Wilmot, E G

    2017-08-01

    In the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long-term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes. Patient-level data were obtained for CSII users at Derby Teaching Hospitals, UK. Patient confidence and satisfaction questionnaires using the Likert scale were used to assess confidence in self-management. Comparative statistics were conducted using Pearson's chi-square and Student's t-tests. Some 258 CSII users were identified (60.1% female, mean age 43.9 ± 13.4 years). Overall, there was significant decrease in HbA 1c from 78 mmol/mol (9.3 ± 2.0%) at baseline, to 69 mmol/mol (8.5 ± 1.3%) at 6 months [mean difference (md): -0.64; 95% confidence interval (95% CI): -0.91 to -0.37; P quality of care received in the insulin pump service. CSII therapy led to a sustained long-term improvement in glycaemic control in addition to a reduction in self-reported hypoglycaemia. © 2017 Diabetes UK.

  3. Risk factors associated with postpartum haemorrhage at Juba Teaching Hospital, South Sudan, 2011

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    Thomas Tako Akim Ujjiga

    2014-08-01

    Full Text Available Objective: To study risk factors associated with post partum haemorrhage (PPH in Juba Teaching Hospital, South Sudan. Method: An unmatched case control study was conducted in which 44 cases and 88 Controls were involved, from September to December 2011. Data was collected using a structured questionnaire in face to face interviews, and analyzed using Epi-info 3.5.3 statistical programme to determine if there was a correlation. Results: Maternal demographic and obstetric characteristics were found to be associated with the risk of bleeding during Bivariate analysis. However, age was found to confound emergency admission, uterotonic use (Oxytocin and Misoprostol use and delivery type, the latter being modified, in the development of post partum haemorrhage. Conclusion: These results indicate that active management of the third stage of labour (AMTSL and prompt intervention reduced the risk of developing PPH. Understanding the factors that cause PPH will allow us to better strengthen and effect pre delivery and emergency obstetric care which may help us reduce maternal mortality due to post partum haemorrhage.

  4. A survey of infection control practices of consultant anaesthesiologists in teaching hospitals of pakistan

    International Nuclear Information System (INIS)

    Yaqub, K.M.; Tariq, M.; Janjua, S.; Masroor, R.

    2007-01-01

    To determine the infection control practices of Anaesthesiologist in the teaching hospitals of Pakistan. Cross-sectional survey. The survey was closed after allowing 6 months for return of the replies. A questionnaire was distributed to 170 consultant anaesthesiologist randomly selected from all over Pakistan. Out of these, 90 (53%) were returned and analyzed. To reduce self-report bias, the forms were filled anonymously. Thirty four percent of the respondents always used masks, and only 9% used gloves in their every day practice. Only 18% of respondents stated that they always washed their hands after every patient contact and 54% reported that they always used aseptic technique for placing an indwelling cannula. Most respondents had a good knowledge of universal precautions for prevention of occupational transmission of infection. Five percent of the anaesthetists reported frequently or always reusing syringes for more than one patient. The practice of reusing syringes was significantly greater when the same consultants were anaesthetizing patients in private clinics rather than in their primary institutions (p 5, in 58% of cases. Whereas most responding anaesthesiologist exhibit appropriate infection control behaviour, there are several potentially hazardous practices that continue unabated. (author)

  5. Vaginal candidiasis and its risk factors among women attending a Nigerian teaching hospital.

    Science.gov (United States)

    Nwadioha, S I; Nwokedi, E O P; Egesie, J; Enejuo, H

    2013-03-01

    The study was set to detect Candida species in female genital discharge and validate the associated risk factors. A prospective study of female genital swabs collected from women with abnormal vaginal discharge (test group) and a control group who were attending gynaecology, family planning, antenatal care or HIV/STI clinics of Aminu Kano Teaching Hospital, Kano Nigeria and analysed for microscopy and culture in microbiology laboratory from December 2008 to December 2009. Data on epidemiologic indices were collected from the patients, using structured interviewer- administered questionnaires. Candida species were detected in the test group in 60% (n=600/1000) cases of infective vaginal discharge while 12% (120/1000) in the control group. The isolation rate of Candida albicans was 69% more than the non- albicans. Distribution of vaginal candidiasis in the test group, was prevalent in young adults age group of 21 to 30 years with 50% (n=300/600), in patients with pregnancy 38% (n=225/600) and patients with chronically debilitating illnesses 26% (n=157/600). The result shows that vaginal candidiasis is quite common and Candida albicans is the most prevalent species. We therefore recommend early diagnosis and prompt treatment of vaginal candidiasis in all women clinics especially among the patients with chronic debilitating illness, pregnancy and young adults in order to avert the complications of vaginal candidiasis and reduce HIV transmission.

  6. Association between placental abruption and caesarean section among patients at Khyber teaching hospital Peshawar

    International Nuclear Information System (INIS)

    Gul, S.; Jamal, T.; Rana, G.E.; Majid, A.; Iqbal, M.; Abrar, S.

    2016-01-01

    Background: Ante partum haemorrhage remains to be a major cause of morbidity and mortality. 30 percentage of this haemorrhage is attributed to placental abruption. Along with other adverse maternal outcomes, it increases the risk of Caesarean sections in patients, which is a public health concern. This study was conducted to find out whether any significant association exists between placental abruption and C-section in our set up. Methods: A cross-sectional study was conducted from July 26th, 2011 to May 1st, 2013 (i.e., 21 months) in the Department of Obstetrics and Gynaecology, Khyber Teaching Hospital Peshawar on a sample of 334 patients who presented with antepartum haemorrhage after 28 weeks of gestation. All those patients with and without placental abruption were followed throughout pregnancy and labour to detect the risk of caesarean section. Results: Among study participants, parity had the highest dispersion while gestational age had the lowest. Caesarean section was performed on 26.3 percentage (95 percentage CI) of the study participants. Proportion of placental abruption among patients presenting with ante partum haemorrhage was 20.6 percentage, (95 percentage CI) out of which 7.5 percentage underwent C-section. Association between placental abruption and C-section was found significant at a=0.05 (ρ=0.03). Conclusion: Risk of caesarean section is increased in pregnancies complicated by placental abruption as compared to pregnancies complicated by other causes of ante partum haemorrhage. (author)

  7. Breech deliveries in Usmanu Danfodiyo University Teaching Hospital Sokoto, Northwestern Nigeria: A 10-year review

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    Karima Tunau

    2013-01-01

    Full Text Available Background: Breech delivery is a major issue in obstetric practice mainly because of the high perinatal morbidity and mortality associated with it. The aims of the study are to determine the prevalence management and perinatal outcome of singleton breech deliveries in our center. Materials and Methods: A retrospective study involving 395 singleton breech deliveries out of 24,160 deliveries conducted at the Usmanu Danfodiyo University Teaching Hospital Sokoto, Sokoto, over a 10-year (2001-2010 period. Results: The prevalence rate of singleton breech delivery was 1.7%. Breech deliveries occurred more in the primigravidae. Most babies (69.1% had vaginal delivery. There was a high caesarean section (CS rate of 30.9%. Babies delivered by CS had better Apgar scores than those delivered through the vagina (P < 0.05. The perinatal mortality rate in breech deliveries (410/1000 was significantly higher than that (101.5/10000 in their cephalic counterparts (P < 0.05. Similarly, perinatal deaths were more common in unbooked than in booked patients (P < 0.05. Conclusion: Breech delivery was frequent in the study population. Singleton breech delivered by CS had better outcome than those who were delivered through the vagina.

  8. [Urological emergencies at the Dakar university teaching hospital: epidemiological, clinical and therapeutic features].

    Science.gov (United States)

    Fall, B; Diao, B; Fall, P A; Diallo, Y; Sow, Y; Ondongo, A A M; Diagana, M; Ndoye, A K; Ba, M; Diagne, B A

    2008-11-01

    To present the epidemiological, clinical and therapeutic features of the urological emergencies in Senegal, West Africa. The authors conducted a 20 months retrospective study that analyzed the epidemiological, clinical and therapeutic features of all urological emergencies admitted to the urology department of the university teaching hospital Aristide-Le-Dantec (Dakar). There were 1237 urological emergencies. The mean age of the patients was 58.8 years (range one month-94 years). The sex ratio (M/F) was 20.32. These patients had an age equal to or higher than 60 years in 50.7% of the cases. The most frequent illness was urinary retention (53%) and genitor-urinary system infectious, which represented as a whole 16.4% of the cases. The gangrenes of male external genitalia (Fournier's gangrene) accounted for 4.1% of the cases and the priapism 1.3%. In emergency, 331 surgical operations were performed. The most performed procedures were the installation of a suprapubic catheter (59.8%) and debridement of a gangrene of male external genitalia (15.4%). The most frequent urological emergency in our country was the acute urinary retention. Some serious illness like gangrene of male external genitalia (Fournier's gangrene) and priapism are not rare there.

  9. Assessment of leadership among clinical laboratories managers of teaching hospitals: Quantum leadership approach

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    H. Dargahi

    2017-10-01

    Full Text Available Background: Quantum leadership approach causes efficient and effective procedures among health care organizations, specially clinical laboratories. Objective: This research was aimed to determine the status of quantum leadership dimensions among all management levels of clinical laboratories of teaching hospitals of medical sciences universities in Tehran. Methods: This descriptive, analytical and cross-sectional study was induced among 180 managers of 35 clinical laboratories of Iran, Shahid Beheshti and Tehran Universities of Medical Sciences 2016. The research tool was researcher - constructed questionnaire of quantum skills, demographic details that its content and face validity and reliability were confirmed. For analysis of data, T-test and ANOVA techniques were used. Findings: Most of the studied clinical laboratories managers were male, married, with 15-20 years work experiences, 1-5 years managerial services, and minimally one training courses in clinical laboratory management. The managers had relatively desired and desired score of quantum skills and leadership respectively. Also, there was significant correlation between quantum leadership with age (P=0.01, and with management training courses (P=0.02. Conclusion: It is expected this paradigm may change the clinical laboratory management in the near future with regards to desirability of quantum leadership dimensions among clinical laboratories.

  10. Job satisfaction of nurses in a Saudi Arabian university teaching hospital: a cross-sectional study.

    Science.gov (United States)

    Al-Dossary, R; Vail, J; Macfarlane, F

    2012-09-01

    Saudi Arabia is developing very fast in all disciplines, especially in nursing and health. Only about five studies between 1990 and 2010 have been undertaken in Saudi Arabia concerning factors influencing job satisfaction of nurses, although a body of knowledge exists globally. The purpose of this research was to measure nurses' job satisfaction in Saudi Arabia in a university teaching hospital and to determine the influencing factors. A quantitative, cross sectional method, self-administered questionnaire was used for this study. A systematic sample of N=189 nurses was used to collect data. The SPSS version 16.0. was used to analyze the data. An independent t-test and one-way analysis of variance were used to test hypotheses concerning different groups, and correlation tests (the Pearson's and Spearman's rank tests) were used to examine relationships between variables. Overall, nurses were neither satisfied nor dissatisfied with their jobs. However, nurses indicated satisfaction with supervision, co-workers and nature of work. The sources of dissatisfaction were with subscales such as pay, fringe benefits, contingent rewards and operating conditions. These findings indicate that there is a need to increase nurses' salaries and bonuses for extra duties. More training programmes and further education also should be encouraged for all nurses. Therefore, it is imperative that nursing managers and policy makers in Saudi Arabia consider these findings to improve nurses' job satisfaction. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

  11. Drug-induced diseases (DIDs: An experience of a tertiary care teaching hospital from India

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    Vishal R Tandon

    2015-01-01

    Full Text Available Background & objectives: Drug-induced diseases (DIDs are well known but least studied. Data on DIDs from India are not available. Hence, this retrospective cross-sectional study was undertaken using suspected adverse drug reaction (ADR data collected form Pharmacovigilance Programme of India (PvPI to evaluate profile of DIDs over two years, in a tertiary care teaching hospital from north India. Methods: The suspected ADRs in the form of DID were evaluated for drug and disease related variables and were classified in terms of causality. Results: DID rate was 38.80 per cent. Mean duration of developing DIDs was 26.05 ± 9.6 days; 25.16 per cent had more than one co-morbid condition. Geriatric population (53.99% accounted for maximum DIDs followed by adult (37.79% and paediatric (8.21%. Maximum events were probable (93.98% followed by possible (6.04%. All DIDs required intervention. Gastritis (7.43%, diarrhoea (5.92%, anaemia (4.79%, hypotension (2.77%, hepatic dysfunction (2.69%, hypertension (1.51%, myalgia (1.05%, and renal dysfunction (1.01% were some of the DIDs. Anti-tubercular treatment (ATT, anti- retroviral treatment (ART, ceftriaxone injection, steroids, non-steroidal anti-inflammatory drugs, antimicrobials and anticancer drugs were found as commonly offending drugs. Interpretation & conclusions: Our findings show that DIDs are a significant health problem in our country, which need more attention.

  12. Quantitative Analysis of Bone Scintigrams at the Korle-Bu Teaching Hospital

    International Nuclear Information System (INIS)

    Huguette, E.Y.Y.

    2012-01-01

    Qualitative method of diagnosis has been the traditional means of diagnosing bone tumours at the Nuclear Medicine Department of the Korle-Bu Teaching Hospital over the years. Although this method is commendable, a more accurate diagnostic means is the quantitative approach. Study on ninety-five patients undergoing bone scans has been performed quantitatively using image J. The patients were administered with activity ranging from 15 to 30 mCi depending on their weights, and were then scanned with an installed e.Cam SPECT system. A 256 x 1024 matrix size was used in acquiring the bone scans. Quantitative analyses performed with the image J, revealed that uptake levels in all selected body parts were higher for metastatic tumours compared to non-metastatic tumours. The average normalised uptake in the recorded metastatic cases was 1.37332 cts/mm 2 /mCi and the corresponding uptake in the non-metastatic cases was 0.85230 cts/mm 2 /mCi. The relative higher uptake in metastatic tumours is attributed to high osteoblastic activity and blood flow in metastatic cases compared to non-metastatic cases. Quantitative assessment of bone scintigrams is recommended for its high accuracy and quicker means of diagnosing.(author)

  13. Management outcomes of abruptio placentae at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.

    Science.gov (United States)

    Igwegbe, A O; Eleje, G U; Okpala, B C

    2013-01-01

    The objective of this study is to determine incidence, risk factors and management outcomes of abruptio placentae (AP) and comparing them with cases without AP who delivered within the same period. A 10 year retrospective study of AP managed at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, between January 2001 and December 2010 was undertaken. Proforma was initially used for data collection before transfer to Epi-info 2008 software. Test of associations were evaluated and P < 0.05 was considered significant. Sixty nine cases out of a total delivery of 8,811 were seen, giving an incidence of 0.8%. The mean age and parity of women with AP were 30.8 +/- 0.9 years and 4.1 +/- 0.6 respectively and majority (78.3%) of cases were unbooked (p = 0.0019). Grand multiparity and age = 35 years were significant risk factors ( p < 0.05). Fifty two (75.4%) cases were delivered by caesarean section (c/s) ( P = 0.0000). The sex ratio was 160 ( p = 0.0134). The overall maternal mortality ratio during the study period was 987 per 100,000 live births with AP contributing 3.8% of the maternal deaths while perinatal mortality rate was 52.2%. A significant number of cases have high perinatal mortality. Unbooked, high parity, advanced maternal age and previous c/s scar were significant aetiological risk factors.

  14. Malignant renal tumours in adults in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.

    Science.gov (United States)

    Mbaeri, T U; Orakwe, J C; Nwofor, A M E; Oranusi, C K; Ulebe, A O

    2012-01-01

    Malignant renal tumour is the third commonest urological tumour after prostate and bladder cancer. It is however the urological tumour with the highest mortality/incidence ratio. To review the frequency, mode of presentation and histological pattern of patients with malignant renal tumours in Nnamdi Azikiwe University Teaching Hospital. A 7 year retrospective review of all our renal tumour folders in the institution. 19 patients qualified for the study with a male/female ratio of 1:2.8 and a mean age of 52.6 +/- 15.8 years. The peak age was in the seventh decade. Most patient present late (78.9%).Renal cell cancer was the commonest tumour type with the commonest mode of presentation being abdominal mass and pain. Malignant renal tumours present very late in our environment and patients hesitate in accepting available treatment option which is surgery. There is need for increased patient awareness and high index of suspicion by the clinician, particularly during imaging procedures, as this would significantly enhance the early detection of these patients.

  15. Improving maternal mortality at a university teaching hospital in Nnewi, Nigeria.

    Science.gov (United States)

    Igwegbe, Anthony O; Eleje, George U; Ugboaja, Joseph O; Ofiaeli, Robinson O

    2012-03-01

    To evaluate the impact of the introduction of the Service Compact with all Nigerians (SERVICOM) contract on maternal health at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. A retrospective and comparative study of maternal deaths between 2004 and 2010 was carried out. The main outcome measures were yearly maternal mortality ratio (MMR), relative risk (RR) of maternal mortality, and presentation-intervention interval. The yearly MMR and the RR of maternal mortality were compared with the figures from 2004, which represented the pre-SERVICOM era. There were 4916 live births and 54 maternal deaths during the study period, giving an MMR of 1098 per 100,000 live births. Pre-eclampsia/eclampsia was the most common direct cause (25.0%), followed by hemorrhage (18.8%) and sepsis (8.3%). Anemia (12.5%) was the most common indirect cause. There was a progressive reduction in MMR and RR of maternal mortality, with a corresponding increase in live births. The presentation-intervention interval improved significantly from 2006. A positive change in the attitude of health workers and the elimination of fee-for-service in emergency obstetric care would reduce type 3 delays in public health facilities, and consequently reduce maternal mortality. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  16. 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.

  17. Frequency of Blood Culture Isolates and their Antibiogram in a Teaching Hospital

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    Subha Shrestha

    2014-03-01

    Full Text Available Introduction: Bloodstream infections are associated with significant patient morbidity and mortality. Antimicrobial susceptibility patterns should guide the choice of empiric antimicrobial regimens for patients with bacteremia. Methods: Blood sample received from the patient attending Nepal Medical College and Teaching Hospital from March 2013 – August, 2013 were subjected to for culture. Isolate identification and antimicrobial susceptibility testing was done by standard microbiological method Results: Out of the total 2,766 blood samples, 13.3% showed bacterial growth. The percentage of neonatal septicemia was 13.3%. Staphylococcus aureus (28% was the most common isolates followed by Salmonella enterica Serotype Typhi (22%, Coagulase negative Staphylococci (9.5%, Salmonella enterica Serotype Paratyphi ((7.6% and Klebsiella pneumoniae (7.6%. 26.3% of the isolates of Staphylococcus aureus were oxacillin resistant. Most of the gram positive organisms were susceptible to amikacin and vancomycin and showed high level resistance to cefuroxime and cotrimoxazole. Out of 109 isolates of typhoid bacilli, 95.3% were resistant to nalidixic acid ,79% to ciprofloxacin and 60.5% to ofloxacin. More than 50% of the isolates of Klebsiella pneumoniae and Escherichia coli showed resistance to cephalosporins and cotrimoxazole. Acinetobacter spp showed high resistance (more than 60% to ceftriaxone and ofloxacin. More than 20% of the isolates of Pseudomonas aeruginosa were resistant to ciprofloxacin and amikacin. Conclusions: Ongoing surveillance for antimicrobial susceptibility remains essential, and will enhance efforts to identify resistance and attempt to limit its spread. Keywords: antibiotic; bacteria; blood stream infections.

  18. Fertility status of males working in radiology departments of teaching hospitals

    International Nuclear Information System (INIS)

    Goyal, O.P.; Jain, A.K.; Sankhla, D.K.; Kothari, L.K.; Agarwal, G.R.

    1985-01-01

    All the 33 male doctors and para-medical staff employed in the radiology departments of two teaching hospitals have been studied for their fertility status. Their mean age was 32.5 years and they had been doing radiological work for 8.6 years on an average. Out of the 33 males, all of whom were married, one had primary infertility with severe oligospermia. He was successfully treated with oral vitamin A and E along with a 3-month off from handling x-ray machines; the child born was healthy and normal. Another 5 subjects had been married for only less than two years and their seminograms were essentially normal. They were classified as 'Unproven fertility'. The remaining 27 persons had fathered 61 children-16 born before the father had started working in radiology and 45 conceived later. There was 1 case of still-birth and 1 of microcephaly. However, the overall incidence of infertility and congenital defects was not significantly different than in the general population. (author)

  19. Prevalence of methicillin resistant Staphylococcus aureus in Lumbini Medical College and Teaching Hospital, Palpa, Western Nepal.

    Science.gov (United States)

    Raut, Shristi; Bajracharya, Kishor; Adhikari, Janak; Pant, Sushama Suresh; Adhikari, Bipin

    2017-06-02

    Multidrug resistant Staphylococcus aureus is common in both tertiary and primary health care settings. Emergence of methicillin resistance in S. aureus (MRSA) along with macrolide, lincosamide, streptogramin B (MLSB) has made treatment of Staphylococcal infection more challenging. The main objective of this study was to detect MRSA, MLSB (inducible; MLSBi and constitutive; MLSBc) resistant S. aureus using phenotypic methods and to determine their antibiogram. Various samples were collected from 1981 patients who attended Lumbini Medical College and Teaching Hospital (LMCTH) during the period of 6 months from September 2015 to February 2016. Out of a total of 1981 samples, 133 S. aureus were isolated. Cefoxitin was used to detect MRSA by the disk diffusion test. Inducible clindamycin resistance (MLSBi) was detected by the D-zone test. The antibiotic profile of all isolates was tested by a modified Kirby Bauer disk diffusion method. Among 133 S. aureus, there were 58 (43.6%) MRSA, 34 (25.6%) MLSBi and 30 (22.6%) MLSBc. Of a total of 64 MLSB, a significant proportion (62.5%) was MRSA (p aureus, MRSA showed significant resistance to 9 (p resistance to multiple antibiotics (p resistance profiles from this study can optimize the treatment of multi-drug resistant S. aureus.

  20. Intestinal parasitosis: data analysis 2006-2011 in a teaching hospital of Ancona, Italy.

    Science.gov (United States)

    Silvestri, Carmela; Greganti, Gianfranco; Arzeni, Daniela; Morciano, Angela; Castelli, Pamela; Barchiesi, Francesco; Cirioni, Oscar; Giacometti, Andrea

    2013-03-01

    Intestinal parasites are a serious problem in developing countries, but should not be underestimated in industrialised countries either. Between January 2006 and December 2011, stool specimens and the scotch tests of 5323 Italian and non Italian patients (adults and children) attending the laboratory of our Infectious Diseases Clinic in a teaching Hospital at Ancona were analyzed specifically for intestinal parasites. The present study shows that, over a six-year period, of a total of 5323 patients 305 harboured at least one species of parasite (5.7%). Among the pathogenic protozoa Giardia lamblia was the most common, the overall prevalence of giardiasis being 1.8 % (99/5323). Helminths were found in 0.9% of the patients (48/5323). In particular, Hymenolepis nana, Strongyloides stercoralis and Trichuris trichiura were most commonly recovered in non-Italian children, suggesting that certain intestinal parasites are restricted to endemic areas in the tropics. Eighteen of the 305 infected patients had more than one parasite in their stools. Our study demonstrates that intestinal parasites must be considered even in industrialised areas and stool examination should be supported by epidemiological data and clinical features.

  1. Social impact of HIV/AIDS on clients attending a teaching hospital in Southern Nigeria.

    Science.gov (United States)

    Johnson, Ofonime E

    2012-01-01

    People living with human immunodeficiency virus and acquired immune deficiency syndrome (PLWHA) face numerous social challenges. The objectives of this study were to assess the level of self-disclosure of status by PLWHA, to describe the level and patterns of stigma and discrimination, if any, experienced by the PLWHA and to assess the effect of sero-positivity on the attitude of friends, family members, health workers, colleagues and community. This was a cross-sectional descriptive study carried out among PLWHA attending the University of Uyo Teaching Hospital, Uyo, Southern Nigeria. Information was obtained using an interviewer-administered semi-structured questionnaire, which was analysed using the Epi 6 software. A total of 331 respondents were interviewed. A majority, 256 (77.3%), of the respondents were within the age range of 25-44 years. A total of 121 (36.6%) PLWHA were single and 151 (46.6%) were married, while the rest were widowed, divorced or separated. A majority, 129 (85.4%), of the married respondents disclosed their status to their spouses and 65 (50.4%) were supportive. Apart from spouses, disclosure to mothers (39.9%) was highest. Most clients (57.7%) did not disclose their status to people outside their immediate families for fear of stigmatization. Up to 111 (80.4%) of the respondents working for others did not disclose their status to their employers. Among those whose status was known, discrimination was reported to be highest among friends (23.2%) and at the workplace (20.2%). Attitudes such as hostility (14.5%), withdrawal (11.7%) and neglect (6.8%) were reported from the private hospitals. Apart from disclosure to spouses, the level of disclosure to others was very low. Those whose status was known mainly received acceptance from their families but faced discriminatory attitudes such as hostility, neglect and withdrawal from friends, colleagues and hospital workers. There is a need for more enlightenment campaigns on HIV/AIDS by

  2. Survey of Employees' Safety Attitude in a Teaching Hospital Tehran 2010

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    M. Mahmmoudi

    2011-01-01

    Full Text Available Background and aimsThe Medical Errors and the potential unsafe actions are always regarded as a serious trouble by the managers and health care providers. Using the employees' attitude data as a measurement criterion in the evaluation of the hospitals performance in the field of the “Safety” can improve the safety level among the personnel and patients . Survey of employees' attitude about safety and its comparison with different groups of offering health services in a teaching Hospital was the main objective of present study.   MethodsIn order to specify patient safety culture in Moddares hospital, all employees including physicians, nurses, managers and employees of Para-clinic, a volume sample consisting of 212 persons were selected. Then it was used from questionnaire of safety attitude within 6 dimensions including Teamwork climate, Safety climate, perceptions of Management , Job Satisfaction, Working Conditions and Stress Recognition. At first this questionnaire was gone under assessing validity and trust. The scale of measuring, Likert was 5 grades. In order to specify difference between groups under study it was used from ANOVA test.   Results Positive safety culture within 6 dimensions including Teamwork Climate, Safety climate, Job Satisfaction, Stress Recognition, Perception of Management , Working Conditions for doctors were 3, 4.13, 17.4, 0, 4.3, and 8.7 respectively; the aforesaid Dimensions for nurses were 19, 2.6, 10.3, 7.8, 2.6 and 15.5 respectively, the aforesaid Dimensions for managers were 30.3, 6.1, 33.3, 0, 18.2 and 21.2 respectively and the aforesaid Dimensions for employees of Para-clinic Were 50, 12.5, 25, 12.5, 10 and 37.5 respectively. There was Significant difference from View Point of statistics (p<0.5 from Dimensions of Job satisfaction among managers and nurses, employees of Para-clinic and nurses this difference Were zero and 0.001. From View Point of Stress recognition among managers and employees of Para

  3. Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital

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    Sabouri Kashani Ahmad

    2005-02-01

    Full Text Available Abstract Background Abdominal surgical site infections are among the most common complications of inpatient admissions and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, nutrition and immunity, prophylactic antibiotics, operation type and duration, type of shaving, and secondary infections. This study aimed to determine the risk factors affecting abdominal surgical site infections and their incidence at Imam Khomeini, a major referral teaching hospital in Iran. Methods Patients (n = 802 who had undergone abdominal surgery were studied and the relationships among variables were analyzed by Student's t and Chi-square tests. The subjects were followed for 30 days and by a 20-item questionnaire. Data were collected through pre- and post-operative examinations and telephone follow-ups. Results Of the 802 patients, 139 suffered from SSI (17.4%. In 40.8% of the cases, the wound was dirty infected. The average age for the patients was 46.7 years. The operations were elective in 75.7% of the cases and 24.7% were urgent. The average duration of the operation was 2.24 hours, the average duration of pre-operative hospital stay 4.31 days and the average length of (pre- and post-operation hospital stay 11.2 days. Three quarters of the cases were shaved 12 hours before the operation. The increased operation time, increased bed stay, electivity of the operation, septicity of the wound, type of incision, the administration of prophylactic antibiotic, type of operation, background disease, and the increased time lapse between shaving and operation all significantly associated with SSI with a p-value less than 0.001. Conclusion In view of the high rate of SSI reported here (17.4% compared with the 14% quoted in literature, this study suggests that by reducing the average operation time to less than 2 hours, the average preoperative stay to 4 days and the overall stay to less than 11 days, and

  4. Colonization with hospital flora and its associated risk factors in neonates hospitalized in neonatal ward of a teaching center in Isfahan, Iran.

    Science.gov (United States)

    Shirani, Kiana; Mostafavizadeh, Kamyar; Ataei, Behrouz; Akhani, Khatere

    2018-01-01

    Due to the high incidence and prevalence of infection in neonatal ward, especially Neonatal Intensive Care Units (NICUs) reported by different studies and the important role of colonization with hospital germs in the development of nosocomial infections, we intended to evaluate the risk of colonization with hospital germs in neonates and its associated risk factors. This cross-sectional, descriptive-analytical study was conducted in 2016 in a Teaching Center in Iran. In total, 51 neonates were selected based on the inclusion criteria, and after recording their information in a checklist, samples were taken by swab from outer ear, axilla, and groin for culture. Neonates with negative culture from mentioned regions were enrolled in the study. The swab samples again were taken and sent for culture from mentioned regions in at least 3 days after hospitalization. Culture results from first and second sampling were collected and analyzed statistically. This study was conducted on 51 neonates. The mean gestational age among the neonates ranged from 35.25 (Week) ± 2.98. 22 girls (43.1%) and 29 boys (56.9%), most of them were born by cesarean. Based on the results of logistic regression, a significant association was found between the occurrence of colonization of hospital flora and the place hospitalization of the newborns (odds ratio (OR): 4.750; 95% confidence interval (CI): 1.26-17.85). This study revealed that the only risk factors of colonization with hospital flora in neonates are the type of delivery and place of hospitalization. Based on findings of the study, it is recommended to focus on efforts in increasing the rate of natural birth as well as improving conditions of infection control in NICUs to reduce the number of incidences of colonization with hospital flora in neonates.

  5. Environmental methicillin-resistant Staphylococcus aureus in a veterinary teaching hospital during a nonoutbreak period.

    Science.gov (United States)

    Hoet, Armando E; Johnson, Amanda; Nava-Hoet, Rocio C; Bateman, Shane; Hillier, Andrew; Dyce, John; Gebreyes, Wondwossen A; Wittum, Thomas E

    2011-06-01

    Concurrent to reports of zoonotic and nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) in veterinary settings, recent evidence indicates that the environment in veterinary hospitals may be a potential source of MRSA. The present report is a cross-sectional study to determine the prevalence of MRSA on specific human and animal contact surfaces at a large veterinary hospital during a nonoutbreak period. A total of 156 samples were collected using Swiffers(®) or premoistened swabs from the small animal, equine, and food animal sections. MRSA was isolated and identified by pre-enrichment culture and standard microbiology procedures, including growth on Mueller-Hinton agar supplemented with NaCl and oxacillin, and by detection of the mecA gene. Staphylococcal chromosome cassette mec (SCCmec) typing and pulsed-field gel electrophoresis profile were also determined. MRSA was detected in 12% (19/157) of the hospital environments sampled. The prevalence of MRSA in the small animal, equine, and food animal areas were 16%, 4%, and 0%, respectively. Sixteen of the MRSA isolates from the small animal section were classified as USA100, SCCmec type II, two of which had pulsed-field gel electrophoresis pattern that does not conform to any known type. The one isolate obtained from the equine section was classified as USA500, SCCmec type IV. The molecular epidemiological analysis revealed a very diverse population of MRSA isolates circulating in the hospital; however, in some instances, multiple locations/surfaces, not directly associated, had the same MRSA clone. No significant difference was observed between animal and human contact surfaces in regard to prevalence and type of isolates. Surfaces touched by multiple people (doors) and patients (carts) were frequently contaminated with MRSA. The results from this study indicate that MRSA is present in the environment even during nonoutbreak periods. This study also identified specific surfaces in a

  6. Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

    Science.gov (United States)

    Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul

    2008-01-01

    With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.

  7. Delivering a quality-assured fracture liaison service in a UK teaching hospital-is it achievable?

    Science.gov (United States)

    Shipman, K E; Stammers, J; Doyle, A; Gittoes, N

    2016-10-01

    To determine whether new national guidance on the specifications of a fracture liaison service are realistically deliverable, 1 year of data on the performance of such a service were audited. Audit targets were mostly met. This audit demonstrates that these standards are deliverable in a real world setting. UK service specifications for a fracture liaison service (FLS) have been produced (National Osteoporosis Society, NOS) to promote effective commissioning and delivery of the highest quality care to patients with fragility fractures. How deliverable these standards are has not as yet been methodically reported. Our FLS was modelled on the ten NOS standards; performance was audited after 1 year to determine whether these standards could be delivered and to describe the lessons learnt. Performance was audited against the NOS FLS Service Standards, with management based on the Fracture Risk Assessment Tool (FRAX®), the four-item Falls Risk Assessment Tool (FRAT), National Institute for Health and Care Excellence (NICE) and the National Osteoporosis Guideline Groups (NOGG) guidance. Data were recorded prospectively on a database. The FLS commenced in May 2014, was fully operational in August 2014 and data were captured from 1 September 2014 to 1 September 2015. The FLS detected 1773 patients and standards were largely achieved. Most, 94 %, patients were seen within 6 weeks, 533 DXA requests were generated, 804 outpatient FRAT assessments were recorded (134 required falls intervention) and 773 patients had bone treatments started. On follow-up at 3 months, between 78-79 % were still taking medication. Preliminary evaluation of a FLS implemented according to UK NOS standards demonstrates that the model is practical to apply to a large teaching hospital population. Collection and review of outcome and cost effectiveness data is required to determine the performance of this model in comparison with existing models.

  8. A blended learning approach for teaching computer programming: design for large classes in Sub-Saharan Africa

    Science.gov (United States)

    Bayu Bati, Tesfaye; Gelderblom, Helene; van Biljon, Judy

    2014-01-01

    The challenge of teaching programming in higher education is complicated by problems associated with large class teaching, a prevalent situation in many developing countries. This paper reports on an investigation into the use of a blended learning approach to teaching and learning of programming in a class of more than 200 students. A course and learning environment was designed by integrating constructivist learning models of Constructive Alignment, Conversational Framework and the Three-Stage Learning Model. Design science research is used for the course redesign and development of the learning environment, and action research is integrated to undertake participatory evaluation of the intervention. The action research involved the Students' Approach to Learning survey, a comparative analysis of students' performance, and qualitative data analysis of data gathered from various sources. The paper makes a theoretical contribution in presenting a design of a blended learning solution for large class teaching of programming grounded in constructivist learning theory and use of free and open source technologies.

  9. The benefit of myomectomy in women aged 40 years and above: Experience in an urban teaching hospital in Nigeria

    OpenAIRE

    Obed, Jesse Y.; Bako, Babagana; Kadas, Saidu; Usman, Joshua D.; Kullima, Abubakar A.; Moruppa, Joel Y.

    2011-01-01

    Background: Abdominal myomectomy remains the mainstay of surgical management of uterine fibroids in our environment. However, its benefit in women aged 40 years and above remains debatable. Materials and Methods: An 11-year prospective study was conducted involving 98 women, aged 40 years and above, who had abdominal myomectomy for the treatment of uterine fibroid at the University of Maiduguri Teaching Hospital, Maiduguri. They were followed up regularly for 1-6 years to detect conception, r...

  10. Investigation of mechanisms and molecular epidemiology of linezolid nonsusceptible Enterococcus faecalis isolated from a teaching hospital in China.

    Science.gov (United States)

    Li, Bin; Ma, Chuan-Ling; Yu, Xiao; Sun, Yao; Li, Mei-Mei; Ye, Jian-Zhong; Zhang, Ya-Pei; Wu, Qing; Zhou, Tie-Li

    2016-08-01

    The epidemiological and molecular characteristics of eight linezolid nonsusceptible Enterococcus faecalis isolated from a teaching hospital in China (January to July 2014) were investigated. The target site modifications and cfr gene associated with linezolid resistance were not found. Results of the epidemiological investigation indicated that linezolid resistance possibly occurred on several independent occasions and was often not related to linezolid administration. Copyright © 2015. Published by Elsevier B.V.

  11. Distribution of Reproductive Cases Presented at the University Of Ibadan Veterinary Teaching Hospital, Nigeria (1995-2009)

    OpenAIRE

    Oluwatoyin O. Ajala; Adetunji P. Fayomi

    2011-01-01

    We studied the distribution of reproductive cases presented at the University of Ibadan Veterinary Teaching Hospital, Nigeria for 15 years (1995 to 2009). Records of presented cases were sourced from the case files and subjected to descriptive analysis. The recorded reproduction cases were distributed by the reproductive condition, species, breed, sex and year of occurrence. Dystocia>pregnancy diagnosis>mastitis>transmissible venereal tumor>metritis were the most frequently presented conditio...

  12. Bacteriospermia and Sperm Quality in Infertile Male Patient at University of Benin Teaching Hospital, Benin City, Nigeria

    OpenAIRE

    Ibadin, O. K.; Ibeh, I. N.

    2008-01-01

    Male Urogenital tract infection plays an important role in men infertility. Asymptomtic bacteriospermia has been regarded as of the contributing factor to male infertility. In this study, 87 semen samples of infertile men attending the Human Reproduction Research Programme and Invitrofertilization unit (HRRP/IVF) of University Benin Teaching Hospital were evaluated Bacteriologically using standard Bacterial culture method. Standard semen analysis was performed according to WHO guidelines. Amo...

  13. Maternal mortality at Nnamdi Azikiwe University Teaching Hospital, Southeast Nigeria: a 10-year review (2003?2012)

    OpenAIRE

    Obiechina, NJ; Okolie, VE; Okechukwu, ZC; Oguejiofor, CF; Udegbunam, OI; Nwajiaku, LSA; Ogbuokiri, C; Egeonu, R

    2013-01-01

    NJ Obiechina, VE Okolie, ZC Okechukwu, CF Oguejiofor, OI Udegbunam, LSA Nwajiaku, C Ogbuokiri, R Egeonu Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria Background: Maternal mortality is high the world over, especially in sub-Saharan Africa, including Nigeria. Nigeria has consistently demonstrated one of the most abysmally poor reproductive health indices in the world, maternal mortality inclusive. This is a sad reminder that, unless thing...

  14. A comparison of the costs of laparoscopic myomectomy and open myomectomy at a teaching hospital in southern Taiwan

    OpenAIRE

    Chi-Chang Chang

    2013-01-01

    Objective: To compare the costs of traditional open myomectomy (OM) with laparoscopic myomectomy (LM). Materials and Methods: A retrospective review was conducted of the medical records of 155 women who underwent traditional open myomectomy (OM) or laparoscopic myomectomy (LM) in a teaching hospital in Taiwan. Results: The total medical service expense and the patient out-of-pocket expense were significantly higher for women who received LM than for women who received OM. However, the o...

  15. The Relation of Work, Family Balance, and Life Quality of Nurses Working at Teaching Hospitals of Kerman-Iran

    OpenAIRE

    Zeynab Sedoughi; Masoumeh Sadeghi; Sedigheh Khodabaneh Shahraki; Seyed Hossein Saberi Anari; Mohammadreza Amiresmaili

    2016-01-01

    Background: Work and family are the source of tranquility and if the balance between these two is not provided, pleasure, happiness and peace of human being would be lost, which will cause unreturnable loss for him. Regarding the importance of nurses’ role in health system, the present study aimed to study the relation of work-family balance and quality of life of nurses working at selected Iranian teaching hospitals. Methods: Present study is a cross sectional, descriptive-analytical study w...

  16. Integrating Web-Based Teaching Tools into Large University Physics Courses

    Science.gov (United States)

    Toback, David; Mershin, Andreas; Novikova, Irina

    2005-12-01

    Teaching students in our large, introductory, calculus-based physics courses to be good problem-solvers is a difficult task. Not only must students be taught to understand and use the physics concepts in a problem, they must become adept at turning the physical quantities into symbolic variables, translating the problem into equations, and "turning the crank" on the mathematics to find both a closed-form solution and a numerical answer. Physics education research has shown that students' poor math skills and instructors' lack of pen-and-paper homework grading resources, two problems we face at our institution, can have a significant impact on problem-solving skill development.2-4 While Interactive Engagement methods appear to be the preferred mode of instruction,5 for practical reasons we have not been able to widely implement them. In this paper, we describe three Internet-based "teaching-while-quizzing" tools we have developed and how they have been integrated into our traditional lecture course in powerful but easy to incorporate ways.6 These are designed to remediate students' math deficiencies, automate homework grading, and guide study time toward problem solving. Our intent is for instructors who face similar obstacles to adopt these tools, which are available upon request.7

  17. Assessment of Service Quality in Teaching Hospitals of Yazd University of Medical Sciences: Using Multi-criteria Decision Making Techniques.

    Science.gov (United States)

    Shafii, Milad; Rafiei, Sima; Abooee, Fatemeh; Bahrami, Mohammad Amin; Nouhi, Mojtaba; Lotfi, Farhad; Khanjankhani, Khatere

    2016-08-01

    Hospitals as integrated parts of the wide-ranging health care systems have dominant focus on health care provision to meet, maintain and promote people's health needs of a community. This study aimed to assess the service quality of teaching hospitals of Yazd University of Medical Sciences using Fuzzy Analytical Hierarchy Process (FAHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). A literature review and a qualitative method were used to obtain experts' viewpoints about the quality dimensions of hospital services to design a questionnaire. Then, using a self-made questionnaire, perceptions of 300 patients about the quality of delivered services were gathered. Finally, FAHP was applied to weigh each quality dimension and TOPSIS method to rank hospital wards. Six dimensions including responsiveness, assurance, security, tangibles, health communication and Patient orientation were identified as affecting aspects of hospital services quality among which, security and tangibles got the highest and lowest importance respectively (0.25406, 0.06883). Findings also revealed that in hospital A, orthopedics and ophthalmology wards obtained the highest score in terms of quality while cardiology department got the lowest ranking (0.954, 0.323). In hospital B, the highest and the lowest ranking was belonged to cardiology and surgical wards (0.895, 0.00) while in hospital C, surgical units were rated higher than internal wards (0.959, 0.851). Findings emphasized that the security dimension got the lowest ranking among SERVQUAL facets in studied hospitals. This requires hospital executives to pay special attention to the issue of patients' security and plan effectively for its promotion.

  18. Estimating the direct costs of ischemic heart disease: evidence from a teaching hospital in BRAZIL, a retrospective cohort study.

    Science.gov (United States)

    Schlatter, Rosane Paixão; Hirakata, Vânia Naomi; Polanczyk, Carisi Anne

    2017-07-04

    Coronary artery disease is the most prevalent cardiovascular disease. In the United States, 7% of adults over 20 years of age are estimated to have coronary artery disease. In Brazil, a prevalence of 5 to 8% has been estimated in adults over 40 years of age, with an increased number of hospitalizations associated with both stable and acute clinical manifestations; and health care costs have quadrupled in the last decade. To estimate the direct costs of managing ischemic heart disease patient care in a teaching hospital in Brazil from the perspective of the service payer, the Brazilian Unified Health System. This study was a retrospective cohort study for the identification and valuation of resources used at both the outpatient and in-hospital levels in a sample of 330 patients selected from the hospital's ischemic heart disease clinic. Data were collected from computerized hospital records and patients' hospital bills from January 2000 to October 2015. A bivariate analysis and binary logistic regression were performed with p cost of outpatient management was US $1,521 per patient. The mean cost per hospitalization was US $1,976, and the expenses were higher in the first and last years of follow-up. Unstable angina, revascularization procedures, diabetes, hypertension and obesity were predictors of higher hospitalization costs (p cost estimates in this study indicate a high proportion of drug treatment costs in the treatment of ischemic heart disease. Treatment costs are higher in the first year and at the end of treatment, and some clinical factors are associated with greater hospital care costs. These results may serve as a basis for the evaluation of existing public policies and inputs for cost-effectiveness studies in coronary artery disease. CEP HCPA 11-0460 . Ethics Committee of Hospital de Clínicas de Porto Alegre.

  19. Experiences of leaders in the implementation of Lean in a teaching hospital--barriers and facilitators in clinical practices: a qualitative study.

    NARCIS (Netherlands)

    Aij, K.H.; Simons, F.E.; Widdershoven, G.A.; Visse, M.A.

    2013-01-01

    Objectives: To date, experiences of leaders in the implementation of Lean after a Lean Training Programme have not been systematically investigated within teaching hospitals. Existing studies have identified barriers and facilitators only from an improvement programme perspective and have not

  20. Evaluation of pneumococcal vaccination rates after vaccine protocol changes and nurse education in a tertiary care teaching hospital.

    Science.gov (United States)

    Smith, Jennifer G; Metzger, Nicole L

    2011-11-01

    Pneumococcal vaccination in eligible patients is recommended by the Infectious Disease Society of America and the Centers for Disease Control (CDC) Advisory Committee on Immunization Practices. Because hospitalization provides an opportunity to vaccinate patients at high risk for developing serious pneumonia complications, eligibility screening and administration of the pneumococcal vaccine prior to discharge in qualified patients are evaluated by the Joint Commission and the Centers for Medicare Medicaid Services (CMS) as part of pneumococcal vaccination core quality measures. Among patients with an inpatient diagnosis of pneumonia in 2008, 56% in our 580-bed tertiary care teaching hospital, compared with 84% nationwide, received pneumococcal vaccination. To improve pneumococcal vaccination rates for all patients in the study facility and not just those with pneumonia, a multifaceted intervention including a revised nurse screening tool, rescheduling of the vaccine order, storage of the vaccine in automated dispensing cabinets on the nursing unit, and creation of a vaccine tracking system was developed and implemented between August 2009 and October 2009. To determine the impact of a multifaceted intervention on pneumococcal vaccine screening and administration rates in eligible patients according to the CDC recommendations who were admitted to an internal medicine unit of a tertiary care teaching hospital. All patients aged 18 years or older from 2 internal medicine units were identified during 4-month time intervals before (pre-intervention, April through July 2009) and after (post-intervention, November 2009 through February 2010) implementation of the multifaceted pneumococcal vaccine protocol. Of these, 150 patients from each 4-month period were randomly selected for electronic medical record review. Eligibility for pneumococcal vaccination was derived from the CDC recommendations and consensus of the vaccine steering committee at the study institution; the

  1. Teaching the Thrill of Discovery: Student Exploration of the Large-Scale Structures of the Universe

    Science.gov (United States)

    Juneau, Stephanie; Dey, Arjun; Walker, Constance E.; NOAO Data Lab

    2018-01-01

    In collaboration with the Teen Astronomy Cafes program, the NOAO Data Lab is developing online Jupyter Notebooks as a free and publicly accessible tool for students and teachers. Each interactive activity teaches students simultaneously about coding and astronomy with a focus on large datasets. Therefore, students learn state-of-the-art techniques at the cross-section between astronomy and data science. During the activity entitled “Our Vast Universe”, students use real spectroscopic data to measure the distance to galaxies before moving on to a catalog with distances to over 100,000 galaxies. Exploring this dataset gives students an appreciation of the large number of galaxies in the universe (2 trillion!), and leads them to discover how galaxies are located in large and impressive filamentary structures. During the Teen Astronomy Cafes program, the notebook is supplemented with visual material conducive to discussion, and hands-on activities involving cubes representing model universes. These steps contribute to build the students’ physical intuition and give them a better grasp of the concepts before using software and coding. At the end of the activity, students have made their own measurements, and have experienced scientific research directly. More information is available online for the Teen Astronomy Cafes (teensciencecafe.org/cafes) and the NOAO Data Lab (datalab.noao.edu).

  2. Evaluation of the peer teaching program at the University Children´s Hospital Essen - a single center experience.

    Science.gov (United States)

    Büscher, Rainer; Weber, Dominik; Büscher, Anja; Hölscher, Maite; Pohlhuis, Sandra; Groes, Bernhard; Hoyer, Peter F

    2013-01-01

    Since 1986 medical students at the University Children's Hospital Essen are trained as peers in a two week intensive course in order to teach basic paediatric examination techniques to younger students. Student peers are employed by the University for one year. Emphasis of the peer teaching program is laid on the mediation of affective and sensomotorical skills e.g. get into contact with parents and children, as well as manual paediatric examination techniques. The aim of this study is to analyse whether student peers are able to impart specific paediatric examination skills as good as an experienced senior paediatric lecturer. 123 students were randomly assigned to a group with either a senior lecturer or a student peer teacher. Following one-hour teaching-sessions in small groups students had to demonstrate the learned skills in a 10 minute modified OSCE. In comparison to a control group consisting of 23 students who never examined a child before, both groups achieved a significantly better result. Medical students taught by student peers almost reached the same examination result as the group taught by paediatric teachers (21,7±4,1 vs. 22,6±3,6 of 36 points, p=0,203). Especially the part of the OSCE where exclusively practical skills where examined revealed no difference between the two groups (7,44±2,15 vs. 7,97±1,87 of a maximum of 16 points, p=0,154). The majority of students (77%) evaluated peer teaching as stimulating and helpful. The results of this quantitative teaching study reveal that peer teaching of selected skills can be a useful addition to classical paediatric teaching classes.

  3. PATIENT'S PERCEPTION ON THE QUALITY OF RADIOTHERAPY SERVICES IN TWO TEACHING HOSPITALS IN NIGERIA.

    Science.gov (United States)

    Sowunmi, Anthonia C; Fatiregun, Omolara Amina; Alabi, Adewumi O; Zaccheus, Ibitoye A; Kingsley, Irurhe A; Oyedeji, S A

    2015-01-01

    Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. A review of quality of services from the patient's perspective could be a method of assessing in order to improve services and achieve total quality management. This study was designed to assess patients' perception on the quality of Radiotherapy services in Lagos University Teaching Hospital (LUTH) Lagos and University College Hospital (UCH) Ibadan. This study is a cross-sectional study. This research lasted for a period of two months and all patients receiving radiotherapy within is period were included in this study. A total of 246 questionnaires were completed (152 and 94 in LUTH and UCH respectively) and the data collection was by semi-structured questionnaire. Data obtained were collected and analyzed using SPSS statistics [Social Sciences Statistical Package] 17.0 version. The findings of this research indicated that 68.4% in LUTH and 53.2% in UCH of the patients experienced good care. It also revealed that there is good interaction between the staff and the patient. Most of the patients spent more than 3 hours before receiving treatment and also the reason for such delay were not explained to them. The rate of preferential treatment was noted to be high. This study will contribute positively towards achieving effective and qualitative radiotherapy services by creating awareness for the need to minimize patient waiting time as well as the need to explain the reason for such delays. The department should adopt better ways of appointment system so that treatment will be on first come first serve basis. This study will contribute positively towards achieving effective and qualitative radiotherapy services by creating awareness for the need to minimize patient waiting time

  4. Knowledge, attitudes, and practices among mothers of children with epilepsy: A study in a teaching hospital.

    Science.gov (United States)

    Kolahi, Ali-Asghar; Abbasi-Kangevari, Mohsen; Bakhshaei, Pouya; Mahvelati-Shamsabadi, Farhad; Tonekaboni, Seyed-Hassan; Farsar, Ahmad-Reza

    2017-04-01

    Knowledge about epilepsy and attitudes towards patients with epilepsy can affect measures taken to manage epilepsy and seizures. Support and understanding of mothers is invaluable in enabling children with epilepsy to develop normal life skills in living with epilepsy. In order to identify the educational needs of mothers of children with epilepsy, their knowledge, attitudes, and practices should be assessed. Therefore, we interviewed a group of mothers of children with epilepsy who were referred to a pediatric neurology clinic in a teaching hospital. The objective of this study was to assess knowledge, attitudes, and practices among mothers of children with epilepsy in order to identify their educational needs. In the period of August 2014 to January 2015, mothers whose children were diagnosed with epilepsy for at least six months participated in this cross sectional study, while returning to the neurology clinic of a pediatric hospital for usual follow-up. Data were collected through face-to-face interviews, held by trained female general practitioners. The interviewer used questions from a questionnaire. The knowledge section of the questionnaire included questions regarding prevalence and general knowledge about epilepsy, its etiology, symptoms, and seizure provoking factors. The attitudes section included statements regarding the mother's attitudes towards epilepsy and patients with the disease. The practice section included questions about first-aid measures taken by mothers who had witnessed generalized seizures by the time of interview. Responses of 206 participants were analyzed. At least 83% of mothers knew that epilepsy is a noncontagious neurological disorder which can be treated by regular drug therapy. In spite of demonstrating good knowledge scores, the majority of mothers felt the need for further training in epilepsy. More than 98% of mothers were against the idea that patients with epilepsy should hide their disease. Though having been referred to

  5. Patient dose assessment from fluoroscopic procedures at Korle-Bu Teaching Hospital

    International Nuclear Information System (INIS)

    Gyekye, P. K.

    2008-06-01

    Organ and effective dose to ninety (90) patients undergoing myelogram, urethrogram, barium swallow, barium meal and barium enema examinations at the KorIe-Bu Teaching Hospital was estimated using the Monte Carlo Code (PCXMC). Free in air measurements were made with a calibrated ionisation chamber to estimate the entrance surface air kerma for each examination. Evaluation of fluoroscopy beam on time and number of radiographs taken per patient was done for all the examinations considered and studies were done on how they affect patient dose. Dose area product (DAP) was calculated from the entrance surface air kerma and the area of the beam on the surface of the patient and compared with internationally accepted reference levels. Excess relative risk of site specific solid cancer and all solid cancers excluding thyroid and Non-melanoma skin cancers incidences were estimated for the various examinations using Biological Effects of Ionising Radiation VII Committee risk model from the knowledge of the mean effective doses for each examination. The mean effective dose was found to be 0.29 :±: 0.07 mSv for urethrogram, 0.84:±: 0.13 mSv for barium swallow, 3.15 :±: 0.44 mSv for barium meal, 6.24 :±: 0.7 mSv for barium enema and 0.38 :I: 0.05 mSv for myelogram examinations. The estimated mean dose area product (DAP) was found to be 3.55 :±: 0.95 Gycm2 for urethrogram, 16.44:1: 2.60 Gycm2 for barium swallow, 50.81 :±: 7.04 Gycm2 for barium meal, 99.69 :±: 10.85 Gycm2 for barium enema and 9.32 :±: 0.99 Gycm2 for myelogram examinations. The estimated excess relative risk for the occurrence of all solid cancer was found to be 9.5700E-S and 1.6530E-4 for males and females respectively undergoing urethrogram examination, 2.7720E-4 and 4.7880E-4 for males and females respectively undergoing barium swallow examination, 1.0395E-3 and 1.7955E-3 for males and females respectively undergoing barium meal examination, 2.0592E-3 and 3.5568E-3 for males and females respectively

  6. Barriers to Participation in an Online Nursing Journal Club at a Community Teaching Hospital.

    Science.gov (United States)

    Rodriguez, Christopher; Victor, Carol; Leonardi, Nathaniel; Sulo, Suela; Littlejohn, Gina

    2016-12-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Barriers to Participation in an Online Nursing Journal Club at a Community Teaching Hospital," found on pages 536-542, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until November 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the benefits and barriers to participating in an online nursing journal club (ONJC) over a

  7. A Survey of Managers' Access to Key Performance Indicators via HIS: The Case of Iranian Teaching Hospitals.

    Science.gov (United States)

    Ahmadi, Maryam; Khorrami, Farid; Dehnad, Afsaneh; Golchin, Mohammad H; Azad, Mohsen; Rahimi, Shafei

    2018-01-01

    The challenges of using health information systems in developing countries are different from developed countries for various reasons such as infrastructure and data culture of organizations. The aim of this study is to assess managers' access to key performance indicators (KPI) via Hospital Information System (HIS) in teaching hospitals of Iran. All managers (Census method) of the four teaching hospitals affiliated to Hormozgan University of Medical Sciences (HUMS) were included in this study. KPIs which are linked to the strategic objectives of organizations were adopted from the strategic plan of HUMS. The questionnaire used in this study included three categories: Financial, Human Resources and clinical. One-sample t-test was used and the significant difference score was calculated for the acceptable level. We found that HIS cannot facilitate access to KPIs for managers in the main categories, but it was effective in two subcategories of income (p = 0.314) and salary (P = 0.289)). A study of barriers to the use of managers of HIS in hospitals is suggested.

  8. The profile of infertility in a teaching Hospital in North West Nigeria

    Directory of Open Access Journals (Sweden)

    Abubakar A Panti

    2014-01-01

    Full Text Available Background: Infertility is a global health problem and a socially destabilizing condition for couples carrying several stigmas and a cause of marital disharmony. We determined the prevalence, causes, and clinical pattern of infertility at Usmanu Danfodiyo University Teaching Hospital (UDUTH, Sokoto. Materials and Methods: This was a prospective study conducted at the Gynecological Department of UDUTH Sokoto between 1 st January, 2011 and 31 st July, 2011. All the patients that presented with infertility within the study period were recruited into the study. Relevant demographic, clinical, and laboratory/radiological data were documented using a structured questionnaire. The patients had their case folders tagged and followed up to 31 st December 2011 (6 months. Data was analyzed using SPSS version 11. Results: A total of 1,264 new gynecological cases were seen during the study period, and 198 infertile patients were evaluated. The prevalence of infertility was 15.7%. Primary infertility constituted 32.8%, while secondary infertility was 67.2%. Previous history of evidence of genital infection including lower abdominal pain (78.8% and vaginal discharge (76.6% were common. Female gender-related causes of infertility accounted for 42.9%; male causes accounted for 19.7%. Both partners contributed to infertility in 16.7%, while no cause was found in 20.7% of patients. Conclusion: The study shows a dominance of secondary infertility with probable genital tract infection being a major contributor. Early presentation and prompt treatments of genital tract infections may reduce the prevalence of infertility in the study population.

  9. Work-Related Musculoskeletal Disorders among Health Workers in a Nigerian Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Chidozie Emmanuel Mbada

    2012-10-01

    Full Text Available AIMS: Studies comparing the occurrence and characteristics of work – related musculoskeletal disorders (WMSDs across various occupational groups in the health sector from Sub-Sahara Africa are sparse. This study investigated the prevalence and pattern of WMSDs among health workers in Obafemi Awolowo University Teaching Hospitals complex, Ile-Ife, Nigeria. METHODS: An adapted questionnaire from the Nordic musculoskeletal questionnaire was used as the survey instrument. Data were collected on demographics, lifetime, 12-months and point prevalence, and pattern and consequence of WMSDs. A response rate of 91% was obtained in this study. RESULTS: Sixty eight point seven percent of the respondents have experienced WMSDs in their occupational lives with a higher percentage among males than females (39.6 vs.29.1%. The 12-months period and point prevalence rate of WMSDs was 64.4% and 48.2% respectively. WMSDs reported mostly for low back (50% followed by the shoulder (27.5% and knees (18.1%. Nurses (30.4% had the highest rate of WMSDs among the health workers. Most nurses with complaints (53.4% took a sick leave as a result of WMSDs, followed by doctors (32% and support staff (25%. CONCLUSIONS: WMSDs are common among health workers from Nigeria with the low back being injured most often. The rate of WMSDs and consequent sick leave is higher among nurses than other health workers. Preventive programmes on musculoskeletal disorders among health workers are recommended in order to reduce the rate of WMSDs among them and to promote efficiency in patient care. [TAF Prev Med Bull 2012; 11(5.000: 583-588

  10. Worldwide Lineages of Clinical Pneumococci in a Japanese Teaching Hospital Identified by DiversiLab System.

    Science.gov (United States)

    Kashiwaya, Kiyoshi; Saga, Tomoo; Ishii, Yoshikazu; Sakata, Ryuji; Iwata, Morihiro; Yoshizawa, Sadako; Chang, Bin; Ohnishi, Makoto; Tateda, Kazuhiro

    2016-06-01

    Pneumococcal Molecular Epidemiology Network (PMEN) clones are representatives of worldwide-spreading pathogens. DiversiLab system, a repetitive PCR system, has been proposed as a less labor-and time-intensive genotyping platform alternative to conventional methods. However, the utility and analysis parameters of DiversiLab for identifying worldwide lineages was not established. To evaluate and optimize the performance of DiversiLab for identifying worldwide pneumococcal lineages, we examined 245 consecutive isolates of clinical Streptococcus pneumoniae from all age-group patients at a teaching hospital in Japan. The capsular swelling reaction of all isolates yielded 24 different serotypes. Intensive visual observation (VO) of DiversiLab band pattern difference divided all isolates into 73 clusters. Multilocus sequence typing (MLST) of representative 73 isolates from each VO cluster yielded 51 different STs. Among them, PMEN-related lineages accounted for 63% (46/73). Although the serotype of PMEN-related isolates was identical to that of the original PMEN clone in 70% (32/46), CC156-related PMEN lineages, namely Greece(6B)-22 and Colombia(23F)-26, harbored various capsular types discordant to the original PMEN clones. Regarding automated analysis, genotyping by extended Jaccard (XJ) with a 75% similarity index cutoff (SIC) showed the highest correlation with serotyping (adjusted Rand's coefficient, 0.528). Elevating the SIC for XJ to 85% increased the discriminatory power sufficient for distinguishing two major PMEN-related isolates of Taiwan(19F)-14 and Netherlands(3)-31. These results demonstrated a potential utility of DiversiLab for identifying worldwide lineage of pneumococcus. An optimized parameters of automated analysis should be useful especially for comparison for reference strains by "identification" function of DiversiLab. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd

  11. Upper gastrointestinal endoscopy in children: The Lagos University Teaching Hospital experience

    Directory of Open Access Journals (Sweden)

    Oluwafunmilayo Funke Adeniyi

    2016-12-01

    Full Text Available Background. Paediatric endoscopy is now standard care in the developed world for the management of gastrointestinal (GI disorders. However, in developing countries endoscopy remains an underutilised tool. Objective. To determine the indications and the spectrum of endoscopic findings in children seen at the Lagos University Teaching Hospital, Nigeria. Methods. The indications for upper GI endoscopy and endoscopic findings in children ≤16 years old, referred for the procedure from June 2013 to June 2016, were documented. The endoscopic yield in these children was also determined. Results. In total 71 children were referred for upper GI endoscopy during the study period. There were 35 boys and 36 girls aged 3 months to 16 years. The indications for upper endoscopy were recurrent abdominal pain in 37 (52.1%, upper GI bleeding in 17 (23.9%, recurrent vomiting in 7 (9.9%, dyspepsia in 5 (7.0, heartburn in 2 (2.8%, dysphagia in 1 (1.4, portal hypertension in 1 (1.4 and ingestion of corrosives in 1 (1.4% of the subjects. Endoscopic findings were as follows: gastritis 19 (26.8%, hiatus hernia in 13 (18.3%, gastric erosions in 12 (16.9%, oesophageal varices 6 (8.4%, duodenitis in 4 (5.6%, gastric ulcer in 3 (4.2%, gastric polyp in 2 (2.8%. The overall endoscopic yield was 60.2%. Conclusion. There is a need to increase the awareness of the role of paediatric endoscopy in the diagnosis and treatment of GI disorders in developing countries. Recurrent abdominal pain still remains a relevant indication for the procedure. The need to develop training programmes for paediatric endoscopy and paediatric gastroenterology in general in developing countries cannot be overemphasised.

  12. Knowledge, Attitude and Practice Regarding Cervical Cancer Screening Among Women Attending a Teaching Hospital, Bharatpur, Chitwan.

    Science.gov (United States)

    Shrestha, Smita; Dhakal, Prativa

    2017-03-01

    Objective: To find out the knowledge, attitude and practice regarding cervical cancer screening among women. Materials and methods: A descriptive cross-sectional study design was used to collect data from 96 women. Each woman was selected alternately from Gynae Out-Patient Department of Teaching Hospital. Data was collected by using semi-structured interview schedule to find out knowledge and practice and Likert scale to find out the attitude regarding cervical cancer screening. Data was analyzed by using SPSS version 20.0 and interpreted in terms of descriptive and inferential statistics. Results: Out of 96 women, mean age was 38.83 ± 6.57 and 90.6% respondents followed Hinduism. More than three fourth (85.4%) were literate and 59.4% were housewife. Only 9.4% were involved in cervical cancer prevention and screening awareness programme and 2.1% had family history of cervical cancer. As per the findings, only 34.4% and 27.8% had adequate knowledge and practice respectively whereas cent percent women had favorable attitude. Only education level of women was statistically significant with level of knowledge regarding cervical cancer screening (p = 0.041). There was strong negative correlation between knowledge score and practice score regarding cervical cancer screening among women (r = -0.194). Conclusion: Considerable proportions of women have inadequate knowledge and practice regarding cervical cancer screening. Therefore cervical cancer screening health camps and awareness program should be conducted at community level for women to increase the level of knowledge and practice regarding cervical cancer screening.

  13. Upper gastrointestinal endoscopy at the korle bu teaching hospital, accra, ghana.

    Science.gov (United States)

    Aduful, Hk; Naaeder, Sb; Darko, R; Baako, Bn; Clegg-Lamptey, Jna; Nkrumah, Kn; Adu-Aryee, Na; Kyere, M

    2007-03-01

    To study the indications for endoscopy, the endoscopic diagnosis and other lessons learnt. A retrospective and prospective audit of all upper gastrointestinal endoscopies performed in the Endoscopy Unit of the Korle-Bu Teaching Hospital from January 1995 to December 2002 was performed. A total of 6977 patients, 3777 males and 3200 females with age range 1 year 8 months to 93 years were endoscoped. The mean age of males was 43.5 +/- 0.5 and females 43.7 +/- 0.6 years. Epigastric pain (42.5%), dyspepsia (32.8%) and haematemesis and melaena (14.2%) were the commonest reasons for endoscopy. Chronic duodenal ulcer (19.6%), acute gastritis (12.7%), duodenitis (10.2%), oesophagitis (7.5%) were the commonest diagnoses. Normal endoscopy was reported in 41.1% patients, and was higher in the younger age group compared to the older (R = 0.973, P<0.001). Nine hundred and ninety (14.2%) patients were endoscoped for haematemesis and melaena of which chronic duodenal ulcer (32.1%), gastritis/gastric erosions (12.8%), oesophageal varices (9.8%), carcinoma of the stomach (6.4%), and duodenitis (4.2%), were the commonest causes. No lesion was found in 20.6% of these patients. Urease test was positive in 75% of all biopsy specimen and 85% in chronic duodenal ulcer, gastritis and duodenitis. The normal endoscopy rate is high and needs to be reduced in order to help prolong the lives of the endoscopes. Chronic duodenal ulcer is usually associated with H. pylori infection and is the commonest cause of upper gastrointestinal bleeding.

  14. Traffic flow and microbial air contamination in operating rooms at a major teaching hospital in Ghana.

    Science.gov (United States)

    Stauning, M T; Bediako-Bowan, A; Andersen, L P; Opintan, J A; Labi, A-K; Kurtzhals, J A L; Bjerrum, S

    2018-07-01

    Current literature examining the relationship between door-opening rate, number of people present, and microbial air contamination in the operating room is limited. Studies are especially needed from low- and middle-income countries, where the risk of surgical site infections is high. To assess microbial air contamination in operating rooms at a Ghanaian teaching hospital and the association with door-openings and number of people present. Moreover, we aimed to document reasons for door-opening. We conducted active air-sampling using an MAS 100 ® portable impactor during 124 clean or clean-contaminated elective surgical procedures. The number of people present, door-opening rate and the reasons for each door-opening were recorded by direct observation using pretested structured observation forms. During surgery, the mean number of colony-forming units (cfu) was 328 cfu/m 3 air, and 429 (84%) of 510 samples exceeded a recommended level of 180 cfu/m 3 . Of 6717 door-openings recorded, 77% were considered unnecessary. Levels of cfu/m 3 were strongly correlated with the number of people present (P = 0.001) and with the number of door-openings/h (P = 0.02). In empty operating rooms, the mean cfu count was 39 cfu/m 3 after 1 h of uninterrupted ventilation and 52 (51%) of 102 samples exceeded a recommended level of 35 cfu/m 3 . The study revealed high values of intraoperative airborne cfu exceeding recommended levels. Minimizing the number of door-openings and people present during surgery could be an effective strategy to reduce microbial air contamination in low- and middle-income settings. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  15. Clinical profile of newly presenting diabetic patients at the University of Uyo Teaching Hospital, Nigeria

    International Nuclear Information System (INIS)

    Unadike, B.C.; Akpan, N.A.; Essien, I.O.

    2010-01-01

    Diabetes Mellitus is emerging as a major health challenge with the incidence and prevalence of the disease on the increase. It also contributes to overall morbidity and mortality with complications like cardiovascular disease, neuropathy, nephropathy, retinopathy and lower extremity amputation. There are few local studies on the clinical characteristics of the disease in our wet up and this study therefore set out to characterize the clinical profile of newly presenting diabetic patients in a health facility in Nigeria. It is a cross sectional, descriptive study carried out at the diabetes clinic of the University of Uyo Teaching Hospital between January 2007 and September 2008. Data obtained included age, sex, anthropometric indices, symptomatology, co-morbidities, complications and treatment of diabetes. Data was analyzed using SPSS version 10. A total of two hundred and seventy patients were studied (120 males, 150 females). About 89.2% were Type 2 DM patients and majority of the study subjects were overweight. Diabetic neuropathy was the commonest complication present in 38.8% of the subjects. Polyuria was the commonest symptom and hypertension the commonest comorbidity. Majority of the subjects were on oral hypolgycaemic agents for the management of their disease with the sulphonyureas and biguanides being the most common medication that was taken by them. A few of the patients were also taking herbal medication for treatment of their disease. Majority of the patients presenting in our facility have Type 2 diabetes, were hypertensive and overweight. Hypertension was the commonest co-morbidity and diabetic neuropathy the commonest complication. Adequate health education, subsidies on medications and proper funding of the health sector is necessary to stem the tide of the burden attributable to the disease. (author)

  16. Hypertensive disorders in pregnancy among pregnant women in a Nigerian Teaching Hospital

    Science.gov (United States)

    Singh, Swati; Ahmed, Ekele Bissallah; Egondu, Shehu Constance; Ikechukwu, Nwobodo Emmanuel

    2014-01-01

    Background: Hypertensive disorders in pregnancy (HDP) represent a group of conditions associated with high blood pressure during pregnancy. It is an important cause of feto-maternal morbidity and mortality, particularly in developing countries. The aims of the study were to find the prevalence of hypertensive disorders and its associated risk factors among women attending the antenatal clinic of Usmanu Danfodiyo University Teaching Hospital,(UDUTH) Sokoto. Materials and Methods: A longitudinal study of 216 consecutively recruited women that were less than 20 weeks pregnant at booking was carried out. Blood pressure was measured for each woman at booking and at subsequent visits. Urinalysis was done at booking and whenever blood pressure was elevated. Patients were followed-up to delivery and 6 weeks postpartum. Data entry and analysis was done using Statistical Analysis System (SAS) statistical package. Results: The prevalence of HDP in the study was 17% while preeclampsia was 6%. Previous history of preeclampsia (P < 0.001; Relative risk (RR) 4.2; conficence interval (CI) 2.144-6.812), multiple gestation (P < 0.03; RR 3.8; CI 1.037-6.235), gestational diabetes (P < 0.02; RR 4.8; CI 1.910-6.751) and obesity (P < 0.002; RR 2.7; CI 1.373-5.511) were the significant risk factors in the development of HDP among the study population. Conclusion: The prevalence of HDP in the study group is high. Therefore, paying attention to the risk factors will ensure early detection and prevention of the progression of the disease and its sequelae. PMID:25298602

  17. Sleep quality assessment in 35 Parkinson's disease patients in the Fann Teaching Hospital, Dakar, Senegal.

    Science.gov (United States)

    Maiga, B; Diop, M S; Sangare, M; Dembele, K; Cisse, L; Kone, O; Seck, L B; Landoure, G; Guinto, C O; Ndiaye, M; Ndiaye, M M

    2016-03-01

    Sleep disorders are diverse in Parkinson's disease. We aimed to assess the quality of sleep in patients with Parkinson's disease in an African population. In a transversal and prospective study from April to June 2014, all parkinsonian patients followed at the Fann Teaching Hospital Neurology Clinic (Dakar, Senegal) were assessed using the Hoehn and Yahr's scale and filled out the following questionnaires: Parkinson's disease sleep scale (PDSS), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). A PDSS score5 indicated poor quality or impaired sleep. An ESS score>10 indicated excessive daytime sleepiness. We used the Pearson coefficient to search for correlation between age, disease stage, disease duration, and the importance of sleep impairment. Hoehn and Yahr staging was 2.42±0.90 in the 35 patients (60% male, mean age 65.7±7.4years, disease duration 32.4±23.4months). The mean total PDSS score was 99.5±24.1 and 74.3% of the patients had an abnormally high PSQI score, indicating high frequency and intensity of sleep disorders. Most frequent disorders were pain or cramps interrupting sleep, night waking to urinate and fatigue or sleepiness on waking. Patients exhibited excessive diurnal sleepiness in 22.9% of the cases; they often had an abnormal PSQI score. Both the total PDSS score and the difficulty to sleep increased with disease stage, but not with age or disease duration. We found evidence of major alteration of sleep quality in Senegalese Parkinson patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. "Chase CRP", "Review patient": Improving the Quality of Weekend Medical Handover at a London Teaching Hospital.

    Science.gov (United States)

    Saifuddin, Aamir; Magee, Lucia; Barrett, Rachael

    2015-01-01

    Clinical handover has been identified as a "major preventable cause of harm" by the Royal College of Physicians (RCP). Whilst working at a London teaching hospital from August 2013, we noted substandard weekend handover of medical patients. The existing pro forma was filled incompletely by day doctors so it was difficult for weekend colleagues to identify unwell patients, with inherent safety implications. Furthermore, on-call medical staff noted that poor accessibility of vital information in patients' files was affecting acute clinical management. We audited the pro formas over a six week period (n=83) and the Friday ward round (WR) entries for medical inpatients over two weekends (n=84) against the RCP's handover guidance. The results showed poor documentation of several important details on the pro formas, for example, ceiling of care (4%) and past medical history (PMH) (23%). Problem lists were specified on 62% of the WR entries. We designed new handover pro formas and 'Friday WR sheets' to provide prompts for this information and used Medical Meetings and emails to explain the project's aims. Re-audit demonstrated significant improvement in all parameters; for instance, PMH increased to 52% on the pro formas. Only 10% of Friday WR entries used our sheet. However, when used, outcomes were much better, for example, problem list documentation increased to 100%. In conclusion, our interventions improved the provision of crucial information needed to prioritise and manage patients over the weekend. Future work should further highlight the importance of safe handover to all doctors to induce a shift in culture and optimise patient care.

  19. Anthropometry of children with cerebral palsy at the Lagos University Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Titilayo Olubunmi Adekoje

    2016-01-01

    Full Text Available Background: Cerebral palsy (CP is one the most common causes of disability among children in developing countries and is often associated with poor growth. The assessment of growth and nutrition of children is an important aspect of health monitoring and is one of the determinants of child survival. Aim: To assess the nutritional status of children with CP as seen in Lagos University Teaching Hospital (LUTH. Subjects and Methods: A prospective case-control study was conducted on children with CP attending the weekly pediatric neurology clinic of the LUTH between April 2005 and March 2006. Controls were apparently healthy children being followed up at the children′s out-patient clinic of LUTH for acute illness that had resolved. Anthropometric measurements of weight, length/height, mid-upper arm circumference, and skinfold thickness were taken according to the protocols recommended by the International Society of the Advancement of Kinanthropometry. Statistical Analysis: EPI-INFO (version 6.04 was used for analysis. Chi-square test was used to determine associations. Student′s t-test was used to compare means of patients and matched controls. Probability P < 0.05 were taken as statistically significant. Results: The controls had higher weight than the patients with mean weight (standard deviation of 13.7 (4.8 kg, and 12.0 (4.5 kg, respectively (P = 0.01. There were also statistically significant differences in the subscapular and biceps skinfold measurements between the patient and control groups (P = 0.00004 and 0.000008, respectively. Twenty-four (25.8% and 5 (5.4% of the patients had moderate and severe undernutrition compared to 6 (6.1% and none, respectively, in the control group (P = 0.00005. Conclusion: Children with CP had significantly lower mean anthropometric parameters and were more malnourished compared with the control group of children matched for age, sex, and social class.

  20. Clinical Profile and Outcome of Asphyxiated Newborn in a Medical College Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Kiran Panthee

    2016-06-01

    Full Text Available Introduction: Perinatal asphyxia, a major topic in neonatology, is a severe condition which has a high impact on neonatal mortality and morbidity and neurological and intellectual development of the infant. It is defined by WHO as "failure to initiate and sustain breathing at birth". It is estimated that around four million babies are born asphyxiated and among those one million die and an equal number of babies develop serious neurological consequences ranging from cerebral palsy and mental retardation to epilepsy. This study was done to identify the occurrence, clinical profile and, immediate outcome of perinatal asphyxia in Lumbini Medical College Teaching Hospital. Methods: It was a retrospective study where 82 cases who fulfilled the inclusion criteria were included between December 2014 to November 2015. Inclusion criteria included newborns with: a Apgar score equal to or less than six at five minutes, b requirement of  more than one minute of positive pressure ventilation, c signs of fetal distress (heart rate of less than 100 beats per minute, late decelerations. Results: Out of total 425 neonatal intensive care unit (NICU admissions, 82 (19.3% cases were of asphyxia among which 56 were inborn and 26 were referred from outside. Of those 82 cases, 47 (57.3% cases developed hypoxic ischemic encephalopathy (HIE; HIE stage I had good outcome with survival rate of 95% and HIE stage III had poor outcome with survival rate of only 25%. Conclusion: Despite advances in management of neonates, perinatal asphyxia is still the leading cause of neonatal intensive care unit admission and mortality and morbidity in neonates.

  1. The Auckland Cataract Study: Assessing Preoperative Risk Stratification Systems for Phacoemulsification Surgery in a Teaching Hospital.

    Science.gov (United States)

    Kim, Bia Z; Patel, Dipika V; Sherwin, Trevor; McGhee, Charles N J

    2016-11-01

    To evaluate 2 preoperative risk stratification systems for assessing the risk of complications in phacoemulsification cataract surgery, performed by residents, fellows, and attending physicians in a public teaching hospital. Cohort study. One observer assessed the clinical data of 500 consecutive cases, prior to phacoemulsification cataract surgery performed between April and June 2015 at Greenlane Clinical Centre, Auckland, New Zealand. Preoperatively 2 risk scores were calculated for each case using the Muhtaseb and Buckinghamshire risk stratification systems. Complications, intraoperative and postoperative, and visual outcomes were analyzed in relation to these risk scores. Intraoperative complication rates increased with higher risk scores using the Muhtaseb or Buckinghamshire stratification system (P = .001 and P = .003, respectively, n = 500). The odds ratios for residents and fellows were not significantly different from attending physicians after case-mix adjustment according to risk scores (P > .05). Postoperative complication rates increased with higher Buckinghamshire risk scores but not with Muhtaseb scores (P = .014 and P = .094, respectively, n = 476). Postoperative corrected-distance visual acuity was poorer with higher risk scores (P < .001 for both, n = 476). This study confirms that the risk of intraoperative complications increases with higher preoperative risk scores. Furthermore, higher risk scores correlate with poorer postoperative visual acuity and the Buckinghamshire risk score also correlates with postoperative complications. Therefore, preoperative assessment using such risk stratification systems could assist individual informed consent, preoperative surgical planning, safe allocation of cases to trainees, and more meaningful analyses of outcomes for individual surgeons and institutions. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Knowledge of nurses towards dengue fever in a tertiary care teaching hospital in Nepal

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    S Valarmathi

    2014-01-01

    Full Text Available Background: Nurses are important health care professionals and should have wide knowledge about common diseases especially infectious diseases like dengue. Dengue is associated with shock and can lead to death. Aim: To assess the knowledge of nurses regarding dengue fever and to study the association between the demographic variables. Setting and design: A cross sectional study was conducted at the College of Medical Sciences-Teaching Hospital, Nepal among the nurses during December, 2010. Study tool: Semi structured question was prepared to assess the knowledge of nurses in which there was objective question and Yes or No type questionnaire. Statistical analysis: The filled questionnaires were collected and data were entered in Microsoft excel sheet and analyzed as per study objectives. Descriptive statistic was used to calculate the median (IQR and non parametric tests (Kruskal Wallis test and Mann Whitney test to compare the total scores with demographic profile of the subjects. Results: Of the study members 89% were from Proficiency Certificate level (PCL background and the mean (IQR age of the respondents was 21 years (20-22.75. Overall score of the nurses was 11 (9-13 with a maximum possible score of 17. There were no association between the respondents knowledge scores with age (p=0.14; educational qualifications (p=0.86; duration of experience (p=0.59; ward (p=0.28. Conclusion: The study findings report a low knowledge among the nursing practitioners on dengue fever and its complications and their knowledge did not have any association with their demographic variables. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 7-13 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9667

  3. Acute coronary syndrome-related mortality audit in a teaching hospital at Port Blair, India

    Directory of Open Access Journals (Sweden)

    Shiv Shankar Singh

    2017-01-01

    Full Text Available Background: India has a growing trend of acute myocardial infarction (AMI due to shifting lifestyle. Objective: To study the profile of patients died due to AMI and to find its risk correlates. Methods: A study was conducted on consecutive AMI cases admitted in the teaching hospital at Port Blair from April 2011 to March 2016. During inpatients management, outcomes were followed up from admission till discharge or expiry. Results: Of the total 491 cases, majority (75.99% had ST-elevated myocardial infarction (STEMI; mean age of 73 deaths was 58.01 ± 13.60, mortality probability among females was less; in the age group 41–50 years the case fatality rate was the lowest (7.58%. Mean age of survival was 56.75 ± 10.47; great majorities were males across all age groups in cases and deaths; highest number of cases were in the age group 51–60 (34.21%; reportedly 83.10% had some physical activities; 6.52% were vegetarian; 34.22% were smokers; 10.39% had family history of AMI, majority (59.06% were from white collar profession (teacher, clerical, etc.; 52.95% were diabetics; and 47.45% were hypertensives. Lifestyle-related risk factors, physical activity, and vegetarian diet were not protective; family history and addiction to smoking were significantly associated with AMI deaths. Thrombolytic intervention helped the survival of 73.68%, and the odds ratio of survival showed benefit. Conclusions: Acute STEMI had male and middle-age predominance with a common risk factor of family history, smoking, diabetes, and hypertension.

  4. Evaluation of Nutritional Status in a Teaching Hospital Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Mohammadreza Rafati

    2015-02-01

    Full Text Available Background: Extrauterine growth restriction remains a common and serious problem in newborns especially who are small, immature, and critically ill. Very low birth weight infants (VLBW had 97% and 40% growth failure at 36 weeks and 18-22 months post-conceptual age respectively. The postnatal development of premature infants is critically dependent on an adequate nutritional intake that mimics a similar gestational stage. Deficient protein or amino acid administration over an extended period may cause significant growth delay or morbidity in VLBW infants. The purpose of this study was to evaluate current nutritional status in the neonatal intensive care unit in a teaching hospital. Methods: During this prospective observational study, the nutritional status of 100 consecutive critically ill neonates were evaluated by anthropometric and biochemical parameters in a tertiary neonatal intensive care unit. Their demographic characteristics (weight, height and head circumference, energy source (dextrose and lipid and protein were recorded in the first, 5th, 10th, 15th and 20th days of admission and blood samples were obtained to measure serum albumin and prealbumin. The amount of calorie and protein were calculated for all of preterm and term neonates and compared to standard means separately. Results: The calorie and amino acids did not meet in the majority of the preterm and term neonates and mean daily parenteral calorie intake was 30% or lower than daily requirements based on neonates’ weight. Mortality rate was significantly higher in neonates with lower serum albumin and severity of malnutrition but not with serum prealbumin concentration. Conclusion: Infants were studied did not receive their whole of daily calorie and protein requirements and it is recommended early and enough administration of calorie source (dextrose, lipids and amino acids. Prealbumin was a more benefit biochemical parameter than albumin to evaluate short term nutrition

  5. Knowledge, Attitude and Practice Regarding Cervical Cancer Screening Among Women Attending a Teaching Hospital, Bharatpur, Chitwan

    Science.gov (United States)

    Shrestha, Smita; Dhakal, Prativa

    2017-01-01

    Objective: To find out the knowledge, attitude and practice regarding cervical cancer screening among women. Materials and methods: A descriptive cross-sectional study design was used to collect data from 96 women. Each woman was selected alternately from Gynae Out-Patient Department of Teaching Hospital. Data was collected by using semi-structured interview schedule to find out knowledge and practice and Likert scale to find out the attitude regarding cervical cancer screening. Data was analyzed by using SPSS version 20.0 and interpreted in terms of descriptive and inferential statistics. Results: Out of 96 women, mean age was 38.83 ± 6.57 and 90.6% respondents followed Hinduism. More than three fourth (85.4%) were literate and 59.4% were housewife. Only 9.4% were involved in cervical cancer prevention and screening awareness programme and 2.1% had family history of cervical cancer. As per the findings, only 34.4% and 27.8% had adequate knowledge and practice respectively whereas cent percent women had favorable attitude. Only education level of women was statistically significant with level of knowledge regarding cervical cancer screening (p = 0.041). There was strong negative correlation between knowledge score and practice score regarding cervical cancer screening among women (r = -0.194). Conclusion: Considerable proportions of women have inadequate knowledge and practice regarding cervical cancer screening. Therefore cervical cancer screening health camps and awareness program should be conducted at community level for women to increase the level of knowledge and practice regarding cervical cancer screening. PMID:29114264

  6. The pattern of acute poisoning in a teaching hospital, north-west Ethiopia.

    Science.gov (United States)

    Abula, Teferra; Wondmikun, Yared

    2006-04-01

    Poisoning by means of hazardous chemicals through ignorance, mishap or intentionally is becoming a serious health problem worldwide. Epidemiological data on this important health issue are, however, scarce in Ethiopia. The purpose of this study is to assess the pattern of acute poisonings and determine the approaches employed for the management of poisoning. The medical records of patients with acute poisonings presented to the Gondar University hospital between July 2001 and June 2004 were reviewed retrospectively. One hundred and two patients presenting to the emergency department of the hospital were due to acute poisoning; accounting for about 0.45% of emergency room admissions. Organophosphates, rat poison and alcohol were the commonly encountered poisoning agents (in about 70% of cases) mainly in adults possibly with suicidal or para-suicidal intention. The approaches employed in the management of poisoning mainly involved gastrointestinal decontamination procedures. Specific antidotes were used in a substantial number of patients. The fatality rate was 2.4%. Poisoning with suicidal intention is becoming a serious health problem particularly in adults. Pesticides are commonly used toxicants. The approaches in the management of poisoning are justifiable in some cases. However, much is to be done to improve the recording of patient-related information and record-keeping processes. Further large scale studies are required to investigate national trends of poisoning and factors associated with poisoning.

  7. Etiology and characteristics of large symptomatic pericardial effusion in a community hospital in the contemporary era.

    Science.gov (United States)

    Abdallah, R; Atar, S

    2014-05-01

    The etiology and laboratory characteristics of large symptomatic pericardial effusion (LSPE) in the Western world have evolved over the years, and vary between regions, community and tertiary hospitals. We reviewed data of 86 consecutive patients who underwent pericardiocentesis or pericardial window due to LSPE in a community hospital from 2001 to 2010. The characteristics of the PE including chemistry, hematology, bacteriology, serology and cytology have been analyzed. We correlated the etiologies of PE with age, gender and clinical presentation. The most frequent etiology of LSPE was idiopathic [36% (77% with a clinical diagnosis of pericarditis)], followed by malignancy (31.4%), ischemic heart disease (16.3%), renal failure (4.6%), trauma (4.6%) and autoimmune disease (4.6%). The average age of all the etiological groups excluding trauma was over 50 years. Laboratory tests did not modify the pre-procedure diagnosis in any of the patients. The most frequent presenting symptom was dyspnea (76.6%). Chest pain was mostly common in patients with idiopathic etiology (58.06%). The most frequent medical condition associated with LSPE was the use of anticoagulant or antiplatelet drugs (31.40%), especially aspirin, and in those, the PE tended to be bloody (73%, P = 0.11). Most of the effusions were exudates (70.9%). PE due to renal failure was the largest (1467 ± 1387 ml). The spectrum of etiologies of LSPE in a community hospital in the Western world in the contemporary era is continuously evolving. The most frequent etiology is now idiopathic, followed by malignancy. Routine laboratory testing still rarely modifies the pre-procedure diagnosis.

  8. 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...

  9. Neonatal Outcomes of Infants Admitted to a Large Government Hospital in Amman, Jordan

    Science.gov (United States)

    Sivasubramaniam, Priya G.; Quinn, Cristin E.; Blevins, Meridith; Hajajra, Ahmand Al; Khuri-Bulos, Najwa; Faouri, Samir; Halasa, Natasha

    2015-01-01

    Objective: To describe characteristics and outcomes of Jordanian newborns admitted to a large governmental neonatal intensive care unit (NICU). Methods: Newborns born at the government hospital, Al Bashir, in Amman, Jordan were prospectively enrolled. The study focused on newborns admitted to the NICU and a retrospective chart review was performed. Abstraction included in-hospital mortality, antibiotic days, ventilation, oxygen use, and CRP levels. Rank sum and chi-squared tests were used to compare across outcomes. Logistic regression of hypothesized risk factors with death adjusted for gestational age. Results: Of the 5,466 neonates enrolled from 2/10-2/11, medical records were available for 321/378(84.9%) infants admitted to the NICU. The median gestational age was 36 weeks, median birth weight was 2.3 kg, and 28(8.7%) infants died. The two most common reasons for admission and mortality were respiratory distress syndrome and prematurity. Low Apgar scores and positive CRP were predictors of mortality. Risk factors associated with increased use of antibiotics, oxygen hood, and mechanical ventilation included lower gestational age and prematurity. Conclusion: Infants admitted to the Jordanian NICU have significantly higher median gestational age and birth weights than in developed countries and were associated with significant morbidity and mortality. Continuations of global efforts to prevent prematurity are needed. PMID:25946927

  10. Lived experiences of nurse educators on teaching in a large class at a nursing college in Gauteng

    Directory of Open Access Journals (Sweden)

    Maria G. Ndawo

    2016-07-01

    Full Text Available Background: The gradual increase in the number of learners admitted into a nursing college in Gauteng resulted in an increase in class size without a proportional increase in the number of nurse educators. Objectives: To explore and describe the experiences of nurse educators teaching in large classes at a nursing college in Gauteng in order to present recommendations to facilitate teaching and learning. Method: A qualitative, exploratory, descriptive, and phenomenological research design which is contextual in nature was used. A total of 20 nurse educators were selected through purposive sampling, and in-depth phenomenological semi-structured individual interviews were conducted between January and February 2013. Data were analysed together with the field notes, using Tesch’s open coding protocol of qualitative data analysis. Lincoln and Guba’s four principles were used to ensure trustworthiness. Results: The themes that emerged from this study were that nurse educators experienced difficulty in recognising learners as individuals in a large class, using innovative pedagogical strategies, and managing a large class. These findings had a negative impact on meaningful teaching and learning as they interfered with an enabling learning environment. Recommendations: Nurse educators should be empowered with facilitative skills in order to effectively manage a large class and hence to achieve teaching and learning abilities. Conclusion: There is a need for nurse educators to finding alternative ways to overcome challenges associated with teaching in large classes and prepare learners to render individualised, caring and holistic nursing care to each unique patient in the healthcare setting. Keywords: Large class, Teaching, Learning; Hindrance

  11. Prevalence of nasal carriage and diversity of Staphylococcus aureus among inpatients and hospital staff at Korle Bu Teaching Hospital, Ghana

    DEFF Research Database (Denmark)

    Egyir, Beverly; Guardabassi, Luca; Nielsen, Søren Saxmose

    2013-01-01

    %) was more common than for other agents (resistant S. aureus carriage was observed among IP compared with HS (P = 0.01). High genetic diversity was shown by spa typing, with 55 spa types found among 105 isolates; the predominant spa types were t355 (10%) and t084 (10......There is a paucity of data on Staphylococcus aureus epidemiology in Africa. Prevalence of nasal carriage and genetic diversity of S. aureus were determined among hospital staff (HS) and inpatients (IP) at the largest hospital in Ghana. In total, 632 nasal swabs were obtained from 452 IP and 180 HS...... in the Child Health Department (CHD) and Surgical Department (SD). S. aureus carriage prevalences were 13.9% in IP and 23.3% in HS. The chance of being a carrier was higher in HS (P = 0.005) and IP staying ≤7 days in hospital (P = 0.007). Resistance to penicillin (93%), tetracycline (28%) and fusidic acid (12...

  12. [Infective endocarditis: Clinical features and prognosis between 2004 and 2014 in a non-teaching hospital].

    Science.gov (United States)

    Capilla, E; Poyet, R; Tortat, A-V; Marchi, J; Brocq, F-X; Pons, F; Kerebel, S; Jego, C; Mayet, A; Cellarier, G R

    2017-04-01

    Despite diagnostic and therapeutic advances, infective endocarditis (IE) remains a severe disease. The aim of the study was to describe clinical features and prognosis of patients with IE in a non-teaching hospital and compare them with current data and a similar study conducted 10 years earlier in the same center. We performed a single institution retrospective study including all patients with Duke-Li definite IE between 2004 and 2014. Ninety-four patients were included. Results are consistent with current French and international data, including in-hospital death rate of 16%. In accordance with literature, we report on an increase in Staphylococcus and health care-associated IE and endocarditis on pacemaker leads, but without significant difference compared to our previous study. In univariate analyses, renal failure, age over 77 years and Staphylococcus aureus IE were associated with in-hospital mortality. In multivariate analyses, predictors of in-hospital death were renal failure and lack of surgery. There was a non-significant trend of excess mortality in Staphylococcus endocarditis and in patients with heart failure. IE remains a severe disease and S. aureus is more often involved. IE seems to be safely managed in a peripheral hospital provided that there is a partnership with a reference hospital. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Pleasure and pain: teaching neuroscientific principles of hedonism in a large general education undergraduate course.

    Science.gov (United States)

    Bodnar, Richard J; Stellar, James R; Kraft, Tamar T; Loiacono, Ilyssa; Bajnath, Adesh; Rotella, Francis M; Barrientos, Alicia; Aghanori, Golshan; Olsson, Kerstin; Coke, Tricia; Huang, Donald; Luger, Zeke; Mousavi, Seyed Ali Reza; Dindyal, Trisha; Naqvi, Naveen; Kim, Jung-Yo

    2013-01-01

    In a large (250 registrants) general education lecture course, neuroscience principles were taught by two professors as co-instructors, starting with simple brain anatomy, chemistry, and function, proceeding to basic brain circuits of pleasure and pain, and progressing with fellow expert professors covering relevant philosophical, artistic, marketing, and anthropological issues. With this as a base, the course wove between fields of high relevance to psychology and neuroscience, such as food addiction and preferences, drug seeking and craving, analgesic pain-inhibitory systems activated by opiates and stress, neuroeconomics, unconscious decision-making, empathy, and modern neuroscientific techniques (functional magnetic resonance imaging and event-related potentials) presented by the co-instructors and other Psychology professors. With no formal assigned textbook, all lectures were PowerPoint-based, containing links to supplemental public-domain material. PowerPoints were available on Blackboard several days before the lecture. All lectures were also video-recorded and posted that evening. The course had a Facebook page for after-class conversation and one of the co-instructors communicated directly with students on Twitter in real time during lecture to provide momentary clarification and comment. In addition to graduate student Teaching Assistants (TAs), to allow for small group discussion, ten undergraduate students who performed well in a previous class were selected to serve as discussion leaders. The Discussion Leaders met four times at strategic points over the semester with groups of 20-25 current students, and received one credit of Independent Study, thus creating a course within a course. The course grade was based on weighted scores from two multiple-choice exams and a five-page writing assignment in which each student reviewed three unique, but brief original peer-review research articles (one page each) combined with expository writing on the first

  14. Evaluation of hospital information systems of the teaching hospitals affiliated to Shiraz University of Medical Sciences, based on the American College of Physicians Criteria

    Directory of Open Access Journals (Sweden)

    E Emami

    2014-01-01

    Full Text Available Introduction: Hospital information system (HIS is a computerized system used for management of hospital information as an electronic device and has an indispensible role in the field of qualified healthcare services. Nevertheless, compared to other industrial and commercial systems, this information system is lagged in using the information technology and applying the controlling standards for satisfying the customers. Therefore, the present study aimed to evaluate HIS, identify its strength and weak points, and improve it in the teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Method: The present descriptive, cross-sectional study was conducted in the 8 teaching hospitals of Shiraz University of Medical Sciences which used HIS in 2011. The study data were collected through interview and direct observation using the criteria of American Physician College check-list. Finally, SPSS statistical software was used to analyze the data through descriptive statistics. Results: The study results showed that laboratory and medical records had respectively the most %43.5 and the least %21.03 conformity to the criteria of American College of Physicians. Also, Faghihi and Zeinabiye hospitals respectively had the most %41.8 and the least %25.2 conformity to the American College of Physicians’ criteria. In pharmacy, data entrance mechanism and presentation of reports had complete conformity to the scales of American College of Physicians, while drug interactions showed no conformity. In laboratory, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. The possibility of receiving information from centers out of laboratory had no conformity to the desired criteria. In the radiology department, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. Besides, the possibility

  15. Accreditation Council for Graduate Medical Education Core Competencies at a Community Teaching Hospital: Is There a Gap in Awareness?

    Science.gov (United States)

    Al-Temimi, Mohammed; Kidon, Michael; Johna, Samir

    2016-01-01

    Reports evaluating faculty knowledge of the Accreditation Council for Graduate Medical Education (ACGME) core competencies in community hospitals without a dedicated residency program are uncommon. Faculty evaluation regarding knowledge of ACGME core competencies before a residency program is started. Physicians at the Kaiser Permanente Fontana Medical Center (N = 480) were surveyed for their knowledge of ACGME core competencies before starting new residency programs. Knowledge of ACGME core competencies. Fifty percent of physicians responded to the survey, and 172 (71%) of respondents were involved in teaching residents. Of physicians who taught residents and had complete responses (N = 164), 65 (39.7%) were unsure of their knowledge of the core competencies. However, most stated that they provided direct teaching to residents related to the knowledge, skills, and attitudes stated in each of the 6 competencies as follows: medical knowledge (96.3%), patient care (95.7%), professionalism (90.7%), interpersonal and communication skills (86.3%), practice-based learning (85.9%), and system-based practice (79.6%). Physician specialty, years in practice (1-10 vs > 10), and number of rotations taught per year (1-6 vs 7-12) were not associated with knowledge of the competencies (p > 0.05); however, full-time faculty (teaching 10-12 rotations per year) were more likely to provide competency-based teaching. Objective assessment of faculty awareness of ACGME core competencies is essential when starting a residency program. Discrepancy between knowledge of the competencies and acclaimed provision of competency-based teaching emphasizes the need for standardized teaching methods that incorporate the values of these competencies.

  16. Assessment of Predictable Productivity of Nurses Working in Kerman University of Medical Sciences' Teaching Hospitals via the Dimensions of Quality of Work Life.

    Science.gov (United States)

    Borhani, Fariba; Arbabisarjou, Azizollah; Kianian, Toktam; Saber, Saman

    2016-10-01

    Despite the existence of a large community of nurses, specific mechanisms have not been developed yet to consider their needs and the quality of their work life. Moreover, few studies have been conducted to analyze the nature of nursing, nursing places or nurses' quality of work life. In this regard, the present study aimed to assess predictable productivity of nurses working in Kerman University of Medical Sciences' teaching hospitals via the dimensions of Quality of Work Life. The present descriptive-correlational study was conducted to assess predictable productivity of nurses via the dimensions of Quality of Work Life. The study's population consisted of all nurses working in different wards of teaching hospitals associated with Kerman University of Medical Sciences. Out of the whole population, 266 nurses were selected based on the simple random sampling method. To collect data, the questionnaires of 'Quality of Nursing Work Life' and 'Productivity' were used after confirming their reliability (test-retest) and content validity. Finally, the collected data were analyzed through the SPSS software (version 16). Although the quality of work life for nurses was average and their productivity was low but the results showed that quality of life is directly related to nurses' productivity. Quality of life and its dimensions are predictive factors in the in the nurses' productivity. It can conclude that by recognizing the nurses' quality of work life situation, it can realize this group productivity and their values to the efficiency of the health system. For the quality of working life improvement and increasing nurses' productivity more efforts are needed by authorities. The findings can be applied by managers of hospitals and nursing services along with head nurses to enhance the quality of health services and nursing profession in general.

  17. A Simulation of Rainwater Harvesting Design and Demand-Side Controls for Large Hospitals

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    Lawrence V. Fulton

    2018-05-01

    Full Text Available Inpatient health buildings in the United States are the most intensive users of water among large commercial buildings. Large facilities (greater than 1 million square feet consume an average of 90 million gallons per building per year. The distribution and treatment of water imposes a significant electrical power demand, which may be the single largest energy requirement for various states. Supply and demand-side solutions are needed, particularly in arid and semi-arid regions where water is scarce. This study uses continuous simulations based on 71 years of historical data to estimate how rainwater harvesting systems and demand-side interventions (e.g., low-flow devices, xeriscaping would offset the demand for externally-provided water sources in a semi-arid region. Simulations from time series models are used to generate alternative rainfall models to account for potential non-stationarity and volatility. Results demonstrate that hospital external water consumption might be reduced by approximately 25% using conservative assumptions and depending on the design of experiment parameters associated with rainfall capture area, building size, holding tank specifications, and conservation efforts.

  18. Potential drug-drug interactions in a Brazilian teaching hospital: age-related differences?

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    Daniela Oliveira Melo

    2016-07-01

    Full Text Available This study proposes to measure frequency and to characterize the profile of potential drug interactions (pDDI in a general medicine ward of a teaching hospital. Data about identification and clinical status of patients were extracted from medical records between March to August 2006. The occurrence of pDDI was analyzed using the database monographs Micromedex® DrugReax® System. From 5,336 prescriptions with two or more drugs, 3,097 (58.0% contained pDDI. The frequency of major and well document pDDI was 26.5%. Among 647 patients, 432 (66.8% were exposed to at least one pDDI and 283 (43.7% to major pDDI. The multivariate analysis identified that factors related to higher rates of major pDDI were the same age (p< 0.0001, length of stay (p< 0.0001, prevalence of hypertension [OR=3.42 (p< 0.0001] and diabetes mellitus [OR=2.1 (p< 0.0001], cardiovascular diseases (p< 0.0001 and the number of prescribed drugs (Spearman’s correlation=0.640622, p< 0.0001. Between major pDDI, the main risk was hemorrhage (50.3%, the most frequent major pDDI involved combination of anticoagulants and antiplatelet drugs. Among moderate pDDI, 3,866 (90.8% involved medicines for the treatment of chronic non-communicable diseases, mainly hypertension. In HU-USP, the profile of pDDI was similar among adults and elderly (the most frequent pDDI and major pDDI were same, the difference was only the frequency in either group. The efforts of the clinical pharmacists should be directed to elderly patients with cardiovascular compromise, mainly in use of anticoagulants and antiplatelet drugs. Furthermore, hospital managers should increase the integration between levels of health care to promote safety patient after discharge.Keywords: Drug interactions. Aged. Internal Medicine. Hospitals, University. RESUMOInterações medicamentosas potenciais em um hospital escolar brasileiro: diferenças relacionadas à idade?O estudo tem por objetivo descrever o perfil de intera

  19. A stochastic mathematical model to locate field hospitals under disruption uncertainty for large-scale disaster preparedness

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    Nezir Aydin

    2016-03-01

    Full Text Available In this study, we consider field hospital location decisions for emergency treatment points in response to large scale disasters. Specifically, we developed a two-stage stochastic model that determines the number and locations of field hospitals and the allocation of injured victims to these field hospitals. Our model considers the locations as well as the failings of the existing public hospitals while deciding on the location of field hospitals that are anticipated to be opened. The model that we developed is a variant of the P-median location model and it integrates capacity restrictions both on field hospitals that are planned to be opened and the disruptions that occur in existing public hospitals. We conducted experiments to demonstrate how the proposed model can be utilized in practice in a real life problem case scenario. Results show the effects of the failings of existing hospitals, the level of failure probability and the capacity of projected field hospitals to deal with the assessment of any given emergency treatment system’s performance. Crucially, it also specifically provides an assessment on the average distance within which a victim needs to be transferred in order to be treated properly and then from this assessment, the proportion of total satisfied demand is then calculated.

  20. Knowledge and practice of malaria prevention among caregivers of children with malaria admitted to a teaching hospital in Ghana

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    Emmanuel Ameyaw

    2015-08-01

    Full Text Available Objective: To assess the knowledge and practice of malaria prevention among caregivers of children admitted to a teaching hospital in Ghana. Methods: A descriptive cross-sectional survey was conducted on caregivers of children who were hospitalized at the paediatric wards of the Komfo Anokye Teaching Hospital from March 2009 to June 2009. Data were analysed using StataTM version 8.2. Results: Nearly all caregivers (97.1% had heard of malaria. Of this proportion, 89.7% knew mosquito bite as a cause of malaria. The proportion of caregivers who were able to recognise the signs and symptoms of malaria were 87.6% (for fever, 47.1% (for vomiting and 28.1% (for headache. Radio and television were the major sources of information about malaria. Conclusions: Caregivers of children have adequate knowledge about malaria and its mode of transmission. Further education on the implementation of the preventive methods is still needed to help reduce the incidence of malaria among children.

  1. Adverse incidents resulting in exposure to body fluids at a UK dental teaching hospital over a 6-year period

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    Hughes A

    2012-10-01

    Full Text Available A Hughes,1 L Davies,1 R Hale,1 JE Gallagher21Kings College Hospital NHS Foundation Trust, 2King's College London Dental Institute, London, United KingdomBackground: The safety and protection of patients and health care workers is of paramount importance in dentistry, and this includes students in training who provide clinical care. Given the nature of dental care, adverse incidents can and do occur, exposing health care workers to body fluids and putting them at risk of infection, including contracting a blood-borne virus. The aim of this research was to analyze trends in the volume, rate, nature, management, and outcome of adverse incidents reported at one dental teaching hospital from 2005 to 2010.Methods: Descriptive analysis of trends in the volume, rate, nature, management, and outcome of adverse incidents reported at one dental teaching hospital over a six-year period was undertaken in relation to the level of outpatient and day surgery activity.Results: In total, 287 incidents were reported over a six-year period, which amounted to 0.039% of outpatient or day surgery appointments. Nearly three quarters of all the incidents (n = 208, 72% took place during treatment or whilst clearing away after the appointment. The most frequent incidents were associated with administration of local anesthetic (n = 63, 22%, followed by burs used in dental hand pieces (n = 51, 18%.Conclusion: This research confirms that adverse incidents are a feature of dental hospitals and reports the common sources. The importance of accurate and consistent reporting of data to ensure that these issues are monitored to inform action and reduce risks to staff, students, and patients are highlighted.Keywords: risk management, blood-borne virus, dental hospital, body fluids exposure, adverse event reporting

  2. A high prevalence of culture-positive extrapulmonary tuberculosis in a large Dutch teaching hospital

    NARCIS (Netherlands)

    D.A. Hesselink (Dennis); S.M. Yoo; G.T. Verhoeven; J.W. Brouwers; F.J. Smit (Frank); J.L.C.M. van Saase (Jan)

    2003-01-01

    textabstractBACKGROUND: In the Netherlands the incidence of tuberculosis (TB) has increased during the last decade. Growing immigration and international travel were important determining factors. To determine if this has resulted in altered clinical manifestations of the disease,

  3. Intestinal parasites isolated in a large teaching hospital, Italy, 1 May 2006 to 31 December 2008.

    Science.gov (United States)

    Masucci, L; Graffeo, R; Bani, S; Bugli, F; Boccia, S; Nicolotti, N; Fiori, B; Fadda, G; Spanu, T

    2011-06-16

    Intestinal parasites account for the majority of parasitic diseases, particularly in endemic areas. Most are transmitted via contaminated food. Because of increased immigration and travel, enteric parasitoses are now distributed worldwide. Between May 2006 and December 2008, we examined stool specimens from 5,351 patients (4,695 Italians, 656 non-Italians) for ova and parasites using microscopy, culture techniques, and molecular methods. Stools from 594 patients (11.1%) were contaminated and for all patients samples combined, a total of 700 intestinal parasites were counted. Ninety of the 594 infected patients had more than one parasite in their stools. Parasites causing intestinal disease occurred in 8.8% of patients. The prevalence was over twice as high among non-Italians (26.8% vs 8.9% in Italians, p003). Most isolates were pathogenic protozoa, including in decreasing order of frequency: Blastocystis hominis, Giardia intestinalis, Entamoeba histolytica, and Cyclospora cayetanensis. The latter two species tended to be more common in Italians, although not at significant level (3.6% (15/418) vs 1.7% (3/176) in non-Italians, OR: 2.15; 95%CI: 0.60–11.70, p=0.22). Helminthes were found in 28 patients, mainly non-Italians (5.7% (10/176) vs 4.3% (18/418), OR: 1.34; 95%CI: 0.54–3.13, p=0.47). Ascaris lumbricoides and Hymenolepis nana were the most common. Strongyloides stercoralis, Enterobius vermicularis, Taenia spp. and Trichuris trichiura were also found. Intestinal parasites are a serious problem in developing countries, but should not be underestimated in industrialised countries.

  4. Clinical Characteristics of Patients with Isolated Calf Vein Thrombosis in a Large Teaching Hospital

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    Santin Brian

    2011-01-01

    Methods. A retrospective review of the records of 100 consecutive patients diagnosed with ICDVT by DUS was conducted. Results. Patients (59% male were predominantly Caucasian (86% and inpatients (69% with an average age of 53 years. The most frequent risk factors were malignancy (22%, immobility (18%, and previous DVT (13%. Thrombus was present in named tibial veins in 58% and muscular branches in 42%. The peroneal vein was most frequently involved (39/117, 33% followed by the gastrocnemius veins (29/117, 22% and muscular calf tributaries (14%. Conclusions. Our patient population with ICDVT was predominantly symptomatic, in-patient cohort with a high incidence of risk factors such as malignancy, immobility, previous DVT, trauma, and postoperative status. Partial or complete resolution was documented by DUS in 53%.

  5. Intestinal parasitosis and shigellosis among diarrheal patients in Gondar teaching hospital, northwest Ethiopia

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    Huruy Kahsay

    2011-10-01

    Full Text Available Abstract Background Diarrheal diseases are the major causes of morbidity and mortality in developing world. Understanding the etiologic agents of diarrheal diseases and their association with socio-demographic characteristics of patients would help to design better preventive measures. Thus, this study was aimed to determine the prevalence of intestinal parasites and enteropathogenic bacteria in diarrheic patients. Methods A cross-sectional study involving 384 consecutive diarrheal patients who visited Gondar teaching hospital, Gondar, Ethiopia from October 2006 to March 2007 was conducted. Stool specimens were collected and examined for intestinal parasites and enteropathogenic bacteria following standard parasitological and microbiological procedures. Results Intestinal parasites were diagnosed in 36.5% of the patients. The most frequently encountered protozoan parasite was Entamoeba histolytica/dispar (7.3% followed by Giardia lamblia (5.0%, Cryptosporidium parvum (1.8% and Isospora belli (1.3%. The dominant helminthic parasite identified was Ascaris lumbricoides (5.5% followed by Strongyloides stercoralis and Schistosoma mansoni (3.1% each, hookworm infection (1.8%, and Hymenolepis species (1.3%. Multiple infections of intestinal parasites were also observed in 6.3% of the patients. Among the enteropathogenic bacteria Shigella and Salmonella species were isolated from 15.6% and 1.6%, respectively, of the patients. Escherichia coli O57:H7 was not found in any of the stool samples tested. Eighty eight percent and 83.3% of the Shigella and Salmonella isolates were resistant to one or more commonly used antibiotics, respectively. Intestinal parasitosis was higher in patients who live in rural area, in patients who were washing their hands after visiting toilet either irregularly with soap and without soap or not at all, in patients who used well and spring water for household consumption, and in patients who had nausea (P P Conclusions The high

  6. Working towards implementation of a nuclear medicine accreditation program in a South African teaching hospital

    International Nuclear Information System (INIS)

    Eiselen, T.; Ellmann, A.

    2004-01-01

    Full text: Introduction: Quality assurance in Nuclear Medicine is of utmost importance in order to ensure optimal scintigraphic results and correct patient management and care. The implementation of a good quality assurance program should address all factors that playa role in the optimal functioning of a department. It should be developed by scientific findings as well as national and international guidelines. Aim: To develop a tailor made program that can be managed according to the individual needs and requirements of a Nuclear Medicine department in a teaching hospital. This program is aimed at international accreditation of the department. Materials and methods: Auditing of the following aspects was conducted: organizational, clinical and technical, personnel satisfaction, patient experience and satisfaction, referring physicians experience and satisfaction. Information was collected by means of questionnaires to groups and individuals for opinion polls; one-to-one interviews with personnel and patients; technical evaluation of equipment according to manufacturer's specifications and international standards; laboratory equipment evaluation according to precompiled guidelines and investigation of laboratory procedures for standardization and radiation safety. Existing procedure protocols were measured against international guidelines and evaluated for possible shortcomings of technical as well as cosmetic details, and data storage facilities were evaluated in terms of user friendliness, viability and cost effectiveness. A number of international accreditation experts were also visited to establish the validity of our results. Results: Patient questionnaires indicated overall satisfaction with personal service providing, but provision of written and understandable information, long waiting periods and equipment must receive attention. Staff questionnaires indicated a general lack of communication between different professional groups and the need for

  7. Knowledge, Attitude and Practice of Contraception among Postpartum Women Attending Kathmandu Medical College Teaching Hospital.

    Science.gov (United States)

    Bajracharya, A

    2015-01-01

    Background Failure to plan a pregnancy can adversely affect the health of the family as a whole. High parity is related to increased maternal, perinatal and infant deaths and is associated with nutritional problems of both mother and child. Hence, good knowledge, attitude and practice of family planning among women are important. This study is aimed to determine the knowledge, attitude and practice of contraception among the postpartum women attending Kathmandu Medical College Teaching Hospital. Objective To determine the knowledge, attitude and the practice of various contraceptive methods among the postpartum women. Method A cross-sectional observational study was conducted in the department of Obstetrics and Gynecology on 400 postpartum women (within 42 days of delivery) who delivered and came for follow-up in this institution. All the postnatal women were interviewed with pre-designed questionnaire and information on sociodemographic variable, awareness and knowledge of various contraceptive methods, previous and current use of family planning methods, source of information, utilization and reasons for use/non-use of family planning methods were obtained. Data collected were entered and analyzed using SPSS 20. The results were presented as percentages, means, tables and charts. Result Majority of the participants 363 (90.8%) were aware of contraceptive usage. Amongst 60.5% of women who had previously used contraception, OCPs were the commonest one. Maximum number of participants (60.35%) had used modern contraceptives in the past. The most common source of information on contraception was media (55.7%). The reason of using contraception was spacing between the subsequent pregnancies, while the most common reason of discontinuation or not willing to use family planning methods was husband being abroad, fear of side effects and not knowing which contraceptives to use. Conclusion The contraceptive awareness and knowledge among the postpartum women was high but

  8. Hirschsprung′s disease: 8 years experience in a Nigerian teaching hospital

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    Nasir A

    2007-01-01

    Full Text Available Background: Hirschsprung′s disease (HD is a common cause of intestinal obstruction in children. Despite increased understanding of the disease and several techniques of treatment, significant complications continued to be associated with its management. Objective: To study the outcome of management of HD in the University Teaching Hospital, Ilorin, Nigeria. Materials and Methods: The clinical records of all children managed for HD between January 1998 and December 2005 were retrospectively reviewed. Demographic data, modes of presentation, methods of diagnosis, age at colostomy formation, age and type of definitive operations were noted from patients′ records. Complications associated with colostomy, pre- and postoperative complications, final outcome and duration of follow-up were also noted. Results: Twenty-one patients (20 males, one female managed for HD were reviewed. Eight (38% were diagnosed in the neonatal period, the mean age at diagnosis being 22 months. Fourteen patients had completed the three stages of the operation, one is awaiting colostomy closure and two patients are waiting for definitive operations. Out of the 15 patients who had definitive surgery, nine had Swenson′s pull-through operations while six had Duhamel operations. At presentation, six patients had enterocolitis, one of whom had spontaneous colonic perforation, two patients had sepsis. Colostomy-related complications recorded included sixteen patients with dermatitis, nine with colostomy prolapse, one patient with colostomy diarrhea and one with enterocolitis and sepsis. Following definitive surgery, three patients had wound infection, one partial intestinal obstruction, one postDuhamel hemorrhage and two enterocolitis. Complications after colostomy closure included two wound infections and one severe enterocolitis. There were five deaths (23.8%-two from sepsis, two from enterocolitis and one from an adverse drug reaction. One of the children who had

  9. Delivery of pharmaceutical services at ward level in a teaching hospital.

    Science.gov (United States)

    Schellack, N; Martins, V; Botha, N; Meyer, J C

    2009-03-01

    Poor management of pharmaceuticals could lead to wastage of financial resources and poor services in the public sector. The main aim of the study was to investigate the quality of pharmaceutical services at ward level in a teaching hospital. The design of the study was descriptive. Three data collection instruments were designed and pilot-tested prior to the actual data collection. Two structured questionnaires were used to interview the sister-in-charge of each ward and the stock and drug controller at the pharmacy. A checklist for the management of pharmaceuticals was completed for each ward. Descriptive statistics were used to describe and summarise the data. Sisters-in-charge of 30 wards and the stock and drug controller at the pharmacy participated in the study. The relationship with the pharmacy was perceived to be average by 54% (n = 30) of the sisters-in-charge of the wards. Communication with the pharmacy was mainly by telephone and 57% of the sisters-in-charge mentioned that they experienced difficulties in conveying messages to the pharmacy. Ten of the wards received regular ward visits by a pharmacist. Expiry dates were checked by all wards but at different intervals. The majority of the wards (90%) used patient cards, which refer to prescription charts, for stock control and ordering from the pharmacy. Fridge temperatures were checked and charted on a daily basis by 30% of the wards. Written standard operating procedures (SOPs) were used by the pharmacy for issuing ward stock. Although 83% of the wards indicated that they used SOPs, evidence of written SOPs was not available. The results indicated that the management of pharmaceutical services at ward level could be improved. Implementation of appropriate communication systems will enhance cooperation between the pharmacy and the wards. A uniform ward stock control system, either by computer or stock cards, should be introduced. Regular ward visits by a pharmacist to oversee ward stock management are

  10. Hospitals Participating In ACOs Tend To Be Large And Urban, Allowing Access To Capital And Data.

    Science.gov (United States)

    Colla, Carrie H; Lewis, Valerie A; Tierney, Emily; Muhlestein, David B

    2016-03-01

    Relationships between physicians and hospitals have changed considerably over the past decade, as hospitals and physician groups have integrated and new public and private payment policies have created financial interdependence. The extent to which accountable care organizations (ACOs) involve hospitals in their operations may prove to be vitally important, because managing hospital care is a key part of improving health care quality and lowering cost growth. Using primary data on ACO composition and capabilities paired with hospital characteristics, we found that 20 percent of US hospitals were part of an ACO in 2014. Hospitals that were in urban areas, were nonprofit, or had a smaller share of Medicare patients were more likely to participate in ACOs, compared to hospitals that were in more rural areas, were for-profit or government owned, or had a larger share of Medicare patients, respectively. Qualitative data identified the following advantages of including a hospital in an ACO: the availability of start-up capital, advanced data sharing, and engagement of providers across the care continuum. Although the 63 percent of ACOs that included hospitals offered more comprehensive services compared to ACOs without hospitals, we found no differences between the two groups in their ability to manage hospital-related aspects of patient care. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Do large-scale hospital- and system-wide interventions improve patient outcomes: a systematic review.

    Science.gov (United States)

    Clay-Williams, Robyn; Nosrati, Hadis; Cunningham, Frances C; Hillman, Kenneth; Braithwaite, Jeffrey

    2014-09-03

    While health care services are beginning to implement system-wide patient safety interventions, evidence on the efficacy of these interventions is sparse. We know that uptake can be variable, but we do not know the factors that affect uptake or how the interventions establish change and, in particular, whether they influence patient outcomes. We conducted a systematic review to identify how organisational and cultural factors mediate or are mediated by hospital-wide interventions, and to assess the effects of those factors on patient outcomes. A systematic review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Database searches were conducted using MEDLINE from 1946, CINAHL from 1991, EMBASE from 1947, Web of Science from 1934, PsycINFO from 1967, and Global Health from 1910 to September 2012. The Lancet, JAMA, BMJ, BMJ Quality and Safety, The New England Journal of Medicine and Implementation Science were also hand searched for relevant studies published over the last 5 years. Eligible studies were required to focus on organisational determinants of hospital- and system-wide interventions, and to provide patient outcome data before and after implementation of the intervention. Empirical, peer-reviewed studies reporting randomised and non-randomised controlled trials, observational, and controlled before and after studies were included in the review. Six studies met the inclusion criteria. Improved outcomes were observed for studies where outcomes were measured at least two years after the intervention. Associations between organisational factors, intervention success and patient outcomes were undetermined: organisational culture and patient outcomes were rarely measured together, and measures for culture and outcome were not standardised. Common findings show the difficulty of introducing large-scale interventions, and that effective leadership and clinical champions, adequate

  12. Large-volume paracentesis with indwelling peritoneal catheter and albumin infusion: a community hospital study

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    Daniel K. Martin

    2016-10-01

    Full Text Available Background: The management of ascites can be problematic. This is especially true in patients with diuretic refractory ascites who develop a tense abdomen. This often results in hypotension and decreased venous return with resulting renal failure. In this paper, we further examine the risks and benefits of utilizing an indwelling peritoneal catheter to remove large-volume ascites over a 72-h period while maintaining intravascular volume and preventing renal failure. Methods: We retrospectively reviewed charts and identified 36 consecutive patients undergoing continuous large-volume paracentesis with an indwelling peritoneal catheter. At the time of drain placement, no patients had signs or laboratory parameters suggestive of spontaneous bacterial peritonitis. The patients underwent ascitic fluid removal through an indwelling peritoneal catheter and were supported with scheduled albumin throughout the duration. The catheter was used to remove up to 3 L every 8 h for a maximum of 72 h. Regular laboratory and ascitic fluid testing was performed. All patients had a clinical follow-up within 3 months after the drain placement. Results: An average of 16.5 L was removed over the 72-h time frame of indwelling peritoneal catheter maintenance. The albumin infusion utilized correlated to 12 mg/L removed. The average creatinine trend improved in a statistically significant manner from 1.37 on the day of admission to 1.21 on the day of drain removal. No patients developed renal failure during the hospital course. There were no documented episodes of neutrocytic ascites or bacterial peritonitis throughout the study review. Conclusion: Large-volume peritoneal drainage with an indwelling peritoneal catheter is safe and effective for patients with tense ascites. Concomitant albumin infusion allows for maintenance of renal function, and no increase in infectious complications was noted.

  13. Evaluation of Randomly Selected Completed Medical Records Sheets in Teaching Hospitals of Jahrom University of Medical Sciences, 2009

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    Mohammad Parsa Mahjob

    2011-06-01

    Full Text Available Background and objective: Medical record documentation, often use to protect the patients legal rights, also providing information for medical researchers, general studies, education of health care staff and qualitative surveys is used. There is a need to control the amount of data entered in the medical record sheets of patients, considering the completion of these sheets is often carried out after completion of service delivery to the patients. Therefore, in this study the prevalence of completeness of medical history, operation reports, and physician order sheets by different documentaries in Jahrom teaching hospitals during year 2009 was analyzed. Methods and Materials: In this descriptive / retrospective study, the 400 medical record sheets of the patients from two teaching hospitals affiliated to Jahrom medical university was randomly selected. The tool of data collection was a checklist based on the content of medical history sheet, operation report and physician order sheets. The data were analyzed by SPSS (Version10 software and Microsoft Office Excel 2003. Results: Average of personal (Demography data entered in medical history, physician order and operation report sheets which is done by department's secretaries were 32.9, 35.8 and 40.18 percent. Average of clinical data entered by physician in medical history sheet is 38 percent. Surgical data entered by the surgeon in operation report sheet was 94.77 percent. Average of data entered by operation room's nurse in operation report sheet was 36.78 percent; Average of physician order data in physician order sheet entered by physician was 99.3 percent. Conclusion: According to this study, the rate of completed record papers reviewed by documentary in Jahrom teaching hospitals were not desirable and in some cases were very weak and incomplete. This deficiency was due to different reason such as medical record documentaries negligence, lack of adequate education for documentaries, High work

  14. [Causes of iron-deficiency anaemia in the internal medecine department of the national teaching hospital of Ouagadougou].

    Science.gov (United States)

    Nacoulma, Eric William Camille; Sakande, Jean; Ouermi, Alain; Tieno, Hervé; Drabo, Youssoufou Joseph

    2008-01-01

    This retrospective study in the internal medicine department of the national teaching hospital of Ouagadougou was conducted to identify the main causes of iron-deficiency anaemia. Among the 65 subjects meeting the inclusion and exclusion criteria, mean haemoglobin was 7.5 g/dl, with mean serum ferritin 8.9 microg/l among women and 15.5 microg/l among men. The most common cause was chronic blood loss, and hookworm was a major cause in 19.6% of cases. These results suggest the need for preventive measures against iron deficiency and for reinforcement of the fight against diseases producing fecal blood loss.

  15. Qualitative Variation in Approaches to University Teaching and Learning in Large First-Year Classes

    Science.gov (United States)

    Prosser, Michael; Trigwell, Keith

    2014-01-01

    Research on teaching from a student learning perspective has identified two qualitatively different approaches to university teaching. They are an information transmission and teacher-focused approach, and a conceptual change and student-focused approach. The fundamental difference being in the former the intention is to transfer information to…

  16. Design and Large-Scale Evaluation of Educational Games for Teaching Sorting Algorithms

    Science.gov (United States)

    Battistella, Paulo Eduardo; von Wangenheim, Christiane Gresse; von Wangenheim, Aldo; Martina, Jean Everson

    2017-01-01

    The teaching of sorting algorithms is an essential topic in undergraduate computing courses. Typically the courses are taught through traditional lectures and exercises involving the implementation of the algorithms. As an alternative, this article presents the design and evaluation of three educational games for teaching Quicksort and Heapsort.…

  17. Prevalence and clinical characteristics of tori and jaw exostoses in a teaching hospital in Jordan.

    Science.gov (United States)

    Sawair, Faleh A; Shayyab, Mohammad H; Al-Rababah, Mohammad A; Saku, Takashi

    2009-12-01

    To determine the prevalence and clinical characteristics of oral bony outgrowths (OBOs); torus palatinus (TP), torus mandibularis (TM), and exostoses in Jordanian dental patients. This cross-sectional study was conducted between November 1 and December 31, 2008 at the University of Jordan Hospital, Amman, Jordan. Clinical examinations of 618 patients (354 men and 264 women), 10-82 years of age, were conducted to determine the presence of OBOs. There were 239 subjects (38.7%) who had OBOs. Nearly one-third (34.6%) had TP, TM, or both. The prevalence rates were 25.7% for TM, 15.4% for TP, and 14.4% for exostoses. The OBOs were mostly noted in patients in their fifth decade of life, with attrition, clenching, or bruxism. Women had more TP, but gender differences were not statistically significant in cases of TM and exostoses. Most TP were large in size (71.6%), spindle (41.1%), or flat (40%) in shape, and located at the premolar-molar region (45.3%). The TM were mostly medium to large in size (84.9%), bilateral (81.1%), composed of single node (69.2%), and located at the premolar region (65.4%). Of the studied subjects, 7.1% had mandibular buccal exostosis, 10% had maxillary buccal, and 2.4% had palatal exostoses. Statistically significant associations were noticed between the concurrent existence of OBOs. A relatively high prevalence of OBOs was noted, and this should be taken into consideration when planning periodontal surgery and prosthodontic treatment.

  18. Uterine Fibroid Embolization for Symptomatic Fibroids: Study at a Teaching Hospital in Kenya

    Science.gov (United States)

    Mutai, John Kiprop; Vinayak, Sudhir; Stones, William; Hacking, Nigel; Mariara, Charles

    2015-01-01

    Objective: Characterization of magnetic (MRI) features in women undergoing uterine fibroid embolization (UFE) and identification of clinical correlates in an African population. Materials and Methods: Patients with symptomatic fibroids who are selected to undergo UFE at the hospital formed the study population. The baseline MRI features, baseline symptom score, short-term imaging outcome, and mid-term symptom scores were analyzed for interval changes. Assessment of potential associations between short-term imaging features and mid-term symptom scores was also done. Results: UFE resulted in statistically significant reduction (P < 0.001) of dominant fibroid, uterine volumes, and reduction of symptom severity scores, which were 43.7%, 40.1%, and 37.8%, respectively. Also, 59% of respondents had more than 10 fibroids. The predominant location of the dominant fibroid was intramural. No statistically significant association was found between clinical and radiological outcome. Conclusion: The response of uterine fibroids to embolization in the African population is not different from the findings reported in other studies from the west. The presence of multiple and large fibroids in this study is consistent with the case mix described in other studies of African-American populations. Patient counseling should emphasize the independence of volume reduction and symptom improvement. Though volume changes are of relevance for the radiologist in understanding the evolution of the condition and identifying potential technical treatment failures, it should not be the main basis of evaluation of treatment success. PMID:25883858

  19. Uterine Fibroid Embolization for Symptomatic Fibroids: Study at a Teaching Hospital in Kenya

    Directory of Open Access Journals (Sweden)

    John Kiprop Mutai

    2015-01-01

    Full Text Available Objective: Characterization of magnetic (MRI features in women undergoing uterine fibroid embolization (UFE and identification of clinical correlates in an African population. Materials and Methods: Patients with symptomatic fibroids who are selected to undergo UFE at the hospital formed the study population. The baseline MRI features, baseline symptom score, short-term imaging outcome, and mid-term symptom scores were analyzed for interval changes. Assessment of potential associations between short-term imaging features and mid-term symptom scores was also done. Results: UFE resulted in statistically significant reduction (P < 0.001 of dominant fibroid, uterine volumes, and reduction of symptom severity scores, which were 43.7%, 40.1%, and 37.8%, respectively. Also, 59% of respondents had more than 10 fibroids. The predominant location of the dominant fibroid was intramural. No statistically significant association was found between clinical and radiological outcome. Conclusion: The response of uterine fibroids to embolization in the African population is not different from the findings reported in other studies from the west. The presence of multiple and large fibroids in this study is consistent with the case mix described in other studies of African-American populations. Patient counseling should emphasize the independence of volume reduction and symptom improvement. Though volume changes are of relevance for the radiologist in understanding the evolution of the condition and identifying potential technical treatment failures, it should not be the main basis of evaluation of treatment success.

  20. Collective response to public health emergencies and large-scale disasters: putting hospitals at the core of community resilience.

    Science.gov (United States)

    Paturas, James L; Smith, Deborah; Smith, Stewart; Albanese, Joseph

    2010-07-01

    Healthcare organisations are a critical part of a community's resilience and play a prominent role as the backbone of medical response to natural and manmade disasters. The importance of healthcare organisations, in particular hospitals, to remain operational extends beyond the necessity to sustain uninterrupted medical services for the community, in the aftermath of a large-scale disaster. Hospitals are viewed as safe havens where affected individuals go for shelter, food, water and psychosocial assistance, as well as to obtain information about missing family members or learn of impending dangers related to the incident. The ability of hospitals to respond effectively to high-consequence incidents producing a massive arrival of patients that disrupt daily operations requires surge capacity and capability. The activation of hospital emergency support functions provides an approach by which hospitals manage a short-term shortfall of hospital personnel through the reallocation of hospital employees, thereby obviating the reliance on external qualified volunteers for surge capacity and capability. Recent revisions to the Joint Commission's hospital emergency preparedness standard have impelled healthcare facilities to participate actively in community-wide planning, rather than confining planning exclusively to a single healthcare facility, in order to harmonise disaster management strategies and effectively coordinate the allocation of community resources and expertise across all local response agencies.

  1. Nurses' Knowledge, Practices, and Barriers in Care of Patients with Pressure Ulcers in a Ugandan Teaching Hospital

    Science.gov (United States)

    Mwebaza, Ivan; Katende, Godfrey; Groves, Sara; Nankumbi, Joyce

    2014-01-01

    Pressure ulcers have been identified as a major burden of hospitalization worldwide, and nurses are at the forefront of prevention. The purpose of this study was to determine the nurses' knowledge and practices regarding risk factors, prevention, and management of pressure ulcers at a teaching hospital in Uganda. The study employed a descriptive cross-sectional design. Fifty-six Ugandan registered practicing nurses were sampled. A composite self-administered questionnaire and an observation checklist were utilized. The nurses had limited knowledge about critical parameters of pressure ulcers. Prevention practices were observed to be unreliable and uncoordinated related to a significant shortage of staff and logistics for pressure ulcer prevention. Nurses had poor access to current literature on pressure ulcer prevention. Translation of nurses' knowledge into practice is possible if barriers like staff shortage, pressure relieving devices provision, and risk assessment tools are addressed at Mulago. PMID:24707398

  2. Nurses’ Knowledge, Practices, and Barriers in Care of Patients with Pressure Ulcers in a Ugandan Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Ivan Mwebaza

    2014-01-01

    Full Text Available Pressure ulcers have been identified as a major burden of hospitalization worldwide, and nurses are at the forefront of prevention. The purpose of this study was to determine the nurses’ knowledge and practices regarding risk factors, prevention, and management of pressure ulcers at a teaching hospital in Uganda. The study employed a descriptive cross-sectional design. Fifty-six Ugandan registered practicing nurses were sampled. A composite self-administered questionnaire and an observation checklist were utilized. The nurses had limited knowledge about critical parameters of pressure ulcers. Prevention practices were observed to be unreliable and uncoordinated related to a significant shortage of staff and logistics for pressure ulcer prevention. Nurses had poor access to current literature on pressure ulcer prevention. Translation of nurses’ knowledge into practice is possible if barriers like staff shortage, pressure relieving devices provision, and risk assessment tools are addressed at Mulago.

  3. The Role of Mental Health Disease in Potentially Preventable Hospitalizations: Findings From a Large State.

    Science.gov (United States)

    Medford-Davis, Laura N; Shah, Rohan; Kennedy, Danielle; Becker, Emilie

    2018-01-01

    Preventable hospitalizations are markers of potentially low-value care. Addressing the problem requires understanding their contributing factors. The objective of this study is to determine the correlation between specific mental health diseases and each potentially preventable hospitalization as defined by the Agency for Healthcare Research and Quality. The Texas Inpatient Public Use Data File, an administrative database of all Texas hospital admissions, identified 7,351,476 adult acute care hospitalizations between 2005 and 2008. A hierarchical multivariable logistic regression model clustered by admitting hospital adjusted for patient and hospital factors and admission date. A total of 945,280 (12.9%) hospitalizations were potentially preventable, generating $6.3 billion in charges and 1.2 million hospital days per year. Mental health diseases [odds ratio (OR), 1.25; 95% confidence interval (CI), 1.22-1.27] and substance use disorders (OR, 1.13; 95% CI, 1.12-1.13) both increased odds that a hospitalization was potentially preventable. However, each mental health disease varied from increasing or decreasing the odds of potentially preventable hospitalization depending on which of the 12 preventable hospitalization diagnoses were examined. Older age (OR, 3.69; 95% CI, 3.66-3.72 for age above 75 years compared with 18-44 y), black race (OR 1.44; 95% CI, 1.43-1.45 compared to white), being uninsured (OR 1.52; 95% CI, 1.51-1.54) or dual-eligible for both Medicare and Medicaid (OR, 1.23; 95% CI, 1.22-1.24) compared with privately insured, and living in a low-income area (OR, 1.20; 95% CI, 1.17-1.23 for lowest income quartile compared with highest) were other patient factors associated with potentially preventable hospitalizations. Better coordination of preventative care for mental health disease may decrease potentially preventable hospitalizations.

  4. AAA application in diagnosis exams in a large public hospital, RS, Brazil

    International Nuclear Information System (INIS)

    Bacelar, A.; Ferret, A.A.; Vanni, S.; Galhardi, M.P.; Lykawka, R.

    2013-01-01

    Objective: the initiative AAA - Awareness , Appropriateness and Audit , promotes consciousness ( Awareness) , fitness ( Appropriateness ) and Audit ( Audit) . This paper analyzes the application of the concept in the AAA requests and justifications examinations using ionizing radiation within a large public hospital. Materials and methods: we collected and analyzed data between the years 2011 and 2012, concerning the number of exams performed with the use of radiation and their justifications. After, we sought to raise awareness of the clinical team through training on the risks and benefits of the various modalities of the radiology department and the need to justify the use of ionizing radiation on health. After the data were collected again of test requests for verification of the effectiveness of training. Results: the mean requests that need to be appropriate to the AAA in the last quarter of 2011 was 75 % lower than the average demands of the first quarter, matched against the last two months of 2012 increased by up to four times the number requests that require improvements in relation to the excellent results obtained in July 2012. Conclusion: it is shown in this paper the need of implementing this initiative AAA continuously added to the clinical staff awareness about the risk of the use of ionizing radiation, the appropriateness of the requests of these tests , as well as the control of this process in order to optimize use of ionizing radiation on health

  5. Developing a pediatric palliative care service in a large urban hospital: challenges, lessons, and successes.

    Science.gov (United States)

    Edlynn, Emily S; Derrington, Sabrina; Morgan, Helene; Murray, Jennifer; Ornelas, Beatriz; Cucchiaro, Giovanni

    2013-04-01

    We report the process of creating a new palliative care service at a large, urban children's hospital. Our aim was to provide a detailed guide to developing an inpatient consultation service, along with reporting on the challenges, lessons, and evaluation. We examined the hiring process of personnel and marketing strategies, a clinical database facilitated ongoing quality review and identified trends, and a survey project assessed provider satisfaction and how referring physicians used the palliative care service. The pilot phase of service delivery laid the groundwork for a more effective service by creating documentation templates and identifying relevant data to track growth and outcomes. It also allowed time to establish a clear delineation of team members and distinction of roles. The survey of referring physicians proved a useful evaluation starting point, but conclusions could not be generalized because of the low response rate. It may be necessary to reconsider the survey technique and to expand the sample to include patients and families. Future research is needed to measure the financial benefits of a well-staffed inpatient pediatric palliative care service.

  6. Presentations and Preceding factors of Drug Overdose amongst adolescents admitted to a Large Regional Hospital.

    LENUS (Irish Health Repository)

    Maduemem, KE

    2018-04-01

    Suicide is the third most common cause of death among adolescents globally, and poisoning is the leading method of attempted suicide. Survival after self-poisoning or drug overdose (OD) is common, providing an opportunity for secondary prevention. The aim of this study was to highlight pattern of presentations and preceding factors of OD in an adolescent population. We retrospectively evaluated the data of 85 adolescents presenting to a large regional hospital with OD over a 3-year period. The female-to-male ratio was 4.3:1. The median age of adolescents was 15.83 (range: 11.32 – 16.98) years. History of deliberate self-harm (DSH) was documented in 44.7%. Twenty-eight (33%) patients had been under the care of the CAMHS prior to index admission. Acetaminophen was the commonest drug used. Depression was the most common cause of mental illness in the study group. Substance abuse and conduct disorder were significantly commoner in males (p<0.05). Self-poisoning including OD in adolescence is a strong predictor of suicide; understanding the probable triggers can be significant in establishing appropriate prevention strategies.

  7. After the Recall: Reexamining Multiple Magnet Ingestion at a Large Pediatric Hospital.

    Science.gov (United States)

    Rosenfield, Daniel; Strickland, Matt; Hepburn, Charlotte Moore

    2017-07-01

    To evaluate the effectiveness of a mandatory product recall on the frequency of multiple mini-magnet ingestion at a large tertiary pediatric hospital, and to examine the morbidity and mortality associated with these ingestions. In this retrospective chart review, we searched our institution's electronic patient record for patients aged magnetic foreign bodies between 2002 and 2015, a period that included the mandatory product recall. We compared the frequency and character of ingestions before and after the recall. Comparing the postrecall years (January 1, 2014, to December 31, 2015) with the 2 years immediately preceding the recall year (January 1, 2011, to December 31, 2012) yields an incidence rate ratio of 0.34 (95% CI, 0.18-0.64) for all magnet ingestions and 0.20 (95% CI, 0.08-0.53) for ingestion of multiple magnets. Based on the Fisher exact test, the incidence of both magnet ingestion (P magnet ingestion (P magnet ingestion decreased. There were no deaths in either study period. There was a significant decrease in multiple mini-magnet ingestion following a mandatory product recall. This study supports the effectiveness of the recall, which should bolster efforts to keep it in place in jurisdictions where it is being appealed. More broadly, the result provides general evidence of a recall helping decrease further harm from a product that carries a potential hazard. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. A large outbreak of Listeria monocytogenes infection with short incubation period in a tertiary care hospital.

    Science.gov (United States)

    Johnsen, Bjørn Odd; Lingaas, Egil; Torfoss, Dag; Strøm, Erik H; Nordøy, Ingvild

    2010-12-01

    Listeria monocytogenes is a foodborne pathogen with a high mortality rate. We report a large, nosocomial outbreak of Listeria monocytogenes infection. Patients with L. monocytogenes isolated from a sterile site, or from faeces when diarrhoea and fever were present, were included. Clinical data were collected from the patient records. The incubation period was calculated as the time between exposure and start of symptoms. Seventeen patients (11 women, median age 64 years) were infected of whom 15 patients were at increased risk for listeriosis. Eleven patients received empiric antibiotic treatment, eight of them with cephalosporins. Three patients died with a resulting mortality rate of 18%. The source of the outbreak was a Camembert cheese made from pasteurised milk containing up to 360 million colony forming units per portion. The median incubation period was 3-4 days. The incubation period in this outbreak was significantly shorter than previously reported, a fact that may be due to the high number of ingested bacteria. Furthermore, food restrictions in hospitals seem warranted, as do treatment with antibiotics effective against L. monocytogenes in at-risk populations. Copyright © 2010 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  9. Knowledge attitude and practice (kap) of chronic kidneys disease among medical officers of teaching hospitals of lahore

    International Nuclear Information System (INIS)

    Anees, M.; Mumtaz, A.

    2014-01-01

    This study was conducted to determine the knowledge, attitude and practice (KAP) about kidney diseases among medical officers working in different hospitals of Lahore.Doctors working on the medical floors of different tertiary care teaching hospitals (Mayo Hospital (MH), Sir Ganga Ram Hospital (SGRH), Service Institute of Medical Sciences (SIMS), Fatima Memoral Hospitals (FMH), Lahore General Hospitals (LGH), Shalamar Hospital (SH), Jinnah hospital (JH)) of Lahore were included in the study. Each doctor was given a questionnaire comprising of 28 questions. Each participant was given 10-15 minutes for completing the questionnaire at the spot. Categorization of doctors according to the KAP score was done as poor ( 70%).Results: One hundred eighty five doctors participated in the study who fulfilled the criteria. In this study majority 134 (62.6%) of the doctors were not taught about nephrology during their graduation which was statistically significant. Most of the doctors either had some knowledge or didn't know about procedures done in nephrology. Majority of the doctors 208(97.2%) know that nephrology deals with medical diseases of the kidney which was statistically significant. Most of the doctors 138(64.5) feel that nephrology services are insufficient in their hospital. More than 90% doctors want that kidney diseases should be taught during MBBS curriculum and separate nephrology department should be established which was statistically significant. Most of the doctors don't know the management of hyperkalemia very well. About 90% of the doctors know that there are five stages of CKD. Majority of the doctors know that ACE inhibitors are used in hypertension and diabetic nephropathy. They also know that urine complete examination help in early detection of diabetic nephropathy which was statistically significant.Conclusion:Most of the doctors have poor to average knowledge and practice about kidney diseases. Most of the doctors think that nephrology services are

  10. Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital.

    Science.gov (United States)

    Ferreira, Carolina Justus Buhrer; Plodek, Caroline Koga; Soares, Franciny Kossemba; Andrade, Rayza Assis de; Teleginski, Fernanda; Rocha, Maria Dagmar da

    2016-01-01

    to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r) program, and frequencies were calculated. 786 errors were observed, 63.9% (502) in Phase 2, and 36.1% (284) in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes. analisar o impacto de diretrizes sobre erros em medicamentos prescritos para administração via sondas enterais. estudo quantitativo, em três fases, realizado em clínica médica, neurologia e unidade de terapia intensiva de hospital geral universitário. Na Fase 1 elaborou-se: protocolo de diluição, unitarização - transformação e

  11. The effect of hand hygiene compliance on hospital-acquired infections in an ICU setting in a Kuwaiti teaching hospital.

    Science.gov (United States)

    Salama, Mona F; Jamal, Wafaa Y; Mousa, Haifa Al; Al-Abdulghani, Khaled A; Rotimi, Vincent O

    2013-02-01

    Hand washing is widely accepted as the cornerstone of infection control in the intensive care unit (ICU). Nosocomial infections are frequently viewed as indicating poor compliance with hand washing guidelines. To determine the hand hygiene (HH) compliance rate among healthcare workers (HCWs) and its effect on the nosocomial infection rates in the ICU of our hospital, we conducted an interventional study. The study spanned a period of 7 months (February 2011-August 2011) and consisted of education about HH indications and techniques, workplace reminder posters, focused group sessions, and feedback on the HH compliance and infection rates. The WHO HH observation protocol was used both before and after a hospital-wide HH campaign directed at all staff members, particularly those in the ICU. Compliance was measured by direct observation of the HCWs, using observation record forms in a patient-directed manner, with no more than two patients observed simultaneously. The overall HH compliance rate was calculated by dividing the number of HH actions by the total number of HH opportunities. The nosocomial infection rates for the pre- and post-interventional periods were also compared to establish the effect of the intervention on rate of infections acquired within the unit. The overall rate of HH compliance by all the HCWs increased from 42.9% pre-intervention to 61.4% post-intervention, P<0.001. Individually, the compliance was highest among the nurses, 49.9 vs. 82.5%, respectively (P<0.001) and lowest among the doctors, 38.6 vs. 43.2%, respectively (P=0.24). The effect of the increase in the HH compliance rate on the nosocomial infection rate was remarkable. There were significant reductions in the following: the rate of overall health care-associated infections/1000 patient-days, which fell from 37.2 pre-intervention to 15.1 post-intervention (P<0.001); the rate of bloodstream infections, which fell from 18.6 to 3.4/1000 central-line-days (P<0.001); and the rate of lower

  12. Antibiotics-related adverse events in the infectious diseases department of a French teaching hospital: a prospective study.

    Science.gov (United States)

    Courjon, J; Pulcini, C; Cua, E; Risso, K; Guillouet, F; Bernard, E; Roger, P-M

    2013-12-01

    Antibiotics are a significant cause of adverse events (AE), but few studies have focused on prescriptions in hospitalized patients. In infectious diseases departments, the high frequency and diversity of antibiotics prescribed makes AE post-marketing monitoring easier. The aim of our study was to assess the incidence and type of AE in the infectious diseases department of a French teaching tertiary-care hospital. The main characteristics of each hospitalization, including all antibiotics prescribed and any significant AE were recorded prospectively in the medical dashboard of the department. We included all patients having suffered an AE due to systemic antibiotics between January 2008 and March 2011. Among the 3963 hospitalized patients, 2682 (68%) received an antibiotic and 151/2682 (5.6%) suffered an AE. Fifty-two (34%) AE were gastrointestinal disorders, 32 (21%) dermatological, 20 (13%) hepatobiliary, 16 (11%) renal and urinary disorders, 13 (9%) neurological and 11 (7%) blood disorders. Rifampin, fosfomycin, cotrimoxazole and linezolid were the leading causes of AE. Sixty-two percent of the antibiotics causing an AE were stopped and 38% were continued (including 11% with a dose modification). Patients suffering from AE had an increased length of stay (18 vs 10 days, P antibiotic when several options are possible.

  13. A model for the use of blended learning in large group teaching sessions.

    Science.gov (United States)

    Herbert, Cristan; Velan, Gary M; Pryor, Wendy M; Kumar, Rakesh K

    2017-11-09

    appreciated for their flexibility, which enabled students to work at their own pace. In transforming this introductory Pathology course, we have demonstrated a model for the use of blended learning in large group teaching sessions, which achieved high levels of completion, satisfaction and value for learning.

  14. A model for the use of blended learning in large group teaching sessions

    Directory of Open Access Journals (Sweden)

    Cristan Herbert

    2017-11-01

    modules were described as enjoyable, motivating and were appreciated for their flexibility, which enabled students to work at their own pace. Conclusions In transforming this introductory Pathology course, we have demonstrated a model for the use of blended learning in large group teaching sessions, which achieved high levels of completion, satisfaction and value for learning.

  15. A comparative study teaching chemistry using the 5E learning cycle and traditional teaching with a large English language population in a middle-school setting

    Science.gov (United States)

    McWright, Cynthia Nicole

    For decades science educators and educational institutions have been concerned with the status of science content being taught in K-12 schools and the delivery of the content. Thus, educational reformers in the United States continue to strive to solve the problem on how to best teach science for optimal success in learning. The constructivist movement has been at the forefront of this effort. With mandatory testing nationwide and an increase in science, technology, engineering, and mathematics (STEM) jobs with little workforce to fulfill these needs, the question of what to teach and how to teach science remains a concern among educators and all stakeholders. The purpose of this research was to determine if students' chemistry knowledge and interest can be increased by using the 5E learning cycle in a middle school with a high population of English language learners. The participants were eighth-grade middle school students in a large metropolitan area. Students participated in a month-long chemistry unit. The study was a quantitative, quasi-experimental design with a control group using a traditional lecture-style teaching strategy and an experimental group using the 5E learning cycle. Students completed a pre-and post-student attitude in science surveys, a pretest/posttest for each mini-unit taught and completed daily exit tickets using the Expert Science Teaching Educational Evaluation Model (ESTEEM) instrument to measure daily student outcomes in main idea, student inquiry, and relevancy. Analysis of the data showed that there was no statistical difference between the two groups overall, and all students experienced a gain in content knowledge overall. All students demonstrated a statistically significant difference in their interest in science class, activities in science class, and outside of school. Data also showed that scores in writing the main idea and writing inquiry questions about the content increased over time.

  16. Audit of antibiotic prescribing in two governmental teaching hospitals in Indonesia.

    NARCIS (Netherlands)

    Hadi, U.; Duerink, D.O.; Lestari, E.S.; Nagelkerke, N.J.; Keuter, M.; Huis in 't Veld, D.; Suwandojo, E.; Rahardjo, E.; Broek, P. van den; Gyssens, I.C.J.

    2008-01-01

    This article estimates the magnitude and quality of antibiotic prescribing in Indonesian hospitals and aims to identify demographic, socio-economic, disease-related and healthcare-related determinants of use. An audit on antibiotic use of patients hospitalized for 5 days or more was conducted in two

  17. Exploring the use of smartphones and tablets by medical House Officers in Korle-Bu Teaching Hospital.

    Science.gov (United States)

    Barnor-Ahiaku, Edem

    2016-03-01

    Smartphones and tablets are being used widely in the Western World creating benefits in healthcare. The Ministry of Health in Ghana has an e-Health strategy, with the aim of integrating such resources into healthcare. Whilst there are numerous mHealth projects going on in Ghana, there is little evidence of doctors using such devices in their practice. A qualitative study was undertaken in Korle-Bu Teaching Hospital. Random sampling was used to identify House Officers, who engaged in semi-structured interviews. Interviews were recorded, transcribed and analysed using thematic content analysis. Consent was gained from all participants and the University of Leeds granted ethical approval. The results demonstrate that current House Officers began using smartphones and tablets at various stages during medical school. Their use has increased since qualification. Although the overall use has increased, some staff remain resistant to the use of smartphones and tablets. In the future, the integration of smartphones and tablets into medical practice can be improved by integration with the medical curriculum and accepted practice. House Officers are routinely using smartphones and tablets to assist them in their daily practice. The use is informal and is peer led. Whilst they bring many benefits, there are issues, which need to be addressed. In Korle-Bu Teaching Hospital integrating smartphone and tablet use into practice is feasible and would prove beneficial.

  18. Awareness and attitude of antenatal clients towards HIV voluntary counselling and testing in Aminu Kano Teaching Hospital, Kano, Nigeria.

    Science.gov (United States)

    Iliyasu, Z; Kabir, M; Galadanci, H S; Abubakar, I S; Aliyu, M H

    2005-01-01

    Mother to child transmission accounts for the majority of HIV infections in children in the developing countries. This study assessed pregnant women's knowledge of HIV/AIDS, awareness and attitudes towards Voluntary Counselling and Testing (VCT) in a teaching hospital in northern Nigeria. A pre-tested structured interview questionnaire was administered on a cross-section of 210 antenatal clients in Aminu Kano Teaching Hospital, Nigeria. All respondents were aware of HIV/AIDS. Fifty seven percent had good knowledge, 32% had fair knowledge and the remaining 11% had poor knowledge of the infection. Most respondents were aware of VCT through health workers, mass media and friends. Similarly, most respondents (81.0%) approved of VCT, 13.0% disapproved of it and the remaining (6%) was undecided. The main reasons for disapproval were; fear of stigmatisation, isolation and effect on marriage security. Those that had tertiary level of education were three times more likely to accept VCT compared to those with lower levels of education (O.R=3.2, 95% confidence interval =1.3-8.0). Although the awareness of VCT for HIV was quite high with most antenatal clients harbouring positive attitudes towards it, there is a need to intensify health education to convince the remaining minority who are still sceptical or ignorant of the benefits of VCT.

  19. The Effect of Service Compact (SERVICOM on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    Directory of Open Access Journals (Sweden)

    Jude Kennedy Emejulu

    2014-12-01

    Full Text Available This study examined the effect of service compact (Servicom Service delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that required re-evaluation and attention based on the submissions of every service unit and department, after an analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT of each of the service areas. A pre-SERVICOM Charter workshop which was supervised by the Federal Government was held in the various institutions nationwide to enable care providers enumerate their current service capacity and identify their impediments. In the light of the foregoing, some of the recommendations proffered are that the SERVICOM Charter project should be sustained and supervision and control of the SERVICOM Charter project should be intensified in order to ensure that the Nigerian factor of service-fatigue would not supervene in care delivery in the near future.